0"T' LAERT> "! - USP

« 

iflfel 

• ^K^dj 

B»* • 

r^rf^XF 

!TX 

m

A HISTORY .OF MEDICAL , EDUCATION 

•*

Ihr durchstudirt die gross' und kleine Welt, 

Urn es am Ende gehn zu lassen, 

Wie's Gott gefallt. 

Vergebens, dass ihr ringsum wissenschal'tlieh schweift, 

Ein Jeder lernt nur, was er lernen kann; 

GOETHE. 

Nature is made better by no mean, 

But nature makes that mean : so, o'er that art, 

Which you say adds to nature, is an art 

That nature makes. * * * * 

__ . , . This is an art 

Which does mend nature—change it rather : but 

The art itself is nature. 

SHAKESPEARE. 

Oui; cela etoit autrefois ainsi: mais nous avons change tout, wla ot «„„., (.«.„.„ 

maintenant la medecine d'une methode toute nouvelle? g MOLIERB. 

' 

US faiSOnS 

°

A HISTORY 

* ••$• 

OF 

MEDICAL EDUCATION 

FROM 

THE MOST REMOTE TO THE MOST RECENT TIMES 

BY 

DR THEODOR PUSCHMANN 

PUBLIC PROFESSOR IN ORDINARY AT THE UNIVERSITY OF VIENNA 

TRANSLATED AND EDITED BY 

EVAN H. HARE 

M.A. (OXFORD), F.R.C.S. (ENGLAND), L S.A. (LONDON) 

UNIVERSIDADE DE SAO f AULO 

LONDON 

H. K. LEWIS, 136 GOWSR STREET 

MDCCCXCI

60UECAO JOHN LANE 

BIBUOTECA/FSftUSP 

an

TRANSLATOR'S PREFACE. 

VERY few words are required from me here; but to say 

nothing at all would savour of disrespect to the Author, 

whose work I have endeavoured to render more accessible 

to English readers, as well as to that very public, whose 

benevolent consideration for this English edition is now 

solicited. 

The truth is that I am very conscious of my responsi 

bilities to both. 

In the course of the translation, it became apparent that 

some slight addition was required in the chapter on England. 

With the Author's approval I have added a few 

pages, which contain matter limited almost exclusively to 

statements of facts concerning the existing arrangements 

at the universities and medical schools of the United 

Kingdom. I have much pleasure in acknowledging the 

debt I owe in connection with this to the " Guide to the 

Medical Profession," by C. B. KEETLEY, Esq.. F.R.C.S., 

and to the "Students' Numbers" of the "Lancet" and 

" British Medical Journal." To these sources I beg to refer 

those in need of more detailed information. 

It now remains for me to express my most grateful 

thanks to those who have assisted me in various ways. 

While the responsibility for errors and shortcomings of all 

kinds must rest entirely upon myself, I have to thank those 

whose names I am about to mention, that such inaccuracies 

and deficiencies are not more numerous than is actually the 

case. From members of my own family I have received 

very great help. To my neighbour, H. A. B. COLE, Esq., 

M.I.N.A., I am especially indebted for valuable assistance 

throughout the year and a half during which I have been 

engaged with the work. To A. W- CADMAN, Esq., I am

vi TRANSLATOR'S PREFACE. 

under a great obligation for revising a portion of my MS. 

Herr OTTO GERNER, of Ealing, has rendered me very 

considerable assistance in revising MS., for which I beg to 

thank him very much. I have much pleasure in acknowledging 

the courtesy and promptitude with which Professor 

PUSCHMANN has replied to the questions with which I have 

from time to time been obliged to trouble him. 

In spite, however, of the numerous lines of defence I 

have arranged to oppose the invasion of mistakes, I am 

well aware that some—perhaps many—have broken through 

and established themselves. I am not, however, about to 

point out the weak spots in my armour. 

Nor will I presume to utter a word of criticism upon 

Professor PuSCHMANN's work. For the task of the critic, 

whether of books or institutions, an independent standpoint 

is needful, and this, never attainable in ideal perfection, is 

by some unapproachable; and certainly a translator's 

views, in regard to a work he translates, must be peculiarly 

liable to distortion. 

My additions are indicated by square brackets in the 

text and by my initials in the notes. 

I have now said enough, but may be permitted to express 

the hope that some readers will be found to whom the 

chapters of the- learned Austrian professor will afford as 

much pleasure and instruction as they have to their English 

Editor. 

E. H. H. 

CROUCH END. 

October, 1891.

PREFACE. 

THE following work is the first attempt at a systematic 

exposition of the history of medical education. In 

literature, up to the present time, only fragmentary 

contributions have been made to this end, such as have 

to deal with the origin and development of individual 

medical schools and institutions, their scientific doctrines 

and methods of teaching, the persons engaged and their 

work. These sources of information had to be collected, 

examined and compared with one another before becoming 

of use for this book. For particular parts of the subject 

reliable and detailed information was at times found want 

ing; the documents required to throw light upon them 

being perhaps still locked up in archives and libraries. I 

must limit myself to affording information up to that point 

only where the fountains of knowledge become small or 

altogether dry, and I must leave it for later inquirers to dig 

up this ground and to collect material for the solution of 

questions to which no answer can now be given. 

The history of medical teaching is full of significance, 

not only in its relation to the history of medicine and 

of education, but also generally in relation to the history of 

civilization, of which it. may truly be said to constitute a 

necessary and an essential part. On this ground I have 

considered myself bound, as well as entitled, to carefully 

follow up and present the connection which my theme 

has with the general development of civilization. Many 

a fact which, viewed apart from general contemporary 

efforts, appears enigmatical and astounding, receives in 

this way a flood of light upon its meaning.

viii PREFACE. 

If I have made use of this opportunity to rectify numerous 

errors which have been incorporated in textbooks of the 

history of medicine and at the same time to bring some 

truths into prominence which have hitherto not attracted 

notice, the value of my book as a contribution to knowledge 

will certainly not be thereby injured. 

I fulfil an agreeable duty in giving utterance here to my 

most respectful thanks for kind assistance afforded me in 

my undertaking by the following gentlemen :—Ministerial- 

Rath Dr. B.von David, and Sektions-Rath Dr. von Kleemann 

of Vienna, Geh. Ober.-Med.-Rath Dr. Kersandt, and Geh. 

Ober.-Regierungs-Rath Dr. Althoff of Berlin, Medicinal- 

Rath Dr. Geissler of Dresden, Regierungs-Rath Dr. Bumm 

of Munich, Dr. von Riedel of Madrid, Physician to H.M. 

the Queen of Spain, Prof. Serra de Mirabeau of Lisbon, 

Prof. A. Corradi of Pavia, Prof. Albini of Naples, Prof. 

Anagnostakis of Athens, Prof. Felix of Bucharest, Prof. 

von Winiwarter of Liege, Dr. Daniels of Amsterdam, Prof. 

Petersen of Copenhagen, Prof. H. Heiberg of Christiania, 

Prof. Hedenius of Upsala, Prof. Rauber of Dorpat, Prof. 

Kollmann of Basel, Geh. Rath Prof. Hegar of Freiburg-im- 

Brisgau, Geh. Rath Prof. Schultze of Jena, Prof. Eckhard of 

Giessen, Prof. (Esterlen of Tubingen, Prof. W Krause of 

Gottingen, Prof. Uffelmann of Rostock, Prof. G. Ebers of 

Leipzig, Profs. Buhler and Heinzel of Vienna, and also the 

superintendents and officials of the libraries of Paris, 

London, Munich and Vienna. 

VIENNA. 

THE AUTHOR.

INTRODUCTION 

CONTENTS. 

I. MEDICAL TEACHING IN ANCIENT TIMES. 

India 

PAGE 

Egypt 18 

The Jews 26 

The Parsees 32 

The Greeks before Hippokrates 34 

The Time of Hippokrates 47 

In Alexandria 72 

Medicine in Rome 83 

Medical Teaching in Rome 96 

The Medical Profession in Rome 123 

II. MEDICAL TEACHING IN THE MIDDLE AGES. 

The Influence of Christianity 134 

Arabian Civilization 154 

Medical Science and Medical Teaching among the 

Arabs 162 

Medicine among the Germans and Teaching in the 

Monastic Schools 184 

The School of Salerno 197 

The Medical School of Montpellier 212 

The most ancient Academies of Italy 220 

The most ancient Academies of France . 227 

The other Universities of Europe existing in the 

Middle Ages 231 

The Training of Doctors in general 2 

7

X CONTENTS. 

PAGE 

24.2 

Teaching in Anatomy 

Teaching in Pharmacy and in Medical Practice 251 

Medical Examinations 

Surgery and Midwifery 

The Medical Profession and Medical Literature of 

this Period 

III. MEDICAL TEACHING IN RECENT TIMES. 

266 

2 7^ 

The Character of the Sixteenth Century 285 

Emancipation from the belief in Authorities in the 

Sphere of Medicine and the progress of Science 294 

The Universities in the.Sixteenth Century ? 312 

Medical Teaching 3 2 ° v ' 

The Medical Profession and its attitude towards the 

' •'•* 'I 

movements of the Sixteenth Century 335 

The experimental direction taken by the Natural 

Sciences, Physics and Chemistry during the 

Seventeenth Century 34 1 ^ / 

Microscopical investigation in Anatomy and experi 

ment in Physiology 353 

Progress in the other branches of Medical Science 

during the Seventeenth and Eighteenth Centuries 368 

The character of that period in regard to Art and 

Philosophy • 3 Sl 

The Learned Societies and Universities in the Seven 

teenth and Eighteenth Centuries 3 85^ 

Medical Teaching in the theoretical departments and 

in Anatomy, Botany, Chemistry and Materia Medica 396 v/ 

Clinical Teaching in the Seventeenth and Eighteenth 

Centuries 4io\/ 

Teaching in Surgery, Ophthalmology and Obstetrics 418 

Medical Teaching at the close of the Eighteenth 

Century and position of the Medical Profession 433 \J 

IV. MEDICAL TEACHING IN MODERN. TIMES. 

The wide outlook of the Natural Sciences in the 

Nineteenth Century 440

CONTENTS. XI 

PAGE 

Physics and Chemistry in the last hundred years 452 

Medical Systems and the Progress in Anatomy and 

Physiology 461 

Diagnosis, Pathological Anatomy and Experimental 

Pathology, Nosology, and Materia Medica 472 

Surgery, Ophthalmology, Obstetricsand State-Medicine 483 

Medical Teaching at the present time 495 L- 

England 49 8 

North America 534 

France % 535 C 

Austria-Hungary 555 

The greater and lesser German States before the 

foundation of the German Empire 574 

Prussia and the present German Empire 584 L. 

Italy 59 8 " 

Spain and Portugal 601 

Holland and Belgium 603 

Switzerland 606 

Denmark. Norway. Sweden 608 

Russia 611 

Greece and the Christian lands of the Balkan 

Peninsula .. 612 

Final Considerations 613

HISTORY OF MEDICAL EDUCATION. 

INTRODUCTION. 

Quis nescit, primam esse historiae legem, ne quid falsi dicere audeat ? dein 

ne quid veri non audeat? ne qua suspicio. gratiae sit in scribendo ? ne qua 

simultatis ? 

CICERO, De oraloie ii, 15. 

THE historical development of medical, teaching exhibits 

a character similar to that of medical science in general. 

Necessity, the inventive Instructor of Mankind, furnished 

the occasion, as indeed HIPPOKRATES* says, for the 

first attempts at healing. The combative* habits of 

rude barbarians, whose favourite pursuits were hunting 

and war, entailed the infliction of wounds for which help 

was demanded. Sympathizing friends and fellow-soldiers 

tended the hurts, washing out the wounds and dressing 

them with cooling herbs. Soon there arose a select few, 

who investigating the healing properties of plants, turned 

their knowledge of this subject to account for the benefit 

of- their neighbours. If they were naturally endowed with 

the gifts required for observing Nature they no doubt 

soon made the attempt, as occasion offered, to study the 

fundamental character of the wounds which they undertook 

to treat. In this way gradually a kind of medical craft 

was formed, the members of which, by empirical methods, 

arrived at remarkable dexterity in healing external injuries. 

In the case of internal affections, particularly however in 

the case of epidemics, the causes of which are not so manifest 

as those of external injuries, recourse was had for counsel 

to those who, in that early period of civilization, passed 

* HIPPOKRATES. Ed. Littre. Paris 1839. ' • l ' P-- 574- 

B

INTRODUCTION. 

for the representatives of all knowledge*—the priests. To 

them, people looked the more readily for help, inasmuch as 

the origin of these diseases, being dark and mysterious, 

was ascribed to supernatural powers. The priests took 

care, by prayers and offerings to appease the anger of the 

gods and to enlist their sympathy. By these measures they 

instilled hope and confidence into the minds of the sick—in 

fact they subjected them to " expectant treatment." Here, 

however, it could not fail to be noticed, that results did 

not always tally with expectations; often indeed expected 

results entirely failed to occur at the very time when the 

public attention was directed to the matter, as in the case 

of widely devastating pestilences. Unless the priests were 

willing to lose their reputation, which was injuriously 

affected by these disappointments, it became necessary for 

them to aim at ensuring a greater influence upon the 

course of the prevailing diseases, by ordering diet and 

drugs. For this, they felt the want of medical knowledge, 

which they now sought to acquire by careful observation of 

the phenomena of diseases and by investigation of their 

causes and means of cure. In course of time they collected 

a quantity of information which, transmitted by word of 

mouth or by writing, became the property of later generations 

and by these was rendered more and more complete. The 

practice of the healing art was now exercised according to 

strict rules and the acquisition of the required knowledge 

was pursued systematically. 

Medicine was included among the subjects which were 

taught in the Temple-schools, and the priests took care 

that the medical knowledge acquired there should be 

bound up so closely with religious exercises, held in awe 

* " The Sanscrit vaidya from vid, to know, and the Latin medicus from medh, 

to be wise, point out that the Doctor has received his name from his insioht." CH. 

LASSEN : Indische Alterthumskunde, London u'nd Leipzig 1874, Bd. ii, S. ei7. 

Of. AD. PICTET : Etymologische Forschungen iiber die alteste Arzneikunst bei den 

Indogermanen in der Zeitschrift fur vergleichende Sprachforschung, Bd. v, S. 24 

et seq., Berlin 1856.

INTRODUCTION. 3 

by popular superstition, that the priests themselves 

should appear to be of essential importance in the treat 

ment of diseases. They however were compelled, in 

accordance with the advance of knowledge, to prove 

themselves capable men independently of such external 

assistance. And in this way the emancipation from 

religious influence and the formation of an independent 

medical class w r as brought about. The representatives of 

this class combined the knowledge received at the Temple- 

schools with the medical experience of the Empirics. 

They did not limit themselves, like the Priests, exclusively 

to the treatment of internal diseases but attached them 

selves also to surgery and obstetrics. This combination of 

internal with external Medicine, which was brought about 

by the followers of HIPPOKRATES and generally by the 

doctors of the Greek and Roman periods of civilization 

acted on both branches of the healing art as a stirring and 

stimulating force, and led to great results. The wonderful 

progress which the healing art, and especially surgery, 

made in Alexandria and Rome affords an intimation of the 

great advances probable in the immediate future had not 

political revolutions, attending the downfall of the Roman 

Empire, put a stop to the further development of Medicine 

as of other Sciences and Arts. Races in an early stage of 

civilization, as were those which then peopled the world, 

must assimilate to themselves the knowledge acquired in 

former days before presuming to think of increasing if by 

-discoveries or inventions of their own. During the next 

thousand years intellectual development proceeded in the 

•direction of breadth rather than of height, for while the 

sum of knowledge was not substantially increased it never 

theless diffused itself over a larger tract of the inhabited 

earth. Even in the Orient, where traditions of distinct 

periods of civilization are interwoven with the crowded 

actions and efforts of a people pressing with the enthu 

siasm of youth towards ends of the loftiest character—even 

there practically no important treasures in the domain of

INTRODUCTION. 

medicine have been bequeathed to us, none, at least, 

of any permanence or profoundly affecting its growth. 

Arabian medicine is but an episode—though a grand 

one—in the history of the Science^ In the West 

the priests took over again the office of teachers of 

medicine. The Roman and German peoples* were 

converted to the belief that the Christian Church 

possessed and preserved not only the truths of heavenly 

life but the knowledge of this world too. The Cleric 

united in himself, at that period, all learning; and the 

Cloister became the School of Man. The practice of the 

healing art had for priests, even then, many inconveniences 

in store ; respect for their Order forbade them toi&ndertake 

surgical operations, since through their mistakes death 

might ensue to their patients, and they abstained from the 

treatment of the diseases of women. It was thus -possible, 

that an independent class of practitioners should'maintain 

itself and grow alongside of, but unconnected -with, any 

priestly profession. Amongst these might be reckoned the 

numerous Jewish doctors who settled down in Christian 

lands and on account of their practical ability combined 

with extensive knowledge were highly esteemed : so, too, 

those people who in the south of Europe had become 

acquainted with Arabian medical science. These latter 

played a prominent part in the foundation of self-supporting 

medical schools at Salerno and MontpeVier'- while the 

Christian cleric, on his side, exercised a c^mtrolling influence 

upon the origin of the oldest Universities and their 

regulations. The Universities, which henceforth served as 

centres of learning and culture, reckoned also the training 

of doctors amongst their tasks, but they had regard only 

to the acquirement of theoretical knowledge and neglected 

practical aims. This deficiency in the training of practitioners 

had to be filled up by visits to hospjtals or by the 

personal teaching of experienced practical men, if the 

young doctors wished to enjoy the confidence of their 

patients. From this circumstance the priestly origin of 

1

t*7^*ifca> INTRODUCTION. 

Universities brought about the result that the medical 

teaching there imparted, by preference brought internal 

diseases into the sphere of consideration. Hence arose 

the necessity that along with skilled physicians should be 

found -a class of doctors devoting themselves to surgery 

and the treatment of external injuries. The formation of 

these wound-doctors was a matter connected with trade 

and ha

6 • * INTRODUCTION. • 

:,.'•» • ' •. ., ,;. .1 

• . - * - - • , • ' • ^ if. ' • . * ' • - * • ' 

• „ . •* . '*'. •' 

wbich" represent the contests of .medical science, and while 

-^bearing" indisputable testiagnofty to. the state of medicine at 

different .periQdggiy-e.^direetion^form, and completeness to 

thejiistory of the science,, The form and method of medical 

, • £ea,ching wereêg_ial§ted.as imiach bythe general condition 

pfîvihz.atibn at any given time as by the particular position 

of medical science. ,TKe age .of scholasticism demanded • 

•; that medical, theories brought forward in the lecture-rooms i 

.should be in accordance with the , dictates of the ruling." 

.authorit-ips;* so also the^following periods were satisfied 

with formal theses, historical and theoretical; and only in 

the seveeteentH century did,,the observation of Nature and' 

H-* independent investigation advance into 1 '- the foreground. 

v ;With-the _awakening of the Natural-Sciences, especially 

,-, Chemistry ,an^ Physics, with the foundation of schools of 

",t^natomy where students had the opportunity of dissectfcg 

:the;huma,n-fblody, with the introduction of clinical teaching 

••: in to','appropriate hospitals and the inducement of students 

tp undertake private independent work, a complete revolution* 

was "brought about iri medicab education. Practical 

u. demonstrations and experiments^ which had hitherto^bee?' 

.•' either altogether wanting, or n^4£e1i 

permitted, formed now an essential partôf medicaTtra^ 

Xing, ' In this way it obtained that broad foundation**whicn 

. 'is so indispensable foe a harmonious structure in thtr^duW. 

. tibr^ of doctors *and by these means the lattef fee'ca^ne", 

. .fjtted both for the practice of their art and also for scientific/ 

V investigation.

«•*-*.- '• •- 

»•*'•' HI * • •< 

•' '«• . i- -C .- ' 'S ' .-"W ' '• 

: • ^.-x^y-.t. 

• ,' • *?*•" ,1k. > • • * 

... 'Vife'v' • 

I. MEDICAL TEACHING IN ANCIENT TIMES. 

'* INDIA. '" •F.. 

THE roots of our civilization lie in the East. On the • 

banks of the Ganges, on the plains of Egypt, and in seagirt 

Greece, thousands of years ago, Arts and Sciences, 

flourished and attained a remarkable development. The,. 

healing art there also celebrated its" earliest triumphs. itwas 

in India at first practised by the priests; who the're,, 

as elsewhere, passed as the.treasurers of all knowledge, 

ituman and divine. In the oldest writings of the Indians, 

the Vedas, which originated, six hundred years before^ 

GhrisJ", diseases appear to'have been lookedj on as punjsh- 

,;meats-inflicted by angry deities or spirits, or Is the result,'• 

*o*f*t% art-magic of wicked men. To allay these visitations^ 

prayers, offerings and-conjurations were employed. But 

jLl!rea"dV in; the Rig-Veda* we find certain dietetic and 

roekcinal remedies referred to. •The larger the siim pf 

medical knowledge and experience .grew, the .more did - 

men recognize the necessity of conferring, the privilege of 

.•the,practiceôf medicine not 'exclusively on the priests but 

alspôn the members of other castes," if by their knowledge 

#id*ability they showed themselves fitted for it. Thus 4 

^distinct medical,class-by degrees was developed, organizing 

fl-gelf"put of the three higher grades of society; onlylhe 

tiered Sudra, 'who, by their racial peculiarity, were 

distinguished from the Aryan îmmigrants, remained excluded. 

Later an,1 by ,tfre levelling ..influence of Buddhism, 

this limitation was in some degree removed. Detailed 

* ROTH in the Zeitephrift der -dfptschen morgenlandischen Gesellshaft, B^ 

xxiv, S. 301 et seq., and Bd. xxv*;/&,~6jjr5.'et':seq.. * .{

8 ANCIENT TIMES. 

information concerning the training of doctors is found in 

the two commentaries on the Ayur-Veda composed by 

CHARAKA and SUSRUTA and constituting the oldest medical 

works in Sanscrit literature. CHARAKA* counsels youths, 

who are desirous of studying medicine, that they should 

seek a teacher "whose precepts are sound, and whose 

practical skill is generally approved, who is clever, 

dexterous, upright, and blameless; who knows also how 

to use his hands, has the requisite appliances and all his 

senses about him, is confident with simple cases and sure 

of his treatment in difficult ones; of genuine learning, 

unaffected, not morose or passionate, patient and kind to 

his pupils." Those pupils were pronounced to be.quite 

fitted for the study of medicine " who spring from a family 

of doctors or associate with doctors and who have lost 

none of their limbs and none of their senses." On 

admission, the teacher admonished his pupils "to be chaste 

and temperate, to speak the truth, to obey him in all* 

things and to wear a beard." As the three best means of 

acquiring medical knowledge, were mentioned : the study 

of medical writings, the personal teaching of the instructor, 

and association with other doctors. " When the doctor"' 

says CHARAKA « attended by a man known to the patient 

and having the right of entry into his house, advances into 

the dwelling of the sick man he should make his appearance 

in good clothes, with an inclination of the head he 

should be thoughtful but of firm bearing and observe all 

possible respect. So soon as he is within, word, thought 

and attention should be directed to nothing else but the 

examination of the patient and what appertains to his 

fL Z'l -t CVen thG WisCSt " Sa ? s he " ^come 

puffed up with his wisdom. Many recoil even from a man 

of skill if he loves to boast. And medicine is by no means 

easy to learn. Therefore let each one practise himseff Tt 

carefully and incessantly. Concerning the procedures and 

m^sr^.18;^;.^:i.-rt:t in the zeitschr - der

INDIA. 9 

accomplishments of the practitioner much may be learnt 

from others; for the whole world may be called a teacher 

of the man of understanding and to fools only is a foe. 

Considering this, even from the counsel of an adversary he 

may venture to expect prosperity, honour and livelihood, 

and to act in accordance with such counsel." 

He strongly recommends intercourse with other doctors. 

u For conversation with a colleague increases knowledge, 

confers pleasure, enlarges experience, imparts readiness of 

speech, and induces consideration. Whoever is uncertain 

about something learnt, will have his doubts removed by 

repeated instruction; whoever has no uncertainty or doubt, 

will be able thus to fortify his opinion. Thus often a man 

comes to hear what up to that time he never knew. Often 

a teacher can seize the opportunity of a conversation of this 

kind to fully and at once impart to his pupil some information 

partially or entirely withheld hitherto." In Susruta* 

(Chap. 2.) it is said that the doctor should choose as 

pupil the son of a Brahman, being Ksatrya or Vaisya (nobleman 

or freeman) and of good family: he should be sixteen 

years of age, should show a respectable behaviour, should 

possess a love of cleanliness, kindness and bodily strength, 

understanding, a good memory, and the desire to learn and 

to reach the ends he has in view. " He must have a clean 

tongue, small lips, regular teeth, a noble countenance, wellformed 

nose and eyes, a cheerful spirit and good bearing 

and be prepared to undergo weariness and pain. And 

whoever possesses the opposite characteristics should not 

be admitted to the doctor's calling." 

The admission of the scholar ensued on a propitious day 

and the festivities connected therewith were celebrated in 

the evening when the moon and stars were shining above. 

They thus began. The gods were propitiated by offerings 

of rice, flowers, and precious stones on an altar which consisted 

of a mound of earth measuring four ells on each 

* The Susruta Samita ed. by UDOY CHAND DUTT, Calcutta 1883. 

{Bibliotheca Indica, fasc. 490, 500.) 

i"' !

IO ANCIENT TIMES. 

side situated towards the north or east and which was 

covered with cowdung* and Kusa-Grass (Poa Cynosuroides), 

while the Brahmans and Doctors received presents. Then 

the Brahman conducting the ceremony drew a line upon 

the earth, sprinkled the place with water and allowed the 

novitiate of medicine to take a seat on his right side. 

Before him a fire was made in which, obediently to the 

directions of religion, wood of Khadira (Acacia catechu) 

Palasa (Butea frondosa) Devadaru (Cedrus deodara) and 

Vilva (iEgle marmelos), or of Vata (Ficus Bengalensis), Jaina 

dumbara (Ficus glomerata), Asvattha (Ficus religiosa) and 

Madhuka (Bassia latifolia), was burned after havingpreviously 

been dipped in curdled milk, honey and clarified butter. 

At the end of the ceremony the teacher conducted his 

pupil, three times round the fire and thus addressed him, 

at the same time calling the god of Fire to witness: '< Lay 

aside now all passionate desires, all anger, covetousness, 

foolery, conceit, pride, envy; all roughness, duplicity, 

deceit and indolence, and all blameworthy conduct. Thy 

hair and thy nails shalt thou from this time: forth keep 

short, a red cloak shalt thou wear and lead a pure life, 

all dissolute intercourse shalt thou avoid and shalt obey him 

who is set over thee. Thou must stay, go, lie down or 

sit down, eat and study as I direct and always be diligent 

to further my success. If thou dost neglect this, thou dost 

commit a sin and all knowledge is useless and unavailing 

to thee. If however I act badly towards thee, while thou 

fulfillest thy duty, I then commit a sin and my knowledge 

bears no fruit." Further, he admonished him that later on 

as a doctor he should treat without reward Brahmans. 

^, teachers, poor people, his friends and neighbours, religious 

people, orphans and foreigners and should give them 

remedies. So on the other hand he ought to refuse any 

medical advice to those who kill animals by hunting or 

'* T ^ blrdS ' aS Hkewi$e to ° utlaws and criminals. 

Whosoever thus practises makes himself known as a 

* The cow was considered sacred.

INDIA. II 

man of wisdom and acquires friends, renown, virtue, riches 

and other desirable things." On certain days the pupil 

should not study, for example on the 8th, 14th and 15th 

days of the new and full moon ; it was likewise forbidden 

him to study " in the morning or evening twilight, during-; 

thunder and lightning (when this happens at an unusual 

period of the year), when the king of the country is laid up 

on a bed of sickness ; after a visit to the scene of a con 

flagration, after attending a burial, during war, on any high 

festival, during any alarming manifestation of Nature such 

as an earthquake or meteoric shower, or on such a day as 

the Brahmans themselves might select on which to abstain 

from study, or which he might himself consider polluted for 

any reason." 

In these sometimes strange rules there lay obviously at 

bottom a reasonable notion, namely to secure to the 

students the relaxation and leisure necessary to their call 

ing, as well as to remind them that when their attention is 

given up to other things they understand in only a super 

ficial and incomplete way what they are taught. SuSRUTA 

further demands (Chap. 3) that the students of medicine 

should receive both theoretical and practical training : first 

they should read medical treatises and then learn the prac 

tice of the.art. "The man who has had nothing but a 

theoretical training" says he "and is unskilled in the 

details of treatment knows not what to do when he comes 

to a patient and behaves himself as pitiably as a coward on 

a battle-field. On the other hand a doctor who is only 

practical does not win the esteem of the best men." " Both 

these classes of incompletely prepared doctors are not 

fitted for practice, any more than a Brahman is to perform 

Church ceremonial properly if he has only read half the 

Vedas or than a bird is to soar in the air if it has only one 

wing. For, if medicines are administered by an unskilful 

doctor they may—although like nectar in flavour—work 

like poisons or other instruments of destruction." 

• Such people, as SuSRUTA remarks, only obtain permis-


sion to practise when the Government is careless and lax. 

The instruction consisted in the teacher reading to the pupil 

extracts from the medical writings, and making him repeat 

them again, so often, that finally the student knew them by 

heart. The delivery should be " in a loud and clear voice 

and with distinct accentuation of the words which should 

not be slurred over or rendered indistinct by a nasal tone." 

The scholar must endeavour to lay hold of what is taught 

him not only by the ear but by the understanding: otherwise 

he " resembles an ass who bears a burden of sandalwood, 

knowing only the weight, not the worth of his load." 

(Chap. 4). The teacher is enjoined (Chap. 9) to instruct 

the pupil in the carrying out of surgical operations, in the 

application of ointments and generally in practical matters 

for "without practical training' and merely by hearing 

lectures and by the repetition of discourses, no one is fitly 

prepared for medical practice." Particular surgical operations 

were taught and practised.on fruits, for instance 

melons ; puncturing was practised on bladders or leather 

bottles filled with water, mud or clay; scarification, on 

pieces of leather stretched out and with the hair on ; bloodletting 

upon the vessels of dead animals or the stalk of a 

water-lily; explorations with the probe,' on worm-eaten 

wood, bamboo, reeds or dried gourds; extraction of teeth, 

•on dead animals; the opening of abscesses, on a lump of wax 

spread out on a piece of Salmali (wood of Bombax Malabaricum) 

; the sewing up of wounds on thick garments or 

the edges of two pieces of t'hin leather; the application of 

bandages, on models of the human body prepared from wood 

or clay; the application of caustics and cauteries on thin 

slices of meat; the drawing-off of urine from the bladder or 

the removal of matter from the pelvis by means of reeds 

and an earthen vessel provided with a spout and filled with 

water, or else a gourd. In India very high consideration was 

given to surgery. When DHANVANTARI (Chap; 1) asked 

his pupils which branch of the healing art he should ex 

pound to them, they answered : 'teach us everything but

.'K. 

INDIA. 

take surgery as the foundation of your discourse !' Indian 

medicine has in this sphere of work achieved remarkable 

results. The Indian doctors were familiar with amputation, 

tapping the abdomen, laparotomy, suturing the intestine; 

they removed stone from the bladder by operation, treated 

cataract by couching the lens, undertook plastic operations, 

practised turning and extraction in the case of abnormal 

presentations in childbed and undertook Caesarean section 

in the case of those who died before delivery.* The great 

number of different instrumentst shows how experienced 

they were in surgical technicalities : we find among them 

knives of various shapes, lancets, cupping-glasses, trocars, 

probes, reed-like catheters, scissors, bone-saws, polypus- 

forceps, specula and many more. The examination of the 

body of the patient was performed with great care. 

SUSRUTA (Chap. 10) admonished young doctors to bring 

all five senses to bear on this subject. " By the sense of 

hearing we can, for instance, determine whether the con 

tents of an abscess are frothy and gaseous, for the emptying 

of such is attended with noise; by the sense of feeling we 

may know whether the skin is hot or cold, rough or smooth, 

thick or thin; by the sense of sight we can determine 

corpulence or emaciation, vital power, energy, and change 

of colour; by the sense of taste we can assure ourselves 

concerning the state of the urine in diabetes and other 

diseases of the urinary tract; and by the sense of smell we 

can recognise the peculiar perspiration of manyy, diseases 

which has an important bearing on their identification." 

"At the same time the patient must be interrogated con/fi 

cerning the character of the quarter he lives in, considera 

tion must be taken of the time of year, the patient's position, 

his apprehension, the nature of his pain, his natural powers, 

his appetite and the duration of his illness : we then\ 

should proceed to the examination of the urine, the gaseous! 

* VUI.LERS in the Janus, Bd. i, S. 242 el seq. Breslau, 1846. 

t Well collated in T. A. WISE'S Review of the History of Medicine among 

the Asiatics, London, 1867, Vol. i, p. 354 et stq.


* .and solid excreta and the menstrual flow, and also make 

inquiries concerning the surroundings of the patient, in 

< reference to the nature of the disease." 

The Indian doctors were careful observers of Nature. 

They were aware of crepitation as throwing light on the 

•t diagnosis of a fractured bone, and of the sweet taste* of 

the urine in certain cases of sickness (diabetes mellitus) 

long before these facts were known in Europe. 

The high development of the healing art and especially 

of surgery in India, excites the more surprise from the fact 

that the study of anatomy and physiology was if not completely 

non-existent at least on quite a wrong track. The 

small anatomical knowledge of the Indian doctors was 

dependent on the fact that they certainly never undertook 

the dissection of the human body; indeed such investigations 

were forbidden, or at least made difficult by religious 

injunctions. Nevertheless they appreciated the importance 

of anatomy for practical medicine and declared that the 

doctor must acquire a competent knowledge of the human 

body before undertaking the treatment of its diseases. 

Magisterial authority was required for anyone beginning 

the practice of physic. 

By SUSRUTA (Chap. 10) it is said that the student of 

1 medicine at the termination of his studies must petition. 

the king to grant him authority to practise independently. 

In this connection SuSRUTA imparts to him certain 

maxims which throw remarkable light on the social 

position of Indian doctors. "Keep thy hair and nails 

short " he writes " keep thy body clean, wear white linen, 

put on shoes and carry a stick or umbrella in thy hand. 

Let thy bearing be humble and thy heart pure and free 

from guile. Show thyself courteous in speech and friendly 

to every human being and take 1 care that thy servant has a 

good character." He recommends him peculiar caution 

.when his patients " are learned Brahmans, princes, women 

•*!.' '' ' 

,-.,* Perhaps the observation that ants sought out and enjoyed this urine 

led them to make this discovery. „

INDIA. 1 5 

children or old men, timorous people, servants of the king, 

crafty or feeble folk, calumniators of doctors, poor, miser.- 

able or irritable people, orphan children or persons who 

conceal their illnesses or are not supervised in their actions." 

He Very earnestly warns him however against " gossiping 

or jesting with women or taking any presents from them 

with the exception of some light refreshment." Further 

he gives the shrewd, if somewhat unkind, advice " only to 

treat such persons as have curable diseases but to avoid 

any cases of incurable disease and generally to give up 

every patient who is not cured at the end of a year's treat 

ment, for curable diseases commonly become incurable in 

a year." 

CHARAKA* shows still greater caution in recommending 

the doctor " not to order any remedies for persons disliked 

by the king or people or who are themselves hostile to 

the king or people ; and moreover, very deformed persons, 

or such as are corrupt, difficult, wild or intractable are not to 

receive advice or help, nor are the dying, or women either, 

except only in the presence of their lord or guardian." 

CHARAKAf fills his pupils with contempt for those people 

" who making a great display in the train of a learned 

doctor eagerly seek after opportunities for practice. No 

sooner have these people heard of a patient than they 

hurry off to him, fill his ears with their own medical 

ability and are unceasing in their enumeration of the 

failures of the attending doctor. They try to win over the 

friends of the patient by little attentions, flatteries, and 

innuendoes and they extol their own modesty. If they 

happen to have secured a case they deem it an occasion 

for making perpetual visits. In order to conceal their 

want of skill—being unable to cure the complaint 1 —they 

attribute their want of success'to the absence of the neces 

sary means and nursing, and to the patient's neglect of 

medical injunctions. If they notice that things are going 

badly with the patient they at once make off. • If they find 

* Op. cit., S. 448. f i, 29, in EpT;H op. cit., S. 452.

I 6 ANCIENT TIMES. 

themselves in mixed company they affect modesty and yet 

without appearing to do it, they magnify their own skill and, 

speaking as laymen, undervalue the knowledge of the truly 

accomplished. However, they avoid the company of the 

learned as travellers do the dangers of a close forest." A 

picture fresh as life, the realistic touches of which show much 

resemblance to some scenes of the present day! The 

doctors in India took an important position. Nowhere has 

the respected calling of the doctor been more beautifully 

or strikingly portrayed than in the Indian proverb : " To 

the sick man the doctor is a father: to the man in health, a 

friend: the sickness passed and health returned, a preserver."* 

The Indian doctors were, like other learned men, 

free from taxes and other charges and for the services 

they rendered patients were paid by presents. It seems _, 

that their claims in this respect were not small, judging from 

the information we have respecting the remarkable cures 

of the doctor GIVAKA KOMARABHAKKA who lived in the* 

time of BUDDHA.t He was the son of a courtesan and was 

brought up at the cost of a prince who adopted him; he was 

then trained by a Professor whose teaching he enjoyed for 

seven years, till at last he became a famous practitioner. 

Has this account an allegorical significance ? Is there a 

desire to show how the mean mercenary activity of the 

doctor maybe ennobled by the high ideal aims of his work ? 

In the schools of the Bikkhus, the Buddhist monks, which 

were formed after the model of the Brahman schools, the 

sciences were neglected and the formation of character 

through renunciation of the world and its delights was 

chiefly aimed at. The Bikkhus considered life worthless, 

so naturally cared nothing for remedies for the purpose of 

maintaining it. Their, rule only to eat what others had left K 

and to make usej of the urine of a cow as a remedy shows 

'X 

* BOHTLINGK: Indische Spriiche, Petersburg. 1870. * 

t The Sacred Books of the East translated by MAX MUUJKK, Oxford 1881, 

Vol. xiii, p. 191, xvii, p. 173 d seq., xx, p. 102 ft set). 

t KOPPEN Religion des Buddha, S. 338. l K -

INDIA. *7 

how little importance they attached tp the care and health 

of the body. And yet it was after all a Buddhist King, 

named ASOKA or PRYADARSIN who promoted the erection 

of hospitals not only for men but for beasts. In these estab 

lishments were held professional consultations, and medicine 

was dispensed just as in our clinical institutions.* To be 

sure it was not so much the love of knowledge, as philan 

thropic tendencies which inspired ASOKA here : neverthe 

less medical knowledge did in any case gain some advan 

tages therefrom. 

In Ceylon also there were infirmaries. King PANDUKAB- 

HAYO is said to have founded as early as the fifth century 

before Christ a hospital at his residence of Anaradhapura, 

and one of his successors, DUTTHAGAMINI who reigned in 

the second century before Christ could boast at his death 

that he had erected in eighteen places infirmaries provided 

with sufficient means, and carefully arranged so that sufferers 

should be treated with professional care, and be provided 

with medicines. Of King BuDHADASO living in the fourth 

century after Christ it is related that he practised the 

healing art himself and compiled a useful work on 

medicine. He arranged a sanitary organization embracing 

the whole country, appointed one medical officer for every 

ten villages and erected hospitals in many places, appro 

priating revenues from twenty villages for their support. 

Moreover, he founded institutions for the reception of 

cripples, deformed persons, and the destitute poor, and he 

took care that the Army should have doctors—not only the 

soldiers but The elephants and horses also.f Hospitals 

existed in Kashmir J as early as in the reign of King 

MEGHAVANAin the first century of our era. 

* G. BU'HLER : Contributions to the interpretation of the Asoka inscription in 

the Zeitschr. d. deutschen Morgenl. Ges. 1883, Bd. 37, S. 98 et seq. (2 Edikt. 

des Konigs Asoka der von 263-266 v. Chr. regierte). 

f The Mahawanso edit, by G. TURNOUR, Ceylon 1837, PP- 6 7> l 9 6 > 2 4.?» 

245- 

X HENSINGER in the Janus (ii, 393) has given some information on this 

subject frornthe " Annales de Caschmir " by KALHANA. 

1 

C


The relations, which the inhabitants of India maintained 

with the Greeks from the time of the expedition of 

ALEXANDER OF MACEDON, their active intercourse-with 

the neighbouring Persians which later on extended itself 

over the domains of knowledge, and their subjection by 

the Arabs, exercised a great influence upon the development 

of Indian medicine, while in recent times European 

medicine, and particularly the professional theories and 

practice of the English have there become paramount. 

EGYPT. 

BY far more ancient than the medical records of the 

Indians are those which disclose to us the^ condition of 

medical science amongst the Egyptians of old. They 

arise out of that early period of civilization of which the 

Pyramids—those mighty witnesses of a legendary pastspeak 

to us; they stand forth in pictorial representation 

on the walls of temples and tombs, in implements—such 

as surgical instruments—which have been preserved by 

chance, and in papyrus-rolls of which the more important 

have only been discovered and deciphered during the last 

half-century. In Egypt, as in Babylon, the custom prevailed 

of laying the sick out before the houses in the 

streets and passages so that the passers-by might tender 

advice as to the treatment of their infirmities. Interest in 

medical subjects was taken by the whole people, and " in 

that land where the fruitful soil bore abundance of herbs 

potent for good or evil, nearly everyone was, so to speak, a 

doctor, a descendant of PÔN and learned among men."* 

But there were also persons who practised medicine professionally 

and to this end underwent systematic teaching. 

The Egyptian physicians, on account of the happy results 

obtained by their treatment earned great reputation and 

were even summoned to the courts of foreign princes. 

The Persian King CYRUS entrusted his sick mother to the 

* HOMER : Odyssey iv, 229-232.

EGYPT. 19 

care of an Egyptian oculist and DARIUS too had a bodyphysician 

who came from that country.* 

The position of the members of the medical profession 

in Egypt, like that of the representatives of other learned 

callings was on a level with the position of the priests ; and 

doctors were accorded corresponding privileges. In the 

schools associated with the temples not only priests but 

judges, doctors, astronomers, mathematicians and other 

learned persons were trained. These teaching-institutes 

combined, as our Universities do, all the higher training and 

subserved not education only but research. The most 

renowned of these schools were situated at Heliopolis, 

Memphis, Thebes, Sais, and Chennu. Here besides a 

corresponding general education the pupils acquired the 

requisite technical training for the particular pursuit of 

their lives. They lived in the houses attached to the 

school under the inspection and discipline of their teachers. 

"Let not idleness overtake thee" is the warning of the 

teacher in one of the passages translated by CHABAS " else 

shalt thou be severely chastised. Hang not thine affections 

upon pleasures and take care that the books fall not from 

thy hand. Exercise thyself in conversation and speak with 

thy superiors in learning. When thou shalt grow older 

thou wilt recognize how important this is: whoso is 

dextrous in his craft achieves power and fame." t The 

Egyptian student life appears in many respects to have 

been like that of to-day. Thus the teacher reproves the 

conduct of his light-hearted pupil EMENA in these words : 

'" It has been reported to me that thou neglectestthy studies 

and seekest only thy pleasure, wandering from tavern to 

tavern. But what profiteth the odour of beer? Avoid it; 

for it drives people away from thee, impoverishes thy wits, 

and likens thee to a broken oar upon the deck of a ship." % 

* HERODOTUS iii, i, 129. 

f CHABAS: Melanges egyptologiques, Paris 1862, p. 117. 

X LAUTH : Die alt-agyptische Hochschule zu Chennu ind. Sitzungsber. d. k. 

bayr. Akad. d. Wiss., Histor. Kl. 1872, S.67.

20 

ANCIENT TIMES. 

Studies were not limited to the sons of the favoured classes 

but were accessible to all. Industry and talent were held 

to be the only conditions imposed upon those who sought 

admission to a course of study. Instruction was founded 

upon "the sacred books" in which all the wisdom of the 

Egyptians was contained. THOTH,* the god of Wisdom, 

was looked upon as their author "who also conferred 

enlightenment upon doctors." The sacred or hermetic 

books formed a kind of encyclopedia and consisted of 

forty-two parts. They dealt with the mandates of religion, 

church ceremonies, the administration of justice, philosophy, 

the art of writing, geography, cosmogony, astronomy, the 

knowledge of weights and measures, medicine etc. With 

medicine the last six books were concerned, being called the 

" Ambres" and the first of these contained a description of 

the different parts of the body ; the second, instruction 

concerning diseases ; the third, discussions about surgical 

instruments and probably about operations also ; the fourth, 

instruction in materia medica; the fifth, a description of 

diseases of the eye, which, it is well known, are widely 

spread in Egypt, and the sixth, instruction on diseases of 

women.f The Author begins with anatomy as the groundwork 

of medicine, passes on to pathology and finally mentions 

the specialities which presuppose a knowledge of the 

other parts of medicine: he arranges his matter in such a 

way as to correspond closely with the rational system of our 

modern scientific method. Unfortunately the text-book of 

general medicine has been lost. Only some fragments are 

said to have been preserved which are probably to be found 

in the Book of the Dead, published by LEPSIUS, and in the 

EBERS papyrus. G. EBERS is of opinion that the papyrus 

named after him contains the fourth of the medical hermetic 

books—the treatise on materia medica.J Although 

* THOTH is the Hermes of the Greeks. Gi UGNI AUT ; de "Kp.uoO seu Mercurii 

mythologia, Paris 1835. 

t Cf. CLEMENS ALEXANURINUS : Stromata, lib. vi, cap. 4; Edit. Dindorf. 

% G. EBERS: Papyios Ebers, Leipzig 1875, T. i, S, 9.

EGYPT. 21 

this was written in the seventeenth century B.C. it most 

likely represents a later treatment of the original text. 

GALEN extracts many passages from it, although it is known 

that he had no high opinion of the scientific value of the 

work* It is not known whether the six medical books 

as well as the remaining thirty-six hermetic books were 

lectured upon to all students of the Egyptian temple 

schools alike, or only to those who had in view the practice 

of medicine. These latter had in any case to study and 

master the contents of the medical writings : moreover they 

were bound strictly to conform to the rules therein laid 

down when engaged later in the practice of their pro 

fession and they drew punishment upon themselves if they 

practised in any other way.f 

It is not probable that medical teaching confined itself to 

the medical works belonging to the hermetic writings or to 

the works illustrating these, in which the libraries connected 

with the temple schools were without doubt very rich. We 

must take it that the students' in addition to this received 

practical guidance in the examination and treatment of the 

sick. The rule existed in Egypt, that patients should be 

brought into the temple, to await help and the alleviation of 

their pains at the hands of the priests. The latter were also 

called to the dwellings of those sick people who were too 

ill to be brought into the temple. Is it not probable that I 

the teachers of Medical Science made use of these opportu 

nities to point out to the students the practical carrying out ^ 

of the theories which they had taught them ? It is also very 

likely, that the students assisted, as pupils of the priests, 

in the treatment of the sick in the temples, since this may 

be looked on as a part of God's service and a religious act. 

Moreover, the condition of the healing art in Egypt gives 

support to the presumption that their theoretical learning 

was made easier to acquire by the help of practical teaching. 

From the pictorial representations which have been pre 

served upon the temple walls it is evident that they were 

* GALEN : Ed. Kiihn, T. xi, p. 798. t DIODOR. h cap. 82.


acquainted with circumcision and castration. * In the 

EBERS papyrus the expression is used : " Restoration oi 

sight in the pupils at the back of the eyes," a passage which 

the editor has referred to the operation for cataract. The 

Cesarean section after the woman's death was perhaps 

first carried out in Egypt.f Can such things as these be 

learned from books ? The requisite skill for carrying out 

such operations can only be acquired by the man who frequently 

looks on at, and himself practises, the required 

manipulations. Again, bones reunited after fracture have 

been observed in mummies ; in their jaws artificial teeth 

have been discovered; and various surgical instruments 

have been found in tombs such as knives, scissors, lancets, 

forceps, probes, cupping apparatus of bullock's horn etc. 

* In ROSENBAUM'S edition of K. SPRENGEI.'S Gesch. d. Arzneikunde (Leipzig 

1846) Bd. i, S. 73 note; as in H. HAKSER'S Lehrbuch der Geschichte der 

Medicin (Jena 1875) Bd. i, S. 57, the remark is found that the Ancient 

Egyptians were acquainted with amputation. This statement depends upon 

LARREY who in his "Relation historique et chirurgicale de l'expe'dition de 

l'armee d'orient" .(Paris 1805), p. 45 note, writes: " Le genial Desaix 

poursuivit l'ennemi jusqu' au-dela. des cataractes et donna ainsi a. la commission 

des arts la facilit6 de visiter les monuments de la fameuse Thebes aux 

cents portes, les temples renommes de Tentyra, de Carnak et de Luxor, dont les 

restes attestent encore l'antique magnificence. C'est dans les plafonds et les 

parois deces temples, qu'on voit.des bas-reliefs representants des membres 

coupes avec des instruments trfcs-analogues a ceux dont la chiruroie s- sert 

aujourd' hui pour les amputations. On retrouve ces memes instruments dans 

lesh.eroglyphesetl'onreconnaitles traces d'autres operations chirurgicale. qui 

prouvent que la chirurgie dans ces temps recules marchait de front ave'c les 

autres arts, dont la perfection parait avoir

EGYPT. 23 

Anatomical teaching was not in any case associated with 

practical demonstrations on the human body. Since, 

according to the religious conceptions of the Egyptians the 

welfare of the soul depended upon the body being preserved 

with the greatest care, the dissection of the human subject 

was clearly not to be thought of. 

Even wounding the body was regarded with so much 

abhorrence that the operation which had to be performed 

upon the corpse before the embalming process brought 

hatred and contempt upon the operator who carried it out. 

This functionary had to take himself off and fly as soon as 

he had made the incision in the left side of the abdomen 

through which the intestines were removed, while at the 

same time he was pelted with stones by the relations and 

friends of the deceased ; a custom, which obviously must 

have been intended to typify the defence of the latter. 

The operators, on whom devolved these duties took a 

place in the social scale similar to that of our dissecting- 

room attendants. They possessed neither anatomical 

knowledge nor scientific interest of any kind, and were by 

the prevailing prejudice kept from making any investiga 

tions which their calling did not force upon them. 

The embalming of corpses exercised thus no beneficial 

influence upon the development of anatomical knowledge. 

This is apparent too in the strange, crude conceptions 

about the construction and composition of the human body 

which we find in the papyrus-rolls.* 

So the anatomical knowledge of the Egyptian doctors was 

certainly very small: they knew however that the heart 

is the seat of origin of the blood-vessels which are dis 

tributed from thence to all parts of the body : a fact which 

even a thousand years later was not generally understood 

and recognized. In the examination of the sick the 

Egyptian doctors were at pains " to investigate the beat of 

* See for example med. papyrus-roll, i, which has been described by CHABAS, 

Melanges Egypt, pp. 55-79, and by BRUGSCH : Recueil des monuments 

egyptiens, Leipzig 1863, Partieii, p. 101 et seq.

24 


the heart "* and to test the nature of the urine. Thus they 

soon observed that the urine of the pregnant female is 

turbid and rich in precipitated matterf and they made use 

of this observation in the diagnosis of pregnancy. They 

attached great importance to dietetics and a reasonable 

regimen of life; they recommended cleanliness and temperance, 

baths, J- frictions and gymnastics for the preserving 

of health. The hygienic properties of sea-baths are said to 

have been known to them at an early period and used by 

them in the treatment of the poet EURIPIDES. § Frequent 

use was made of emetics, purgatives and clysters. In the 

medical papyrus-roll i". are found twenty-eight prescriptions 

for the preparation of clysters which were generally 

accepted by the ancients as an Egyptian discovery.|| 

Prayers were combined with medical treatment in sickness, 

and were specially written for each case. In conformity 

with the priestly character of the doctors, they 

offered up these prayers themselves, and ascribed at least 

as much importance to them as they did to their medical 

directions. But seldom can there in those times have been 

such enlightened views as the Doctor NEBSECHT shows—in 

the novel "Uarda"by G. EBERS, that profound authority 

on life in ancient Egypt—where he delegates the singing 

of prayers to the old blind Pastophorus TETA. 

The Pastophori constituted a class of priests, vxho for the 

rest as G. EBERS has had the kindness to point out to me, 

neld by no means so low a rank as is attributed to them in 

historical works. The doctors were bound to maintain a 

spiritual character and allowed themselves therefore to 

rank with the Pastophori, although the higher priestly 

* Pap. EBERS, op. cit. i, p. 27) T. 45. 

t Med. papyr.-roll, i, in CHABAS, op. cit. p. 69. 

{ HEROD ii, 37, 38. 

a! 0 "T' LAERT> "!' 6 ; !t has been thou * ht that the *«* ES «f E 

(Iph. m Tau. v, „M) : 6dXaa

EGYPT. 25 

dignities probably remained open to them * On the other 

hand the Pastophori were by no means likewise doctors, as 

many think, but had as a body quite other functions as 

their name, indeed, indicates. The relation of the Pasto 

phori to the doctors was doubtless the same, as that of the 

scholar to the cleric in the Christian middle ages; all 

scholars did not belong to the Clergy but at the same 

time all clergymen might be considered scholars. 

Many doctors were members of the great priest-colleges 

and lived in the teaching-institutions belonging to the 

temples. They there taught medicine and carried on 

medical practice. It was to the interest of the priest- 

colleges that the ablest and most prominent representatives 

of the healing art should be selected for these positions, 

for their power was increased by the. number of the 

students and their renown by the successful cures effected 

in their temples. 

The doctors partook of the privileges and advantages 

which the priesthood in Egypt enjoyed. They were 

exempt from taxes and were maintained at the public 

cost. From the sick they received for their medical care 

no payment but presents : in any case they expected that 

at the completion of the cure offerings should be brought 

to the temple with which they were connected. Some 

times models of the parts of the frame which had been 

healed were hung up in the temple; the British Museum 

contains several of these. During war, or in the case of 

anyone falling ill upon a journey, the doctors were bound 

to render help gratis.f 

Whether there existed, in addition to the doctors par 

taking of the priestly character, other practitioners who 

learnt and practised their calling as Empirics is not certain 

but is. probable. The designation " Sunnu " (" one having 

knowledge ") was applied also to doctors. For the rest, 

the number of priest-doctors can hardly have been sufficient 

* The High priest of Sais bore the title " Chief of the Doctors." 

t DIODOR. i, 73, 82—HERODOT. ii, 37.


for all requirements. When we are informed* that 

Egyptian doctors confined themselves to practice in 

particular departments of their profession and to the treatment 

of particular diseases, so that " one treated only 

affections of the eye, another those of the head or teeth or 

abdomen or internal organs," it is evident that only in 

populous districts can the existence of such specialities 

have been possible and the sick man have had it in his 

power to make a selection from a number of practitioners. 

In the great temples, the priest-colleges of which reckoned 

many doctors amongst their members, naturally enough one 

chose this, and another that, speciality : but in general such 

a sharp division of the healing art into departments was 

not carried out. 

Egyptian medicine exercised a great influence upon the 

medical science of Greece. The fame of it outlasted the 

political revolutions of later times and formed a historical 

background for those medical schools which raised Alexandria 

to a prominent place among the nurseries of scientific 

life in ancient times. 

THE JEWS. 

JEWISH civilization is^daughter of_that_of_Egypt, j Moses, 

the great lawgiver and teacher of the Jewish people was 

a pupil of the Egyptian priest-schools, and there studied 

medicine in addition to other arts and sciences, f On the 

Egyptian pattern he founded a priestly class among the 

Jews, which included the representatives of intelligence 

and learning. Its members were supported by the people 

and served them in turn as Priests, Teachers, Judges and 

Doctors. The Mosaic legislature regulated the lives of the 

people by precepts which were directed towards improving. 

their morals, their health, and their material welfare.. The 

prophylaxis of disease and a rational dietary were looked 

upon as the essential antecedent conditions. These ends 

* HERODOT. ii, 84. 

t CLEMENS ALEXANDRINUS : Stromat. Lib. i, cap. 153.

THE JEWS. 27 

were served by those laws which dealt with the care of the 

newly-born, the nourishing of the child, the regimen of 

the mother or nurse, the relation of the sexes (as for 

instance the laws touching on cohabitation w T ith menstrua 

ting women and the marriage between blood-relations) : 

by those relating to cleanliness, clothing, food, dwellings 

and places of burial: so too by the directions for recog 

nizing leprosy or certain sexual afflictions, and for prevent 

ing their extension.* 'People sought for the relief of sick 

ness by means of prayers and offerings, thus appealing to 

the theurgical character of Jewish medicine, according to 

which all affections were looked upon as scourges sent 

from God. In addition however dietetic and medical 

remedies were employed.f For skin-eruptions J the priest- 

doctors recommended above everything the separation of 

the sick from the healthy, most scrupulous cleanliness and 

frequent baths. 

They were acquainted also with the use of medicinal 

springs. And the favourable influence exercised by music 

in many cases of psychical disturbance was known.§ For 

fractures they applied bandages. || Castration was per 

formed in two ways either by crushing or excision of the 

testes. And their performance of the operation of cir 

cumcision shows that the Jewish priest-doctors possessed a 

certain dexterity in surgery. 

Mention was made of midwives while the Jews were still 

undergoing captivity in Egypt. Their practice is described 

* Exod. ii, 15. 26; xix, 6; xxii, 31. Lev. vii, 23; xi. xii. xiii. xiv. xv. 

xvi. xviii. xix. xx, 18. Num. xii, 15; xvi, 41. Deut. xiv, 21; xxviii, 27, 

58-61. Ezek. xvi, 4, etc. 

t Cf. TRUSEN : Darstellung der biblischen Krankheiten, Posen 1843, s. 1. 

J. B. FRIEDREICH : Zur Bibel, Niirnberg 1848, i, s. 41 et seq., 193 et seq. R. J. 

WUNDERBAR ; Biblisch-talmudische Medicin, Rigaund Leipzig 1850, H. 1, S. 8 

et seq., 73 et seq. 

% By this general expression the term Zaraat is more properly translated than 

by Leprosy as it usually is. 

§ 1 Sam. xvi, .23. 

|| Ezek. xxx, 21.


in several passages with realistic completeness.* King 

Solomon manifested great interest in the natural sciences, 

especially in medical science, and is said himself to have 

been.the author of a book on the subject.t During his reign 

the influence of foreigners especially of the neighbouring 

Phoenicians made itself extensively felt. Still more did 

this become the case as the Israelitish people lost their 

national independence. Their political fortunes brought 

them into close relations with the Assyrians, Babylonians, 

Chaldees, and Persians and afforded their learned men 

opportunities of becoming acquainted with the acquisitions 

of. these peoples in the domain of culture and of making 

them their own. They thus gained a broad view of the 

spiritual development of man and became freed from those 

narrow-minded prejudices which were a result of their 

somewhat cramped political surroundings. From this, 

medical science drew the advantage that professional 

practice ceased to be a monopoly of the priests.J From 

this time forth besides them not only the Laity practised 

the healing art but doctors were applied to who did not 

even belong to the Jewish faith. In this respect people 

went so far at a later period as to permit even the rite 

of circumcision to be performed by a non-Jewish doctor 

when an Israelitish operator was not at hand.§ In 

the same way it was held obligatory on Jewish doctors to 

extend medical aid to persons of other faiths. They might 

claim payment for their services,|| and were esteemed and 

'lonoured by their fellow-citizens.f They were taken into ; 

council by the authorities on questions of sanitary adminis- 1 

tration and medical jurisprudence. Later on, each town 

was compelled to have a medical officer and sometimes 1 

* Gen. xxv, 24-26; xxxviii, 27-30. Exod. i, 15-21. 

t SUIOAS: Ezekias. 

t SVBRAND: Diss. hist. med. de necessitate quee fuit apud veteres inter religionem 

et medicinam, Amstel. 1841, p. 28 et seq. 

§ Talmud Tr. Menachoth, 42*. 

I Exod. xxi, 19, 

If JESUS SIRACH, xxxviii, 3.

THE JEWS. 29 

also a surgeon in addition. Besides other duties they 

were bound to carry out circumcision. Special doctors 

were appointed for the priests who in consequence of 

their ceremonies in the Temples involving cold baths, 

light clothing, walking with bare feet on the cold stones 

and fasts, were much predisposed to abdominal diseases* 

Although the medical profession was open—to-all, yet 

those connected with the priesthood seem especially to have 

devoted themselves to it, as appears from the information 

at our disposal. Medical science on account of its intimate 

relation with the religious and social legislation of the Jews 

was surely drawn into the domain of education in the Priestschools 

as in the Prophet-schools which were frequented 

by full-grown youths. Certain prophets, as for instance, 

ELISHA were famous for their successful cures. Who ever 

aspired to be considered a learned man was obliged to be 

possessed of some medical knowledge. This, indeed, was 

a part of general education and was sought after by those 

who desired to occupy a prominent position in public life. 

The technical training of doctors was effected through the 

personal instruction of pupils by a teacher who was practised 

and experienced in the healing art. As to the nature of 

this teaching and the appliances used in it, we unfortunately 

possess no information in regard to the earlier 

times but only in regard to the later—the Talmudic period. 

The Talmud, the origin of which dates from the first century 

after Christ, contains a number of expressions borrowed 

from the vocabulary of the Greek tongue, especially its 

medical terminology, and even directly refers to a connection 

with the medical science of the Greeks. Talmudic 

medicine lacks originality and is supported chiefly by the 

teaching of Greek doctors.? The anatomical knowledge 

of the Talmudists, of whom some distinguished themselves 

as doctors, does not rise above that which had been pro- 

* Talmud Tr. Schekalim v, 1,2. 

f J. BERGEL (Die Medicin der Talmudisten, Berlin u. Leipzig 1885) attacks 

this asserted connection but is able to adduce no facts in support of his views.


pounded by GALEN. Their observations on the development 

of the foetus deserve notice, especially as to the formation 

of the bones. With this aim, they betook themselves to 

the dissection of the human body. Thus it is narrated in 

the Talmud that the pupils of Rabbi ISMAEL BEN ELISHA 

studied the individual bones on the corpse of an unfortunate 

woman, who had suffered the penalty of death, and 

that Rabbi ISMAEL examined the foetuses of certain pregnant 

female slaves, who, with this object in view, were put to 

death during their pregnancy* At the same time the 

Talmudic philosophers endeavoured by dissections of 

animals to enlarge and confirm their anatomical knowledge. 

They recognized the important bearing which 

observations and examinations made on animals have on 

medical knowledge and they drew definite conclusions 

from this method of research. 

In this way they found out that wounds of the kidneys 

are not always fatal and that the spleen can be removed 

and even the uterus cut out without the death of the animal 

resulting.t The doctors performed amputations and were 

acquainted with the use of artificial feet and legs,J were 

skilled" in the treatment of fractures and dislocations, 

healed umbilical rupture in the newborn by a compression 

bandage and in retention of the placenta removed it by 

art, operated on urinary fistula, made observations on 

hermaphroditism, referred to the fact that the descent of 

the testes is sometimes not completed, and published some 

valuable experiences upon injuries of the internal organs :§ 

especially so in observing that injury to the spinal cord in 

animals is followed by paralysis of the hind-legs. They 

possessed a great number of surgical instruments and 

* J. M. RABBI.NOWICZ: La Me'decine du Thalmud, Paris 1880, p. 75.—RAB- 

BINOWICZ: Einleitung in die Gesetzgebung und Medicin des Talmuds, deutche 

Ubers. 1883, S. 250.—Talmud Tr. Bechoroth, 45*. 

t RABBI NO WICZ p. crt.-Talmud Tr. Sanhedrin 31, 33* u. 93", Bechoroth 

28 b . 

% WUNDEHBAR op. cit. iv, S. 66-68. 

§ RABBINOWICZ op. cit. S. 258 etseq.

THE JEW'S. 31 

appliances * and showed themselves dexterous and ex 

perienced in operative midwifery; they were acquainted 

with several causes of abortion, undertook embryotomyt 

and carried out the Caesarean section on the dead and on 

the living.:}; The Talmudic philosphers devoted an ardent 

study to the medical writings of the Greeks, and made 

their scientific acquisitions accessible to the doctors of the 

Jewish people. The medical science of Greece had already 

by that time become the common property of the whole 

civilized world. The Jews possessed at that epoch cele 

brated high-schools at Tiberias, Sura and Pumbeditha, in 

which, as before in the prophet-schools, medicine was 

probably taught at least in its general outlines. Teaching 

lasted only for part of the year: during the remainder the 

students went about their business in order to supply 

themselves with the necessary means to support life.§ 

Among them were to be found, mechanics, merchant-folk, 

and perhaps doctors who were anxious to acquire from the 

teachers of the high schools scientific foundations for their 

observations. And conversely the teachers themselves, 

who were only at home in theoretical subjects, sought 

eagerly for information from experienced practitioners 

upon doubtful and difficult points of practice. || Many 

doctors seem to have undertaken the treatment of both 

internal and external affections, while in other instances 

they only devoted themselves to either the one or the other 

branch of medical science. Whosoever wished to practise 

as a doctor had to obtain the permission of the magistrates 

* WUNDERBAR (op. cil. i, S. 50-56) enumerates 56 distinct kinds, among 

them knives, scissors, probes, lancets, cupping instruments of horn, perforators, 

portable commodes, spoons, sieves, etc. 

f Talmud Tr. Bechoroth 46% Nidah 19. 

t On the meaning of Joxe dophan see also VIRCHOW'S Archiv Bd. 80, H. 3, 

S. 494. Bd. 84, H. 1, S. 164. Bd. 86, H. 2, S. 240. Bd. 89, H. 3, S. 377. 

Bd. 95, H. 3, S. 485.—A. H. ISRAELS in d. Ned. Tijdschr. v. GENEESK 1882, 

p. 121 et seq. 

§ P. BEER : Skizze einer Geschichte der Erziehung und des Unterrichts bei den 

Israeliten, Prag. 1832, S. 55. 

I Talmud Tr. Nidah 2i b .


of the place in which he wished to settle. " No one may 

practise the healing art however fully qualified he may be 

without the permission of the Beth-Din (the couacil of the 

town) and whoso practises without such permission, even if 

fully qualified, is culpable."* Whether this permission 

was granted after examinations, and if so of what character 

these were, is unknown to me. In the following centuries 

Jewish medicine was merged completely into that of the 

other nations. Jewish doctors and philosophers exercised 

a beneficial influence upon the scientific development of 

medical science, especially in the middle ages, and have, at 

every period, maintained a prominent position in this 

domain of knowledge. 

THE PARSEES. 

ONLY very sparse accounts have been handed down to us 

concerning the medicine of the ancient Persians. With 

them, also, the healing art stood in intimate relation to 

culture, and the priests and Magi practised it. The general 

conception was that diseases, which were called into existence 

by evil spirits, could be dispersed by conjurations and 

prayers. With these many superstitious ceremonies were 

combined; here magic celebrated its marriage with medicine, 

t THRITA, a hero celebrated by tradition who later 

on was added to the celestial spirits, was considered the 

first doctor whose privilege it was to remove diseases and 

to subdue the demons who sent them. He was worshipped 

on this account as the patron and guardian of doctors and 

so to speak as the god of the art of healing. The 

religious law-books of the ancient Persians recommended 

purity of mind and body as the best medicine to ward off 

sickness. Sexual excesses were threatened with severe 

punishment. In the same way the induction of abortion 

was forbidden. As to the treatment of diseases we learn 

that in addition to prayers and medicines, of which they 

* WU " DI " BAR : * cit - ! > S ' 36- t PUNY : hist. nat. xxx, ,.

THE PARSEES. 33 

vere acquainted with a great number from the vegetable 

:ingdom, the knife too came into use. Those who cured 

liseases .by prayer alone were looked upon as the most 

sxcellent doctors ; they were, so to speak, " doctors of 

[2£tors/[ Then came those who ordered medicinal herbs 

md the lowest place was assigned to those who handled 

he knife.* Whoever wished to be a doctor was obliged to 

>ractise first of all among the lowest despised classes. So 

oon as he had accomplished three satisfactory cures upon 

nembers of these classes, he was at liberty to practise 

imong the higher grades of society. But if the three 

est-patients died he was never allowed to become a 

loctor. As in ancient Egypt so here too the doctors 

>ractised the veterinary art as well as their own. There 

vas a kind of medical-taxation regulated in accordance 

vith the position and wealth of the patients. From a priest 

he doctor might demand nothing further for his services 

han a benediction ; on the other hand from the chief of a 

>rovince he received four oxen, from his wife, a female 

:amel; from the chief of a town, a large draught-horse, 

rom his wife, a mare ; from the head of a village, a medium- 

iized draught-animal, from his wife, a cow ; from a house 

holder, a small draught-animal, from his wife, a she-ass. In 

ike manner it was ordained how much he should demand 

or the treatment of the various domestic animals.f 

This fragmentary information supplies us with no in- 

ormation regarding the medical knowledge or professional 

caching among the ancient Persians, and enables us to 

orm no settled opinion as to the state of medical science 

imongst them. In any case, their doctors were later on 

.urpassed in skill by their Egyptian and Greek colleagues, 

or the Persian kings caused doctors from these countries 

o repair to their courts. 

* Vendidad vii, 118-121. t Ibid, vii, 105, 117.

34 


THE GREEKS BEFORE HIPPOKRATES. 

THE earliest information concerning the medical science of 

the Greeks is veiled in mythical surroundings. In these 

APOLLO appears as a god sending diseases and pestilences 

but also vouchsafing the remedies to cure them and control 

their power for evil. When, later on, the several characteristic 

powers and attributes of this god of Light,—who in 

the worship of a primitive people obvipusly represented the 

Sun were personified and obtained separate representatives, 

ASKLEPIOS assumed the character of the God of the 

healing art. Tradition spoke of him as the son of 

APOLLO, in order to give expression to the intimate 

relations of the two. Enlightened Greeks of a later age 

explained this in an allegorical manner when they said: 

" If ASKLEPIOS is the air,—indispensable to the health of 

man and beast, yet APOLLO is the sun and rightly is he 

called the father of ASKLEPIOS, for the sun by his yearly 

course makes the air wholesome."* HOMER and PlNDAR 

celebrate the cures of ASKLEPIOS ; but neither they nor 

HESIOD call him a god. How the fame of his cures, preserved 

by legend and enlarged by posterity gradually led 

to his apotheosis, unfortunately no information has been 

handed down to us. Later on, temples were erected to 

him, and by fervent worshippers powers ascribed to him 

similar to those of ZEUS the creator and preserver of all 

things. The poets, who, as HERODOTUSt says, found 

serviceable material in mythology, adorn the narratives of 

the birth and life of ASKLEPIOS with their rich fancy. 

PlNDAR states that he was instructed in medical science by 

the centaur CHEIRON : he was taken to CHEIRON " that he 

might teach him the ways of healing diseases which bring 

many woes on mankind. All who approached him suffering 

from ulcers arising from internal causes, those too whose 

members were injured by the sword or by the stone slung 

* PAUSANIAS vii, 23. t HERODOT. ii, 53.

THE GREEKS BEFORE HIPPOKRATES. 35 

from afar and those again whose bodies were enfeebled by 

excessive heat and cold; all these he delivered from their 

multifarious ills : on some using gentle incantations, giving 

others refreshing drink or applying soft healing salves to 

:heir wounds : some also he cured by operation."* 

By ASKLEPIOS stood his wife EPIONE the "Pain-Soother" 

ind his daughters HYGIEIA, JASO and PANAKEIA whose 

illegorical significance is seen in their names. These all 

issisted him. Doubtless, there is more historical truth 

:ontained in the statement that he had two sons, MACHAON' 

ind PODALIRIOS, to whom he transmitted his acquirements 

n the healing art. They were numbered among the suitors 

)f HELEN and proceeded to Troy with the Grecian armies 

is commanders of the Thessalian warriors from Trikka, 

thome, and Oichalia. They were considered as dexterous 

n the art of war as in that of medicine, and were on 

everal occasions called upon by their comrades in arms to 

dve professional counsel and help.f MACHAON made 

limself chiefly prominent as a surgeon, while PODALIRIOS 

listinguished himself in the treatment of internal diseases. 

^.s in the Iliad, so too in the vEthiopis of the poet 

^RKTINOS which was composed soon after the former poem 

>ut is now only extant as a fragment, allusion is made to 

his separation of the two chief branches of medical 

cience, in the words : " then ASKLEPIOS bestowed the 

ower of healing upon his two sons, nevertheless he 

:iade one of the two more celebrated than the 

ther : on one did he bestow the lighter hand, that he 

light draw missiles from the flesh and sew up and heal 

11 wounds ; but the other he endowed with great precision 

f mind so as to understand what cannot be seen, and to 

eal seemingly incurable diseases.":]; 

It is noteworthy that here internal medicine was given 

le preference. This opinion remains to the present day, 

* PINDAR Pyth. Od. 3, 80-95. 

t Dionoit. iv, c. 7 1. 

1 F. G. WELCKKR : Kleine Schriften, Bonn 1850, Bd. iii, S. 47.

3 6 


and must have originated in the fact that the recognition 

and cure of internal diseases appears more difficult and 

wonderful to the laity than the. treatment of external 

injuries, the cause and seat of which are, in most cases, 

apparent to everyone. 

The healing art of those early periods of Greek history 

was limited essentially to extracting arrows and lancepoints, 

arresting bleeding, alleviating pain, and applying 

bandages. In the Iliad a great number of wounds of 

various kinds are described, and the methods of treatment 

which were applied to them illustrated.* MACHAON and 

PODALIRIOS are not the only doctors mentioned in the 

heroic poems of HoMER.f ACHILLES, PATROKLOS, and 

other military commanders and warriors were renowned 

for their healing powers. Many of them owed their knowledge 

on the subject to CHEIRON,! " the Man of the 

Hand." They made use of these acquirements for the 

welfare and assistance of their men, just as other heroes 

gladdened their men's spirits by their power of song; but 

they did not use the healing art as a calling or for pay. 

The instruction in medical science took place under the 

personal supervision of a teacher who united in himself 

knowledge and experience. The father imparted 

his medical lore to his sons, and these in turn bequeathed 

their art to their progeny.§ This fact appears 

to lie at the root of those legends which suggest that 

medical acquirements were confined to the relations of 

CHEIRON and ASKLEPIOS, and were preserved by them as 

precious family legacies. As the professional fame of the 

descendants of ASKLEPIOS became more and more widely 

* Ilias iv, 190. v, 73-75, 112, 694. xi, 349-60, 397, 846. xiii. 438-45. 

xiv, 409-439. xv, 394. Cf. DAREMBERG: La Me'decine dans Homere, Paris 

1865. H. DUNBAR : The Medicine and Surgery of Homer, Brit. Med. Jour. 

Lond. 1880, 10 Jan. 

t Bias xiii, 213. xvi, 28.. 

t Bias iv, 219. xi, 831. Panofka in den Sitzungsber. d. Akad. d. Wiss. zn 

Berlin, Philos-hist. Kl. 1843, s - 269 et seq. 

§ PI.ATO,: jderepubl. x,c. 3.

THE GREEKS BEFORE HIPPOKRATES. 

spread, and a thankful generation began to attribute the 

honour of godhead to their ancestor, it may easily have 

arisen that other practitioners took to giving themselves 

out as members of the family, and in possession of the 

family secrets. So gradually there became developed a 

professional class tracing its origin from ASKLEPIOS. 

The Asklepiadae, the putative descendants of this mythical 

ancestor of Greek doctors, united, later on, into societies 

which celebrated their mutual relations by offerings made 

in common and by religious festivals. An inscription 

found in the, ruins of the temple of ASKLEPIOS at Athens, 

and published by GlRARD,* and which KOHLER ascribes to 

the first half of the third century, establishes the fact that 

these w r ere ancient"customs. The Asklepiadae were moreover 

doctors bound together in a guild and by no means 

identical with the priests who were established at the 

temples of ASKLEPIOS as K. SPRENGEL and other medical 

historians have erroneously thought. 

The most ancient sanctuaries of ASKLEPIOS were situated 

at Trikka in Thessaly, at Titane, Tithorea, Epidauros, on 

the Island of Kos, at Megalopolis, in Knidos, Pergamus, 

Athens,t and other places. Here the god of the healing art 

was worshipped and approached by the sick who implored 

at his hands a deliverance from their maladies. In connection 

with the temples where the religious service was held ? 

were dwelling-places for the priests and. attendants of the 

temple, and large covered' and pillared halls which served 

as places of retreat for the pious pilgrims and the helpless 

sick.J 

The Asklepieia were generally distinguished for their 

healthy situation and cheerful surroundings. They were 

* P. GIRARD: " L'Ascle'pieion d'Athenes d'apres de re'centes de'couvertes " in 

the Bibliotheque des ecoles francaises d'Athenes et de Rome, T. 23, p. 85, 

Paris 1881. 

"t JOH. HEINR. SCHULTZE mentions in his Historia Medicinae (Lips. 1728), 

p. 118-125, a great number of Asklepieia and names the authors by whom they 

are mentioned. 

% PAUSANIAS ii, c. 11, 27 et seq. x, 32, and GIRARD op. cit. p. 5.


lilt in a fertile region on mountains or hills in the 

cinity of forests and woods which protected them from 

jurious winds and evil epidemic influences and by the 

de of streams and springs yielding a fresh, sweet-tasting 

ater.* Some had salubrious thermal and mineral springs 

great celebrity for the cure of disorders. These 

mples of health were surrounded by pleasant well 

ired-for gardens, in which fresh water was continually 

wing, and contained in their interior statues, frescoes, 

id votive offerings of all sorts. By the side of statues of 

SKLEPIOS and other deities were memorial tablets keep- 

g alive the fame of celebrated doctors as favourites of the 

)ds.f 

Stringent rules provided that these sanctuaries should be 

ipt clean and free from anything which might endanger 

eir sanitary condition. On the gate of the temple at 

Didauros were inscribed these words : " Whoso desires to 

iter here, must possess a pure spirit."J There, as strictly 

in Delos, it was forbidden that a birth a burial or a 

emation should take place in the precincts of the temple. 

/en if a patient died there the sanctuary was held to be 

filed. The persons who sought relief were compelled to 

•serve scrupulous cleanliness, to bathe in the stream, in 

e sea, or at the fountain, and to fast and abstain from wine 

certain number of days before venturing to approach the 

mple or to make prayers or offerings to the deity. 

veet-smelling vapours which arose from the fumigations 

ed the air, and the song of priests extolling the might 

d power of the god of healing entranced the soul. Con- 

rsation with fellow-sufferers whom the patients met in 

2 halls of the temple, and the sight of the numerous 

tive tablets and inscriptions telling of happy restora- 

ns to health which had occurred in the place, imparted 

nfidence and hope. Willingly did they therefore submit 

* PAUSANIAS iii, 24. viii, 32. VITRUV. : dearchit. i, c. 2. 

+ ANAGNOSTAKIS in the Bull, de corn hellen: i, p. 212, pi. ix. 

J CLEMENS ALEXAND. : Stromat. v, c. i, 13.


to the injunctions of the priests and with painstaking care 

follow their orders. 

As in the famous Amphiaraion and in other ancient 

oracular places so too in the temples of ASKLEPIOS means 

of cure were suggested by dreams. The sufferers slept 

during the night in the hall of the temple and awaited the 

dreams in which the deity should reveal himself to them. 

When, in them, the treatment of their malady was not 

clearly and plainly pronounced, they told the substance 

of their dreams to the priests and their assistants, who 

expounded the same to them, naming the remedy they 

were to apply. If the patient on the first night had no 

dream at all, he passed another and if necessary a third 

night in the Asklepieion. If dreams refused to come to 

him altogether, he begged the priest or some other 

man of a pious disposition to sleep there for him and to 

dream. This method of consultation by deputy was 

already customary at oracles* and led, later on, to deceit; 

for cunning speculators, like many spiritualistic mediums 

of the present day, turned the intercourse with celestial 

beings into a profitable business.! The deceit was of 

a still grosser kind when the priests appeared at night 

in the mask of the god to the visitors at the temple in 

order to make them believe they had been dreaming. 

ARISTOPHANES has represented this in his comedy of Plutos 

in an exceedingly droll manner.J 

The remedies which were enjoined were—at least in the 

more ancient times—rather of a dietetic and psychical than 

of a strictly medical character. Many of the methods of 

cure recommended were thoroughly rational § and highly 

adapted to bring about a successful issue. W T hich may 

* HERODOT. viii, c. 134. 

t Cf. the biography of APOLLONIOS of Tyana by PHILOSTRATOS i, 89. iv, 1. 

% v, 620 et seq. 

§ Cf. VERCOUTRE: "La Medicine sacerdotale dans l'antiquite grecque " in 

the Re-vue Archeolog, Paris 1885. Ser. iii, T. 6, p. 285 etseq.-v. WILLAMO- 

WITZ-MOELLENDORFP: Die Kur des M. J. Apellas, in dessen PhiloK Untersuchungen, 

Berlin 1886, H. 9, S. 116 et seq.

4° 


be explained in this way that the dream-pictures giving 

expression to the predominant, sometimes the single, subject 

of interest in the mind of the sleeper, drew forth from 

the depths of his soul some half or wholly forgotten 

reminiscences of happy cures effected. 

When the dreamers failed then the priests came to their 

aid. The latter having by tradition and personal experience 

acquired some medical knowledge of their own were able 

to help the sick with counsel and explanation. When 

they got either no result at all or an unfavourable one, 

they withdrew themselves by sophistical artifices from the 

painful position.* 

The priests of the temples of Asklepios were not 

doctors, as many assume. Certainly there were among 

them as among their assistants the Zakoroi, many who 

were skilled in medical science,t indeed they had probably 

learned the subject systematically. But between the 

healing art as practised in the Asklepian temples and 

that of the professional doctors the great distinction existed 

that in the former case it was held to be not a fruit of the 

human understanding, but a divine revelation. Medical 

interference must from this circumstance here have 

appeared at least superfluous. On this ground it is not 

probable that between the priests of Asklepios and the 

doctors there existed any competitive or unfriendly relations.! 

It is much more reasonable to take the contrary 

for granted, when one considers what humble reverence 

both doctors and Asklepiadae paid to the sanctuaries of 

Asklepios, and what submissive trust they reposed in his 

imagined utterances in doubtful cases of their practice. 

The Asklepiadae settled down by preference in the 

neighbourhood of the Temples dedicated to Asklepios and 

founded medical schools there. Among these, those which 

were situated at Rhodos, Kroton, Kyrene, Kos and Knidos 

* ARTEMIDOR: Oneirocrit. v, 94. 

t GIRARD op. cit. p. 34. 

| MALGAIGNB in the "Journal de Chirurgie," Paris 1846, iv, p. 340.—CH. 

DAREMBERG in the " Revue Archeol.,' Paris 1869, T. 19, p. 261 et seq.


•acquired the highest reputation. A noble spirit of emula 

tion was established among them which favoured the 

development of medical knowledge.* So too must the 

fact that the Asklepiadae were constant frequenters of the 

temples, where they saw maladies of all kinds, heard of 

successful cures and the means employed to effect them, 

and read the thanksgivings left on record by the cured, 

have operated powerfully upon them and increased their 

professional knowledge and experience. 

The schools of the Asklepiadae were societies of doctors 

who subscribed to the same theories and corresponded 

rather to our Academies than to the departments of Univer 

sities. The training of doctors was carried on by the same 

methods as in the most ancient times, the teacher impart 

ing to one pupil or more the knowledge and skill required 

for the practice of medicine. In the admission of students 

no limitation was miade, as in former times, to scions of 

families deriving their origin from Asklepios,t and if the 

Asklepiadae sought by keeping registers of their pedigrees 

to preserve this belief, they only wished in this way to 

assert that the healing art of their ancestor Asklepios was 

transmitted by them pure and unadulterated.J On a like 

ground they enjoined on their students strict secrecy con 

cerning the subjects taught them and forbade them to 

•impart their knowledge to others, not of the Asklepiadae - 

guild.§ Similar rules were made by other learned societies 

to prevent the profanation of their secrets especially where 

a religious bond held them together as, in this case, the 

common worship of Asklepios. 

Medical teaching began in early youth. If the father was 

a doctor he naturally was the first teacher of the son who 

devoted himself to medicine : he then both sought for and 

* GALEN : Ed. Kiihn, T. x, p. 5. 

t GALEN op. cit. T. ii, p. 281. 

X For the rest, the still existing fragments of the genealogical tablets of the 

Asklepiadae, are of a later period and consequently have no claim to authenticity. 

TZETZES (12th century post Christ.): Histor. var. chil. ed. Th. Kiessling. Lips. 

1826, p. 276, v. 944-989. 

§ HIPPOKRATES : Ed. Littre', T. iv, p. 642.

4 2 ANCIENT TIMES. 

found opportunities for further practical training amongst 

other skilful doctors. The teacher imparted to the pupils 

his opinions concerning the structure and functions of the 

body, explained to them the origin of sicknesses and brought 

them to the bedside and there pointed out to them the symptoms 

of the various maladies and their treatment. The 

pupils were obliged to pay* an honorarium for their instruction 

and to teach the sons of their teacher the healing art_ 

without remuneration. When the training of the student 

was finished, he was received into the Society of the Asklepiadae 

on taking the following oath :f—" I swear by Apollo, 

the Healer, by Asklepios, by Hygieia and Panakeia and by 

the other gods and goddesses and call them to witness, 

that I will hold to this my oath with all my strength and 

capacity. I will revere him who has taught me the healing 

art as I do my parents, sharing my means of living with 

him and caring for his wants. His children shall be treated 

by me like my brothers and sisters; and his sons, should 

they wish to learn the healing art, will I teach without 

payment or indebtedness on their part. The professional 

rules and all that I have heard and learned of the healing 

art, will I impart to my own sons, to the sons of my 

teacher and to my pupils who, in accordance with the 

professional law, have been consigned and bound to me 

for that purpose; but beyond these, to none. The way of 

living of the sick, as far as I am able and know, will I 

regulate for their good and protect them from injurious 

and unwholesome influences. Never will I give a deadly 

drug, not even if I am asked for one, nor give any advice 

tending in this direction. Neither will I at any time give 

to a woman any drug or instrument for the purpose of 

causing abortion. Purely and holily will I spend my life 

and possess my art. Castration will I not carry out J even 

* PLATO: Menon c. 27. Protagoras c. 3. 

t HIPPOKRATES op. cit. T. iv, p. 628-632. 

t The words : obrefj.iuj Si ouSe /j.^v\i9tiAjvTaQ have at all times afforded great 

difficulty to commentators and translators. They mostly think that the person 

taking the oath binds himself not to perform lithotomy. By this explanation


on those who suffer from stone, but leave this to those 

people who make a business of it. When I enter a house 

it shall be for the purpose of healing the sick. I will do 

wrong to no one intentionally nor inflict any injury, and I 

wifl never incite to unchastity either women or men, bond 

or free. Whatever I, in my medical practice or out of it 

may hear or see in respect of the private life of men, if 

such ought not to be publicly known, thereon will I observe 

silence and secrecy. May it be my lot, observing and not 

breaking this oath, to make full use of my life and art and 

to earn an enduring reputation among men. If, however, 

I break my oath and am forsworn, may the opposite happen 

to me." From the tenor of this oath, which without doubt 

belongs to the Ante-Hippokratic period, it is clear that castration, 

which was undertaken in order to supply eunuchs, was 

left to those people who undertook the performance of 

however, the ovSs fif,v of the text is superfluous and disturbing to the sense since 

lithotomy could only have been undertaken in the case of those suffering from 

vesical calculus. LITTRE conjectured therefore that ufriovrag should be substituted 

for XiQtwvrac, so the translation should run : " I will not perform lithotomy even 

if the patients request me." But perhaps the passage does not refer exclusively 

to lithotomy: for the doctors of that period were not at all shy of undertaking 

other operations and busied themselves also with the investigation and treat 

ment of diseases of the bladder. (HIPPOKRATES op. cit. T. vi, p. 150.)—The 

view of R. MOREAU, CHARPIGNON and others has greater authority, that it is a 

question in this passage of the forbidding of castration ; for this appears in 

close connection with other disgraceful things, for instance the giving of poisons, 

procuring abortion, etc. Moreover the word TE/XVEIV occurs in this sense in 

Greek literature, though it is true the compounds kurk^vuv and airoriiiv^v 

were used with this meaning more frequently. The immediately following 

oide iirjv XiQiwvrac means then, that castration is not permitted even in those 

suffering from stone although the considerations against it must have been 

less in such cases, since lithotomy by the methods of operating then in use 

generally resulted in incapacity for sexual intercourse in consequence of the 

destruction of the seminal ducts. Moreover \tfi*v has also the meaning " to 

suffer from a swelling of stony hardness," and according to TH. GOMPERZ is 

used, in this sense, of indurations in the eyelids, joints, uterus, etc. Perhaps 

reference is here made to the testes and the passage in question must be trans 

lated: "I will not perform castration even in those who have indurated testes." 

— Cf. CHARPIGNON: fitude sur le serment d'Hippocrate, Orleans and Paris 

1881.-TH. PUSCHMANN in Bursian's Jahresber. f. Alterthumswissenschaft 

1884, iii, p. 55, and in the Jahresber. iiber. d. Fortscher. d. ges. Medicin, 

herausgeg. v. VIRCHOW U. HIRSCH. 1883, i, S. 326.


this operation as a matter of business. Perhaps other 

branches of surgery, for instance cystotomy and the treatment 

of fractures and sprains, were practised by empirics 

who had acquired great skill and certainty therein.* At 

any rate we are permitted to assume that in addition to 

the Asklepiadae there were other doctors who did not 

belong to their association.f It was at a later period that 

all doctors were called " Asklepiadae." 

The Philosophers exerted great influence upon the development 

of medical science and especially upon the training 

of practitioners. The mode of Greek thought which sought 

to fathom the origin and essential characters of things 

brought into view before all else Man and Nature surrounding 

him. PYTHAGORAS who saw in number, in the relations 

of masses, and in law, the principles lying at the bottom of 

every existent thing, was himself a doctor and concerned 

himself with the 1 structure of the body and with the activity 

of thought and spirit no less than with the procreation and 

development of man. After a somewhat lengthy sojourn 

in foreign lands especially in Egypt where he must have % 

been initiated into the wisdom of the learned priests, he 

settled down in the Greek colonial town of Kroton in Lower 

Italy, where the famous Asklepian school was situated. 

There he founded a confederation which strove after 

objects of an ethical and political, rather than a philosophical, 

character. Its members were generally doctors 

and soon found here a centre for the scientific interests 

which* they had in common. They turned their attention 

chiefly to dietetics and sought by simple remedies, by 

fomentations, by frictions and ointments to bring about 

cures; surgery was neglected by them.§ Amongst the 

disciples of PYTHAGORAS are mentioned the doctors 

PHILOLAOS, ELOLATHES who considered health to be due 

* Cf. H. HAESER; Geschichte der Medicin, 3. Aufl., Jena 1875, h S. 88. 

f WELCKKR op. cit. S. 103 et seq. 

X DIODOR. i, 69, 98. 

§ JAMBLICH : de vita Pythag. c. 29, § 163 et seq.


to the harmonious correspondence of humours in the body, 

likening it to a condition of harmony in music,* EPI- 

MARCHOS, METRODOROS and others. Probably ALKMÊON 

and DEMOKEDES who had received their professional training 

in Kroton, belonged to his school. The last-mentioned 

by his successful cures spread the fame of the healing art 

of his native country in foreign lands and obtained a 

prominent position at the court of King DARlUSt whose 

sprained foot he was able completely to restore after the 

vain attempts of his Egyptian body-surgeons. ALKM/EON 

is said to have been the first to undertake anatomical 

dissections and by these means he discovered the origin of 

the optic nerves from the brainj. He taught that the 

human spirit is immortal and. like the stars is engaged in 

everlasting movement. He sought to explain the origin of 

the five senses and formulated the first theory of sleep. 

" When the blood," he said, " retires into the great blood 

vessels, sleep comes on ; when it again disperses into the 

smaller vessels awakening takes place."§ His views con-cerning 

the nourishing of the child in its mother's womb 

and concerning the causes which lie at the bottom of the 

infertility of hybrids are deserving of less attention. One 

of the most prominent natural philosophers of that time 

was EMPEDOKLES, who, musing on the eternity of the 

universe, attacked || the theory of the origin and extinction 

of matter, seeing in it himself nothing but change manifesting 

itself in association and division, and being evoketd 

by love and hate. He established, as ARISTOTLE tells us,^[ 

that doctrine of the four elements which exerted the greatest 

influence upon the physiology and pathology of later times 

* KUHN : Opusc. Acad., Lips. 1827, i, p. 47-86. 

f HEROD, iii, c. 129-134. 

X CHAI.CIDIUS in Platon. Timaeum ed. Meursius, Lugd-Bat, 1617, p. 340. 

M. A. UNNA: De Alcmseone Crotoniata ejusque fragmentis quae supersunt in 

CH. PETERSEN : Philologisch-historische Studien, 1. H., Hamburg 1832, S. 41-87. 

§ PLUTARCH : de placit. phijos. v, c. 24. 

|| HIPPOKRATES op. cit. T.'vi, p. 474. 

^f ARISTOTEI.ES : Mataph. i, 3, 4.


and he already foreshadowed that great theory of creation 

which asserts that the development of organisms proceeds 

from lower to higher forms, and that only the conformable 

survive. He was of opinion that not only men and 

brutes but plants also are endowed with souls; he busied 

himself with the subject of the senses and with the act of 

respiration which he sought to elucidate in a mechanical 

way; and he regarded the labyrinth of the ear as the seat of 

hearing. His contemporaries ANAXAGORAS of Klazomene, 

and DIOGENES of Apollonia directed their attention chiefly 

to anatomy. The former undertook the dissection of 

animals* and noticed the lateral ventricles of the brain : 

moreover he was the first to give utterance to the opinion— 

raised into a dogmaf by later doctors—that the bile is the 

cause of acute sickness. DlOGENES left behind him a 

description of the vascular system which it must be confessed 

contains numerous errors.^ HERAKLITOS saw in 

the constant changes of form, in the everlasting mutations 

of things, the individual nature of these. Like EMPEDOKLES 

he ascribed a weighty influence upon the activities of the 

organism to fire, the internal heat. His views hold a place 

in the collection of dogmas belonging to the Hippokratic 

school and for a' long time played an important part in 

physiology and pathology. In a higher degree was this 

the case with the theories of LEUKIPPOS and DEMOKRITOS. 

The materialism which dominated their doctrine of atoms, 

led to the investigation of nature,, as the only way which 

promised results. DEMOKRiTOS§ devoted himself with 

great zeal to anatomical investigations and appears to have 

been very skilful in them for he was able to compose a 

special treatise upon the structure of the chameleon.|| He 

* PLUTARCH : Perikles, c. 6. 

t Vide die Nach-Galen'sche Schrift liber die kritischen Tage in HIPPOKRATES 

op. cit. T. ix, p. 300 et srq. 

X ARISTOTELES: Hist. Animal, iii, 2. 

§ ARISTOTELES: de generat. i, 2.—CICERO: Tusc.qufest. v, 39. 

|| PLINIUS: Hist. Nat. xxviii, c. 29.


also appears to have written on various diseases ; on ca 

rabies, on the healing influence of music,* etc. 

A tradition, having origin in remote times,? tells that the 

people living in the vicinity of the great philosopher, considering 

him to be insane, summoned HIPPOKRATES to 

Abdera to investigate his case. But he, knowing the abundance 

of wisdom and intellect possessed by DEMOKRITOS 

may well have felt himself compelled to give utterance to 

the opinion that he was the wisest of all men. He owed to 

his intercourse with DEMOKRITOS many suggestions and 

doubtless much in formation. J The philosophers reckoned 

the study of man and of diseases as belonging to their 

weightiest problems.§ Many of their number belonged to 

the medical profession, and practised as doctors. 

This happy relation of mutual understanding between 

philosophy and medicine was maintained till a later period, 

and was attended with advantages to both departments of 

learning, drawing the former away from barren speculation 

and towards a secure foundation of facts, and offering the 

latter a deeper comprehension of things and a general 

scientific foundation for professional endeavours and aims. 

THE TIME OF HIPPOKRATES. 

THE medical school at Rhodes appears to have exi 

only a short time : for the later authors make no further 

mention of it.|| In the fifth century before Christ the 

medical school of Kroton was in the highest repute 

owing, no doubt, partly, to its connection with the 

Pythagoreans. The School of KyreneH commanded the 

second position, and there other branches of knowledge, 

* GELLIUS: Noct. Attic, iv, c. 13. 

t HIPPOKRATES op. cit.T. ix, p. 320-386.-SOBANCS: Leben des HIPPOKRATES 

in IDELER: Physici tt medici Graeci minores (Berlin 1841) T. i p 2-c?_ 

JELIANUS: Var. hist, iv, c. 20. ' ' 

t CELSUS: Praef.—SORANUSO/,. «7.p. 252.-3CETHIUS: de musica i, 1. 

§ ARISTOTELES: de respir. c. 8.—CELSUS : Preef. 

GALEN op. cit. T. x, p. 6. 

U HEKODOT. iii, c. 131.


especially mathematics and philosophy, were ardently 

pursued* Not long after this the Asklepiadae-Schools of „ 

Knidos and Kos flourished. Unfortunately the writingst 

of THEOPOMPOS, treating of these, have been lost: but we 

possess in the Hippokratic collection a source giving us 

valuable information concerning their performances and 

individual administration. According to it there existed 

between these two schools essential differences in respect 

of medical theories and methods of investigation and 

treatment. The doctors of Knidos were good observers 

and skilful surgeons, showed an interest in scientific questions 

and liked treatment to be as simple as possible. \ v 

Since, however the work in which their maxims, were 

collected, namely the Knidian Sentences, has not been 

handed down to us, if we wish to form a conception of 

their scientific significance we are obliged to refer to the 

few remarks made upon the subject by other writers of 

antiquity. They proceed for the most part from opponents of 

the Knidian-school and are consequently neither favourable 

nor just. The reproach is made against the latter that it was 

» contented with inquiring into the subjective complaints of 

the sick and in consequence neglected the accurate objective 

investigation of their bodies.^ The Knidian doctors 

were further blamed in that they divided diseases accord-. 

ing to the various parts and organs of the body, and distinguished 

between too many forms of disease. They laid 

it down as a law, for instance, that there were seven kinds 

of diseases of the bile, twelve of the bladder, four of the 

kidneys, as many kinds of strangury, three forms of 

i tetanus, four of jaundice, three of consumption and several 

forms of quinsey, assigning chiefly the exciting causes as 

The points of distinction between them.§ Their descrip- 

* Cf. HouDART : Histoire de la me'decine grecque depuis Esculape jusqu' a 

HIPPOCRATE, Paris 1856, p. 128 et seq. •-1 ; 

f Photii Bibl. p. i2o b ed. BEKKER. 

; 

X HIPPOCRATES op. cit. T. ii, p. 224.

THE TIME OF HIPPO*KRATES. 49 

•tion of the symptoms of disease was short and striking 

as may be seen by the fragment of RuFUS concerning 

nephritis* In chronic diseases they ordered chiefly milk, 

whey and purgatives, for consumption they recommended 

much exercise on foot. EURYPHON, one of the most noted 

doctors of this school who lived in the age of HIPPOKRATES 

and distinguished himself as a medical author,t advised 

consumptives to drink asses' milk or to take women's milk 

straight from the breast, + and as appears from a scene of 

the comic dramatist PLATON he also used moxae in this disease.§ 

Another representative of this School, KTESIAS, 

lived for a long time as body-physician at the Persian 

Court and composed historical works on Persia and India 

and also some medical writings. || Of the remaining 

Knidian doctors of that period we know little more than 

the names.^f Information concerning the school of Knidos 

is more meagre almost than the remains left of its once 

flourishing civilization. 

More favoured by fate was the medical school of Kos.** 

Its merits in connection with medical science have been 

handed down to posterity by HIPPOKRATES—its most renowned 

representative. The doctors of Kos were indebted 

to him for their writings having by later generations been 

made the foundation of the structure of medical teaching 

and for their school being even at the present day named 

with admiration and reverence. 

" A ray of glory fell on her; its glow 

Did straightway immortality bestow." 

* GEuvres de Rufus d'Ephese, ed. par Daremberg et Ruelle, Paris 1879, P> 

'59- 

f GALEN op. cit. T. vi, p. 473 ; xi, 795; xv, 136; xvii, A. 886; xix, 721. 

X GALEN op. tit. T. vii, 701. 

§ GALEN op. cit. T. xviii, A. 149. 

|| DIODOR, ii, c. 32.—CEuvres d'Oribase ed. p. BUSSEMAKER ET DAREMBERG 

Paris 1851-76, T. ii, p. 182.—GALEN op. cit. T. xxiii, A. 731. 

If HOUDART op. cit. p. 255 et seq. 

** M. DUBOIS (De Co insula, Paris 1884) tells us about the excavations 

carried on in the Island of Kos by order of the French Government. 

E

5° ANCIENT TIMES. 

HIPPOKRATES, whose life extended approximately over 

the period between 460-377 B.C. was a scion of an ancient 

family of the Asklepiadaa residing on the island Kos and 

tracing its descent from ASKLEPIOS and HERAKLES. His 

grandfather and father distinguished themselves by their 

medical skill. From the latter HIPPOKRATES received his 

first instruction in medical science. For his more extended 

medical training he betook himself to Athens where he 

received manifold suggestions and instruction. There, at 

that period, flowed in a mighty stream all that Greece 

possessed of the Great, the Beautiful, and the Noble. It 

was the age of PERIKLES—that period of outward splendour, 

of civic prosperity, and of artistic activity, when the spirit 

of Hellenism was celebrating its imperishable triumphs. 

By the side of the philosophers SOKRATES and PLATO were 

to be seen the great tragic poets EURIPIDES and SOPHOKLES, 

the historian THUKYDIDES, the sculptor PHEIDIAS and the 

Architect lNNESlKLES,'who were filling the world with their 

fame, while the comic dramatist ARISTOPHANES and the lyric 

poets ION of Chios and DiONYSiOS attuned men's minds to 

happiness and serenity. Athens was adorned with splendid 

buildings ; there arose the Propylasa, the Temple of Athene 

with its rich ornamentation of statues and sculpture, the 

imposing broad steps leading to the Akropolis, and the 

Odeion, while PHEIDEAS was creating the Olympian Zeus 

and the two statues of Pallas Athene. Impressions 

such as these must have exercised an influence upon 

the spiritual development of HIPPOKRATES; must have 

stimulated his ambition and fortified his energies. He 

sought the opportunity, in his intercourse with prominent 

doctors and philosophers, to perfect himself in his own 

province, and soon it was his lot to occupy a distinguished 

position in this sphere. His successful cures caused him 

to be much sought after as a doctor and his fame began to 

overstep the limits of his native land. He was summoned 

first to this and then to that town in order to give professional 

advice in difficult cases. His renown brought him a

THE TIME OF HIPPOKRATES. 

multitude of pupils who hoped under his guidance to train 

themselves into becoming skilful doctors* Among these 

were his sons THESSALOS and DRAKON and his son-in-law 

POLYBOS. THESSALOS, if his speech to the Athenianst 

contained in the pseudo-Hippokratic writings and dating 

from early times, is founded on fact, took part in his youth, 

as military surgeon, in the expedition of ALKIBIADES 

against Sicily: he lived later as body-physician at the 

court of King ARCHELAOS of Macedonia J and was 

esteemed as the author of numerous writings, of the 

Hippokratic collection.§ That certain portions of these 

proceed from POLYBOS is a fact historically authenticated : 

for ARISTOTLE cites a fragment upon the distribution of the 

blood vessels from a book of POLYBOS which is found word 

for word in the Hippokratic writing upon the nature of 

man. || POLYBOS practised in Kos and at a later period 

gave instruction in medicine in the place of his father-in- 

Jaw.^f Around the life of HIPPOKRATES a multitude of 

traditions and legends are crowded, only a few of which 

•can have truth in them. Thus the tale that he burned the 

library of Knidos ** or the Temple of ASKLEPIOS in his 

native town ft so that he might appear as the discoverer of 

medical learning contained in the inscriptions there and 

•which he appropriated to himself,—this tale which contradicts 

all that we know of the character of HIPPOKRATES 

is certainly false. Had he perpetrated an incendiary act of 

this kind, worthy of HEROSTRATOS, instead of the universal 

reverence which was paid to him in- ancient times, he would 

•only have met with scorn, however important a man he 

* HIPPOKRATES op. cit. T. ix, p. 420.—SORANUS op. cit. p. 254. 

f HIPPOKRATES op. cit. T. ix, 404. 

X GALEN op. cit. T. xv, p. 12. 

§ GALEN op. cit. T. vii, 855,89c. ix, 859. xvii, A. 796, 882. 

|| Cf. ARISTOTELES : Hist. Animal, iii, c. 3.—HIPPOKRATFS op. cit. T. vi, 

p. 58, and GALEN op. cit. T. iv, 653. xv, 108, 175. xyiii. A. 8. 

If GALEN op. cit.T. xv, n. 

** SORANUS op. cit. p. 253. 

ft PLINIUS: Hist. Nat. xxix, c. 1. 

51


5 

might have been in his profession. The writings ascribed 

to him bespeak genuine philanthropy, sincere religious 

feeling, and glowing patriotism. From the prevailing petty 

agitations of political or social parties he held himself 

aloof and lived only for his science and his calling. The 

words which EURIPIDES addresses to the Natural Philo 

sopher may be applied to him : 

" Oh ! happy the man 

Who exploring the realms of knowledge has thoroughly surveyed them. 

Thought does not lead him towards strife pernicious to the citizens 

Or to a deed of wrong: 

He thoroughly investigates the never-aging Universe 

Of the Everlasting Mother—Nature ;-how it came into being: 

Never harbours in the heart of the upright man 

A thought of shameful actions." 

HIPPOKRATES passed the last years of his life in Thessaly : 

and there he is said to have died. Even up to the time of 

SORANUS* his tomb was pointed out in the district 

between Gyrton and Larissa: on it a swarm of bees had 

settled, and the honey thence derived was considered to 

have the power of healing sores in the mouths of children. 

The high importance of HIPPOKRATES was already recognized 

by his contemporaries. PLATO t compared him with 

POLYKLEITOS and PHEIDIAS, and ARISTOTLE X called him 

the 'Great' HIPPOKRATES. His writings were preserved 

by his successors with the works of the other members of 

his family and served them for medical teaching and for 

instruction when they had need of counsel in their professional 

practice. When the Ptolemies began to found a 

library and with this object caused the works of the most 

celebrated authors to be bought, transcripts of the Hippokratic 

collection reached Alexandria. Through the unprincipled 

acts of interested speculators, who turned the 

love for books manifested by Egyptian kings to their own 

account, the opportunity was seized upon for ascribing to 

renowned authors many works not belonging to them in 

* Op. cit. p. 254. t Protagoras c. 3. J Polit. vii, 4.

THE TIME OF HIPPOKRATES. 53 

order to increase their selling value * The librarians who 

were charged with the inspection and examination of the 

acquired books did not always possess the knowledge and 

means necessary to distinguish the true from the false or to 

make certain of the authenticity of documents. Thus it 

came about that certain works were declared to be by 

authors who really had had no hand in them. The Hippokratic 

writings among others met with this fate : even at 

that time people had been at work upon them with the 

result that essential differences had been introduced into 

the text.t Can we wonder then if to the collection which 

originally contained only the works of HIPPOKRATES and 

of his nearest relatives, other writings have been added 

which did not emanate from them at all.J The transcribers, 

who used the manuscripts at hand in the libraries to copy 

from, contributed to this, by giving confirmation and more 

general acceptance to certain writings as of real Hippokratic 

origin, and bold editors increased the error by 

arbitrary additions to, and enlargements and alterations 

of, the text.§ When GALEN wrote his commentary to the 

works of HIPPOKRATES he had before him a copy of the 

text with many different readings : he followed the plan, as 

he says himself, || of always considering the most ancient 

reading as the correct one. Under these circumstances it 

is conceivable that even in very ancient times differences 

of opinion prevailed as to which writings were really composed 

by HIPPOKRATES and which were not. This question 

has exercised the ingenuity of the learned and of critics up 

to the most recent times, and even in the last few years 

LlTTRE, ERMERINS, KUHLEWEIN and others have made 

attempts to bring it nearer solution. In its present form 

* GALEN op. cit. T. xvi, 5. 

f GALEN op. cit. T. xvii, A. 606. 

X Cf. the letter of ST. AUGUSTINE to FAUSTUS, the ManicfiEean, L. 7,3, 6 (T. 

vi, p. 493. Edit. FROBEN 1556). 

§ GALEN op. cit. T. xv, 21. xvii, A. 795. 

|| GALEN op. cit. xvii, A. 1005.


the collection of medical writings known by the name 

of the Hippokratic collection contains, by the side of a 

great number of treatises which without any doubt were 

composed by him and his nearest relatives, a mass of 

writings not less in quantity which came from other 

authors. Almost all belonged to the age of HIPPOKRATES, 

only a few additions coming from an earlier or 

later period. They furnish a complete survey of the 

medical acquirements possessed by people in the age of 

HIPPOKRATES and give us important information regarding 

the regulation of medical teaching and the position of the 

medical profession which with the help of other notices of 

the subject in literature we will try to illustrate in an 

accurate way. 

It was generally recognized that the art of healing is 

not to be transferred from one person to another in any 

mysterious manner but has to be learned like any other 

art and that for this purpose recourse must be had to 

teachers who understand it, and are skilled in the 

practice of it.* The doctors' calling stood open to all. 

Medical studies began in early youth.f The teaching was 

probably organized in the same way as in the Platonic 

academies and other schools of philosophy; a teacher 

undertook the whole medical training of a student and 

made him acquainted with everything worth knowing in 

the various branches of medicine. He only was allow r ed to 

act as a teacher who was in actual practice, and who 

appeared to unite knowledge and experience in medicine. 

He demanded an honorarium from the students whose 

medical training he undertook, for the teaching 

given by him ; this was secured by an agreement and 

was sometimes pretty considerable. On the entry of a 

pupil on his course of study care was taken to see that he 

was in good health; for the doctor must appear healthy in 

which case the people think " that he is at liberty to look 

* PLATO : Ion. c. 8. Gorgias c. 14, on the civic qualification (beginning). 

f PLATO: Rep. L. iii, c. 16. HIPPOKRATES op. cit. T. iv. p. 638.


after the health of others."* The author of the Hippo 

kratic writing "on the Physician" takes this opportunity 

of making the amusing remark that it is also advantageous 

for a doctor to be "fairly plump in body"; unfortunately 

he omits to inform us whether the confidence of the patients 

m this case depended upon their belief that fat men are 

kinder than thin, or whether their plumpness suggested a 

larger income and consequently a more extensive practice. 

Furthermore it was enjoined upon doctors " to keep them 

selves clean, to be respectably dressed, and to make use of 

sweet ointments spreading an agreeable, but not suspicious, 

aroma."t Many seem to have given too great weight to 

this piece of advice, so that there was opportunity given for 

making merry over practitioners "Adorned with curls on 

the forehead and oiled, and overburthened with rings."! 

"The doctor, like a prudent man, will be careful to ob 

serve silence on many matters and in intercourse with his 

patients to maintain a becoming demeanour. Good manners 

have a most favourable influence on public opinion." 

'•'When he acts inconsiderately or rashly, he will be 

blamed." " Let there be deep thought without ill-humour 

in his lineaments : he must not appear arrogant or misan 

thropic. Whoso bursts out laughing and is unrestrained 

in his behaviour will be considered—an uncultivated man. 

This must be avoided. It is highly important that the 

doctor should know how to conduct himself properly: for 

his relations to his patients then become very close. Not 

only these are committed to the hands of the doctor but in 

treating them he has also to do with their wives and 

daughters and property. It is worth a man's while to be 

master of himself."§ In another Hippokratic writing it is 

said that "the doctor should assume a certain courtliness 

of manner, for a rough disposition is displeasing to the 

* HIPPOKRATES op. tit. T. ix, 204. 

t HIPPOKRATES op. cit. T. ix, p. 266. 

X ARISTOPHANES: Clouds: v, 330. 

§ HIPPOKRATES op. tit. T. ix, 206.


healthy and the sick alike." And again "he should not 

chatter too much with the people but only say what is 

necessary and what appertains to the treatment." Like a 

true philosopher he must strive " to be free from covetousness, 

to be reserved, modest, dignified, to form opinions and 

judgments for himself, to be of a peaceful disposition, 

sociable and of pure morals; he must speak intelligently, 

and should acquire prudent habits in life, must be on his 

guard against vice and superstition, and be distinguished 

for piety."* The author of the book " on the Sacred 

Disease " gives expression in one place to belief in the 

power and goodness of God; he is speaking of the idea 

that diseases are sent by God and he makes use of these 

beautiful words : " I cannot believe that there is any defilement 

of the body of man caused by God—injury to the 

lowest by an act of the Highest. Should a blemish be 

caused to it or a hurt inflicted upon it by anyone, the Deity 

is much more ready to cleanse and restore it than to cause 

it further abasement; for God it is who purifies us from the 

heaviest afflictions and takes away their stains."f 

Beside this ethical training of the doctor his scientific 

education was not neglected. This matter was entered on 

with the correct view that the normal relations of the body 

must be first studied, J since the knowledge of these forms 

the groundwork of all medical acquirements^ Anatomy 

was for the most part pursued upon the bodies of the lower 

animals. The dissection of the human body was made difficult 

by religious and social prejudices. Only in the case of 

enemies and traitors to the state or of heinous criminals 

was examination of the human body possible. Opportunities 

of this kind were certainly made use of by doctors 

seeking for information to confirm and augment their 

anatomical knowledge. The corpses of children left out 

* HIPPOKRATES op. cit. T. ix, 232-234. 

t HIPPOKRATES op. cit. T. vi, 362. 

+ Cf. PLATO: Laws, I., xii, c. 10. 

§ HIPPOKRATES op. cit. T. vi, 278.—ARISTOTLE : Eth. Nicom. i, 13.

THE TIME OF HIPPOKRATES., 

to die must also have attracted their attention. So too 

may the glimpses into the structure of the body afforded by 

external wounds have been not without result. Various 

accounts point to the fact that there was no shrinking with 

horror from opening and examining the human body* 

Even if no scientific aims were pursued in these investigations, 

evidence is nevertheless afforded that anatomical investigations 

were possible. That these were actually undertaken 

is an assumption of great probability in consequence of 

certain remarks of ARISTOTLE and the Hippokratic writers 

and above all in view of the extent of the anatomical knowledge 

of that period. The author of the Hippokratic 

treatise "on the joints" says incidentally of dislocation of 

the spine that it is permitted in the dead, but not in the 

living, to open the body by incision in order to reduce the 

dislocation by the hand, and in the lecture " on the Heart " 

the statement is made that this organ is to be withdrawn 

from the body of a dead person for the purpose of examination 

in the manner customary for a long time previously.t 

A passage in the 5th book of the Epidemics speaks indeed 

of a dissection which was undertaken for the purpose of 

determining the origin and extent of a disease.^ Speaking 

generally they appear to have confined themselves to 

opening the thoracic and abdominal cavities; and the 

position and form of the contained organs are fairly 

correctly described. ARISTOTLE who on various occasions 

drew comparisons between the structure of the human body 

and that of the lower animals declared that the internal 

organs of man were as yet but little known.§ Certainly, 

the knowledge possessed by the doctors, of the Hippokratic 

period, of the brain, nerves, vessels and even muscles was 

scanty and deficient. On the other hand, the bones were 

* PLINIUS: Hist. Nat, xi, 70.—VALER. MAXIM, i, 8, 15.—PAUSANIAS iv, 9. 

—HEHODOT. ix, 83. 

f HIPPOKRATES op. tit. T. iv, 198. vi, 16. ix, 88.—GALEN ii, 280. 

X HIPPOKRATES op. cit. T. v, 224.—ARISTOTLE : de part, anim : iv, 2. 

§ ARISTOTLE: Hist. anim. i, 16.


very exactly described and even minute particulars noticed 

about them which only strike one on very careful examination. 

That human bones served chiefly as objects for study 

appears certain from the descriptions. If the examination 

of the human body or of parts of the same was the privilege 

only of certain prominent investigators, nevertheless the 

dissection of animals, which, as ARISTOTLE more than once 

observes, formed the principal source of anatomical knowledge, 

was accessible to everyone. This no doubt formed 

an essential assistance in anatomical teaching. Perhaps 

artificial imitations of skeletons were used for this purpose 

like that one which was preserved as a votive offering at 

Delphi and originally, according to UPORT, came from 

HIPPOKRATES.* Broadly, anatomical teaching consisted 

in this, that the teacher imparted to his pupils what he 

himself knew or thought about the structure and composition 

of the human body. It was the same with instruction 

in physiology, which consisted of a loose fabric of unfounded 

hypotheses and unsupported speculations. Training in the 

examination and treatment of the sick promised much 

greater results. The doctors of ancient Greece were masters 

in the art of observing the symptoms of diseases and in 

controlling them in ways conformable to nature. To the 

complaints of the sick and even to their dreams they paid 

great attention; but they attached the greatest weight to a 

close examination of the ailing body. In performing this 

the colour and condition of the skin and mucous membrane 

were observed, as also the state of the abdomen and the 

form of the thorax ; the temperature was tested by application 

of the hand; and the excretions were subjected to a 

.careful examination. By the touch they were able to 

recognize the size of the liver and spleen: nay, even the 

change in form of the latter which occurs in certain diseases.f 

Succussion served them at the same time for diagnosis and 

for therapeusis as pus might thus be caused to break through 

* PAUSANIAS X, 2, 4. 

t HIPPOKRATES op. cit. T. vii, 244. —PLATO : Timaeos, c. 33.


into the bronchial tubes. They were acquainted with the 

pleuritic friction-sound and with vesicular crepitation which 

were compared with the creaking of leather and the boiling 

of vinegar respectively.* In this connection it is expressly 

stated that the ear was placed for a considerable time 

against the chest-wall to enable the sounds to be heard 

(TTOWOV yjiovov wpotrk^wv TO oy? aKovaZprj 7rpo? ra irkevpd). 

The descriptions of individual diseases and of their course, 

as they mostly lend themselves to observation in private 

practice are admirable. Certain particular descriptions, as 

those of pneumonia, pleuritis, and phthisis, (which they 

considered contagious,) are so complete that even now 

little can be added to them. Among the causes of disease, 

in addition to the influence of heredity and defects of diet 

much also was ascribed to climate, nature of soil, the 

quality of the drinking-water, the time of year, the winds 

and the temperature. Prognosis stands on a high grade of 

development. In the Hippokratic writings a number of 

symptoms are mentioned which foretell a favourable or 

unfavourable termination to diseases. The doctors valued 

very highly the art of " predicting the future from the past 

and present." " Truly" writes the author of the 

Prognostics, " it is better to cure diseases than to foretell 

their course, but this is unfortunately not always possible."t 

In other passages the doctors are exhorted to observe 

caution in prognosis and are warned against asserting more 

than they can be answerable for.J The Hippokratic doctors 

have earned for themselves imperishable fame by their 

therapeutic principles which have endured from their time 

to ours. The high importance of dietetics was recognized 

by them in such a way as is seldom the case among their 

representatives of a later age. In a life spent in accord 

ance with natural laws, in the use of baths, in exercise of 

the body and in wholesome nourishment they saw the best 

* HIPPOKRATES op. cit. T. vi, 24. vii, 92, 94. 

f HIPPOKRATES op. cit. T. ii, no. 

X HIPPOKRATES op. tit. T. ix, 6 et seq.


means of avoiding illness. The doctor was looked upon as 

the hodman of Nature, whose efforts to heal it was his duty 

to second and imitate. Above all things he had to 

endeavour to remove the causes of the complaint if possible, 

in his general treatment to have regard to the special circumstances 

of the case, and especially to keep his attention 

fixed rather upon the patient than the disease: he had to 

be careful always to render aid or at least never to do any 

harm.* 

The therapeutic agents used were chiefly of a dietetic 

nature: but mention is made of the more important 

drugs of the materia medica, which are still ordered at the 

present day. They were used as lotions, fomentations, 

injections, clysters or draughts. For blood-letting they 

employed venesection, scarification, and cupping. All these 

things were not only taught to the students in theoretical 

discourses but were also pointed out and explained at the 

bed-side. With this object they either accompanied the 

teacher in his professional visits f or received the necessary 

instruction in the Iatreion attached to his residence.:}: 

The latter was an institution like our private sanatorium, in 

which patients obtained medical advice, received medicines, 

were operated upon, and sometimes stayed and were taken 

•care of for a considerable time.§ They were, as is mentioned 

in the Hippokratic treatise " on the Doctor," so 

situated as to be sheltered from the wind and the dazzling 

sunshine for " if for the doctor engaged in his work the 

sunshine is not unpleasant, to the patient it is troublesome, 

and injurious to his eyes." "The chairs must, as far as 

possible, be all of a similar height. Only the instruments 

should be made of bronze : for it seems a superfluous luxury 

to have the utensils of this metal. The drinking-water 

supplied to the patients must be agreeable and pure." 

* HIPPOKRATES op. cit. T. i, 624. ii, 634. v, 314. vi, 92, 490. 

f PLATO : Gorgias, c. ii. 

X HIPPOKRATES op. cit. T. ix, 206 el seq.—ÊSCHINES in Timarch. 124. 

§ PLATO: "Laws,'' i, 14. Repub. iii, 13, 14.—HIPPOKRATES op. cit.T. ii, 

•604. iii, 272 et seq. ix, 206 etseq.—ARISTOPHANES: Acharn, v, 1030.

THE TIME OF HIPPOKRATES. 6l 

' The napkins must be kept clean and be of soft texture as 

also the linen used for the eyes and the sponges for the 

wounds for these things are of great importance for the 

healing. The instruments must be adapted in size, hard 

ness, and delicacy to the purpose for which they are 

used." In the Iatreia besides surgical instruments there 

were always at hand sponges^ clean soft linen, slings, 

bandages, cupping glasses, porringers, enema syringes, 

basins, bathing-tubs, etc. The metal of which these objects 

were made, imparted to the whole a very bright aspect* 

The number of Iatreia possessed by a place depended 

upon its wants in this respect. " Where many diseases pre 

vail " writes PLATO f " there are also many Iatreia." The 

doctors prepared the medicines themselves, and bought the 

substances used for this purpose from simplers or else col 

lected them themselves. There were no apothecaries in 

our sense of the word: for the pharmacopolae not only 

traded in drugs and special preparations but also sold other 

things such as amulets, burning glasses and curiosities of 

all kinds. J His students and assistants stood by the doctor 

while compounding the drugs, performing operations, and 

generally during the treatment of the sick. The assistants 

were, as PLATO says, also called doctors. Students too 

were employed in this service, especially such as already 

possessed some knowledge of the healing art " so that they, 

upon occasion, could give directions and apply remedies 

without hesitation." The duty also devolved upon them of 

watching over the state of health of the patient during the 

absence of the doctor, their teacher, "so that nothing- 

which had occurred in the interval should remain unknown 

to him." The Hippokratic author gives strict warnings 

upon this point not " to entrust such duties to the 

inexperienced : for if a mistake is made the blame falls 

upon the doctor." The students were also instructed in the 

* ANTIPHANES in POLLUX : Onom.x, 46. 

t PLATO : Rep. iii, 13. 

X CJ. W. A. BECKER : Charikles iii. S. 52, Leipzig 1854. 2 Aufl. 

Jl


H- • 

use of surgical instruments and apparatus* " In surgical 

operations the assistants," as is described in The Doctor's 

laboratory,' " in part hold forth that, part of the body on 

which the operation is performed and in part hold the rest 

of the body secure: and while thus employed must 

observe silence, only listening to what the master says." 

" The instruments must be so placed that they are not in 

the way but are ready to hand when required. If one 

of the students hands them to the operator he should lay 

them out in order for himself beforehand and be prepared 

to execute the orders of the operator." Complete directions 

were given to the operator concerning his clothing, 

his attitude, the manner in which he; should hold his arms 

and how he should place his feet during the operation. 

" The nails ought not to project beyond the finger tips and 

tftet not to be too short, since use is made of the tips of the 

fingers. A man should test this on himself by moving the 

fore-finger against the thumb, bending the hand so as to 

present a level surface with the finger tips, and then 

pressing one hand against the other. It is a very favourable 

circumstance for a doctor if the spaces between the 

fingers of his hand are large and if the thumb is in good 

opposition to the forefinger." " He must accustom himself 

to the use of both hands and be able to accomplish the 

same tasks with one hand as well, as nicely, with equal 

celerity and order, as with the other, without its being 

tedious or difficult for him."f The doctors of the Hippokratic 

period practised surgery as well as internal medicine. 

It appears that as yet there were no specialists]: though 

some doctors no doubt by ^preference gave special attention 

to particular departments of medical science, for 

instance the treatment of the eyes or teeth.§ Surgery 

was in a very imperfect state, which is explained by the 

neglect of anatomy. 

* HIPPOKRATES op. cit. T. ix, 216. 

t PLATO: Laws iv, 10.—HIPPOKRATES op. cit.m, 278 et seq., 288. ix, 242. 

X CICERO : ,de oratore iii, 333. 

§ Cf. BKCKER op cit. S. 59.


The tying of vessels for the purpose of arresting the 

flow of blood was not yet known and therefore it was 

impossible to risk such operations as amputations and the 

removal of large tumours which entail a free loss of blood. 

On the other hand trepanning, the operation for empyema, 

paracentesis abdominis, and similar operations where the 

loss of blood is insignificant, were carried out. 

The descriptions and treatment of wounds and fistulse 

but especially that of dislocations and fractures deserve 

recognition. Here the experience gained in the gymnasia 

must have materially contributed to pave the way for a 

simple and natural method of cure. Fractures and dislocations, 

which occurred in the practice of gymnastics 

demanded prompt assistance and the teachers installed at 

the gymnasia must have acquired a certain amount of 

knowledge in these matters to enable them to make the 

necessary preparations for such accidents. If they were 

endowed with good powers of observation and practical 

dexterity they could not have failed to take notice of other 

ailments which came in their way. Through the study of 

medical treatises and intercourse with doctors they then 

sought to obtain enlightenment and confirmation on the 

subjects of their private experiences. Certain gymnasts, 

as IKKOS and HERODIKOS the latter of whom, as PLATO 

says, associated medicine with gymnastics, gained great 

reputation for themselves by their medical ability. They 

made use principally of dietetic means of cure, vapour 

baths, ointments, frictions and exercise of the body, as in 

long runs* At the same time we must not look upon the 

gymnasts as doctors. PHILOSTRATOS defines in his book 

" on Gymnastics" the position of gymnasts and their 

relations to the healing art, in a short and striking manner, 

when he says " that their appropriate work consists in such 

matters as these—dispersing collections of fluid, removing 

superfluous material, making hard places soft, making other 

* PLATO: Rep. iii, 14. Protagoras c 8. Phadros c. 1.—HIPPOKRATES op. 

cit. T. v, 302.—PLINIUS: His. Nat. xxix, 2.


parts fat, modifying the shape or raising the temperature 

of parts," whereas in serious organic diseases, in wounds, 

and affections of the eyes and matters of that kind, applica 

tion was made to the doctor.* 

The Hippokratic doctors possessed fairly advanced knowledge 

in gynaecology. They were acquainted with various " 

alterations in the position of the uterus, with the prolapse of 

this organ, and with a great number of diseases of the female 

sexual organs. Midwifery was in the hands of midwives and 

only in difficult cases was the help of the doctor sought. They 

trusted to the workings of Nature and interfered only when 

danger menaced the life of mother or child. In abnormal 

presentations they employed turning; prolapsed extremities ;'; 

were replaced or when this was impossible, separated from . 

the body.t SOKRATES the son of " the stout and dignified^ 

midwife PH>ENARETE," as he calls himself with pride, has 

left us some information about the vocation of the midwife. 

Women who devoted themselves to the business must have 

borne children but must also have reached the age at which. 

they could no more become pregnant. They gave information 

whether of not the birth was near at hand, endeavoured . 

by medicines and psychical means to hasten it, tried to*, 

alleviate the pain, and divided the umbilical cord after the 

birth. When they considered it necessary they producedabortion. 

Along with this they carried on the no doubt very 

lucrative business of match-making attaching themselves to 

it of course on more grounds than one. J Many midwives, 

it appears, took pregnant women into their homes.§ 

No information has unfortunately reached us con- • 

cerning the professional training of midwives. Probably 

they were instructed in their duties by an old colleague* 

who was already rich in experiences of this field of activity^ „ 

Does not a tradition worked into poetry, that the practice A; 

* PHILOSTRATOS : to irepl yvfivaar^g, Jidit. Daremberg, Paris 1858. 

f HIPPOKRATES op. cit. T. viii, 146 et seq., 480, 512. 

+ PLATO Theaetetos, c. 6. > % 

§ ARISTOPHANES: Lysistratos v,


of midwifery was at first confined to men and was given 

over to women only after they had received instruction 

from men, point to the fact that the midwives owed their 

medical knowledge to the doctors?* 

_ Medical practice was permitted to everyone who con 

sidered that he possessed the requisite knowledge. The 

doctors treated patients, as has been already said, either 

in the Iatreia or else visited them professionally in their 

own homes. In the Hippokratic writings and especially 

in the "Epidemics" a number of cases of illness are 

mentioned and in every instance the residences of the 

patients are given. In their visits the doctors took 

with them certain of their assistants and pupils and 

charged them with many of the functions appertaining 

to the treatment. Thus they had firmly fixed in their mind 

" the medicines and their properties and all that has been 

written upon the subject " as also the methods of treatment, 

before they trusted themselves with the sick. " On enter 

ing a sick room a man should sit down, show a modest 

dignified demeanour, should not speak too much or let 

himself become embarrassed. He then should approach the 

patient, pay attention to him, reply to his complaints, 

remove any hindrances to his repose, criticize any want of 

order,, and be prepared to render any service." These 

visits must be frequently repeated, in which way any 

mistakes can be corrected. The doctor must take care to 

see how the sleeping apartment of his patients is situated, 

and whether they are disturbed by noise or annoyed by 

strong smells and in such a case he must urge with tact but 

with firmness that such conditions be improved.f In 

serious cases of illness consultations between several 

doctors took place " for it is no subject for shame " as is 

stated in the Hippokratic treatises " if a doctor, who in a 

"given case of disease is in doubt and from want of ex 

perience does not see to the bottom of the circumstances 

•'•* HYGINUS: fabul. 274.—WELCKER op. cit. S. 195 et seq. 

r».v f HIPPOKRATES ofi. cit. T. ix, 238 et seq.


attending it, calls in other doctors so that he may confer 

with them and place on a firmer basis the treatment for 

the relief of the patient."* 

Many doctors practised not only at their own place of 

residence but even undertook journeys for this purpose. 

On these occasions they took instruments with them which 

were of simple manufacture and easy to carry, t The 

doctors were entitled to demand a fee for services rendered 

to patients. J But the Hippokratic author exhorts them " to 

allow themselves to be influenced only by the motive of 

gaining in this way a greater opportunity for improving 

their knowledge. They were also to conduct themselves 

in this respect in not too sordid a spirit, but to consider the 

means and position of the patient, sometimes indeed to 

afford gratuitous aid and to consider that the recollection 

of a good deed is of more value than a temporary profit. 

The opportunity should not be neglected of helping a 

stranger or a poor man, for a love for humanity goes hand 

in hand with a love for knowledge." § 

Quite at an early period the practice of paying doctors 

out of public funds was instituted, the obligation being 

laid on them of treating patients without further charge. 

This regulation must have existed before CHARONDAS (7th 

century B.C.).|| In any case it was, an ancient institution, 

and DEMOKEDES who was mentioned in the preceding 

chapter affords a well-known instance of it from the sixth . 

century B.C. for he, before coming to Darius, had been district 

medical officer in Êgina with the yearly pay of a talent, was 

then appointed to a similar post in Athens with a salary of 

one hundred minae, and was called thence to Samos by POLY- 

KRATES, who settled upon him the salary of two talents.^f 

* HIPPOKRATES op. cit. T. ix, 260, 262. 

t HIPPOKRATES op, cit. T. ix, 236. 

X PLATO : Politikos, c. 37.—ARISTOTLE : Rep. iii, 16.—XENOPHON : Memorabil. 

i, 2, 54.—PLINIUS: Hist. Nat. xxix, 2. 

§ HIPPOKRATES op. cit. T. ix, 258. 

|| Diodor. xii, 13. 

% Herodot. iii, 131.


The BrjfwatevovTe,, the " people's doctors " were elected by 

the community. In Athens, the candidates desirous of 

idling such posts had to present themselves at a public 

meeting of the citizens, to give information concerning 

their education and to name the master from whom they 

had learned the healing art. In the election, which probably 

was conducted in the same way as those of other 

public officers, the most able candidate came off victorious.* 

Similar to that of Athens must have been the procedure 

for.the appointment of public medical officers in the other 

towns of Greece. Their salaries were levied upon the town 

and its environs, as were the sums required for providing 

music and other things for the public advantage. In an 

inscription discovered at Delphi which however dates from 

a somewhat later period (214-163 B.C.) it is mentioned that 

some had immunity from this tax.f Besides the State 

subsidy the amount of which depended upon the work 

the doctors had to do and the wealth of the town, the 

public medical officers probably had an Iatreion erected and 

maintained at the cost of the public.} There they received 

patients who sought professional assistance at their hands, 

and imparted medical teaching. The public medical officers 

were summoned in the case of epidemics to give directions 

calculated to remove the same, and attended the authorities 

as experts. Their particular duty, however, consisted in 

the treatment of sick people without charge. The public 

in establishing a doctor in this way wished especially to 

assure themselves that in case of necessity their citizens 

should at all times find medical aid at hand. Although 

from the information that has reached us it is not certain 

that free treatment was exclusively for the poor, it may be 

assumed that this was practically the case and people of 

* XENOPHON : Memorab. iv, 25.—PLATO: Gorgias, C. IC, 70.— Politikos, c. 

2 > 37-—Cf- also BOCKH: Staatshaushalt der Athener 1, c. 21. 

f C. WESCHER and P. FOUCART : Inscriptions k Delphes, Paris 1863, p. 20, 

No. 16. 

X Cf. VERCOUTRE : " La Medecine publique dans l'antiquite grecque" in the 

.Revue Archeologique, Paris 1880, Ser. ii, T. 39, p. 332.


means showed their recognition of the doctor's services by 

presents. < , 

Just as the Greeks originated the institution of public 

medical officers, so too did they take care that their troops 

were provided with doctors. LYKURGOS considered this 

an important matter and appointed medical officers to the 

Spartan army* Among the " ten thousand " commanded 

by XENOPHON there were eight military medical officers, f 

THESSALOS the elder son of HIPPOKRATES must have been 

practically a military medical officer for a certain time, and 

the author of the HIPPOKRATIC treatise " on the Doctor" 

writes "that the doctor gives himself the best training in 

surgery by entering on service with an army : " and he also 

takes occasion to remark that already a distinct literature 

of military medical science existed, in which the wounds 

met with in war were described.} The Army of ALEXANDER 

of Macedon was accompanied by PHILIPPOS of Akarnania, 

KALLISTHENES of Olynthia, GLAUKIAS and ALEXIPPOS—all 

celebrated doctors of that period. 

The medical profession enjoyed high consideration. The 

expression of HOMER§ "that a single doctor is as valuable 

as many other men put together" was held to be true at a 

later period also. Doctors who distinguished themselves by 

unselfish devotion and remarkable performances in their 

calling and deserved well of their country were rewarded 

with eulogies and honours. On the bronze tablet of Idalion 

which dates from the 5th century B.C. the services of the 

doctor ONASILOS are commemorated : he served in war with 

his pupils gratuitously and received in consequence a grant 

and exemption from taxes. || The Athenians are reported 

to have overwhelmed HIPPOKRATES with honours, initiated 

* XENOPHON : on the Government of Sparta, c. 13. 

f XENOPHON : Cyropasd. i, 6, 15.—Anabasis iii, 4, 30. 

X HIPPOKRATES op. cit, T. ix, 220. 

§ llias xi, 514. 

|| M. SCHMIDT: Der Inschrift von Idalion, Jena 1875, and Sammlung 

Kyprischer Inschriften, 1876, Taf. 1..


him into the Eleusinian mysteries at the public expense, 

crowned him with a golden crown, and distinguished him 

in other ways.* The doctor EUENOR who, as is stated in 

an inscription of the year 388 B.C.,t " being entrusted by 

the people with the superintendence of the preparation of 

medicines for the public Iatreion, for this purpose has 

devoted a large sum out of his private means and has 

treated many sick people gratuitously," was publicly praised 

for this act and was honoured with a wreath and by having 

conferred on him rights of citizenship. In the inscription 

of Karpathos which WESCHERj ascribes to the end of the 

4th or beginning of the 3rd century B.C. it is stated " that 

in consideration that MENOKRITOS, the son of METRO- 

DOROS of Samos in his position of public medical officer 

has devoted himself for more than twenty years with zeal 

and devotion to the care of the sick and has comported 

himself with spotless integrity in his professional capacity 

and in his private life ; in consideration further that during 

a pestilence which broke out in the town and exposed to 

great danger both natives and strangers, by his self-sacrifice 

and frugality he contributed chiefly to restore health; in 

consideration finally that instead of demanding payment 

he willingly lived in indigence, saved many citizens in 

dangerous diseases without receiving any reward, as would 

have been only right and just, and that he never refused to 

visit sick people living in the environs of the town—the 

people of Brykontion have decided to honour him and to 

adorn him with a golden wreath and to cause this decree 

to be proclaimed publicly at the games of Asklepios and 

further to confer on him the privilege of participation in all 

festivals of the people of Brykontion and to erect to him a 

marble statue in the temple of Neptune on which this 

decree of the people extolling him, shall be inscribed." 

* HIPPOKRATES op. cit. T.ix, 402. 

t RHANGABE : Antiquites hellen. 1855, T. ii, No. 378.— E. CURTIUS in d. 

Gott. gelehrt. Anz. 1856, No. 196 et seq. 

| Revue Archeologique, Paris 1863, T. viii, p. 469.


Certain authors,* relying upon the isolated judgments of 

doctrinaire philosophers, have considered that the medical 

profession since it was practised for money and was classed 

among the "handicrafts of citizens"—for so the word 

8r)/jLLovpyia may be translated —did not meet with its due 

share of respect among the Greeks. But PLATO says 

expressly that "the true doctor follows a nobler object 

than the making of money" and that the healing art 

even if it is practised for rewards yet is not mercenary.f 

Although he writes in the " Laws " that the health of the 

body does not belong to those goods which are of primary 

importance to the State, yet he declares it to be a duty 

of the State to take care that able doctors are trained 

up:j The amount of esteem given to the doctor 

depended, as it always has', upon the individuality of the 

doctor himself, his acquirements, his endowments in the 

qualities of intelligence and of sympathy, and upon the out 

ward conduct of his life. A slave, who as the assistant 

of a doctor, acquired an important amount of information 

and manifested great devotion and industry, remained 

however still in a subordinate dependent position. It 

seems moreover that the doctors derived from the slave 

class did not have such a technical education as other 

doctors but learned their art in a purely empirical manner. 

" If any one" says PLATO " should care to exchange some 

philosophic conversation with such a man upon the struc 

ture and functions of the body he would assuredly enjoy a 

hearty laugh and exclaim : ' Thou fool! thou art no doctor 

but the dry-nurse of thy patients.' " § 

In judging of a doctor his scientific education served very 

certainly as an important point for consideration. Ignorant 

and unskilful doctors were laughed at and mocked and given 

* Cf. K. F. HERMANN : Lehrbuch der griech. Privat-Alterthumer, Heidelberg 

1852, iii, S. 192. 

+ PLATO: Rep. i, c. 15, 18. 

X PLATO : Laws i, 6.—Rep. iii, 16. 

§ PLATO : Laws iv, 10. ix, 4.


over to public scorn. In the Hippokratic " Law " they are 

likened to the supernumeraries in a theatre " who appear to 

be actors, are clothed and wear masks like them and yet 

are only so in name, not in reality." * In another place it 

is said that it is with unskilful doctors as with bad pilots. 

u If they alter the rudder and commit a mistake in a calm 

sea no one notices it; but if an adverse wind and violent 

storms arise and the ship is cast on shore every one is convinced 

that their ignorance and mistakes are to blame. 

Even so is it with bad doctors, who form a majority among 

their professional colleagues. When they are treating 

lighter cases of illness, in which the greatest mistakes 

may be committed, without serious results ensuing, their 

want of skill will not strike the laity ; when on the other 

hand they are called to a serious, violent, dangerous case 

it becomes clear to every one that they know nothing 

about it and give wrong directions." f " Ignorance is a 

bad possession, a poor ornament, a constant illusion, a 

picture of the fancy, affords no pleasure or happiness, and 

is the nurse of timidity and of rashness." J The Hippokratic 

doctors exhorted their pupils to diligence and 

assiduous study. "Art is long, life short" they told 

them,§ and " the healing art cannot be learned in a 

hurry." || They strongly recommended perusal of the 

medical treatises and with affecting piety recalled the 

honest, if not always successful attempts, which the doctors 

of an earlier period made to advance medical knowledge 

and to raise it to the rank of a science.1[ 

The intimate relations between medicine and philosophy 

which existed before HIPPOKRATES were made still more 

binding by him and his school and endured to a later period. 

" Philosophy and medicine have mutual need of one another 

and each is illustrated by the other. The doctor, who is 

also a philosopher stands in the highest position " writes a 

* HIPPOKRATES op. cit. T. iv, 638. § HIPPOKRATES op. cit. T. iv, 458. 

+ HIPPOKRATES op. cit. T. i, 590. || HIPPOKRATES op. tit. T. vi, 330. 

X HIPPOKRATES op. cit. T. iv, 640. f HIPPOKRATES op. cit. T. i, 596.


Hippokratic author.* SOKRATES and PLATO had amongst 

their pupils several doctors and students of medicine as 

may be gathered from the frequent use of similes drawn 

from medical science ; and ARISTOTLE the founder of comparative 

anatomy and the advanced explorer in all departments 

of the investigations of Nature wrote f "most 

naturalists seek in medicine the end and object of their 

studies and of the doctors those who practise their art in a 

scientific spirit begin the study of medicine by working at 

natural science." 

IN ALEXANDRIA. 

THE youthful ALEXANDER of Macedon had subdued in a 

rapid series of conquests a great part of Europe, Africa, 

and Asia. The Thracian and Illyrian races as far as the 

Danube, Greece, Phoenicia, Palestine, Egypt, Persia and 

the whole of Asia Minor were subject to the sway of 

his sceptre; even many Indian states recognized his 

sovereignty; and from Italy and the Celtic tribes came 

embassies to seek his protection and alliance. Already 

must his heart, swollen with ambition, have conceived the 

daring project of a world-monarchy embracing all the 

regions of the earth as far as they were then known. But 

his sudden death put an abrupt termination to all these 

hopes. He died at the age of thirty-three in the vigour* of 

youth and in possession of a power such as no mortal had 

exercised before him. The tragedy of his death is of even 

greater significance than his unexampled victories and 

successes. His empire fell to pieces as quickly as it had 

been built up. Aspiring generals shared in the heritage 

and made themselves masters of single provinces. But 

only his political creations were demolished. Whatever in 

the way of civilization and knowledge had been advanced 

by means of him or under his sway remained firm and 

bore rich fruit. 

* HIPPOKRATES op. cit. T. ix, 232. f ARISTOTLE: De Sensu, C. 1.

IN ALEXANDRIA. 73 

The contact of the spirit of Greece with the peoples of 

the Orient exercised an abiding influence upon both sides. 

The Orientals learned to understand Science and Art which 

with them were but little developed if at all, and obtained 

the opportunity of acquiring Grecian education and refine 

ment of manner; while the Greeks were freed from that 

narrow-mindedness which, evidently as a consequence of 

their small political commonwealth, had resulted in an over- 

estimation of themselves and a contempt for foreigners. 

Hellenism drew from this source that cosmopolitan colour 

ing which distinguished the efforts of the later Greeks. 

Art and Science derived from this acquaintance with 

foreigners many suggestions and improvements; espe 

cially so the natural sciences, —Zoology, Botany, Compara 

tive Anatomy, and Materia Medica. These received a rich 

influx of material from lands thrown open to discovery, 

which, arranged and sifted by able hands, facilitated and 

promoted the carrying on of systematic work in these 

branches of knowledge. ALEXANDER'S dreams of future 

political power were soon forgotten. Only the plan of 

making Egypt the central state, and Alexandria—named 

after him—the capital of the world-empire he strove to 

create, was carried out, though in a manner quite different 

from his intentions. Egypt was indeed not the political, but 

the intellectual, centre of nations and undertook the part of 

dispenser of civilization, being especially called to this, as 

much by its situation as by its possessing a history of 

thousands of years. The princely family of the PTOLEMIES, 

on whom after ALEXANDER'S death the dominion of the 

Nile valley devolved, were of Greek descent and remained 

true to their Greek character in their new home. 

While the trade and industry of Egypt flourished and 

her ships sailed as far as Madeira westwards, and east 

wards to India and Persia, Arts and Sciences were 

nurtured at home and Greek culture was diffused. The 

PTOLEMIES brought artists and learned men from Greece 

to their court; caused magnificent buildings to be

74 


erected, adorned their residences with the choicest objects 

the world could produce, and supported the sciences with 

royal liberality. They laid out botanical and zoological 

gardens, founded libraries, and created the Museum and the 

Serapeum,* two institutions in which learned men received 

accommodation and maintenance so that they might devote 

themselves to scientific studies without having to give 

their attention to providing the daily necessaries of life. 

These edifices contained, besides day and night apartments, 

great halls for meals and covered colonnades adorned with 

pictures, opening on to spacious courts and shady pleasure 

grounds.t The great libraries, in founding and extending 

which no expense was spared, stood adjoining, and no 

doubt in organic connection with them. Ecclesiastics of 

high rank exercised supreme control over these institutions 

and in conjunction with the heads of the several departments'—into 

which the whole was divided according to the 

sciences pursued—exercised administrative power. 

The Museum lay in immediate vicinity to the royal palace 

and was even treated as a part of it. The Serapeum was 

situated in a more remote part of the town and ranked after 

the Museum in importance. The library of the Serapeum 

was not sO rich as that of the Museum. The lofty welllighted 

halls of the libraries, in which the statues of 

celebrated men of learning were erected, contained many 

thousand papyrus-rolls of the most important works, 

especially of Greek literature. As to their number, 

accounts differ: while AMMIANUS and GELLIUS, for 

instance, estimated the whole of the papyrus-rolls of the 

Museum-library at 700,000, EPIPHANIUS reports that the 

number only reached 54,8004 The learned men who lived 

in the Museum and Serapeum formed societies like our 

* G. PARTHEY: Das Alexandrinische Museum, Berlin 1838.—Fr. RITSCHLL 

Die Alexandrinischen Bibliotheken, Breslau 1838. 

t STRABO xvii, 1. 

X AMMIAN. xxii, 16.—A. GELLIUS: Noct. Attic, vi, 17.—Cf. also PARTHEV 

op. cit. S. 77.


Academies. In friendly intercourse and in free conversation 

they discussed the scientific questions which had been 

suggested to them by reading or observation. Their princely 

patrons took a stirring interest in their investigations and 

encouraged them by large stipends and rich presents. They 

busied themselves with grammar, with criticizing the texts 

of the manuscripts contained in the libraries, with the art 

of poetry, with music, history, philosophy, mathematics, 

mechanics, astronomy, geography, the natural sciences, and 

medicine. But these " priests of the Muses," as THEOKRITOS 

calls them,* did not live only for research : they devoted their 

time also to teaching. Students from all countries inhabited 

by Greeks came to Alexandria in order to obtain there the 

best instruction for their future professions. The Museum 

and Serapeum were thus not only academies but also high 

schools. Information is unfortunately wanting concerning 

the relation of these to the institutions which served the 

purpose of teaching medicine. 

Two medical schools arose in Alexandria founded by 

different persons but alike, or nearly so, in the scientific 

principles guiding them. Both took their stand on the 

doctrines of the schools of Kos and Knidos and made the 

scientific acquisitions of these the foundations for their own 

investigations. At the head of one was HEROPHiLOSf and 

of the other ERASISTRATOS. 

The former was born about the year 300 B.C. at Chalcedon. 

His teachers were CHRYSIPPOS of Knidos who made himself 

remarkable for rejecting the too frequent employment of 

blood-letting and drastic medicines, who tried to set limbs by 

bandaging and who recommended -J vapour baths in dropsy, 

and PRAXAGOROS of Kos one of the most copious medical 

writers of that period.§ HEROPHILOS attained to such 

importance that no less than four doctors of ancient times 

* Idyll, xvii, v. 112. 

t K. T. H. MARX: Herophilus, Karlsruhe und Baden 1838. 

X GALEN op. cit. T. iv., 495. xi, 148, 230, 252. 

§ C. G. KUHN : De Praxagora Coo. progr., Lips. 1823.

]6 ANCIENT TIMES. 

undertook the task of writing his life. His most eminent 

services lay in the sphere of anatomy. He was at pains 

to fill up an essential gap in the Hippokratic teaching by 

submitting the nervous system to a careful examination, 

and he succeeded in throwing some light upon this 

hitherto but little investigated department of Anatomy. 

He described the membranes of the brain, the choroid 

plexuses, the venous sinuses, the torcular Herophili 

(named after him), the cerebral ventricles and the calamus 

scriptorius which was so called by him; he traced the 

origin of the nerves to the brain and spinal cord and recognized 

that the nerves transmit sensation and motion.* He 

also gave attention to the structure of the eye, described 

the vitreous body, the choroid, and the retina, drew attention 

to the singular form of the duodenum and noticed that 

the coats of the arteries are thicker than those of the 

veins.f How exact he was in his anatomical investigations 

is shown by his observation that the left spermatic vein in 

certain cases joins the renal vein.J He recognized various 

forms of the pulse according to its volume, strength, 

frequency, and regularity and laid the foundation for a 

scientific treatment of the indications afforded by it.§ 

HEROPHILOS had also remarkable experience as a surgeon, 

as is seen by his remark that dislocations of the femur 

relapse after reduction on account of the destruction of the 

ligamentum teres at the time of injury.|| He recognized 

the cessation of menstruation when pregnancy exists and 

composed a text-book of midwifery, in which subject 

he is said to have imparted instruction.^ Throughout, he 

held himself bound to the principle that in practical 

medicine a man should not be contented with theoretical , 

* GALEN op. cit. T. ii, 712, 731. iii, 708. xix, 330.—RUFUS op. cit. p. 153. 

PLUTARCH : de placit. philos. iv, 22. 

t RUFUS op. cit. p. 154, 171. —GALEN op. cit. T. ii, 572, 780. iii, 445. 

\ GALEN 0^5. cit. ii, 895. 

§ GALEN op. cit. T. viii, 592, 956, 959.—PLINIUS: Hist. Nat.xi,88. xxix, 5. J 

|| ORIBASIUS op. cit. iv, 233. 

% GALEN op. cit. T. ii, 150.


information, but should look upon experience alone as really 

important* STOBÛS relates that HEROPHILOS answered 

the question, who is the best doctor, thus : " He wdio knows 

how to distinguish the possible from the impossible."f 

His contemporary ERASISTRATOS who participated with 

him in the fame won by the school of Alexandria 

derived his origin from Iulis in the island of Keos. 

He too had been taught by CHRYSIPPOS of Knidos: 

in addition to him METRODOROS, the son-in-law of 

ARISTOTLE, is mentioned among his teachers. ERASIS 

TRATOS lived for a long time at the court of the King 

SELEUKOS NlKATOR where he achieved distinction by a 

remarkable diagnosis. ANTIOCHOS, the son of the King, 

was ill and ERASISTRATOS recognized by the agitation 

which he manifested at the sight of his stepmother that his 

disease had been occasioned by the hopeless love he bore 

her.J GALEN makes the humorous remark, touching this 

story, that he is unable to understand the foundation for 

this diagnosis, for " there is no such thing as a lover's 

pulse."§ Like HEROPHILOS, ERASISTRATOS was very 

diligent in anatomical investigations. He described the 

convolutions of the brain and considered the greater 

intricacy of these in man as compared with brutes to be 

the cause of the intellectual preponderance of the former 

over the latter. [| He distinguished the motor from the 

sensory nerves, but thought that the former arose from, the 

membranes, and the latter from the substance, of the brain.! 

He recognized the bronchial arteries, assumed an anatomical 

connection by anastomosis between the arteries and the 

veins and described the valves of the heart so accurately 

that GALEN was unable to add anything to his description.** 

* PLINIUS: Hist. Nat. xxvi, 6. 

t STABJEUS : Elorileg: Ed. A. Meinecke iv, 2. 

t PLUTARCH : Vita Demetrii, c. 38. —PLINIUS : Hist. Nat. xxix, 3. 

§ GALEN op. cit. T. xiv, 631. 

|| GALEN op. cit. T. iii, 673. 

^f RUFUS op. cit. p. 185. 

** GALEN op. cit. iii, 465, 492. v, 166.


Most remarkable of all is his recognition of the lacteal 

vessels,* the functions of which he evidently could not 

know or at most could only surmise: science had to wait 

for this for nearly two thousand years. His attempts to 

explain digestion and other physiological processes in a 

mechanical way deserve also due recognition : and those 

too made for the purpose of discovering the origin of 

diseases by pathological dissections.t 

HEROPHILOS and ERASISTRATOS were undoubtedly 

assisted in their anatomical investigations by much impor- 

' tant work previously done, as by that of DlOKLES of 

Karystus whom GALEN mentions with praise:J but above 

all they owe their extraordinary results to the circumstance 

that the Egyptian Kings placed at their disposal, in any ' 

quantity they wished,'human subjects for dissection. They 

even had the opportunity of opening living men ! Criminals ' j 

from the prisons were handed over to them for this purpose 

" so that they could study the particular organs during life 

in regard to position, colour, form, size, disposition, hard 

ness, softness, smoothness and superficial extent, their pro 

jections and their curvatures." They justified these vivi 

sections in this way, saying " it must be permitted to 

sacrifice the lives of a few criminals if by doing so a per 

manent advantage accrues to the lives and health of many 

worthy men." Their opponents replied to this " that it is 

not only a cruel practice and degrades the healing art, which 

should serve as a blessing to mankind, not as a torture, but 

is also superfluous, since the people whose abdomens have 

been ripped up, diaphragms cut away, and thoracic cavities 

opened, die before it is possible to make scientific experi- 1 

ments on them."§ The pupils and followers of these two 

* GALEN op. cit. T. ii, 649. iv, 718. 

f GALEN op. cit. T. xix, 373.—CELSUS: Proem, and. iii, 21.—DIOSKORIDES, 

Ed. C Sprengel, Lips. 1830, T. ii, p. 72. C/ELIUS AURELIANUS • de chron. iii, 1 

8. v; 10. 

X GALEN op. cit. T. ii, 282, 716. 

§ CELSUS: Proem.—TURTULLIAN : de anima, C. 10.


leaders of the Alexandrian school neglected, unfortunately, 

the exact methods of inquiry which HEROPHILOS had carried 

to remarkable results, and trod the convenient, easy paths of 

speculation. Only a few like the anatomist EuDEMOS, the 

doctors BACCHIOS of Tanagra and MANTIAS who did good 

service in materia medica, the obstetricians DEMETRIOS of 

Apamea and ANDREAS of Karystus, who gave a comprehensive 

and fairly complete exposition of the various causes 

of difficult labour, the surgeon PHILOXENOS and others were 

notable exceptions. Certain of them transported their 

classes to other localities and founded and fostered medical 

schools like ZEUXIS at Laodicea and HlKESlOS at Smyrna. 

The slight differences between the followers of HERO- 

PHILOS and ERASISTRATOS respectively became gradually 

less and less : the former distinguishing themselves from the 

latter chiefly in being more conservative and in ascribing a 

greater authority to the writings of the Hippokratic authors 

which they furnished with commentaries. But both schools 

were doomed to destruction inasmuch as they ceased to 

strive, by independent investigations, after an increase of 

knowledge and confined themselves' to holding fast to 

theories which had been handed down to them and which 

gradually congealed into dead formulas. "Truly it were 

easier" writes PLINY "to sit and listen quietly in the 

schools, than to be up and wandering over deserts and to 

seek out new plants every day." * 

Under such circumstances it was not surprising, that 

thinking doctors forsook these dogmatists and swore 

allegiance to an empiricism which, though certainly 

not promising a solution of physiological and pathological 

problems, satisfied the requirements of medical 

practice. Under the influence of the scepticism which, 

started by PYRRHON and extended by KARNEADES the 

founder of the so-called third Platonic Academy, had 

reached a commanding position in the world, they arrived 

at the opinion that on this earth there is no certainty, no 

* PLINIUS: Hist. nat. xxvi, 6.

80 ANCIENT TIMES.. 

.—. * 

real knowledge concerning phenomena and that probability 

is the highest limit that.,human understanding can reach. 

They thus resigned themost beautiful hopes which have 

animated scientific effort, and pronounced such effort to be 

without prospect. The Empirics neglected anatomy and 

physiology, declaring the study of them to be superfluous 

and unfruitful; they did not concern themselves at all 

about the essential nature of diseases but were satisfied 

with observing their symptoms, discovering their immediate 

causes, seeking remedies and trying which appeared 

adapted to effect a cure. In this they allowed themselves to 

be guided chiefly by experience and moreover did not confine 

themselves to consulting their own previous observations 

but also had, regard to those which had been made by others 

and which in course of time had become historical. When...' 

they met with previously unknown symptoms a course of 

treatment was adopted which had been found to be useful * 

in cases of a somewhat similar character. In thus adding 

the decision per analogiam to that by experience and that* 

by history they completed the so-called empiric tripod. 

The Empirics gave their attention chiefly to practical 

medical science. Materia medica, midwifery and surgery.; 

were by them essentially improved. The method of performing 

lithotomy, as described by CELSUS, we owe to them., 

Even the first attempts at lithotrity, which were undertaken 1 1 

by AMMONlOS, date from this period.* Materia medica was 

enriched by the works of NlKANDER and of KRATEVAS 

who dedicated his book upon the medicinal properties of 

drugs, which was furnished with coloured drawings, to 

King MITHRIDATES of Pontos. Besides these, PHILINOS 

a pupil of HEROPHILOS, SERAPION, GLAUKIAS and. HERAr 

KLIDES of Tarantum were among the well-known representatives 

of the Empiric sect.f While the sciences in- 

* CELSUS vii, 26. 

f CH. DAREMBERG (Histoire des sciences medicales, Paris 1870, T. i, p. 159) 

has arranged in chronological order, beside one another, the adherents of this* 

and of the two dogmatic schools in Alexandria.

IN ALEXANDRIA. gl 

Alexandria flourished and prospered, protection was 

make the 1° ? ^ " "^ ^ Were SOOn *> 

make themselves homeg ^ 

withT°p m SyHa and ° f thG ATTALI » P -gamos v ed 

rls 

P LEM A IES in their guardianship of Intellectual 

treasures. The ATTALI founded both elementary schools* 

a'nd T EK ^ '" '^ lGarned Hke th0Se in Alexandria 

and their library was, after that of the Museum and that of 

the Serapeum, the most celebrated of ancient times The 

opposition which they offered to the PTOLEMIES 'in the 

purchase of manuscripts, led to an order forbidding the 

exportation of papyrus leaves from Egypt which was the 

indirect cause of the discovery of a durable material for 

writing upon, namely parchment, the name of which comes 

from Pergamos. The schools, thus founded, attained a high 

, position and attracted men of learning who distinguished 

themselves in textual criticism, mathematics, and especially 

in medicine.. Pergamos for a long time enjoyed a prominent 

position as a centre of medical training; and 

, GALEN one of the greatest doctors and investigators of any 

period, received his first medical instruction there. 

The last King of Pergamos, the weak-minded ATTALUS III 

has acquired a bad reputation in the history of medical 

science. In continual fear of being poisoned by his 

enemies, he desired that effectual antidotes against poisons 

should be discovered and caused for this purpose experiments 

to be made upon criminals and other persons of 

whom he wished to be quit. "With his own hand he 

•cultivated poisonous plants, henbane, hellebore, hemlock, 

aconite and doryknion in the royal gardens and collected 

their juices and fruits in order to study their properties " f 

The murderous MITHRIDATES of Pontos, another of these 

royal poison-mixers devoted himself to a similar pastimehe 

daily took some poison in order to accustom himself 

gradually to the use of the same. These experiments 

* TH. MOMMSEN : Rom. Geschichte, Bd. v, S. 334. 

t PLUTARCH : Vita Demetrii, C. 20. 

G

82 


although undertaken at the instance of madness and cruelty, 

had this advantage for medical science, that they led to a careful 

examination of the properties and powers of many substances 

; and the statements of medical authors of a later 

period testify that they were not unproductive of results. 

The benevolent protection which was extended to they; 

sciences by the first PTOLEMIES was changed later intoj^ 

indifference and mistrust, and gave place at last to a; 

feeling of hatred and contempt. The seventh PTOLEMY^ 

drove men of learning from Alexandria and shut up their 

institutions. When these were reopened at a later 

period, they bore the signs of decay on their face. The 

appointments for learned men at the museum were now , 

held at the caprice of the Prince and served as rewards 

for flattery and base services. The biting words of TlMON 

of Phlius might have been said of this period, " that the - 

museum is a great food-trough in which scribblers fatten c 

and quarrel about things they do not understand."* Under ] 

the Roman dominion it came to such a pass that athletes ' 

were nominated as members of the museum. The cetebrated 

libraries were partly destroyed by fire, partly pluh-,, 

dered by the foreign conquerors who came to Egypt. Some 

of their literary treasures reached Italy and Constantinople, 

and served to found or enlarge the libraries formed there. 

What remained must, at the capture of Alexandria, have 

suffered mutilation at the hands of the Arabs or have been 

destroyed by the Christians. 

In the year 389 the temple of SERAPIS was changed into 

a Christian Church, and in the Serapeum " monks, so-called, 

took up their abode ; who" as EUNAPIOS writes " in their 

figures resembled men but in their manner of livingswine." 

t He must surely have had in his mind unclean . 

Oriental monks and not highly cultivated people like the | 

Benedictines of our day. The medical schools in Alexandria ,| 

maintained their prominent position under the Roman ; 

* ATIIENJEOS: Deipnosophistse, i, p. 11, Basil. 1535, Ed. Bedrotus. 

t EUNAPIOS in aedes i, p. 43, in Parthey op. cit. S. 102.

MEDICINE IN ROME. 

dominion and even improved it, probably contributing 

materially to that remarkable expansion which the art of 

sealing experienced under the Arabs. 

MEDICINE IN ROME. 

THE Italian peninsula formed for centuries the scene of 

embittered quarrels and feuds, the final result of which was 

the subjection of isolated communities to the Roman 

dominion. The small rural states, which by degrees were 

swallowed up in the general Roman commonwealth, had 

devoted but little attention to the arts and sciences, and the 

Etruscans only could show any pretence to acquisitions of 

civilization containing germs rich in promise of future 

development. The science of medicine exhibited a 

character partly theurgical, partly empirical. Prayers 

offerings, mystical and magical sentences, and invocations 

of deities, along with certain potent simples, the action of 

which chance had taught and experience confirmed, formed 

the principal materia medica of which the people availed 

themselves in sickness. Some knowledge of the treatment 

of wounds they also possessed, as well as of such subjects 

as the arrest of bleeding and the cure of fractures and 

dislocations. SENECA * characterizes the position of the 

healing art of that period appropriately in the words : 

medicina quondam paucarum fuit scientia herbarum 

quibus sisteretur fluens sanguis, vulnera coirent. 

A real medical profession did not exist, and good friends, 

charitable women, and true devoted servants afforded, as in 

Homer's time, in case of necessity the required help. The 

Romans considered that the foundation and extension of 

their political power were the only employments which 

claimed the enlistment of the energies of the nation. 

Having concern with things of inferior importance such as 

the healing art appeared to them opposed to such aims. 

The sum of medical knowledge was from this circumstance 

* Epist. 95. 

83

84 


not added to by them and the practice of the art remained 

in the same hands as before. To be sure the inspection of 

entrails, which the Haruspices undertook might have been 

able to'serve for imparting information of an anatomical 

nature, but these priests lacked the necessary training and 

in their investigations they kept in view not scientific aims 

but mystical religious exercises which predisposed them to 

find peculiarities even where none existed. Notwithstanding 

this, the numerous expressions in anatomical 

terminology* which are borrowed from the Latin tongue 

point to the fact that the Romans knew and were able to 

distinguish from one another the most important organs of 

the body. But only very loose relations existed between 

anatomy and the practice of the healing art. 

The Roman father of a family as he appears before us in M. | 

PORCIUS CATO, had his book of recipes which he consulted | 

in cases of sickness affecting his family, slaves, or domestic 

animals.f In ' this, besides many superstitious magical j 

formula, all manner of expedients were detailed for use 

against internal affections and the treatment was sketched 

which was to be employed in injuries, fractures, dislocations, 

wounds, abscesses, fistulae, nasal polypi and many 

other complaints. Great importance was ascribed to 

dietetics, and certain domestic remedies, such as colewort, 

stood in high esteem.% Even wine was frequently used 

for these purposes and CATO "whose virtue" as HORACE 

writes "often grew warmer under the influence of good' 

wine,"§ recommended it as an addition to various remedies^ 

The patriarchal custom of the father of the family being 

also the family doctor, naturally disappeared with the 

development of the healing art and formed certainly an 

exception even in CATO'S time. 

* RENE BRIAU : "Introduction de la medecine dans leLatium et a Rome" in 

the RfSvue archSol., Paris, 1885, Ser. iii, T. 6, p. 197.—Jos. HYRTL: Onomato- 

logia anatomica, Wien 1880. 

t 1'LINIUS: Hist. nat. xxix, c. 8.—PLUTARCH : Cato major, c. 23. 

X PLINIUS: Hist. nat. xx, C. 33. 

§ Od. iii, 21, Ad amphoram. ^m

MEDICINE IN ROME. 85 

The increased demands which were made upon the 

knowledge and skill of those who professed the art of heal 

ing and the great advances made in political and social con 

ditions justified the education of a distinct medical class. 

Unfortunately historical information fails us as to how 

this process was brought about. May we not suppose that 

the want of assured medical assistance which was ex 

perienced in the frequent military expeditions of the 

Romans, exerted an influence in this direction ? In the 

most ancient times the soldiers used to dress each other's 

wounds and carried with them bandages for this purpose. 

Each took his share in caring for the wounded * but the 

medical help which they received appears to have been 

inadequate, so much so that after the battle of Sutrium 

(309 B.C.) more warriors were lost by dying subsequently 

of wounds than were killed in action by the enemy.f 

Yet it is certain that at that time the healing art was prac 

tised as a profession in Rome. This is demonstrated not 

only by the testimony of the authors of antiquity,^ who on 

various occasions make mention of doctors, but also in a 

convincing manner by numerous other facts. The Lex 

Aquilia made the doctor who had neglected a slave after 

an operation responsible if he met his death in conse 

quence^ PLUTARCH || relates, that among the persons 

attached to the Embassy which the Romans sent to 

Bithynia there was a man on whom the operation of tre 

phining had been successfully performed, and even in the 

twelve law-tables of Numa mention is made of teeth 

artificially bound together with gold thread.^! On the other 

hand PLINY** plainly affirms that Rome for many centuries 

did without doctors though not without medicine (sine 

* TACITUS: Annal. iv, 63. 

f LIVIUS viii, 36. ix, 32. x, 35. xxx, 34. 

J DION. HALICARN. i, 79. x, 53.— LIVIUSXXV, 26. 

§ Institut. iv, tit. 3. § 6 and 7. 

|| Cato major, c. 9. 

% CICERO: de leg. ii, 24. 

** PLINIUS: Hist. nat. xxix, 5.

86 


medicis, nee tamen sine medicina). But he meant by this 

only to say that in Rome until the immigration of Greek 

doctors of whom he soon afterwards speaks there were 

really no persons who deserved the name of doctors and he 

remarks that Greek medicine was expected with joyful 

eagerness but that when a man came to make its acquaintance, 

he was undeceived about it (Medicine vero etiam 

avidus, donee expertam damnavit) ; he corrects himself in 

a later passage by saying that the calling itself was not 

alluded to so much as the particular kind of practice then 

carried on* 

The Greek influence had made itself felt in Rome long 

before Romans were acquainted with the scientific acquirements 

of Greek doctors ; and it is indicative of the mode 

of thought of that period that this influence showed itself 

first in the sphere of religious mysticism. Already, at' 1 

an earlier period, the Romans, during severe epidemics,.\ 

had had recourse to the oracles, and to the healthdeities 

of the Greeks, who were propitiated in conjunction 

with their native Gods. A temple was dedicated 

to APOLLO as Healer during a pestilence which raged , 

in Rome in the fifth century B.C.f In the year 291 

B.C. the service of ASKLEPIOS was transplanted from 

Epidauros to Rome ; a proceeding which has been enlarged 

upon by various authors with poetic ornamentation and 

even glorified by the painter's art.I In the year 154 B.C. 

a Collegium Aisculapii et Hygeise was erected in Rome, 

the document of foundation of which has been preserved 

in an inscription found in the Garden of the Palestrine 

Palace.§ As Rome after the Punic wars grew up to that 

* PLINIUS op. cit. xxix, 8. 

f Livius iv, 25, 29. vii, 20. xl, 51. 

X VAI.ER. MAXIM, i, 6; 8, Livius x, 47. xxix, 22.—OVID : Metam. xv, v. 

626-744.—PANOFKA; Asklepios und die Asklepiaden, Berlin" 1840, S. 52 u. 

Tafel ii, 3.—BOTTIGER in K. SPRENGEL'S Beitragcn 2. Gesch. d. Med., Hal'le 

1795, i, 2, S. 163 et seq. 

§ SPON : Recherches curieuses d'antiquite', Lyon 1683, p. 326.343 and reprinted 

by J. ROSENBAUM : K. Sprengel's Versuch einer Geschichte d. Arznei-


world wide power which was able to contest successfully 

the supremacy over the Mediterranean and the lands on 

its shores, the immigration from abroad increased to a 

remarkable extent. Whoever by birth, ability, talent, or 

knowledge overtopped his fellows, betook himself to the 

City on the Tiber, since there he might hope soonest to 

bring his superiority to a profitable recognition. Thither 

flocked a herd of adventurers seeking their fortunes, and 

leaving no stone unturned to accomplish their object, as 

well as that vast multitude of slaves who were drawn by 

rich Romans from abroad in order to minister to their 

increased luxury. The inordinate enjoyment of sensual 

pleasures resulted in new vices and new diseases against 

which help was sought at the hands of foreign doctors. 

The Greeks, as heretofore, formed the largest contingent 

of the foreign immigration : their tongue and culture were 

widely diffused in Rome. Nothing illustrates the import 

ance possessed by Hellenism at that period more, than 

that CATO himself, that despiser of all appertaining to 

Greece, felt himself impelled to study its language and 

literature, and that the same General Lucius ÊMILIUS 

PAULUS, who conquered the Greeks on the field of battle 

caused his children to be educated by Greek teachers. 

Only on the arena of politics and in war did the Greeks 

yield to the Romans : in a competition of intellects the 

Greeks were victors. 

Graecia capta ferum victorem cepit et artes 

Intulit agresti Latio.* 

Education and medical science experienced in Rome the 

most important modifications from this cause. The won 

derful advancement which medical science owed to the 

Greeks make it intelligible that every effort was made to 

profit by their knowledge and skill in this sphere. The Greek 

kunde, Leipzig 1846, S. 208 Anm., and G. PINTO: Storia della Medicina 

Roma, Roma 1879, p. 191. 

* HORATIUS: Epist, i. 1, v. 156.


doctors were sought out in Rome and their Roman colleagues 

were compelled to pick up special information in 

Greek medical literature if, in the struggle for existence, 

they did not wish to be worsted. The medical art of the 

Romans, so far as it took its rise on a national foundation, 

yielded before the influx of Grecian science and, like all 

civilization of a lower character when absorbed by that of 

a higher, left its traces behind only in popular tradition. 

Professional medicine in Rome was henceforward 

Greek. Its practice was founded on Greek writings and , 

its prominent representatives belonged to the Greek nation. 

This preponderance was maintained even until the later 

periods of antiquity. The Romans have never acquired 

for themselves an independent position in this sphere of 

intellectual activity and their best medical works possess 

the value merely of collated treatises for which the creations 

of Greek genius served as a copy. 

The Greek doctors who were the first to migrate to Rome 

were not, it appears, the most respectable members of their 

profession. Offensive in consequence of their foreign 

manners and of their bias towards quackery, which however 

natural in their oriental home was opposed to the severe 

customs of the Romans, they soon made themselves despised 

and hated for their covetousness and boastfulness. Certainly 

but few of them were inspired by enthusiasm for their art or 

by love of their fellow-creatures : pursuit of riches and pleasure 

attracted the majority of them from their home to foreign 

lands. The grave accusations which CATO made against 

them, even if exaggerated, were not wholly undeserved* 

The doctor ARCHAGATHOS (a good beginning!) who 

came from the Peloponnesus to Rome about 219 B.C. at once 

attracted public attention. His surgical operations excited 

such a sensation that the Senate conferred Roman citizenship 

upon him and at the public cost bought a consulting 

room for him in a populous quarter of the city. But his 

love "of cutting and burning" and perhaps some unsuc- 

* PI.INIUS op. cit. xxix, 5, 7, 8.


•cessful results of operative treatment, soon deprived him of 

the confidence of the people who now called him not a 

surgeon but an executioner (Carnifex).* 

The Bithynian doctor AS.KLEPIADES later on attained a 

prominent position, having settled in Rome in the time of 

POMPEY. Possessed of a thorough general education, endowed 

with unusual intellectual gifts, an acute, penetrating 

understanding, and rich experience of life, he soon raised 

himself above the crowd of ordinary doctors. His polished 

manners in society, his trustworthy courteous aspect in conjunction 

with his gifts of speech, which enabled him to give 

appropriate expression to his unbounded self-confidence, 

provided him with an introduction to the highest circles of 

Rome and procured him the distinguished friendship of such 

men as CiCERO, L. CRASSUS, MARCUS ANTONIUS and others. 

King MiTHRiDATES sought by promises to attract him to 

his Court, but, as ASKLEPIADES declined his invitations, 

-had to be satisfied with the transmission of his writings. 

ASKLEPIADES preferred to remain in Rome where he 

-acquired great riches and was honoured " as one sent 

from Heaven." He knew well how to maintain, and 

if possible, to enhance, the high opinion entertained 

of him by the people and disdained no means to this 

•end. Thus he ' restored a man to life ' whose obsequies 

were actually about to be carried out. With quackish 

boastfulness he declared, that people might cease to consider 

him a doctor if he were ever taken ill himself; 

•and Death was so good as not to give him the lie, for he 

died from the fall of a ladder.f Like other people of 

his disposition ASKLEPIADES disclaimed any authority and 

believed only in himself. He rejected the dogmatic 

teaching of his predecessors and contrived a medical system 

•of his own founded upon the atomic doctrine of the 

* PLINIUS op. cit. xxix, 6. 

t PLINIUS op. tit. vii, 37. xxvi, 7, 8, 9. CICERO: de oratore. i, 14.— 

APULEIUS : florid., c. 19.—SEXT. Empir. ad logic, dogm. i, c. 91, ad. mathem. 

Iv, c. 113 etc.

9° 


Epicureans as the latter had received it from DEMOKRITOS 

and in a somewhat modified form from HERAKLIDES of 

Pontus. He taught that the human body is compounded 

of atoms having no constant shape and subjected to 

continual motion and change, and of spaces lying between 

them which allow the movements of the juices and also 

transmit sensation. He attributed health and sickness to 

the activity and disposition of the atoms and their relation 

to the spaces between them* The human soul appeared 

to him as the result of the activity of thought. He said 

that it is, as it were, a breath which penetrates every part 

of the body, and, in no manner, has its seat in any particular 

organ ; an assertion which has given an opportunity to the 

ecclesiastical author TERTULLIAN of indulging in some 

insipid witticisms.t The materialistic ideas, which at the 

same time found an eloquent advocate in the poet 

LUCRETIUS, had many friends and adherents among men of 

intellectual advancement. ASKLEPIADES sought to combine 

them with the moral philosophy of the Stoa in order that 

they might give no offence to natures spiritually endowed. 

In this way he insured for his teaching the applause and 

admiration of the educated laity while the doctors were won 

over by the preference he showed for the humoral pathology. 

The defective views of physiology and pathology afforded 

by the theory of juices of the Hippokratic writers could not 

satisfy thinking doctors. When ASKLEPIADES suggested 

the part played by the solid structures of the body, the 

matter appeared obvious to them. In this, as also in 

introducing materialism into medicine he rendered great 

services to the development of that science. His 

therapeutic principles culminated in the doctrine that the 

doctor must so act as to make his patient well quickly, 

. safely, and in an agreeable manner. He was opposed to the 

misuse made by the doctors of his time, of drastic purga- 

* CAEL. AURELIANUS : de acut. i, 14, 15. 

f TERTULLIAN: de anima, c. 15.

MEDICINE IN ROME. 9 r 

tives, emetics, and sudorifics and recommended in their 

stead chiefly active and passive exercise of the body,, 

frictions, baths, the drinking of cold water, clysters and 

other similar remedies combined with a strict regulation of 

the diet. To induce sleep he caused his patients to lie in 

hammocks which were put into gentle swinging motion. In 

croup he recommended the performance of tracheotomy,* 

as others before him had done. 

The teachings of ASKLEPIADES were more extensively 

elaborated by his pupils and adherents and formed the funda 

mental tenets of the medical sect called the Methodists. 

The actual founder of this, THEMISON of Laodicea a pupil 

of ASKLEPIADES, undertook the task of adapting the 

philosophical system of his master to the comprehension 

and requirements of practical doctors. He said that 

diseases indicate either a state of increased or diminished 

tension, or else a state involving a mixture of these two 

conditions, manifested by the organs, at various times, in 

the way of exalted, impaired, or otherwise modified 

secreting activity.f The characters common to all diseases 

were called "Communities" and to attack them by 

remedies which possessed an opposite action was decided 

to be the proper aim of medical treatment. The Methodists 

confined themselves to treating the general symptoms of 

diseases : to investigate their seat and origin they con 

sidered superfluous and almost hopeless. They busied them 

selves chiefly with Semeiology and Therapeutics and 

directed their attention by preference to questions con 

nected with practice. Their doctrines were so simple and 

easy to learn and so conveniently carried out that they 

found a ready acceptance with the majority of doctors. 

But such as cherished the interests of science could not 

fail to observe their deficiencies. The Community-doctrine 

which sought to explain everything according to a pattern 

* CELSUS ii, 14. iii, 4. iv, 19. —CAEL. AUREL. : de acut. i, 15. iii, 4, 8.— 

PLINIUS: Hist. Nat. xxvi, 7, 8, 9. 

f CELSUS : Praef.

92 


model, and which not only left unanswered questions of 

scientific theory but seemed unprofitable in practice, was 

bound to prove itself as superficial and untenable in 

time as was the immature materialism which pretended to 

have found a solution of the problem of organic life in a 

fortuitous concourse of atoms. 

For this reason intelligent men embraced an eclecticism 

which sought to combine the Greek philosophy of nature with 

the humoral theories of the Hippokratic writers and the tissue 

pathology of the Methodist school, and, by the adoption of 

the Pneuma—a spiritual element pervading the body and 

denominating it,—to fill up a broad gap in the various medical 

systems. The doctrine of the Pneuma was by no means new: 

it was already pointed at in the Hippokratic writings, discussed 

at length by the Peripatetics, applied by ERASIS 

TRATOS to explain many processes in the human organism 

and at a later period dragged again to the front at the Stoa. 

Certain doctors, as for instance ATHEN/EUS of Attalia,ascribed 

such a prominent part to the Pneuma, that they 

have been characterized as " Pneumatists." In medical 

practice the Eclectics took their stand upon a foundation of v 

facts and saw in experience the only true and certain guide 

for conduct in their craft. Yet they did not assume an 

indifferent or hostile attitude towards scientific investigation 

but favoured the same, and made progress themselves 

in paths, such as those of anatomy and physiology, the use 

of which in practice was not immediately apparent. 

Eclecticism was prepared for and led up to in an efficient 

manner by the writings of the Encyclopaedists which set 

forth in a connected form all that had been achieved in the 

preceding periods of civilization in the different paths of 

intellectual effort. Besides philosophy, history, politics, 

military science, geography, the natural sciences, agricul- ; 

ture, painting and sculpture, etc. they introduced medicine 

also into the field of observation. Their writings on 

this subject bring into review all the medical knowledge of 

that period and are so much the more valuable in that they


contain a multitude of extracts from medical works which 

have been lost. The best known Encyclopaedists were 

M. TERENTIUS VARRO, A. CORNELIUS CELSUS and the 

elder PLINY. The last mentioned in writing his natural 

history made use of not less than 2,000 books as he 

himself relates* and CELSUS in his work on Medicine 

which by its elegant expositions and classic language 

ranks with the best examples of Roman literature, gives 

us some, if insufficient, recompense for the great number 

of medical works of the Alexandrian period of which an 

envious fate has robbed us. Eclecticism developed into an 

organic whole, instinct with life, uniting the advantages of 

the other medical systems in itself without their deficiencies 

and faults. Holding fast to the traditions of past ages but 

free from that pedantry of the schoolmaster which regards 

every departure from the beaten track as wanton risk, it 

was admirably adapted to encourage activity in research 

among individuals and to render possible the advance of 

science. Eclecticism was a want,—a necessity,—for medical 

science if it was not to be reduced to the dead level of rude 

empiricism or one-sided methodism. It is thus easily comprehensible 

that it obtained dominion in medicine. The 

doctors attached themselves to it with enthusiasm and 

medical literature received an eclectic colouring. Even 

the teaching of GALEN which during fifteen centuries of 

the history of the world passed in medical matters as the 

highest and as an almost infallible authority was in its 

origin nothing but a purified eclecticism. It certainly soon 

obtained the power of standing alone and erected itself into 

a compact system through the creative power of its founder, 

who disclosed a crowd of facts to medical science and 

opened for it new paths. 

GALEN was born in the year 131 of our era at Pergamos the 

future seat of government of the Attali. His father the architect 

NlKON was an able and educated man who possessed 

sound acquirements in mathematics, physics, and the natural 

* PLINIUS op. cit. i, praef.

94 


sciences. With loving care he superintended the education 

•of his son and paid particular attention that he should be 

instructed by distinguished teachers. Furnished with an \ 

-admirable preliminary training, GALEN began in his 17th 

year his medical studies. He first of all attended the medical 

school of his native town at which the anatomist SATYRUS, 

a pupil of QuiNTUS, STRATONICUS the Hippokratic, the 

Empiric ,/EsCHRlON and others were working. On. the 

death of his father which occurred four years later he left 

Pergamos and betook himself to Smyrna in order to continue 

his studies there under the guidance of PELOPS a 

famous anatomist and of ALBINUS the Platonist; he then 

went to Corinth where he received instruction from another 

distinguished anatomist, NuMESlANUS* He now travelled 

through Asia Minor and Egypt mainly with the object of 

increasing and confirming his acquirements in the natural 

sciences. In Alexandria where the medical schools and 

•other institutions of a similar kind were of the first order, \ 

he remained until his 28th year. He devoted himself with / 

great zeal to anatomy, greater opportunity being afforded 

him for this study there than anywhere else.f At the same 

time he endeavoured to enlarge and refine his knowledge 

in the other branches of medical science. Alexandria was 

filled to overflowing^ with medical practitioners and there 

was probably no medical system, no method ol treatment 

which had not its adherents and advocates amongst the 

doctors residing there. Nowhere could the student of 

medicine see and learn so much as in Alexandria. On this 

-account the young doctors came there when they wished to 

perfect themselves in their specialities. Even in later '] 

times the best recommendation a doctor could have was to 

have studied in Alexandria.§ Rich in intellectual acquire- 

* J. Cu. ACKEUMANN : Vita Galeni in Galeni opera. Ed. Kuhn, T. 1 (Intro- *" 

•duction) gives the references for this. p 

t GALEN ii, 220. 

X FUI.GENTIUS : M)thol. i, p. 16. 

4 AMMIAN. Marcell. xxii, 16.

MEDICINE IN ROME. 9$ 

ments, GALEN turned his steps back to his home and undertook 

the, professional treatment of gladiators and prizefighters. 

But the mean and petty circumstances of his 

native town, and an insurrection which broke out there, 

induced him after some years to settle in Rome. In order 

to become known there he gave public lectures on the 

structure and functions of the human body. The interest 

of the subject and the practical knowledge of the lecturer 

soon attracted a numerous audience composed of representatives 

of the most distinguished circles of the capital. 

Amongst his hearers were men in influential positions 

such as the philosophers EUDEMUS and ALEXANDER of 

Damascus, the prefect SERGIUS, the consuls BOETHUS 

and SEVERUS, who afterwards mounted the throne, and 

BARBARUS the uncle of the Emperor Lucius. In this way 

GALEN succeeded, within a short time, in obtaining a 

profitable medical practice. But the envy and jealousy of 

his colleagues and other adverse circumstances disgusted 

him with residence in Rome. He on that account took to 

travelling and visited various parts of Italy and Greece, the 

island of Cyprus, Palestine, and Pergamos, his home. A 

year later he was called by the Emperors Lucius VERUS 

and A. MARCUS AURELIUS to Aquileia to accompany them 

in their campaign against the Germans. The death of the 

former changed his destination : he remained in Rome and 

was appointed body-physician to the young heir to the 

throne, COMMODUS* How long he held this office, 

whether he returned to his home and if he did at what 

period, is unknown. As little do we know when and where 

he died. As SuiDAS points out he must have reached his 

70th year, for his death did not take place before 201 A.D. 

If the life of GALEN has been fully described here, the 

justification lies not only in the extraordinary importance 

which he acquired in reference to the healing art but that 

at the same time a prominent example is given of the 

method employed in the training of able doctors at that 

* GALEN xiv, 648 et seq.

g6 ANCIENT TIMES. 

period. GALEN was an experienced and skilful doctor, a 

learned investigator, a teacher of medicine much in request^ 

and an uncommonly industrious author. His literary 

activity is evident from the number of his writings which 

in KUHN'S edition fill 21 volumes each containing about. I 

1,000 pages. It is certain that among these are many ji 

works which have been falsely ascribed to him: but on the 

other hand a multitude of works really written by him are 

absent from the edition—works which partly have been 

lost,f partly only existed as translations and, have never 

been printed. GALEN'S works treat of philosophy,, 

anatomy, physiology, materia medica, practical medicine, 

surgery, gynaecology, the history of medicine, etc. They 

place before the reader all that had been attained in this 

sphere of work and, like the Hippokratic collection, exhibit | 

a picture of the condition of contemporary medical science; 

while particular parts throw much light upon the professional 

acquirements of the doctors as well as upon their':! 

social condition. 

Medical teaching also is mentioned in them in numerous 

passages. The development of this was strictly dependent 

upon the destinies of medical science in general. The subject 

matter and aims of teaching were regulated by the • 

progress of science and by the system prevailing at the time, 

while the manner of imparting instruction was defined by 

the relations of the medical profession to spciety at large. 

i i 

i, MEDICAL TEACHING IN ROME. 

1 

• ' • i 

IN 'the most ancient periods of Roman history medical 

knowledge was transmitted from the father to the son or to 

a relative and friend. The personal superintendence of the 

pupil by the medical practitioner remained also at a later 

period the commonest, if not the only, form of medical 

teaching. When the medical art of the Greeks was transplanted 

to Rome, medical teaching became possessed of 

material borrowed from the rich medical literature of the

MEDICAL TEACHING IN ROME. 

Greeks and also assumed the external form which it had in 

Greece. The Greek doctors who had migrated to Rome 

there acted as teachers of their art and introduced the 

regulations of their home. As in Greece so also in Rome 

the practice of medicine was a Jree-profeaaion which every 

one who thought he possessed the necessary ability was at 

iberty to carry on. There were no legal ordinances regulating 

the character of the training of doctors. They obtained 

their special knowledge how and where they liked. 

Their education was consequently not at all uniform. ''The 

medical profession contained in itself individual members 

differing widely in respect of their knowledge. Alongside 

of men who at that period were an honour to their calling 

there were persons who had no knowledge of medical, or of 

any other, science. PLINY* was right in complaining 

" that people believed in anyone who gave himself out for a 

doctor even if the falsehood directly entailed the greatest 

danger." "Unfortunately there is no law" he writes 

further on "which punishes doctors for ignorance and no 

one takes revenge on a doctor, if, through his fault, someone 

dies. It is permitted him by our danger to learn for 

the future, at our death to make experiments, and without 

having to fear punishment to set at nought the life of a 

human being." 

The junior members of the profession, who wished to 

do honour to their calling were naturally anxious to acquire 

some fundamental knowledge of their subject. They 

addressed themselves to this by a preliminary course, of 

philosophical study which at the same time completed 

their general education. GALENf wrote a treatise upon'the 

necessity that a doctor should possess training both in mind 

and morals—in a word should be a philosopher. In CATO'S 

time general education embraced, besides a knowledge of 

law, military science, and agriculture, an acquaintance with 

medicine as well; it consisted in fact of an encyclopaedic 

* PLINIUS: Hist. Nat. xxix, 8. 

f GALEN op. cit. i, 53-63. 

H 

97

98 ANCIENT TIMES-. 

review of all things of most importance and use in practical 

life. 

When, with the transplantation of Greek civilization 

to Roman soil the sphere of these sciences was so much 

enlarged that the knowledge of them had to be reserved for 

specialists, the conception of a " general education " became 

of a less extensive kind. The necessities of the particular 

case and custom regulated the subjects of instruction 

taught in the schools. Reading, writing, and reckoning 

constituted the elementary stage. To these, after the 

Punic wars, was added, for advanced pupils who desired a 

higher training, the study of the Greek language and literature 

along with the perusal of Latin works, with which was 

associated instruction in history, geography, astronomy, 

the natural sciences, philosophy, music, and other branches 

of knowledge. The schools of rhetoric had an academic 

character and in them industrious youths learned dialectics Jf 

and the art of speaking in public* 

Ancient times knew nothing of medical schools in our 

sense of the word. Medical teaching was everywhere | 

imparted by a single teacher in all its branches. Even 

when numerous teachers of medical science were working 1 

at one place there was not, as it appears, any organic connection 

uniting them for a division of labour. Students 

eager for knowledge were not satisfied with listening to one 

teacher but sought out other doctors in order to become 

acquainted with their opinions and experiences. 

At first, medical teaching was entirely a private con- '.'; 

cern. ALEXANDER SEVERUS (225-235 A.D.) was the first 

to grant stipends to teachers of medicine and to assign \ 

them public lecture-rooms, for which concession indeed they 

were compelled to bind themselves to teach poor students 

who were supported by the state, without remuneration.t 

CONSTANTINE called upon the doctors to initiate a large 

* J. MARSUARDT: Das Privatleben der Romer im Handbuch der romischen | 

Alterthumer, Leipzig 1879, Bd. vii, S. 90 et seq. I 

f LAMPRIDIUS: Alexander Severus, c. 44.

MEDICAL TEACHING IN ROME. 

granted th "^ • '"** *"" SC ~ « » -turn 

th ArcMatri "^ Tr" 6 ** But at a '*« P»od 

of Archte"'a° r SUCH d0Ct ° rS ES had fil,ed ">e office 

theldve [I ^h PPe , ar '. m0re t tha " ° therS * t0 h -e devoted 

^s mnarted ' ^ i " ° f ^ ^ Medi «' 'aching 

" ^parted e.ther for an honorarium or without re 

muneration.t The duration „j ,i • , w "- nout rewas 

different inTcs! 

pe "° d of stu

IOO ANCIENT TIMES. 

superfluous, for they were only concerned to acquire that 

mechanical routine in the treatment of diseases which appeared 

to them necessary to their calling. 

Anatomy had attained a high grade of development 

through the efforts of the Alexandrians and of RUEUS 

of Ephesus, MARINUS, QUINTUS, and their pupils LYKUS, 

SATYRUS, Ir-ELOPS and yEsCHRlON who were GALEN'S 

teachers. The position and form of the various bones 

was known, as too their respective connections, the 

sutures, the periosteum, the medullary membrane, the 

articular cartilages, various joints with the ligaments and 

tendons associated with them and the most important 

groups of muscles, while a fairly accurate conception 

was made of the form and position of the organs in 

the thoracic and abdominal cavities. GALEN* already referred 

to the analogous formation of the sexual organs in 

the two sexes and declared that they chiefly differed from 

one another in this, namely, that in the female the parts 

were disposed with a direction inwards, in the male with a 

direction outwards. The vascular system was as yet but 

little investigated : but a distinction was recognized between 

arteries and veins and the different kind of blood in these 

two kinds of vessels was noticed.f The knowledge of the 

nervous system possessed by the doctors of this period excites 

our astonishment. GALEN gave an accurate description 

of the brain and spinal cord,* and represented the course 

of many nerves. Thus he alludes to the optic nerve, the 

third cranial nerve or oculomotor, the fourth or trochlear,, 

the different branches of the fifth or trigeminus, the. 

auditory and facial, the vagus and glossopharyngeal, the 

nerves of the larynx and pharynx, the sympathetic, and 

even points out the ganglia upon the last; so too he 

refers to the radial, ulnar, median, crural and sciatic 

* GALEN iv, 635. 

t GALEN iii, 491. 

X CH. DAREMBERG: Exposition des connaissances de GALIEN sur ranatomie| 

et la physiologie du systeme nerveux, Paris 1841.—F. FALK : GALEN'S Lehre 

vdm gesunden und kranken Nervensystem, Leipzig 1871.

MEDICAL TEACHING IN ROME. IOI 

by RUEUS th VI " a ^ 

aIready been mentioned 

liL.T ', 

E P hesian > who was also the first to bring to 

light the distinction of nerves into motor and sensory* 

/he results obtained in anatomical investigation were 

chiefly supported by dissection of the lower animals. 

Only exceptionally, opportunities presented themselves 

for studying human anatomy; and even in Alexandria, 

where since the Ptolemies, freer views prevailed on this 

subject, such opportunities in GALEN'S time occurred but 

seldom^ Only the corpses of hostile soldiers, fallen on the 

battle-field, of criminals who had been executed or were 

found unburied, of stillborn children or children exposed 

to die, were employed for this purpose.f Again, injuries 

which were associated with laying bare of the soft parts 

occasionally gave some information about the position of 

organs. There was naturally no thought to be entertained 

of vivisection in Rome, and CELSUS expressed accurately 

the common sentiment when he wrote :—" The opening 

of the living body I consider horrible and superfluous, that 

of corpses on the contrary I hold to be necessary for 

learnefs : for they must know the position and arrange 

ment of the different parts of the body. For the purpose 

of learning these things corpses are more suitable than 

living and wounded men."J GALEN narrates, that the 

doctors who marched with the Roman army in the war 

with Germany, received permission to dissect the corpses 

of their fallen foes. Unfortunately, he adds, they were 

unable to derive thence any addition to their knowledge 

as they lacked the requisite preliminary acquaintance with 

anatomy.§ On another occasion he informs us how by 

chance he became possessed of two skeletons of which 

one was obtained from a corpse which had been floated 

out of its grave by a flooded stream, and the other was from 

the body of a robber who had been slain in the moun- 

* CEuvres de RUFUS, publie'es par CH. DAREMBERG et CH. EM. RUELLE, 

Paris 1879, p. 153, 170. 

f GALEN ii, 385. J CELSUS : Prsefat. § GALEN xiii, 604.


tains* GALEN'S anatomical statements rest chiefly on 

dissections of the bodies of the lower animals. He says 

so himself; it is also evident from his descriptions of 

particular organs. He represents for instance the hand 

and foot not of a man but of a monkey. For his anatomical 

studies he made use chiefly of the kinds of 

monkeys which resemble man.t He thought that their 

bodies were structurally identical with those of men and 

thus allowed himself to be led into some mistakes the 

correction of which was made only at a much later age. 

In addition, he dissected bears, pigs, horses and donkeys, 

ruminants, once even an elephant, also various smaller 

four-footed beasts, besides birds, fishes and snakes, all with 

the view of enlarging his anatomical knowledge. 

Anatomical teaching began by the several, parts being 

pointed out and explained to the students on the naked 

body of a living man, and the organs lying under the skin, 

named. To this were added, later, dissections of animals 

having forms approaching the human. In this way the 

several bones and groups of muscles and the inner parts 

of the body were noted and the position and arrangement 

of the organs in the body-cavity, studied. " If they do not 

resemble the corresponding structures of the human body 

in every particular point," writes RUFUS, who employed 

this method of teaching, " yet this is the case for the most 

part: but no doubt people got a more correct picture in 

former times, when they were allowed to make use of 

human bodies for such investigations."J GALEN speaks in 

a similar way of anatomical teaching. " A man cannot 

learn anatomy from books alone," he says, " neither can 

he from a superficial observation of the parts of the body."§ 

He recommends, therefore, an assiduous, searching study 

of it, beginning with the bones, and passing on to the 

muscles, arteries, veins, nerves, and internal organs. 

Not only did dissections of animals subserve the purpose. 

* GALEN, ii, 221. f GALEN ii, 223. 

X RUFUS d'Ephese op. cit. p. 134. § GALEN ii, 220.

MEDICAL TEACHING IN ROME. 103 

of teaching, but human skeletons or prepared bones were 

used also. May we not assume that in many cases models 

formed of marble were employed for this purpose ? The 

Vatican museums possess three of such carvings. Two of 

these represent the bony thorax: one appears as whenopened, 

and affords a view of the heart, the lungs, and the 

diaphragm, with indications of the liver and intestines. 

The third copy also exhibits the heart and both lungs."* 

WELCKER doubts whether these were applied to medical 

teaching and thinks merely that "the rare spectacle of a 

chest laid open, of a thorax stripped of all flesh, which the 

butcheries of the gladiators and the execution of criminals 

gave the doctors, at times, opportunities of witnessing; 

coupled with the peculiar tendency of many Roman 

sculptors to copy realistically anything they met with, 

often without any artistic feeling or taste, were the 

associated conditions which led to the preparation of these 

carvings."f The imitations of mummified human bodies, 

brought forward at feasts for the purpose of inciting! the 

guests to enjoy life can be as little noticed here as can the 

numerous representations of the inhabitants of the kingdom 

of Death which have been handed down to us on tombs, 

on gems, and in bronze: for they stood in no kind of 

relation to anatomical teaching.§ So too the figure used 

by BLUMENBACH as the title-page vignette of his 

"Geschichte und Beschreibung der Knochen (Gottingen 

1786) " , which was taken from an ancient cornelian and 

represents a bearded elderly man, grasping with his left 

haild a human skeleton erect before him, points rather 

* EM. BRAUM in the Bullet, dell'instituto archeol., Roma 1844, p. 16, 19.— 

J. M. CHARCOT and A. DECHAMBRE: De quelques marbres antiques concern. 

des e'tudes anatomiques in the Gaz. hebd. de me'd. et de chir., Paris 1857, T. 

iv. No. 23, 27, 30 (where too the so-called Êsop of the Villa Albani in Rome is 

mentioned). 

t F. G. WELCKER : Kleine Schriften, Bd. iii, S. 223. 

X PETRONIUS: Satyr., c. 34. 

§ G. E. LESSING: Wie die Alten den Tod abgebildet haben.— J. M. F. v. 

OLFERS : Uber ein Grab bei Kumse in den Abhandlungen der Akad. d. 

Wiss., Berlin 1830.


to the creation of man by PROMETHEUS, than to anatomical 

teaching. 

It is uncertain whether drawings were made use of 

in the teaching of anatomy, but it is not at all improbable, 

since use was made of this method of conveying 

information in teaching other things* Whether the ] 

representations of the uterus and ovaries contained in 

certain manuscripts of MUSCIO have their origin in ancient 

times naturally cannot be determined. The same is the 

case with the anatomical drawings in the " Introductio j 

Anatomica Anonymi" said to have been taken from a 

Leyden manuscript, which were published by J. ST. 

BERNARD (Leyden, 1744). 

The description of the functions of the human body j 

and of its different parts was associated with anatomical 

teaching. Men proceeded in this matter from the a priori 

assumption of a systematic teleological formation of the 

organs, and supposed that the latter were only created 

in order that the functions demanded by Nature should 

be carried out. The opinion advanced by EPICURUS 

and later by ASKLEPIADES and contrary to the above 

mentioned view, namely that Nature makes many un^ 

successful attempts before she attains a permanent 

result, and that the use of organs, that is to say, their 

functions are first acquired after, and in consequence of, 

their construction thus arrived at,t found in GALEN a 

bitter opponent. With all the intellectual acuteness, and 

with all the learning at his command, he made the attempt ] 

to verify a teleological view, which he considered to be the 

best means of reconciling the realism of ARISTOTLE with 1 

the idealism of PLATO. Yet the foreboding seems from 

time to time to have arisen in his mind that speculation j 

alone could give no satisfactory answer. Hence he was 

led to the path of observation and experiment,—the only | 

path leading to results in this matter. In this way he 

* MARQUARDT op. cit., Bd. vii, S. 107, 802. 

f GALEN iii, 74, 364.


endeavoured to investigate the act of breathing and 

the action of the heart. In animals he divided the spinal 

cord, the intercostal muscles or their nerves, and removed 

certain ribs* in order to see what changes were caused 

by this proceeding, in the respiration. In this way he found 

that in quiet breathing the diaphragm plays the principal 

part and that the intercostal muscles only take part in 

forcible respiration.f He observed the movements of the 

heart in animals after the thoracic cavity had been opened ; 

he also once had the same opportunity in the case of a boy 

whose heart had been laid bare by a penetrating wound of 

the thorax. J By means of numerous total or partial 

divisions of the spinal cord and of different nerves and 

by slicing the brain in layers, which operations he carried 

out on pigs, he hoped to discover the physiological 

significance of these organs.§ The results which he 

obtained and which he minutely describes may not have 

answered his expectations, but these attempts deserve full 

recognition, for they were the first of the kind and pointed 

out the right method by which these problems are to be 

solved. 

GALEN was supported in his researches by an ex 

tremely happy imaginative faculty which put the proper 

word in his mouth even in cases where he could not 

possibly arrive at a full understanding of the matter— 

where he could only conjecture the truth. When for 

instance he declares that sound is carried "like a wave "|| 

or expresses the conjecture that that constituent of the 

atmosphere which is important for breathing also acts by 

burning,!" he expresses thoughts which startle us, for it was 

* GALEN ii, 475, 681, 696. iv, 685. v, 289.—ORIBASIUS op. cit. iii, 236. 

+ GALEN iv, 465 et seq. 

X GALEN ii, 631. 

§ GALEN ii, 677, 682,692, 697. v, 645.—CH. DAREMBERG: Histoire des 

sciences me'dicales, T. i, p. 224. 

|| GALEN iii, 644. 

If GALEN iv, 487.-^6?/. also HJESER : Geschichte der Medicin, Bd. i, S. 360, 

3 Aufl.


only possible nearly two thousand years later to understand 

their full significance. 

In the time of GALEN the doctors felt but small 

interest in the problems of physiology. Practical medicine 

claimed their chief attention. The art of healing 

was thought more highly of by them than the science 

of man—and was also more profitable. Their aims in 

this direction led to a diligent study of materia medica.. 

Numerous collections of recipes in verse and prose, and 

lists of drugs give expression to these efforts in .their ' 

literature. The pharmacological writings of PHILO of 

Tarsus, of SCRIBONIUS LARGUS, of SEXTIUS NIGER, of 

MENEKRATES, of ANDROMACHUS, of DAMOKRATES, are 

among the most prominent examples, but above all is the 

work of PEDANIUS DiOSKORiDES of Anazarba in Cicilia 

who had become acquainted with a great part of the Roman ,| 

Empire as a military doctor and from youth had looked 

•J\upon the study of therapeutic agents as his life's work* 

h -/ He subjected to a systematic review, distinguished by its 

yl completeness, all the medicinal agents known at that time 

in the three kingdoms of Nature. In his work the various 1 

"'" names are given by which they were known in different 

' countries, their native countries mentioned, the way to find 

>;,(them or to prepare them artificially described, and their 

• therapeutic action explained. This book is therefore a 

very important one not only for medical science but also 

for comparative philology and especially for botany. 

DiOSKORiDES has described therein about 500 plants and 

so accurately as to render the determination of the majority 

of them possible. E. MEYER has characterized his services 

in this department by the words: " What THEOPHRASTUS 

is to us in the general botany of the ancients, that is 

DiOSKORiDES to us in their special botany—the fountainhead, 

worth more alone than all the rest put together."! 

* PEDANII DIOSCOIUDIS materia medica, ed. CURT. SPRENGEL, Lips. 1829, 

T. i, p. 4. 

t E. MEYER : Geschichte der Botanik, Konigsberg 1885, Bd. ii, S. 117. 

i


The Work of DiOSKORiDES was highly valued by GALEN, 

who appeals to it on various occasions, and formed throughout 

the middle ages even to late times the most valuable 

handbook of materia medica. It certainly served in no 

small degree to arouse and maintain consideration for 

botanical and pharmacological studies. "The doctor 

should be acquainted with all plants or at least with the 

majority and those most used" writes GALEN. "The 

species, or if it is preferred the different sorts are: 

trees, bushes, herbs, thorns and shrubs. Whoever is able 

to distinguish them from their very young state until their 

full growth will find them in many parts of the world. 

Thus I myself have found plants in various districts of 

Italy which those who had only seen them in the dry state 

were unable to recognize either during their growth or 

afterwards. Every vendor of salves knows the plants and 

fruits Avhich are brought here from Crete; but not one 

knows that many of them grow in the neighbourhood of 

Rome. Therefore no one thinks of looking for them when 

the time of their ripening has arrived."* He declares 

thereupon that he is informed upon this point and does hot , 

neglect to gather the plants at the right time before they 

have been dried up by the heat of the sun and the fruit is 

over-ripe. In another place he remarks f that it is impossible 

to learn botany from books—of which many were 

provided with drawings J—but only by hunting for and 

observing the plants under the direction of a teacher. 

" This method of teaching" he adds "applies not only to 

the case of plants but to all specimens of materia medica in 

general." 

The doctors were compelled to pay great attention 

to this subject, as they were obliged to prepare the 

medicines themselves. To be sure, some preferred for 

convenience to buy not the raw material but the medicines 

already made up at the druggists who kept at their stores 

* GALEN xiv, 30.—MEYER op. cit. S. \qv. f GALEN xi, 797. 

X PLINIUS: Hist. nat. xxv, 8. 

t- -c-Z, \ 

r' •' 

*,'*!. 

V. •


in addition to these things dyes for the hair, applications 

to improve the complexion and other articles for the 

toilet* But in general the doctors only cared to buy the 

simple drugs required for making up their prescriptions. 

The fear of being cheated by having damaged or adul- , 

terated goods sold them induced many to acquire drugs at 

first hand or themselves to collect and prepare them. GALEN 

undertook even long journeys for this purpose: he also 

caused drugs to be sent to him from the countries which 

produced them, through the hands of trustworthy friends 

so as to be sure that they were genuine.f This care was 

necessary, for the adulteration of drugs was systematically 

carried out, and it was not even possible to get pure in 

Rome the balsam-juice produced in the royal domain of 

Engaddi in Palestine and which was a state monopoly. 

The drugs for the Court were on this account collected 

under the supervision of officials, packed in paper, furnished 

with a label giving the name of the plant and sometimes 

the place where it was found : they were then sent 

to Rome and kept there in special storehouses. J These 

contained such a stock of drugs that after satisfying the 

needs of the Court, some could be sold thence to private. 

persons. This however was by no means sufficient to 

materially injure the trade in adulterated articles. The 

adulterations, for the rest, were not effected so much by 

the druggists as by the purveyors and simplers who 

brought the plants from the mountains to the city.§ The 

adulterations were effected so skilfully that the most 

experienced connoisseurs, as GALEN says,|| were deceived 

and considered the goods pure. He himself in his youth, 

as he narrates,^ had received instruction from a man who 

occupied himself with rectifying such adulterations, and 

paid him a large fee for being initiated into these secrets. 

Being well acquainted himself with the whole matter he 

* PLINIUS op. cit."xxx\v, 25. t GALEN xii, 216. xiv, 7 et seq. 

X GALEN xiv, 9, 25, 79. § GALEN xiii, 571. || GALEN xiv, 7. 

*ft GALEN xii, 216.

MEDICAL TEACHING IN ROME. IO9 

gave students the valuable advice to devote great attention 

to the study of the materia medica: "Young students 

must see the specimens not once or twice but often. For 

it is only by applying oneself with intelligence to these 

things" he writes* "and by examining them frequently 

that one gets a thorough knowledge of them." 

Each drug was provided with a ticket on which its name 

and that of its discoverer, the disease it was prescribed for, 

the method of using it, and often the name of the patient 

were inscribed. Ointments for the eyes which formed 

saleable articles of trade, were packed in vessels on 

which the seal of the doctor who had prepared 

them was impressed. Seals of this kind have been 

found in France, England, Germany, and Transylvania, 

especially in places where Roman legions had been 

encamped. More than 160 different stamps of ophthalmic 

surgeons have been described.t The prescriptions were 

long and complicated: theriaca for instance consisted of 

more than 70 different vegetable and animal products.J 

Many of them were disgusting and nauseous, and 

GALEN was surprised at the prescriptions of the doctor 

XENOKRATES who had even recommended human flesh 

" for, of course, it is forbidden in the Roman empire to 

devour men."§ On another occasion where mention is 

made of a doctor who ordered the country-folk goats-dung, 

GALEN made the witty remark that a thing of this kind is 

not suitable for refined townsmen ; dung being only useful 

to farmers.|| The unthinking public cherished the mistaken'opinion 

that the most expensive remedies were also 

the most potent for goodl and a rich purse-proud man was 

* GALEN xiii, 570. 

f C. L. GROTEFEND: Die Stempel der romischen Augenarzte, Hannover 

18b'j.—J. KLEIN: Stempel romischer Augenarzte, Bonn 1874 (Nachtrag zu 

Grotefend's Buch).—MARSJUARDT op. cit. S. 758.— HERON JDE VILLEFOSSE et 

H. THEDENAT : Cachets d'oculistes romains, Tours et Paris, 1882. 

X GALEN xiv, 83 et seq. 

§ GALEN xii, 248. 

|| GALEN xii, 299. 

^f PLINIUS: Hist. Nat. xxix, 8. 

iuteti*— \


highly indignant when GALEN recommended him. the same 

kind of medicine which he had used with good effect upon 

his slave. When he heard that it was made of nothino- but 

cheap ingredients he called o

MEDICAL TEACHING IN ROME. I II 

stone,—to which GALEN assigned an origin similar to that 

ot gouty tophi,—* and consumption! were more closely investigated. 

For the last mentioned disease among other 

things sea voyages were recommended and residence in 

sanatoria of suitable climate especially in Egypt The 

pathology of the nervous system was pursued also with 

zeal and success. GALEN states that he was able to trace 

m one case paralysis of the fingers to an injury of the 

spinal cordj and ARETÛS was aware that the nerve fibres 

cross soon after their origin and thence explains the fact 

that after wounds of one hemisphere of the brain the 

opposite side of the body is paralyzed.§ 

Instruction in practical medicine was given partly during 

the private practice of the teacher who took students with 

him to his patients, partly in Iatreia. The latter were 

arranged after the Greek pattern and were called Tabernae 

medic* or Tabernse medicinae.\\ They were the shops or 

public places of business of the doctors who received and 

treated patients at them, performed surgical operations, prepared 

and sold medicines, and dwelt with their assistants 

and pupils. Into some of these institutions patients—for 

instance people of unsound mind—were admitted.^ Many 

towns erected Iatreia at their own cost and gave them 

over to doctors to induce them to take up their permanent 

abode there.** As GALEN,tt who has left complete information 

on this point, says, they were for the most part 

situated in large buildings with high doors letting in plenty 

of light and air and were furnished with surgical instruments 

and medical appliances. 

* GALEN xiii, 993. xvii A, 835. 

f CELSUS iii, 22.—ARET/EUS : de chron. i, 8.—C/EL. AUREL.: de chron 

», 14. 

+ GALEN viii, 213. 

§ ARET,£US: de chron. i, 7. 

I PLAUTUS : Amphytryo iv, 4. Epidic. ii, 1. 

If PLAUTUS: Menachmi v, 947-956".—SPARTIANUS : Vita Hadriani, c. 12. 

** GALEN.xviii B, 678. 

tt GALEN xviii 6,629-925.

112 

0 


The convalescent homes* and sick rooms which the 

great landlords caused to be built for their family - 

domestics and numerous slaves, may also have afforded,^\ 

opportunity for practical teaching in the examination 

and treatment of the sick. In any case it was here that|tj 

the slaves, who were trained for doctors at the wish of 

their lords, were instructed in the healing art. The military \ 

hospitals, with stalls for sick horses, which were established 

wherever masses of troops were collected, must have some- '\ 

times subserved a similar purpose.t , 

The buildings, which ANTONINUS PlUS caused to be ', 

erected in the vicinity of the temples of ASKLEPIOS at 

Epidauros and on the island in the Tiber cannot be looked 

upon as institutions for the sick. They were to give 

admission to dying persons and pregnant women over- | 

taken by the pains of labour, so that the sanctuaries should 'I 

be kept pure and undefiled.J 

Care and treatment of patients in Iatreia and other 

institutions of that kind was comparatively rare in ancient 

times. Patients were for the most part visited in their.* 

dwellings by the doctors. For this reason instruction ., 

in the practice of medicine was more common there | 

than in Iatreia and hospitals. The doctors used to".^ 

be accompanied by. the students of medicine while , 

visiting the sick and in a suitable case explained 

to them the symptoms and treatment of the disease. 

By this the pupils were guided in forming their own j 

judgment of pathological changes by observation and*"| 

manipulation of the ailing body. When the sick rnanf 

PHILISKUS was treated by the doctors SELEUCUS and 

STRATOKLES they brought with them, as PHILOSTRATUS§ 

narrates, more than 30 pupils. The witty epigram off 

* COLUMELLA: de re rusticaxi, 1. xii, 3.—SENECA: de iia i, 16. nat. qusesMI 

i, pisef.—TACITUS : de orat. dial., c. 21. 

f HYGINUS : de munit. castrorum, c. 34. 

X PAUSANIAS ii, 27. 

§ PHILOSTRATUS : Vita Apollonii Tyan. viii, 7. ,

MEDICAL TEACHING IN ROME. .113 

MARTIAL on his doctor SYMMACHUS is well known : " I was 

U1-- Ihou earnest forthwith to me—accompanied by 100 

pupils: 100 ice-cold hands were laid on my body. Till 

then I had no fever: now I have."* 

GALEN exhorts his pupils to. take care that on entering 

a sick room they do not wake their patient or arouse his 

anger by making a noise with their feet or by speaking 

loudly. He then gives them kindly-meant advice in regard 

to their clothing, their behaviour, and the language they 

should use with patients: he recommends them cleanliness 

and a proper attention to their hair and forbids them to 

eat onions or garlic before visiting a patient, or to drink too 

much wine, lest they annoy the sufferer by the offensive 

odour from their mouths and "stink like goats."t The 

high significance and importance of training in practical 

medicine was acknowledged on all sides. GALEN ridiculed 

the' learned theorists and sophists who " from their high 

chairs shower down upon their pupils detailed explanations 

but if called to a patient have no idea of the complaint he 

is suffering from.''J 

The public naturally betook themselves rather to doctors 

who possessed some practical training than to those who 

were only able to make fine speeches about the healing art.§ 

Surgery had, as CELSUS|| remarks, soon after the time 

of HIPPOKRATES separated itself from the rest of medicine. 

From this time forth, it formed a separate and independent 

subject of knowledge and education. In Rome it 

•i was not usual for the doctors who treated internal diseases 

to practise surgery as well: for this reason GALEN 

abstained from practising the latter when he settled down 

there.5 CELSUS mentions the surgeons PHILOXENUS 

GORGIAS, SOSTRATUS, HERON, the two APOLLONII, and 

the lithotomist AMMONIUS of Alexandria, and again the 

elder TRYPHON. EUELPISTUS and MEGES of Rome, who 

* MARTIALIS: Epigram, v, 9. 

f GALEN xviii B, 144-152.—CELSUS iii, .6.' + GALEN xviii B, 258. 

§ LUCIAN: Hippias, c. 1. || CELSUS vii, Praefat. fl GALEN x, 455. 

I

HA T^' 'ANCIENT TIMES. 

distinguished themselves both as teachers and writers in 

the field of surgery. Unfortunately their works have been 

lost and we have to consult references to them in later 

authors if we wish to form, an opinion as to what they 

accomplished. CELSUS writes " that these men have made 

many improvements and discoveries in surgery." 

If we compare the position of this branch of the healing 

art under the Roman Emperors with that of Hippokratic 

surgery we are surprised by the wonderful progress made. 

The Roman surgeons not only possessed correct information 

about the nature and treatment of many diseases and 

wounds which demand surgical interference, but they 

ventured upon the performance of major operations where 

sound knowledge of anatomy and of the use of surgical 

instruments was required. 

Their supply of instruments was fairly large. The 

excavations at Herculaneum and Pompeii, during the 

carrying out of which a great number of such implements 

were discovered, have afforded valuable information 

upon this point. We learn thus that the following 

were in use — straight and curved needles, probes 

of various kinds, hollow sounds, curved and toothed 

forceps, catheters with a gentle S-shaped curve, several 

forms of clips, among them some with clasps and slides, 

conical and spheroidal cupping instruments, sharp and blunt 

hooks, pronged and disk-shaped cauteries, knives, spatulae, 

lint, lancets, bistouries, rectal and vaginal specula etc.* 

Of the specula some were in one piece, some in two or 

three. In the year 1882 one of four parts was found: it 

was composed of two straight and two S-shaped branches.t 

They were acquainted with various kinds of bandages and 

with apparatus for extension and for securing immobility 

* B. VUI.PES: lllustrazione di tutti gli strumenti chirurgici scavati in 

Ercolano e Pompei, Napoli 1847.—QUAHANTA and VULPES in the Museo 

Borbonico, Vol. xiv, 36. xv, 23. 

f A. JACOBELLI -. Speculi chirurgici scavati dalle rovine delle cittk dissepolte 

Pompei ed Ercolano in the Morgagni, Napoli 1883, T. xxv, p. 185 et seq.

•:'.i: 

MEDICAL TEACHING IN ROME, 115 

which came into use in the treatment of fractures and 

luxations. 

The performance of surgical operations was rendered 

easier by the fact that better methods of arresting haemor 

rhage had been learnt: they were no longer limited to 

application of cold, compression, styptics and cautery, but 

the vessels were subjected to ligature * and torsion f if the 

other methods failed to effect the purpose. For this reason 

vascular new growths could be removed and amputations 

and resections undertaken. ANTYLLUS went so far as to 

operate for aneurism.J In amputation the circular method 

and the flap method were both employed.§ 

The skill of the Roman surgeons achieved its greatest 

_ triumphs in resection. ANTYLLUS and HELIODORUS || 

removed diseased portions of a bone while carefully pre 

serving its continuity : they took away the humerus in its 

.entirety, a part of the acromion-process, so also parts of the 

femur, tibia, radius, and ulna, even the inferior maxilla, 

while sparing the joints, and parts of the superior maxilla.' 

Plastic surgery also was not unknown to them. By 

traction of the neighbouring parts of the skin and the sub 

jacent connective tissue they sought to restore lost tissue 

on the ears, the cheeks, the nose and the lips.f 

The question has been discussed by many learned men 

whether among the ancients artificial appliances were used 

to supply the place of lost limbs. On a vase belonging to the 

Durand Collection in the Louvre the figure of a man is 

represented with what appears to be at first sight, a wooden 

leg.** But on a closer inspection one sees that the leg is 

* CELSUS V, 26.—GALEN x, 314. 

f ORIBASIUS iv, 485.—RUFUS in Aetius xiv, c. 51. 

X ORIBASIUS iv, 52. Cf. ED. ALBERT in the Wiener Med. Blattern 1882, No 

; 3, 4, 5- 

§ CELSUS vii, 33.—ARCHIGENES and HELIODORUS in QRIBASIUS iv, 244, 247. 

I ORIBASIUS iii, 582. 615 eêg. 

f CELSUS vii, 9.—ANTYLLUS in ORIBASIUS iv, 56 et seq. 

** E. RIVIERE: Prothese chirurgicale chez les anciens in the Gazette des 

Hop., Paris 1883, No. 132, 136.

Il6 ANCIENT TIMES. 

not absent but is bent round a long staff. On the other hand 

it is certain from a remark of LUCIAN * that artificial feet 

were prepared from fig-tree wood and that those who had 

undergone amputation made use of them. 

Tracheotomy was certainly performed but did not 

yield good results, it appears, and consequently was 

distrusted.f 

CELSUS J has thoroughly described the operation for stone „ 

in the bladder. He mentions at the same time that the*' 

surgeon AMMONIUS made the attempt to crush in the 

bladder the larger "stones which were difficult to remove. 

Unfortunately the description of the procedure is not 

sufficiently clear to enable one to point to it as equivalent 

to lithotrity. But a passage in the biography of the 

saintly THEOPHANES composed by an anonymous author, 

affords conclusive proof that lithotrity was known and 

practised in ancient times: for it is stated therein that. 

THEOPHANES suffered from stone in the bladder which, 

by instruments which had been introduced, was crushed 

to pieces and then passed externally.§ OLYMPIOS believes, 

that instruments resembling forceps and having small, 

sharp, tooth-like points on them, like those found at 

Miletus, were used for this purpose.|| 

A lengthening and laceration of the abdominal wall was 

looked upon as the primary cause of hernia ; but GALEN 

brought into view in addition to this the part played by the 

muscles.l For the relief of hernia trusses or the radical 

operation were recommended.** Of the latter HELIODORUS 

has left a description which by its minuteness and clearness 

* LUCIAN : Ad. indoct. c. 6. 

+ ARETSUS; de acut. i, 7.—CELIUS AURELIAN : de acut. iii, 4—GALEN 

xiv, 734. 

X CELSUS vii, 26. 

§ Corp. script, hist. Byzant., Bonn 1839, Vol. xxvi, Th. i, p. xxxiv.— 

Patrolog. ed. Migne. Ser. grsec, T. 108, p. 37, Paris 1863. 

|| R. BRIAU in the Gaz. hebd. de med et de chir., Paris 1858, No. 9. 

If GALEN vii, 730. 

** CELSUS vii, 20.


arouses just admiration* Even the symptoms of incarcerated 

hernia were described by some observers.f 

HELIODORUS divided strictures of the urethra with a 

cutting instrument and then placed bougies made of dried 

paper, and metal sounds in the urethral It was also 

known how to operate in a skilful way in cases of phimosis 

^ and paraphimosis, condylomata and haemorrhoids. § 

Ophthalmology was also able to show remarkable results. 

.Not only trichiasis, hypopyon, leucoma, lachrymal fistula 

and other affections of the external parts of the eye were 

subjected to operative treatment, but even cataract itself. 

To be sure surgeons were ignorant of the essential nature 

of this disease, but they cured it. Here, as so often in 

medicine, Art preceded Science. Operation in cataract 

was effected by couching the diseased lens. If the lens 

rose up again or showed a soft consistence they then in 

addition proceeded to subject it to discission.|| Perhaps 

extraction was also known. Certainly the remark of 

PLINY that the doctors from greediness preferred pushing 

away, to extracting, the scale in the eye, is too deficient 

in clearness, for us to refer it to that operation. The 

statement of GALEN that some surgeons instead of displacing 

the lens have made the attempt to clear it away 

externally,! rather justifies the assumption that the extraction 

operation was practised.** A description of it is no 

* ORIBASIUS iv, 484.-ED. ALBERT: Die Herniologie der Alten, Wien 1878 

S. 144. 

t CELSUS vii, 18, 2O.-ARET.EUS : de acut. ii, 6—PAULUS #0IN. iii, 4,_ 

AETIUS. xiv, 24. 

X ORIBASIUS iv, 472. 

§ ORIBASIUS iv, 466, 470.—PAULUS MG. vi, 79. 

|| CELSUS vii, 7._GALEN x, IO^.-VEGETIUS RENATUS: Mulomediciua ii, 

i7;-PAULus^GiN:vi,2..-A. ANAGNOSTAKIS: Contributions a l'histoirede la 

chirurgie oculaire chez les anciens, Athenes 1872. 

f PLINIUS: Hist. Nat. xxix, 8.-GALEN X, 987—Cf. hereon v. HASNER : 

Phakolog. Studien, Prague 1868. 

** H. MAGNUS (Geschichte des grauen Staares, Leipzig 1877, S. 226 et seq) 

defends, on grounds not to be gainsaid, the view that it is here not a question 

of cataract extraction but of puncture for hypopyon. In any case as ALFR V

Il8 ANCIENT TIMES. 

where to be found. The Arabian author RHAZES ascribes 

>a- knowledge of it to ANTYLLUS and states at the same time 

that the latter was acquainted with the method of removal 

of cataract by suction* It is much to be deplored that the 

ophthalmological literature of ancient times has for the 

most part been lost. 

.F The work of the celebrated ophthalmic surgeon DEM0S- 

.'THENES which at the end of the thirteenth century was 

; made use of by SlMON of Genoa and a copy of which 

perhaps lies hidden in some library at the present day 

would throw light upon many things about which now 

only conjectures are possible. * , 

The course of surgical teaching embraced accordinglo 

CELSUSt first of all the general principles of the art of 

operating and then the treatment of wounds and abscesses, 

and all diseases of the bones. He required of the 

surgeon treating wounds "that he should be of such 

an age as to enjoy the use of all his faculties, should 

possess a steady and firm hand which never shakes, 

and should be able to use the left as dexterously as the 

right hand : his eyesight should be quick and clear, his i 

spirit fearless and not so prone to sympathy as to allow! 

himself, by the cries of the patient, whose treatment he has 

undertaken, to operate more quickly than the case requires 

or to remove less than is necessary. He should not allow 

himself to be influenced in any way in his work by the 

noise made by the patient." The surgeons were assisted 

in the operations by their assistants and pupils. The 

services which these had to render are fully discussed in 

many of the passages specified above. 

GRAEFE (Klin. Monatsbl. f. Augenheilkunde 1868 Januar) says '* The infancy 

of extraction is one of the most difficult chapters in investigating the history 

of medicine " and a positive answer to the question whether the ancients were 

acquainted with it, is not possible. 

* RHAZES: Continens ii, c. 3, Abs. 7-ed. Venet. 1506, fol. 41.—SicHELin 

the Archiv. f. Ophthalm. 1868, xiv, 3, S. 1. 

f CELSUS vii, Praef.

-* 

MEDICAL TEACHING-IN ROME. I 19 

Midwifery was practised by midwives : only in difficult 

cases did these call in the help of doctors and surgeons* 

Women desirous of being trained for midwives should, as 

SORANUS says in his work on gynaecology " know how to 

read, possess understanding and a good memory, be active 

and respectable, quick witted, healthy and strong, and 

should have long thin fingers and short nails." It was not 

demanded of them, as it was in Greece, that they should 

have already themselves given birth. But SORANUS considers 

it right that they should not be too young. He further 

recommends midwives to be habitually temperate, quiet 

and trustworthy, not greedy of money, or superstitious, not 

to be induced for the sake of gain to give medicines to 

procure abortion or to allow themselves to be hindered in 

the fulfilment of their duties by dreams, forebodings, 

mysteries or religious rites. He also advises them to pay 

especial attention to the care of their hands, to rub them 

frequently with fine ointment, and to avoid working with 

wool, which makes the skin hard and dry.f In the training 

of the midwives, regard was had both to theory and 

practice, but care was especially taken that they should be 

instructed in dietetics, materia medica, and the necessary 

surgical manipulations. Their acquaintance with the structure 

of the female genital organs was very meagre: 

SORANUS was of the opinion that there was no need for 

them to know much about the subject. They had fairly 

correct information about the. course of a normal birth, and 

about the help which should be rendered at that time; they 

supported the perineum of the mother with a napkin, tied 

the umbilical cord after the birth, were careful as to the 

delivery of the placenta, etc. They were also made 

acquainted with the various presentations of the fcetus and 

received fitting directions about the choice of a wet nurse, 

* SORANUS EPHES.US, Ed..Dietz, p. loj.-Cf. J. PINOFF in the Janus i, S. 

7°5-75 2 - »> 16-52, 217-245, 730-744. 

f SORANUS p. 3-5.


and about the care of the newly born child* They even 

undertook important operations such as turning by the 

head or feet in faulty presentations.! Embryotomy was 

only performed when all attempts to deliver a living child 

were fruitless.J 

A law said to have been made by NuMA POMPILIUS, 

ordained that the Cesarean section should be performed 

on women dying in labour, in order if possible to save the 

life of the child.§ PLINY || narrates that it was also carried 

out on living parturient women, and SCIPIO AFRICANUS 

owed his life to this operation. 

Many midwives did not confine their sphere of action 

to midwifery and the treatment of women's diseases, but 

advanced into the domain of general medical science, and 

consequently were really female doctors.^ 

Midwives enjoyed great respect. By the Courts they were 

considered** to be experts and later on possessed the right 

of bringing an action in support of claims for services 

rendered.ft Numerous inscriptions give expression to the 

honours paid to them. On a tombstone, as described by 

MOMMSEN, there is found a laudatory epitaph to " the incomparable 

spouse—noblest woman and accomplished midwife." 

One of the most celebrated of medical authors and 

doctors, THEODORUS PRISCIANUS, even dedicated a book 

to a midwife " the charming helper of his art" as he calls 

her.H 

* SORANUS p. 79 et seq. 

't SORANUS p. noetseq. 

X SORANUS p. 113 el seq.—TERTULLIAN : de anima, c. 25. 

§ Pandect, lib. x., tit. 8, de mortuo inferendo. 

|| PLINIUS: hist. nat. vii, 7. 

If MARTIAL: Epigr. xi, 71.— APULEIUS: Metamorph. v, 24.—PLINIUS: hist. 

nat. xxviii, 7, 18, 23, 80—JUVENAL, ii, 141. 

** SENECA : Epist. 66. 

ft Pandect, lib. 50, tit. 13. 

XX TH. PRISCIAN. lib. iii, Prsef.

-nf^j/uuiytfuAu-n J.V. ,..i... ftm 

* 


THE MEDICAL PROFESSION IN ROME. 

The practice of the medical profession was, as has 

already been said, free to anyone without his being 

obliged to show by any examination his fitness for the 

same; but as. early as 88 B.C., the Lex Cornelia made 

him liable to arrest if death was brought about by his 

fault. Moreover the candidature for employment in the 

public sanitary service, and for reception among the number 

of doctors favoured by definite privileges, so too the con 

ditions of suing for medical fees, and especially the 

•extraordinaria cognitio, must have afforded occasion for a 

distinction being made in practical life if not in law, 

between the scientifically trained doctors and the dabblers' 

in medicine.* 

Since many doctors had received a training that was 

incomplete and limited to certain departments, not 

having been taught in all branches of medical science, 

they, under these circumstances, attached themselves to 

certain parts of it. They could in a shorter time acquire 

thein- knowledge necessary for practice in a narrowly circum- 

,s\g scribed department of the healing art. Specialities, 

.isai the beginnings of which reach back to an earlier period' 

ibri gradually acquired a bad reputation, becoming not so 

;ca| much the indication of extraordinary efforts in a special 

sphere as of half-educated charlatanry. The representa 

tives of this class exposed their weakness in an awkward 

manner in their intercourse with educated doctors, and 

served for favourite objects of scorn to the comic 

dramatists. 

The sub-division of medical work was exaggerated 

;bisi. in a senseless manner. There were not only surgeons, 

accoucheurs, gynaecologists, ophthalmic surgeons, dentists,' 

and aurists, but also specialists for nearly every 

part of the body. Some confined themselves to the 

* TH. LOWENFELD : Inaestimabilitat und Honorirung der artes liberates nach 

Tomischem Recht, Miinchen 1887, S. 428. 

jimi "' iiiiir 

't.


treatment of fistulae and ruptures, or of definite parts 

of the body, for instance the buttocks, others had to 

do exclusively with lithotomy, operations for hernia 

or for cataract* In an epigram of MARTIAL t it is said: 

" CASCELLIUS draws teeth out or restores them, HYGINUS 

burns away eyelashes growing against the eye, FANNIUS 

cures a swollen uvula without cutting it, EROS removes 

marks burnt into the skin of slaves, and HERMES is the best 

doctor for hernia." There were special doctors for diseases 

of children and also for those of old age. 

Many specialists made use of particular methods of cure 

and employed particular agents such as water, wine, milk, 

certain medicines and plants, as for instance hellebore.t 

Able doctors, like GALEN, despised these proceedings and 

devoted their attention to all branches of medical science 

although they might in practice prefer this or that branch 

of it. " I believe " writes CELSUS§ " that it is quite possible 

to master all the departments of the healing art. If they 

are sub-divided, however, I prefer the doctor who is skilled 

in the greatest number of them." 

Friendly relations existed between physicians and 

surgeons. "They support and recommend one another 

reciprocally," || says PLUTARCH. It does not appear that 

the surgeons occupied a lower social position than the 

doctors for internal diseases as was the case in later times: 

and nothing leads us to conclude that the former possessed 

a poorer general education than the latter. 

In many cases several doctors were brought into consultation 

by the patients or their friends : they then settled 

in a general interchange of opinion the diagnosis and 

treatment. These consultations may easily have ledf not 

infrequently to stormy differences of opinion in which the 

* Pseudo-GALEN : de part, artis medic. Ed. CIIARTIER ii, 282.—GALEN 

V, 846. 

t MARTIAL : Epigr. x, 56. 

X PLINIUS: Hist. nat. xxix, 5. 

§ CELSUS vii, Prsef. 

|| PLUTARCH: de fraterno amore, c. 15.—GALEN xviii A, 346. 

% PLINIUS op. cit. xxix, 5.

THE MEDICAL PROFESSION IN ROME. I 23 

limits of good behaviour were passed. The dissimilar 

scientific, training is illustrated by the fact that educated 

and experienced doctors like GALEN, in disgust at the 

ignorance and want of ability of their colleagues, passed 

a sharp judgment upon their views and medical directions* 

TiiEODORUS PRISCIANUS has left us a realistic 

description of such consultations.f " While the patient " 

he writes " racked by his pains, tosses himself to and 

fro on his bed, doctors in crowds rush in, each one of 

whom is only concerned to fix the attention of the rest 

upon himself, and cares but little for the condition of the 

patient. In a spirit of emulation like that displayed in a 

circus or at a pugilistic contest, one endeavours to gain 

extraordinary fame by his oratory or his dialectics, another 

by the artistic building up of theses—a structure which his 

adversary soon levels with the ground." The popular 

humour made merry over these things and invented the 

anecdote mentioned by PLINY that in an epitaph it was set 

forth how the deceased expired in the midst of the doctors 

who were treating him. 

The medical profession did not at first enjoy that respect 

which the strenuous, self-sacrificing activity of its members 

deserved. Romans of rank had even at the best only a 

patronizing regard for medicine and looked upon the 

practice of it as a business which was fitted for persons 

of low birth, for servants or slaves.J When at a later 

period the immigration of foreign doctors came about 

and practitioners of medicine from Greece, Egypt, Asia 

Minor and Palestine settled in Rome, the narrow-minded 

bias and civic prejudice with which all foreigners were 

regarded were obstacles in the way of any improvement 

in the social position of doctors. 

It is true that the doctors themselves were largely responsible 

for this. The boastfulness, covetousness and vice by 

which some among them made themselves scorned, afforded 

* GALEN viii, 357. x, 910. xiv, 623 et seq. 

f THEOD. PRESCIANUS i, Prsef. 

X PLINIUS op. cit. xxix, 8.


to their enemies effective weapons to turn against the 

whole profession. PLINY states that doctors so far misused 

their position of trust as to practise legacy-hunting 

and adultery and to compass the death of a human being by 

the administration of poison* 

GALEN goes so far as to compare the doctors in Rome to 

robbers and says that between them there exists but one 

point of difference, namely that the latter carry on their 

infamous practices in the hills and the former in the town.f 

To this were added the obtrusive and braggart manners of 

many foreign practitioners, displeasing to the dignified 

seriousness of the Romans. THESSALUS, who called himself 

the " Conqueror of Doctors " made his way along the 

streets with such a crowd of attendants " as was scarcely 

possessed by a street performer or a celebrated circusrider." 

% Some doctors carried on the hunt for patients 

quite openly and did not blush to ask the passers-by to enter 

their dispensaries which in this case not unfrequently 

degenerated into places of resort for idlers and swindlers. 

The desire to become known and to get practice induced 

many " to recommend themselves to the favour of powerful 

and influential persons, to strut along the streets with them, 

to give banquets and to make buffoons of themselves, while 

others by the splendour of their dress, by costly rings and 

other ornaments sought to dazzle the unreasoning multitude." 

§ As in all times, so then also, ignoramuses and 

quacks loved to conceal by the splendour of external 

semblance the essential hollowness within.|| 

Doctors who possessed more knowledge and intelligence 

resorted to frequent appearance in public in order to make 

themselves known. They held popular lectures, arranged 

discussions with their colleagues which led to embittered 

* PLINIUS op. cit. xxix, 8.—MARTIAI.IS : Epigr. vi, 31.—TACITUS: Annal. 

iv, 3. xii, 67. 

t GALEN xiv, 622. 

X PLINIUS: Hist. Nat. xxix, 5. 

§ GALEN iv, 600. 

|| LUCIAN : Ad indoctum, c 29.

THE MEDICAL PROFESSION IN ROME. 125 

wars of words and as a general rule contributed more to the 

amusement than to the instruction of the public, and they 

performed surgical operations before the eyes of the people 

in the theatre, the circus, or other public places* This 

custom, which is still kept up in Italy by itinerant practitioners 

and especially by dentists, seems to be of Grecooriental 

origin and to have first reached Rome at the time 

of the immigration thither of foreign doctors. 

The fees received by doctors for their services were 

naturally of various amounts and depended upon the means 

of the patients and the position and ability of the doctors. 

GALEN received from the Consul BOETHUS whose wife he 

had treated for a long period 400 gold pieces.t MANLIUS 

CORNUTUS, formerly Praetor and Legate to the Aquitani 

paid the doctor who cured him of a skin disease 200,000 

sestertii.J CHARMIS who distinguished himself by his coldwater 

treatment received a similar sum for a cure which he 

effected abroad.§ When L. STERTINIUS was offered the 

post of body-physician to the Emperor CLAUDIUS he declared 

that the pay of 250,000 sestertii was too low, since, 

as he showed by enumerating the families where he was 

medical attendant, his practice secured to him the annual 

income of 600,000 sestertii. || The doctor KRINAS, who 

made astrology the foundation of his prescriptions, left behind 

him as PLINY tells us a fortune of ten million sestertii 

although he had expended large sums upon public buildings. 

It is told of the surgeon ALCON % that, after he had been 

condemned to a fine of ten million sestertii and to banishment, 

within a few years of his return he again amassed a 

similar fortune. But such splendid receipts were certainly 

* PLUTARCH : de adulatore et amico, c. 32. 

f GALEN xiv, 647. This sum has according to MARQUARDT (op. tit. Bd. v. 

S. 70) a value cf about 8,000 marks. 

X PLINIUS : Hist. Nat. xxvi, 3. Over 40,000 marks. MARQUARDT op. cit. 

S. 72. 

§ PLINIUS op. cit. xxix, 5, 8. 

|| PLINIUS op. cit. xxix, 5. 

If PLINIUS op. cit. xxix, 8.

]26 ANCIENT TIMES. 

.only the lot of a few fortunate ones. The great majority of 

doctors earned hardly as much as the maintenance ot lite 

required The * unequal distribution of wealth which 

was accumulated in the hands of certain families and 

gave the great masses of the people over to poverty, 

offered to but few doctors the opportunity of acquiring riches 

by the exercise of their art. The inconsiderate competition 

for which they themselves were responsible, contributed 

also to this state of affairs by reducing the rate of pay for 

their services to the smallest possible. Whoever has a 

poor practice remains necessarily himself a poor man. 

It came to such a pass that doctors gave up their calling 

if it did not support them and devoted themselves to the— 

as it appears-more profitable business of gladiator or 

undertaker. The spiteful epigram of MARTIAL refers to 

this • he says " DiAULUS was a doctor, is now an undertaker: 

he makes the best use in his power of his professional art." 

« For the rest, while he was still a doctor he was little more 

than an undertaker."t 

Only slowly and by degrees did the social positions ot 

doctors improve. They owed this partly to the successful 

efforts of those members of their profession who by the 

depth of their knowledge and the purity of their character 

won the respect and admiration of their fellow-citizens, 

partly to the continually increasing recognition of the 

necessity and importance of the medical art. Educated 

people began to feel a lively interest in anatomical and 

physiological investigations and in medical science generally. 

"I am of opinion" writes GELLIUS "that it is a disgrace 

not merely for a doctor, but for every independent man 

who has been well brought up, to be ignorant of those 

things which concern the human body and of the means 

for preserving health which Nature lays open before our 

eyes. I have on this account given all the time I could 

spare to the study of medical works, since it was in them 

> # GALEN xii, 916. 

> f MARTIALIS: Epigr. i, 30. 47. viii, 74.

iiMipHP(iJJ|il. ."T»""P 

&4. ' 

THE MEDICAL PROFESSION IN ROME. I 27 

that I hoped to find the best instruction."* In the same 

way PLUTARCH thought that everyone should be able to 

feel his own pulse intelligently and to recognize what 

affected him beneficially or injuriously.t Moreover the 

ethical side of the medical calling was prominently 

brought into notice by some authors. " The doctor should 

not be constrained to visit the sick " writes LuciANj " he 

should not be intimidated or brought to them by force but 

should go freely and willingly." It is impossible to char 

acterize the high dignity, the ideal worth of the healing art 

better than in the words of SENECA : " People pay the 

doctor for his trouble ; for his kindness they still remain in 

his debt." " Thinkest thou " he says elsewhere " that thou 

owest the doctor and the teacher nothing more than his 

fee ? We think that great reverence and love are due to 

both. We have received from them priceless benefits 

from the doctor health and life, from the teacher the noble 

culture of the soul. Both are our friends and deserve our 

most sincere thanks not so much by their merchantable art 

as by their frank good-will."§ 

Even at an earlier period the necessity of medical aid 

led to such appointments as family doctors, doctors for 

communities, the army,, and societies. Rich people who 

possessed large establishments and many slaves took care 

to have a doctor at command at any time in case of 

sickness. With this object they made a contract with a 

neighbouring doctor, which bound the latter for a yearly 

salary to afford any medical services required. || Still more 

convenient for them was it when there existed in their 

household a slave with medical knowledge whom they 

could trust with the care of the health of themselves and 

their relatives.^ Slaves of this kind were much in request 

* GELLIUS: Noct. Attic, xviii, 10. 

f PLUTARCH : de sanitate tuenda praec. c. 24-25. 

X LUCIAN : Abdicatus (The disowned son), c. 23. 

§ SENECA: de benefic. vi, 15, 16, 17. 

|| VARRO: de re rustica. i, 16. 

*TT SUETON : Nero, c. 2.—Calig. c. 8.—SENECA : de benef. iii, 24. \ \


and commanded a higher price than most; they were 

even sold for larger sums than Eunuchs* It occurred , 

sometimes too that young and gifted slaves were instructed 

in medicine and trained up to be doctors at the cost ot 

their masters. The dependent position of these doctors 

excused them somewhat if instead of confining the apphcation 

of their medical knowledge to dressing wounds and 

curing diseases, they sometimes abused it by perpetrating 

horrible deeds and serious crimes at the command of. 

their masters.t If the master was himself a doctor they 

served him in the capacity of assistant: if they treated 

patients independently they were obliged to hand over any 

fee received in this way to the master, forming for him by 

such means a highly lucrative source of income. Under 

these circumstances it is easily understood that he was very 

unwilling to confer freedom on a slave of-this kind; for by < 

doing so he not only diminished his income but raised up •< 

an opponent, doubly dangerous to him since he knew the 

master's patients. As little were the laymen inclined to 

deprive themselves of a slave possessed of medical knowledge 

since they thus lost a resident doctor always at hand 

and devoted to their service.! The law was compelled ' 

therefore to reconcile the mutually opposed interests of 

masters and slaves, laying down on the one hand the 

conditions under which the slaves were entitled to demand' 

freedom and the scale by which the loss of income might:. 

be calculated, and on the other hand imposing obligations 

'upon the freed men in respect of their former masters, which 

protected the latter from inordinate losses.§ The slaves 

educated in medicine, belonging to the State, who probably 

had the care of the ailing servi public/, appear to have been 

generally under more favourable conditions and in a better 

position than their colleagues who were the property of 

private people. 

* Cod. Just, vi, tit. 43, £ vii, tit. 7, i, 5. 

f CICERO: ad Pison., c. 34.—Pro Cluentio, c. 14 e* seq.—Tacitus Annal.xv, 63. 

X Digest, xl, tit. 5,0. 41, 6. 

§ Digest, xxxviii, tit. 1, c. 25-27.


Certain material advantages and privileges were granted 

to the free doctors as it was recognized how useful and 

important the healing art is to the general good. When 

C-ESAR, during a famine which fell upon Rome in the year 

46 B.C., ordered the expulsion of foreigners he expressly 

excepted the doctors and teachers from this general rule 

"so that they should be all the more willing to dwell in the 

city and even should induce others to come and live there."* 

The Emperor AUGUSTUS granted to the doctors in 10.A.D. 

immunity from taxes and other burdens, professedly in 

recognition of the successful treatment of an obstinate 

rheumatic complaint carried out on him by his bodyphysician 

MuSA, an enthusiastic advocate of hydrotherapeutics.f 

VESPASIAN renewed or confirmed this privilege 

and HADRIAN published rules defining the immunities 

bestowed on doctors.J 

From this ordinance which was renewed under 

ANTONINUS PIUS, we learn that they were exempt from 

bearing various offices entailing expenditure of time and 

money, as that of overseer of the public games, the aedileship, 

and the priestly function : they were also free from 

having soldiers quartered on them and from military service 

: moreover they were not compelled to contribute to 

the purchase of grain and oil, when this was done by the 

State, to execute the functions of judge or legate or to 

perform any military or other public service.§ ANTONINUS 

PIUS ordained however at the same time that these extensive 

privileges should not be granted to all doctors without 

distinction but only to a certain definite number of them. 

It was decreed that in smaller towns only five, in middlesized 

towns seven, and in larger ones ten doctors should 

enjoy this immunity and that at any time on their being 

* SUETON : J. Caesar, c. 42. 

t DION CASSILS liii, 3O.~SUETON: Augustus, c. 59.—HORAT : Epist. i, 15. 

X Digest. 1, tit. 4. de muner. et honor, lex 18, 30. 

§ Digest, xxvii. tit. 1. de excusat., c. 6, 8.—E. KUHN : Die stadtische und 

burgerl. Verfassung des rom. Reiches, Leipzig 1864, i, S. 69 et seq. 

K

13° 


found guilty of culpable negligence the magistracy might 

deprive them of such immunity. 

Moreover in granting these privileges p r e ^ 

shown in favour of doctors who practised m their native 

owns as against those who had emigrated from others. 

These immigrants were only respected when they had n 

some way prominently distinguished themselves. And in 

cases of exceptional merit the prescribed n u * 

receiving immunity might be exceeded. ALEXANDER 

SEVERUS made a decree that in the provinces the imtunity 

should no longer be granted by the State magis- | 

tracy but by the burghers and landowners who were the 

besMudges'of the character and ability of the doctors t 

whom they trusted themselves in sickness* At a later 

period there was granted to the doctors the extraordinary 

cognitio or the right to bring their actions for fees in arrear 

directly before the highest court in the province.f It 

would appear that at first all that was sought was to retain 

able and educated doctors, by such privileges, in a particular 

spot, as the example of ARCHAGATHOS teaches us 

Soon however they may have had certain definite duties : 

laid upon them in the interest of the public When the 

institution of public medical officers as it existed in Greece 

was introduced into the Roman Empire, the rights bound 

up with the duties of public service were reserved for 

them And the above mentioned privileges were at a later, 

period bestowed chiefly if not exclusively upon the public 

medical officers. The number of the latter was dependent 

upon the size of the town and was, as it appears, settled in 

accordance with the law for the granting of immunities. 

In Gaul there were public medical officers % before the^ 

time of STRABO, in Asia Minor perhaps even earlier, § and| 

in Latium at any rate under TRAJAN, as we learn from an 

* Digest. 1, tit. 9. de decretisab ord. fac, c. 1. 

t Digest, i, tit. 13,0. 1. 

t STRABO iv, 1. . 

§ VERCOUTRE op. cit. p. 351.-ORELL1: Inscnpt. lat, No. 3507.


epitaph which is devoted to the salaried doctor of the town 

of Ferentinum.* 

In Rome a doctor was appointed for every district of the 

city. The public medical officers were especially bound to 

attend the poor without being paid by them; but they were 

by no means debarred from private practice. Moreover 

they were called into consultation in epidemics and other 

occurrences which entailed an increase of sickness and 

mortality: in addition, the duty of medical teaching was 

included in the list of their obligations. From the community 

they received a salary which consisted chiefly of 

articles of natural produce. In large cities like Rome they 

formed colleges which when a place fell vacant completed 

the establishment by election. But their choice was subject 

to imperial ratification. The office seems often to 

have passed from father to son.f Under the rule of the 

Emperors VALENTINIAN I. and VALENS (368 A.D.) the 

qualifications for, and conditions of, holding office as 

public medical officer were settled in detail. J 

Since this period they bore the official title of Archiatri 

populares the origin of which dates from a still earlier 

time. The word Archiater is found in ARETÛS§ and is 

obviously, by the analogy of other expressions, formed 

upon the root ap% indicating dignity and high position.|| 

At the earliest period it appears to have been used to 

designate the doctors of the imperial Court. STERTINIUS 

XENOPHON, on whose history an interesting light has been 

thrown by the discovery, a short time ago, of his gravestone 

covered with inscriptions,^ bore the title of Archiater 

* MARQUARDT op. cit. vii, 755. 

t VERCOUTRE op, cit. p. 321. 

X Cod. Theodos. xiii, T. 3. de med. et profess., c. 8-10—Cod. Justin, x, 

T. 52, c. 10. 

§ ARETJEUS : de acut. cur. ii, 5. 

|| G. CURTIUS: Grundzuge der griechischen Etymologie, Leipzig 1879,8. 

189. 

1 M. DUBOIS : Un medecin de l'empereur Claude. Bull. d. corresp. helle'n. 

J88I, NO. 7, 8.


and even before him probably M. Livius EuTYCHUS. In 

a similar way, NERO'S private medical attendant, ANDRO-' 

MACHUS was denominated Archiater, the Emperor wishing 

by this to point out, as GALEN says,t that he surpassed 

other doctors in experience and knowledge. In another 

passage GALEN makes mention of the doctors MAGNUS /> 

and DEMETRIUS who at that time enjoyed the dignity of 

Archiater.J At a later period the Court doctors bore the • 

title Archiatri palatini in contradistinction to the Archie J 

atnpopulares—the public medical officers. At the Court.;; 

of the Emperor ALEXANDER SEVERUS were seven doctors 

of whom however the first, the private body-physician, alone | 

received a salary in money, the rest only receiving their 

board. Moreover they participated in the privileges and 

favours which were extended to Archiatri and to doctors in 

general.§ Like the Courts and Communities, so too 

Societies had their private doctors. Doctors were also 

appointed for certain classes of officials, for the personnel 

of the theatre, for the Circus and the Gladiators.|| 

The various troops had their doctors who accompanied 

them into the field and treated the sick and woundedH 

soldiers either in their tents or in the military hospitals. 1 

They bore arms like other soldiers^ and enjoyed the 

immunities granted to other doctors. But little information -, 

exists as to the relative rank of military medical officers or \ 

their relations to those set over them.** At the head of 

the whole military medical establishment there was probably 

a general medical officer on the staff.tt In the 1 

same way the navy was provided with doctors: and| 

* R. BRIAU : Archiatrie romaine. Paris 1877, c. 2. 

f GALEN xiv, 211. 

X GALEN xiv, 261. 

§ LAMPRIDIUS : Alexander Severus, c. 42. 

H R. BRIAU : L'assistance me'dicale chez les Romains, Paris 1869. 

% On TRAJAN'S column at Rome two military doctors are represented binding 

up wounds and drawing out arrows: they are armed. 

** R. BRIAU : Du service de sante militaire chez les Romains, Paris 1866. | 

-j-f ACHILLES TATIUS: de Clitop. et Leucipp. amor, iv, 10.


amongst them were specialists, as a remark of GALEN 

informs us.* 

Doctors who rendered important services by their ability 

were distinguished by titles and dignities, by promotion 

and other honours. In Rome, as elsewhere, it was chiefly 

the Court doctors on whom these marks of favour were 

bestowed.f MUSA was raised to equestrian rank by the 

Emperor AUGUSTUS, and his statue was placed in the 

temple of ASKLEPIOS. STERTINIUS XENOPHON received for 

his exertions as military doctor the corona aurea and the 

hast a pura at the hands of CLAUDIUS. AS imperial bodyphysician 

he obtained such influence that he was nominated 

to the Secretaryship of State for Greek affairs. Thanks 

chiefly to him, his home, the island of Kos, was relieved 

from taxation.| In later times it not unfrequently happened 

that doctors accepted high positions at Court or in the 

government of the State and in that case they probably 

renounced the practice of their profession. 

The decline of the Roman Empire smothered scientific 

effort, and annihilated many excellent arrangements which 

had been made in the spheres of teaching and of medical 

science; but the essential principles of organization were 

maintained, even if by ignorance and unfavourable circumstances 

they were misused or even entirely perverted. The 

rich medical literature which was saved, handed over to 

later times the acquisitions of a former age and pointed 

out to medical investigation the path it must follow in order 

to achieve success. 

END OF PART I. 

* GALEN xii, 786. t Cod. Just, xii, tit. 13. 

X TACITUS: Annal. xii, 61.

II. MEDICAL TEACHING IN THE MIDDLE AGES. 

THE INFLUENCE OF CHRISTIANITY. 

THE organization of the Roman State became subject t 

insidious diseases which, attacking the vital parts, led to a 

long period of infirmity brought finally to an inglorious 

conclusion by the victorious assaults of external foes 

Incapacity and profligacy upon the Throne, the division of 

the government among numerous rulers mutually, envious 

and hostile, the corruption of officials and the venality^ a 

haughty and overbearing soldiery, undermined the political 

basis of the State, while social life in Rome was poisoned 

by the loosening of family ties, love of pleasure, pride, the 

reckless squandering of riches by the wealthy contrasted 

with the misery of the great masses of the people, and 

finally the audacious effrontery with which vice manifested 

itself on all sides. The people of the North, those healthy 

children of Nature, coming to Rome first as mercenary 

soldiers, then as regularly engaged defenders, and finally -; 

as governing lords, accelerated this process of decay and 

gave, out of compassion, the death-blow to the Roman 

Empire worn to pieces as it was by internal troubles and 

bleeding and maimed by innumerable wounds. The courage 

and heroism, which had covered the name of the Romans 

with glory and had made their state powerful, were extinct J 

or if an isolated courageous act occasionally recalled past | 

times it served only to illuminate with a momentary lightening-flash 

the dark night of the present. The struggles of 

the ambitious towards ideal perfection found outlets rather 

in the domain of theology and of self-sacrificing piety. 

This mode of thought, led up to by the severe simplicity of 

manners of the disciples of the Stoa, but which was first! 

extended into more general acceptance by Christianity,

A 

I 

THE INFLUENCE OF CHRISTIANITY 135 

found in the patient bearing of suffering and in abstention 

from the pleasures of life the greatest and highest virtue 

it was possible for man to strive after. The Christian 

doctrine of Faith gave an effective spur to such ideas in 

offering to people an expectation of a life after death in 

which all injustice is reconciled, virtue receiving its reward 

and vice its punishment. The poor and miserable of this 

world were afforded the hope of a better and brighter 

future in store for them which might console them for the 

wretchedness of the present; pity was instilled into the 

hearts of the rich, and sinners were filled with fear and 

horror and by these means were urged to better things. 

This solution of social questions corresponded to the wants 

and conditions of civilization of that period and on that 

account was bound to obtain for itself general recognition. 

The first adherents of Christianity belonged to the circles 

of the oppressed and the poor : at a later period it found 

believers also amongst those blessed with worldly posses 

sions, the so-called higher classes of society, members of 

which, disgusted by the moral depravity of the time, sought 

for comfort and edification in the doctrines of the new 

Gospel. 

So long as the Christian Church consisted of elements 

such as these, its purity endured, and the religion of peace 

and love remained as conceived of in the mind of its revered 

Founder. But when, with its extension and increase, power 

and riches were added to it, and from this cause a number 

of ambitious and unprincipled adventurers were attracted, 

it became the battle-field of human passions and gave rise 

frequently to more evil than good. 

Christianity concerned itself only with the moral culture 

of mankind : to the training of the intellect it remained 

indifferent, sometimes even openly hostile. This was 

only natural : for in a theory of life which like that held 

by the Christian Church saw its goal in the perfect ideal of 

a world invisible, and declared the moral improvement of 

man to be its principal or only task, no great importance

136 THE MIDDLE AGES. 

could be ascribed to scientific investigation. But science 

stood in direct opposition to Christian dogma when it made 

the manifestations of Nature, as for example the human 

body—which the Christian faith held as impure and worth 

less, if not despicable—the subject-matter of its study. The 

natural sciences and theoretical medicine consequently made 

no essential progress under the authority of the Christian 

Church. .V 

On the other hand the science of medicine has to thankA 

the initiative of the Church for the foundation of numerous 

hospitals and other benevolent institutions which satisfied the 

promptings of humanity and the requirements of the healing 

art in an equal degree. The development of the sciences 

was at this time also impeded by other conditions and cir 

cumstances. The constant wars and predatory expeditions 

of hostile races, the religious persecutions and controversies 

on points of dogma, the social changes called forth by the 

insecurity of property and life, the grievous pestilences 

which depopulated whole countries and turned them into 

wildernesses ;—all these things diverted attention from 

scientific pursuits and deprived people who were inclined 

to such, of the repose required for successfully engaging in 

them. But the chief cause of the arrest of scientific pro 

gress was the fact that the peoples who had divided the 

Roman Empire among themselves were far inferior to the 

Romans in education and consequently had first of all 

the task imposed upon them of assimilating to themselves 

the culture of their predecessors. This process endured 

for centuries and was completely effected only at the end 

of the Middle Ages. 

The division of the Roman Monarchy into an Eastern and 

Western half gave once more clear political expression to 

the old opposition between the Orient and the Occident 

which had never entirely disappeared. But a natural result 

was the disintegration of that great state organization of 

which one limb was thus separated from the other. The 

loose connections of the provinces with the central power at

THE INFLUENCE OF CHRISTIANITY 137 

Rome or Constantinople facilitated their acquisition of 

freedom. The German races, borne on by the tide of 

peoples setting from the North and East towards the South 

and West, soon made themselves at home in their new 

abodes and founded new States. At the close of the fifth 

century the Ostrogoths, followed later by the Lombards, 

ruled in Italy, the Visigoths in Spain and South West 

France, the Burgundians and Franks in the East and North 

•of this district, while the Anglo-Saxon races crossed over 

into Britain, and the Roman province of Africa was the 

prey of the Vandals. Tribes of Saxons, Bavarians, 

Alemanni and Franks remained in Germany and the sway 

•of the Byzantians was pressed upon in Asia by the Persians, 

and in Europe by the Goths, Huns, and Slavs in an ever 

increasing degree. 

The conquerors preserved many of the political and 

social regulations which they found existing in the countries 

subdued by them. This was a triumph which those who 

had been defeated in a contest of physical strength, were, 

in consequence of their higher culture, able to celebrate 

•over their less educated conquerors. The latter were able 

to recognize the great advantages which would accrue to 

them from an increase of knowledge and on this account 

took care that the Schools and Teaching-institutions should 

be as far as possible preserved. The civilizing influence of 

the Romans had been felt in all parts of the Empire, but 

especially in the western half. Numerous places of 

education in Gaul, Spain, Britain and North Africa bore 

witness to this. The literary efforts of the Roman authors 

who drew their origin from these lands show how success 

ful in their work were these institutions.* 

After the pattern of the establishments for advanced 

teaching in Athens, Alexandria, and Rome there arose also 

high schools both in the East and in the various larger 

* MOMMSEN op. cit. Bd. v, S. 69 et seq., 100 et seq., 176 et seq., 643, 655 

•et seq. — GIBBON : Decline and Fall of the Roman Empire. Vol. i, p. 49-50, 

Lond. 1828.

T38 THE MIDDLE AGES. 

towns of Italy, Gaul and Spain* in which, along with 

Greek and Roman literature, were also taught grammar, 

history, philosophy, rhetoric, jurisprudence, mathematics, 

physics and astronomy, and sometimes also medicine. The 

organization of these places resembled in many respects 

that of the English Universities. They had in view not so 

much preparation for any particular calling as the object of 

giving a general education embracing all subjects of knowledge 

then in the possession of mankind. The professors 

of 'these high schools were paid at the public cost and 

enjoyed immunities, freedom from taxation, and other 

privileges. Their number was limited and was regulated— ; ! 

as was that of the Archiatri—in accordance with the size 

of the town. Thirty-one professors were appointed to the • 

high school at Constantinople which was founded in the 

fifth century A.D.f Besides the professors nominated by 

the authorities of the town or the Government there appear 

to have been other teachers who, like private tutors of 

the present day, made a profession of teaching without 

receiving any regular salary. 

The sons of wealthy parents were generally accompanied 

to the high schools by attendants who, partaking of the 

characters both of governors and servants, in most cases 

belonged to the class of slaves either actual or recently 

emancipated. The teachers received from their pupils a 

fee settled by agreement. For such fees to produce a 

satisfactory income it was a matter of great importance 1 

to the teachers that they should have numerous pupils. 

The student life, as it was developed in Rome and.! 

Athens, resembled in many respects the Continental student :i 

life of the present day. The students joined in societies-1 

according to the country of their birth, sought to attract 

and enrol new comers, " freshmen," by all means of per- 

* F. CRAMER : Geschichte der Erziehung und des Unterrichts im Alterthumjl 

Elberfeld 1832, Bd. i, S. 477 et seq. 

' f J. C F. BAHR : De literarum universitate Constantinopoli, Heidelberg- 

1835.—SAVIONY: Geschichte des romischen Rechts, Bd. i, S. 396.

THE INFLUENCE OF CHRISTIANITY. 139/ 

suasion, artifice and often even force, held drinking bouts 

and feasts and, on occasion, gave vent to the furious 

passions of youth. There was, indeed,- no lack of out 

rageous and insolent conduct and deplorable excesses. In 

Antioch it happened once that the students wrapped in a 

rug a pedagogue who had incurred their dislike, and tossed 

him in the air and caught him again such a number of times 

that he finally fainted away. The philosopher LlBANlus, 

who occupied a professorial chair at the same time and 

place, admonished his pupils who had probably participated 

in this rough sport in the following terms: " Bad enough 

were it for students to lay hands on ordinary citizens, to 

insult a goldsmith, to provoke a shoemaker, to beat a 

carpenter, to kick a weaver, to maul a shopkeeper, or to 

threaten an oil merchant: but to ill-use a pedagogue is an 

injury to one occupying a most respectable and useful 

position and deserves chastisement with the rod and the 

whip."* 

For the rest, the students were subject to strict laws. 

According to an ordinance of VALENTINIAN (370 A.D.) they 

were obliged on entering upon their studies to produce 

testimonials from the magistrates of their native towns, and 

their names, addresses and the position of their parents 

were entered on a public register. They were forbidden to 

waste their time in pleasure-seeking. If they transgressed 

these injunctions they rendered themselves liable to 

corporal punishment and could be expelled from the 

school. The prefect of the town made a yearly report 

upon the ability and behaviour of the students to the 

superior imperial authority, f 

With the twentieth year of age the studies had to come 

to an end. It thus appears that they began pretty early. 

In the Isagoge in artem medicam% falsely ascribed to 

* LIBANIUS : Orat. et declamat. Ed. J. J. REISKE, Altenburg 1795, T. iii, 

p. 254, 259 (crept TOV rawifroq). 

t Cod. Theodos. L. xiv, T. 1, 1. 

X VAL. ROSE: Anecdota graeca et graecolatina, Berlin 1864, ii, p. 169, 244 

et seq.


SORANUS but certainly of ancient origin the proper time for 

the commencement of medical studies is declared to be the, 

fifteenth year. The author takes the opportunity of remarking 

" that the student must be industrious, intelligent and 

of ready apprehension, in order to understand and learri 

quickly; that he needs also a strong body that he may 

bear the exertion to which he will be subjected." It was. 

moreover required of him that he should possess a scientific 

preliminary training and that he should have been taught 

grammar, the history of literature, rhetoric, mathematics 

and astronomy. " The doctor," he adds, " must combine 

gentleness and modesty with becoming dignity, must 

possess an irreproachable character, must not act with 

haughtiness but must treat the poor and the rich, slaves 

and free all alike." The medical lectures which were 

delivered in the high schools by learned theorists, the. 

Iatrosophists as they were called, consisted of philosophic 

examination and profound discussion of various questions 

of physiology and pathology : but they did not suffice to 

prepare those who attended them for the actual practice of 

medicine. This part of medical training was effected in a 

more satisfactory and practical way by the Archiatri and 

by practising doctors generally, who imparted instruction 

in the healing art. 

The schools of the Sophists and the higher teaching institutions 

demanded no definite confession of .faith from | 

their teachers or pupils. Heathens and Christians taught 

at them, and in their lecture rooms the adherents of various > j 

churches and sects mixed freely. Only during the short 

reign of JULIAN were the Christians excluded from the I 

position of teachers in the heathen schools. Already at 

that time weak attempts were made to free Christians from 

a heathen education but only one hundred years later did 

success crown the efforts of SALVIANUS, of PRUDENT1US, 

OROS1US and others to produce a literature containing I 

Christian subject-matter and founded on the writings of the ; 

Old and New Testaments. The indifference and contempt j

THE INFLUENCE OF CHRISTIANITY. 141 

which the lights of the Christian Church manifested in 

regard to the intellectual creations of the Greeks and 

Romans* the one-sidedness which moved them to confine 

their choice of material to what had been transmitted 

through Jewish and Christian channels, and the tendency to 

disparage the civilization acquired in ancient times, gave to 

these literary productions a very prejudiced character and 

make it clear to us why enlightened contemporaries, not 

affected by religious bias, were able to discern in them 

no sign of progress in the intellectual development of 

man. 

If the struggle between the Christian training and that of 

the Ancients had been decided with the weapons of the 

intellect the. superiority of the latter must have been 

proved: but it was soon transferred to the fields of political 

power where the victory falls to the strongest. When the 

Christians, after having for centuries been persecuted by 

the heathen, at length obtained dominion in the state, they 

on their side began to oppress their former oppressors. 

Eagerly labouring to dig up the roots which attached man 

kind to the heathen past, they attacked the system of 

teaching resting upon the study of the ancients, and endea 

voured so to modify it in accordance with their way of 

thinking that it should assume a form compatible with 

Christian dogma. Failing in this they employed force 

and abolished the teaching-institutions. By an edict of 

JUSTINIAN' of the year 529 the schools of philosophy at 

Athens and Alexandria were closed. The last of the Greek 

philosophers abandoned their homes and sought protection 

and freedom for thought in foreign lands. In Constantinople 

and other places, especially in the countries of the west, 

the temples of the Muses were transformed into Christian 

schools in which the study of religion was the predominant 

feature. The priests took over the direction of education 

and became the representatives of knowledge. To them 

* Archiv. f. Geschichte u. Literatur; herausg. v. F. C. SCHLOSSER U. BERCHT 

i, S. 253 et seq.


religious faith was the highest law, and limits were imposed 

on investigation which no one dared to transgress. 

In the schools which arose at the residences of the 

bishops and adjoining the cloisters, not only theology and 

Church history were taught but also all subjects belonging 

to general education or of importance and use in daily life. 

Medical science was frequently included in the list of subjects.: 

and was.especially cultivated in the schools of the 

East. ST. BENEDICT introduced this system into the lands 

of the West and aroused the members of the order which 

he founded to the study of medicine. CASSIODORUS also' 

recommended the pursuit of medical knowledge to the 

monks into whose cloisters he had retired after-having 

played an important part in political life for many years as 

Minister to THEODORIC, King of the Ostrogoths: he gave 

them detailed advice as to which medical authors of 

antiquity they should make the- groundwork of their 

studies.* 

Medicine was very zealously pursued, it appears, in the 

schools of the Nestorians. Prominent members of the 

priesthood in this sect were famed for their medical 

abilities and were taken into council by the princes.f The 

teaching establishments of the Nestorians were arranged 

like the schools of ST. ORIGEN at Alexandria.^ Adherents 

of other Faiths and even heathen were employed as 

teachers at them but naturally only in profane sciences. 

The students had to pay a fee for being taught, sometimes 

a not inconsiderable one. The Church paid the fees for 

poor scholars and afforded them support besides. The best 

known educational establishments were at Edessa, Nisibis, 

Seleucia and Dorkena: at a later date schools of the same 

,kindnwere founded in Baghdad, Messene, Hirta, Matotha, 

Jemama and other towns in Syria.§ Many were much 

* CASSIODOR : Institut. divin. lect. i, c. 31. 

t ASSEMANI: Bibliotheca orientalis, Rome 1728, iii, pars 1, p. 166. 

X ASSEMANI op. cit. iii, pars 2, p. 919 et seq. 

§ ASSEMANI op. cit. iii, pars 2, p. 924.


143 

frequented ; Nisibis at one time numbered 800 students, of 

whom some came even from Italy and Africa. 

When the Nestorian men of learning were driven out of 

Edessa by the religious fanaticism of the Byzantine Emperors, 

they fled to Persia where they contributed 

essentially to the rapid progress which the sciences, and 

especially the science of medicine, made at the school of 

Gondisapur. While its origin dated probably three centuries 

earlier* the period of its prime was under KESRA 

NUSCHIRVAN in the sixth century. This monarch was 

thoroughly acquainted with Greek literature and was the 

benevolent protector of all scientific effort. At his hands 

the exiled Nestorians found the same hearty reception as 

the philosophers of Athens ; in the same way he supported 

and helped the Jewish and Syrian men of learning who 

were the means of transmitting to the Persians the culture 

of the Greeks. He sent his physician-in-ordinary, 

BURZWEIH, to India, in order that he might make himself 

acquainted with the medical practice of that country and 

bring back drugs and medical writings : and he imposed as 

a condition when concluding peace with the Emperor of - 

Byzantium that the doctor TRIBUNUS of Palestine, one of 

the most celebrated practitioners of his time, should be " 

given over to him for a year. In Gondisapur the knowledge 

of the West and the wisdom of the East came into contact. 

Greek medicine here walked hand in hand with that of the 

Persians and Indians, and this alliance concealed the germs 

of the rapid growth which the science experienced under 

the Arabs. Medical teaching at the School of Gondisapur 

was chiefly, if not exclusively, carried on by the learned 

Nestorians. It was not merely theoretical but more indeed 

of a practical nature and took place in the Hospital.f This 

hospital was maintained during the Arab rule and was 

mentioned even at the end of the tenth century. 

* J. H. SCHULZE: De Gondisapora Persarum quondam Academia Medica in 

Comment. Acad. Petropolit. 1751, xiii, p. 437 et seq. 

t ASSEMANI op. cit. iii, pars 2, p. 940 et seq.

144 T H E MIDDLE AGES. 

Medical science made no remarkable progress during 

the time of the decline of the Roman Empire and the | 

period following thereupon. The training of doctors was,"

¥• 


cumstance that his works were not destroyed by the theosophists 

of the Christian and Islamite eras, filled with 

rage and brutal fanaticism as they were against the 

literary memorials of antiquity; but that they were on the 

contrary carefully preserved and zealously studied and even 

given wider extension. 

While the theoretical departments of the study of medicine 

were doomed to inaction, a prospect of successful 

scientific effort disclosed itself to practical medical science 

through the foundation of hospitals. The charitable institutions 

which Christian philanthropy called into existence 

afforded opportunities for the observation of diseases 

and injuries of all kinds and offered facilities to doctors for 

acquiring education in their art and for amassing experience. 

To assert that the foundation of public hospitals is 

exclusively a product of jChristianity is certainly inaccurate. 

Even the Buddhists, as we have seen, were acquainted with 

such institutions, and the Iatreia of the Greek physicians 

and especially those maintained at the public cost, were 

essentially nothing but public hospitals. The convalescent 

institutions of the Romans which were fitted up for slaves 

and soldiers differed from them only in the fact that they 

were intended for particular classes of the community. 

The Spaniards on reaching Mexico after the discovery of 

America, found hospitals there too and even praised them* 

highly. VlRCHOW is right when he says that " every 

civilization which humanizes the manners and customs 

of people up to a certain degree and giyes a more finished 

form to society, ends by being moved to the foundation of 

hospitals." t 

Christianity however deserves the incontestable merit' of 

having kindled into a clear flame of enthusiasm the sparks 

of true philanthropy which she found glowing in obscurity. 

No other religion, no political or social power 

* PRESCOTT : The conquest of Mexico, London 1863, 2nd Ed., i, p. 26, 169. 

t" VIRCHOW : Tiber Hospitaler und Lazarethe in seinen gesammelten A.bhand- 

lungen, Berlin 1879, "> S. 8- 

L


has essayed or has effected so much for the human race 

as Christianity, Where it spread and found adherents, 

there works of mercy were practised and temples were 

erected to objects of charity. The extraordinary results 

which the Christian religion succeeded in effecting in the 

first centuries after its origin depended certainly in great 

measure on the humanitarian ideas which it proclaimed. 

To be sure, acts of philanthropy were conspicuous even 

in ancient times, acts which claim our admiration; but 

they were at best isolated and produced no enduring effect. 

Christianity united the humanitarian efforts of individuals 

and gave a collective character to charity. Ancient times 

saw in the slave, a beast endowed with human speech, a 

possession intended for profitable use; Christianity while 

unable, it is true, to do away with slavery had regard also to | 

the dignity of man existing even in slaves. CATO advised 

cultivators of the soil to sell their old and sick slaves like 

cattle no longer able to work and old iron.* Many masters 

drove their slaves out of their houses when through sickness 

and old age they had become unprofitable ; indeed, 

the Emperor CLAUDIUS in order to put a stop to this 

abuse caused the slaves, in this case, to be proclaimed i 

freemen.f Christianity preached compassion for the 

oppressed, support for the poor and helpless, and care for 

the sick. Many adherents to this faith gave their possessions 

to the poor, or to the Church in order that she might 

give alms therewith. The Church in Rome in the third 

century provided 1,500 poor with daily sustenance J and the 

Church at Antioch maintained over 3,000 at the time of 

St. Chrysostom.§ The erection of homes for the poor and 

sick, and of other charitable institutions appears to have 

begun in the East. 

The slaves were treated better and with greater humanity 

in Greece than in any other country of the ancient world : || 

* CATO: de re rustica, c. 2. J EUSEBIUS : Hist, eccles, vi, 43. 

t SUETON: Claudius, c. 25. § CHRYSOST. : hom. 66 in Matth. 

|| MOMMSEN op. cit. v. 250. 

i


there, even in the times of heathendom poor people and 

strangers found a friendly welcome and medical care in the 

Aenodochia, in the event of sickness. 

Christianity, in fine, organized the administration of 

charity and called institutions into existence which in size 

and prevalence surpassed previous experience. The 

institution at Caesarea founded by ST. BASIL resembled 

a town; it contained numerous dwellings for the poor 

and sick, was excellently administered, and had special 

doctors and attendants for the sick in its service* 

GREGORY of Nazianzus calls this institution "the treasury 

of piety, where disease becomes a school of wisdom, 

where misery is changed into happiness."t EDESSA 

possessed in 375 A.D. a hospital which was provided with 

.300 beds.J Similar institutions arose in other places of 

Asia Minor, as also in Alexandria and Constantinople, for 

the relief of the suffering and infirm. 

The first Christian infirmary was, as ST. JEROME narrates, 

founded in Rome by the widow FABIOLA who belonged to 

the ancient family of the Fabii, at the end of the fourth 

century.§ Other rich private persons followed her pious 

example and the erection of charitable institutions became 

the fashion with distinguished Roman ladies. In any case, 

if PAULA built a hospital she conferred a greater blessing 

on humanity by so doing than by condemning her daughter 

to .perpetual virginity, although she was for this act 

honoured by ST. JEROME with the title of the mother-inlaw 

of God, as GIBBON says.|| Elsewhere in Italy, as also 

in Gaul and Spain, asylums for the sick and poor were 

erected. The Bishop MASONA of Merida (573-606), a 

* GREGORY of Nazianzus: Orat. funebr. in Basil. & Orat. de pauperum 

•cura.—BASILIUS: Epist. 94. 

f C.SCHMIDT: Die biirgerliche Gesellshaft in der altromischen Welt und ihre 

Umgestaltung durch das Christenthum, Leipzig 1857, S. 246. 

X E. CHASTEL : Die Christliche Barmherzigkeit in den ersten Jahrhunderten 

der Kirche, fibers v. Wichern, Hamburg 1854, S. 13-. 

§ HIERONYMUS: Ep. 77, Ed. Vallarsi. 

|| GIBBON op. cit. c. 37. p. 398.

J4.8 THE MIDDLE AGES. 

Goth, founded a hospital to which Christians and Jews, 

slaves and freemen found admittance, and he ordered 

that half of the gifts received by the Church" should be 

given to this institution. He ordered the doctors who 

were appointed to it, to go round about the town and 

invite the sick to let themselves be taken to this establishment. 

The Hotel-Djeu at Lyons was founded in 542 A.D. 

by CHILDEBERT I. and was under the supervision of 

laymen.* 

The Church pronounced the care of the sick to be a 

work pleasing to God. The faithful strove earnestly with 

one another in this matter how best to help the afflicted 

and did not shrink from performing the meanest and most 

disagreeable tasks. FABIOLA carried the sick to their 

beds in her arms and washed out wounds which others 

scarcely dared to look upon.t The Empress PLACILLA 

AUGUSTA undertook the duties of a maid-servant in the 

hospitals.!" The Christians displayed a self-sacrificing 

activity in great epidemics such as at that period afflicted 

the human race. When in the third and fourth centuries 

contagious pestilences raged in Alexandria and Carthage 

the Christians took charge of the sick without distinction 

of creed, nursed them, and buried the dead.§ Many were 

consequently attacked by the disease and succumbed to it. 

The heroic spirit of love shown by the Christians on such 

occasions, filled with astonishment and wonder people of 

other faiths. Even JULIAN, the most zealous antagonist of 

Christianity recognized thus their charitable work, he wrote: 

" We see what it is that makes the enemies of the gods 

powerful; it is their kindness to strangers and the poor, 

their care for the dead, and their holiness of life—even if 

assumed.'"'|| He felt himself induced to copy the example 

* C. F. HENsiNGERin the Janus i, S. 772 et seq. 

t HIERONYMUS: Ep. 84. 

X THEODORET : Hist. Eccles. v, 19. 

§ EUSEBIUS: Hist. Eccles. vii, 22. ix, 8.—SOZOMENOS: Hist. Eccles. v, 16. 

|| JULIAN : Epist. 49.

THE INFLUENCE OF CHRISTIANITY 149, 

'of the Christians, and decided to erect hospitals in all 

important towns. 

Among diseases leprosy (under this name a number of 

different kinds of skin disease being included) engaged 

particularly the attention of the public. The lepers were 

shunned by the people on account of their horrible appearance, 

even indeed by their own relations and friends ; they 

were also dreaded on account of the danger of infection to 

which others were exposed in their presence. The Christians 

felt pity for these unfortunate people also, and gave 

them protection and care in their hospitals. ST. BASIL 

" embraced them as brothers, not for the purpose of making 

a parade of his courage but to give an example to those 

whom he entrusted with the care of them."* He assigned 

to them a special department in his institution at Caesarea. 

In Constantinople a hospital was devoted to lepersf and in 

Italy leper-houses arose in many places at an earlier 

period than institutions for other sick people.J In France 

there were leper-houses as early as the time of ST. 

GREGORY of Tours (560) and in a testamentary document 

of the year 636, institutions of this kind are mentioned at 

Verdun, Metz and Mastricht.§ One hundred years later 

ST. OTHMAR collected the lepers from the districts near 

St. Gall and erected a hospital for them. Christian philanthropy 

provided, besides asylums for the poor and sick, 

institutions in which the aged infirm, cripples, blind people, 

women lying in, orphans, and deserted and foundling 

children were received and taken care of. 

The abandonment of newly-born babes was forbidden as 

early as the time of VALENTINIAN : but this criminal practice 

was supported by the public immorality.|| In the fifth 

* GREGORY of Nazianzus. op. cit. Orat. viii. 

t DUCANGE: Constantinop. christ., Paris 1680, iv, 165. 

X MURATORI : Antiq. ital. med. sevi, T. i, Dissert. 16. 

§ R. VIRCHOW : Zur Geschichte des Aussatzes in VIRCHOW'S Archiv, Bd. 20, 

Berlin 1861, S. 169. 

|| LECKY : Sittengeschichte Europas von Augustus bis zu Karl dem Grossen, 

Leipzig 1870, ii, 20 etseq. (' History of European Morals').


century the custom arose in certain towns of Gaul e.g. in 

Aries, Treves, Macon and Rouen of laying children, of 

whom it was wished to be rid, before the Church doors. 

The priests took care of these poor abandoned infants 

and caused them to be reared. The first foundling 

hospitals appear to have arisen at Treves, Angers and 

Milan* 

Unfortunately the care which the Christians devoted, 

to the sick and helpless did not always manifest itself' 

in this noble and reasonable manner. The words of ST.I 

JAMES:f "Is any sick among you? let him call for the 

elders of the Church and let them pray over him anointing 

him with oil in the name of the Lord. And the prayer of 

faith shall save the sick, and the Lord shall raise him up " 

display ignorance and superstition in so far as they pronounce 

the help of the doctor to be superfluous, and the 

power of prayer to be sufficient to heal the sick. It was a 

return to that theurgical point of view from which diseases 

were looked upon as punishments inflicted by God and only 

to be removed by penance and prayers. The sufferers came 

now to the Christian Church as they formerly did to the 

temple of ASKLEPIOS to request advice and aid from the 

priests. Happy recoveries, the cause of which was ascribed, 

to the intercession of a saint, resulted in an increased throng 

of sick people. And thus, especially in Churches where the 

bones of saints reposed, there became developed a kind of, 

worship, hardly distinguishable from that offered at the 

temples of ASKLEPIOS.J The sick spent nights there in 

fasting and prayer, hoping that the saint would appear to 

them in a dream or a vision and would indicate the remedy 

suited to effect their recovery, and the priests interpreted 

the hallucinations and dreams of the patients, wrote down 

the histories of the successful cases which occurred, and 

took care that by means of pictorial representations of 

* CHASTEL op. cit. S. 53, 138. 

t Gen. Ep. St. James, c. 5, v. 14, 15. 

X ALB. MARIGNAN : La me'decine dans l'eglise au sixieme siecle, Paris 1887


the parts of the body which had been successfully treated 

the recollection of such cures should be kept fresh and 

enduring in the minds of the faithful. The reverence 

which was paid to the martyrs who had suffered death for 

their faith very easily led to great healing powers beingascribed 

to their remains. The sick hoped to obtain relief 

from their sufferings if they were allowed to see or to touch 

the saint's body or articles belonging to him, to visit his 

grave or to taste of the dust, covering it. Amulets and 

miracles played a prominent part henceforth in the medicine 

of the Christians. The mystical enthusiasm of the 

Neoplatonists and the Neopythagoreans, which had .just 

been employed as a weapon in the contest against the 

Christian Church, now found acceptance with the latter: 

and under ecclesiastical protection, fraud and superstition 

made their power felt in a sphere where not merely the 

progress of science but the health—even the life of men 

frequently depends upon the truth. 

The medical literature of that period bore the character 

of dependence. Poor in original ideas, incapable in original 

research, writers were satisfied in collating what had been 

effected in bygone times and working it up into concise 

epitomes. The practising doctors demanded books of 

receipts answering to their daily requirements. Of this 

nature were the writings of QuiNTUS SERENUS SAMONICUS, 

SEXTUS PLACITUS PAPYRENSIS, VINDICIANUS, MARCELLUS 

EMPIRICUS, LUCIUS APULEIUS, CASSIUS FELIX, THEODORUS 

PRISCIANUS and others, the Latin translations of certain 

works of the Hippocratic writers, of DiOSKORiDES, GALEN 

and SORANUS, and compilations from PLINY, CAELIUS, 

AuRELlANUS and others. In their language as in their 

subject matter they indicate the rapid decline of intellectual 

aspiration after science which characterizes this period. 

More valuable and richer in matter were the literary 

performances of the Greeks in this domain : yet it might 

here too be detected that the creative power of ancient 

times was gone. The judgment passed by the philosopher


LONGINUS upon his contemporaries in the third century 

was equally applicable to the Greeks. " In the same 

manner as some children always remain pygmies, whose 

infant limbs have been too closely confined; thus our 

tender minds fettered by the prejudices and habits of a 

just servitude, are unable to expand themselves or to attain 

that well proportioned greatness which we admire in the 

ancients."* 

In the fourth century, ORIBASIUS by the wish and command 

of the Emperor JULIAN whose body-physician and 

friend he was, made a collection of extracts from the most 

important writings of the most famous medical authors of 

ancient times,t enriching the same with many interesting 

additions of his own. After the same plan AETIUS in the 

sixth century collected a number of treatises upon the particular 

departments of medicine. Since many of these 

proceeded from doctors, whose works have been lost, and 

many things are alluded to therein which are not to be 

found elsewhere, this collection forms a priceless source of 

information not merely for the history of medicine but also 

for that of philosophy and other branches of knowledge. 

Unfortunately the use of it is made difficult if not impracticable 

by the fact that the Greek text of the work has not 

as yet been printed in its entirety. 

ALEXANDER of Tralles, who lived about the same 

period as AETIUS, is placed by FREIND by the side of 

HIPPOKRATES and ARET/EUS. Being the first doctor who 

for a long time had shown any originality in thought or 

practice he recalled to remembrance once more the mighty 

past of Greek medical science. His text-book of special 

pathology and therapeutics of internal diseases which has 

been edited by me,J contains a multitude of medical obser- 

* LONGINUS: De sublim., as quoted by GIBBON, op. cit. Vol. i c. ii, p. 76. 

f This was edited by CH. DAREMBERG with the support of the French 

Government (Paris 1851-76). 

X TH. PUSCHMANN : Alexander von Tralles, Originaltext und Ubersetzung, 

Wien 1878-79, 2 Bde. On pp. 108-286 of the Introduction is a description of 

the scientific performances and services of A. of T.


vations and experiences, made by him in his practice of many 

years' duration and shows us in the author a man combining 

a correct judgment with extensive knowledge. The 

compendium of general medical science composed with 

great originality and independence by PAULUS vEGINETA 

belongs to the seventh century and, particularly in its 

surgical sections, is of great value, since the operative 

attainments of the surgeons of that period are fully 

described therein.* 

The medical writings of the Byzantines bore almost 

without exception the stamp of superficiality and consisted, 

like the works of MELETIUS, THEOPHANES NONNUS, SIMON 

SETH, NIKETAS, DEMETRIUS PEPAGOMENUS, NICOLAUS 

MYREPSUS and others, to a large extent of compilations 

made without judgment, and collections of receipts. A 

tendency to encyclopaedic literature developed itself 

about the same time, finding representatives in PHOTIUS, 

MICHAEL PSELLUS and others: the same inclination 

was shown also in the Origines of ISIDORE of Seville and 

the Elementa Philosophise of the monk BEDA. The 

Encyclopaedists skimmed over all sciences, discoursed of 

God and the world, of heaven and earth : they began with 

theology and ended with the art of cooking. They drew 

even medicine into the field of their observation ; but they 

seldom did more than furnish a catalogue of names for 

things with which they were really but slightly acquainted. 

The medicine of the Byzantines came to a worthy conclusion 

in the person of JOHANNES ACTUARIUS whose 

writings on the urine and on the physiology and pathology 

of the mind are allied both in substance and form to the 

best literary performances of the Greeks.t He appeared 

as HAESER says "like the last flickerings of a dying flame " 

shortly before the Turks erased for centuries the glorious 

name of the Greeks from the history of nations. 

* F. ADAMS: The seven books of PAULUS ,/EGINETA, London 1844-47. 

t J. L. IDELER : Physici et medici Graeci minores, Berlin 1841-42, i, pp. 312- 

386. ii, 1-193, 353-463.


If we survey the character of the intellectual activity of 

this period we cannot wonder at the dearth of production in 

original matter. On the contrary We feel a legitimate surprise 

that notwithstanding the heavy oppression, which weighed 

on the spirits of mankind, and despite the terrible confusion, 

of all social conditions, energy and power were yet forth^ , 

coming, and equal to the accomplishment of independent 

intellectual tasks. Like desert-plants which are hardy 

enough to dare the arid conditions of life to which they are 

exposed, so the intellectual performances of that time were 

compelled, with painful endurance, to maintain the struggle 

for existence. We should not expect them to transform 

the bare wilderness into a place of luxuriant fertility, but 

must be thankful if they rejoice the eye of the weary ' 

wanderer with the green leaf of hope. 

* * ., 

ARABIAN CIVILIZATION. / ,« * 

W H E N the Semitic hordes of the Arabian peninsula, accuse 

tomed as they were to a life of restless wandering and to 

unceasing campaigns and forays, set forth for the purpose 

of subduing the world, the attractions of art and science" 

were far from their thoughts. Of these things they knew 

only as much as transient relations with the neighbouring 

peoples had taught them. Arabian literature consisted 

of little more than certain heroic poems in which as 

GOETHE says* "the love of home; the greed of fame, 

courage, and an unappeasable thirst for revenge " were the 

subjects of song "tempered by the woes of love, by charity 

and sacrifice." The Koran " chapters of which lying 

scattered about, scrawled on palm-leaves, pieces of leather, 

flat bones and other coarse material or even entirely 

entrusted to the memory of the faithful. ABU BEKR was 

the first to collect and OTHMAN to arrange in the existing. 

order,"t laid the foundation of a literary Arabic language. 

* GOETHE : Noten und Abhandlungen zum west-ostlichen Divan. 

t E. MEYER op. cit. iii, S. 90.

ARABIAN CIVILIZATION. 

For the Koran, inasmuch as it was the religious and civic 

law book of the adherents of Islam, was read and spread 

wherever the doctrines of MUHAMMED found believers, and 

with it the Arabic language extended from country to 

country. It is owing to this fact that Arabic became the 

speech used in the religious worship of Islam and thus 

formed the link uniting the different peoples who professed 

the same faith. This circumstance as well as the care and 

perfecting which it consequently underwent, explain the 

fact that it became the language of the educated and 

learned. It gained the same importance in the Muham- 

medan world as the Latin tongue did in the Christian 

middle ages. 

Gradually, a rich literature and a flourishing civilization 

sprang from it, embracing in its domain nearly one half of 

the earth as known at that time. The Indians in the East, 

the Goths in Spain, the Armenians and Tartars on the 

Caspian, and the Ethiopians at the outlet of the Red Sea 

adopted with their religion the language of the Arabs. 

To be sure, these various nations retained each its own 

language for national intercourse and exceptionally such 

language furnished a literary production, which while differ 

ing from Arabic literature in the form of the characters 

used, breathed in its contents the same spirit and the same 

mode of thought. 

The Arabian people probably contributed but little to 

what we are-in the habit of calling Arabian culture. The 

roots of this must be sought among the Persians, the 

Greeks of Asia Minor and of Alexandria, and in India: 

nearly all the peoples subdued by the Arabs took part in its 

development from the Pillars of HERCULES in the West'to 

the Sea of Darkness, as the Arabs called the Indian Ocean, 

in the far East. During the first decades of their appear 

ance as prominent actors in the world's history, they were so 

much occupied with quarrels among their rulers and wars 

of conquest that they had but little leisure for the arts of 

peace. It was "the day of ignorance." The anecdote 

•**


reported by ABULFARAG* is well known, how that OMAR, 

being asked after the .conquest of Alexandria what should 

be done with the numerous books which were stored therej :| 

answered : " Either these writings contain what is given 

in the Koran, and in this case they are superfluous : 

or they contain other things and are consequently hurtful 

: in either case they must be destroyed." Perhaps 

there is no foundation for this tale, perhaps the farfamed 

libraries of the Ptolemies may for the greater | 

part, as history tells, have fallen a prey at an earlier | 

period to fire or to the mania for destruction of a Chris- J 

tian mob; be this as it may, the story indicates the 

characteristic spirit which animated the first Arab con 

querors. 

As soon as the political dominion of the Arabs was secured, 

under the dynasty of the house of OMMIYAH higher intel-;; 

lectual aspirations manifested themselves. The Caliph 

MOAWIYAH, who took up his residence at Damascus, •-. 

founded schools, libraries, and observatories there. He 

invited the learned of foreign lands, especially Greeks, to 

come to his Court and gave them important works to 

•carry out; even the mosques were built under the direction 

•of Greek architects and artificers. \ 

Greek culture reached the Arabs partly from Alexandria, 

partly was transmitted through Syria and Persia. Medicine 

chose the same routes. In the seventh century numerous 

medical schools existed in Alexandria in which instruction * 

was imparted according to the doctrines of GALEN-t. 

Among the teachers of medical science there was 

ALKINANI, a Christian doctor of Arabian origin, who at j 

a later period was converted to Islam. He seems to have ' 

been the chief agent in bringing it about that medical | 

studies and teaching were transferred from Alexandria to ; 

* ABULFARAGIUS : Hist, dynast, ed. Pococke, >Oxon. 1672, p. 114.—V, 

HAMMER-PURGSTALL: Literaturgeschichte der Araber, Wien 1850, Bd. i, Einl 

S. xxxviii. 

t L. LECLERC: Histoire de la Medecine Arabe, Paris 1876, i, p. 38 et seq.

ARABIAN CIVILIZATION. 157 

Antioch and Harran.* About the same period lived the 

Greek THEODOCUS who took up an influential position as 

body-physician of HEDSCHADSCH, the sanguinary governor 

of Irak: as author he won approval for his excellent dietaries 

and as teacher of medicine he trained numerous pupils— 

among them FQRAT BEN SCHANNATHA, a Jew—who became 

celebrated doctors.f The prince CHALID BEN JAZID, who had 

been taught in medicine by MARIANUS, a Christian Monk, 

probably once a teacher in the medical school of Alexandria, 

caused works on medicine, alchemy and astronomy 

to be translated from Greek into Arabic by the elder 

STEPHANUS, a Greek of Alexandria. These were the first 

translations from a foreign tongue, which were made under 

the rule of Islam, as is stated by the author of the Fihrist.J 

Greek literature had found many friends and admirers in 

Asia Minor where Hellenism had ever since the time of 

ALEXANDER THE GREAT of Macedon possessed an important 

influence which it was able to maintain under the 

political changes of the Roman period. 

Learned Nestorians, who carried on teaching as a profession 

in the School at Edessa, translated the writings! of 

ARISTOTLE from Greek into Syriac.§ Even at an earlier 

date Syriac translations of the New Testament and other ** 

theological works had been prepared. The Nestorians 

continued this meritorious work when they founded educational 

establishments in Persia, and displayed an aptitude. 

for it, meeting with much success at the school of Gondisapur. 

They were however by no means the only people 

engaged in such work. Members of other religious societies 

* v. HAMMER-PURGSTALL op. cit. Bd. ii, S. 194.—FREINO . Hist. MedicinEe, 

Venet. 1735, p. 89. 

f LECLERC op. cit. i, p. 82. 

X Fihrist means " the Index.'' It is an Arabic bibliographical work on the 

scientific treatises translated into Arabic from Greek, Ancient Persian and 

Sanscrit. Its author—MUHAMMED IBN ISHAK who died year 380 of the Flight. 

E. H. H. 

§ J. G. WENRICH: De Auctorum Graecorum versionibus et commentariis 

Syriacis, Arabicis, Armeniacis, Persicisque commentatio, Lips. 1842, p. 8.


and sects distinguished themselves in a similar way. 

Numerous Jacobites made themselves known likewise as 

translators,* among them notably SERGIUS who lived at 

the court of KESRA NUSCHIRWANS. He was a friend of 

the Greek historian AGATHIAS, and as familiar with Greek 

as with Syriac ; he was distinguished for his learning, and 

the best translator of his time.f By him numerous medical 

works—and to such, being a doctor, he devoted especial 

attention—were rendered into Syriac from the Greek, 

among them certain writings of HIPPOKRATES. Moreover 

he wrote explanatory notes to ARISTOTLE and completed the * 

medical compendium of the Alexandrian doctor AHRON.J 

The numerous Jewish men of learning who had settled 

in Syria and Persia, were the means of bringing about an 

acquaintance with Hebrew culture and, in addition, must 

have contributed to an increased extension of Greek 

literature, especially in the domain of medicine. The 

system of teaching among the Jews was admirably organized 

and their high schools at Tiberias in Palestine, at 

Sepphoris and Tvfisibis in Syria, and at Sura and Pumbeditha 

in Persia acquired great fame.§ 

By the rendering of Greek works into the SyriacA 

Hebrew, and Persian languages, the study of these was put 

within easier reach of the Arabs. The mutual relations of 

kinship among these tongues facilitated the translation of 

the compositions from them into Arabic. This pursuit 1 

was systematically exercised and conducted under the 

Abbassides. AL MANSUR, the second Caliph of this line 

of rulers, the founder of the new capital of Baghdad, 

charged his body-physician GEORG BACHTISCHUA with the 

translation of medical works from Greek into Arabic, as is 

stated by IBN ABU OSEIBIA.[| According to the statement 

* WENRICH op. cit. p. 11. 

t AGATHIAS: Histor. iv, c. 30.—ASSEMANI op. cit. T. ii, p. ,,- ,2, _ 

-ABULFARAG op. cit. p. 94, 172. ' ' '' %,.y 

X WENRICH op. cit. Index xxxv.- 

§ CRAMER op. cit.i, S. 109 et seq. 

I WENRICH op. cit. p. 13.—LECLEHC op. cit. i, p. i24 et s,q.

ARABIAN CIVILIZATION. 

of HADJI KHALFA he is said to have sent envoys to 

Constantinople, in order to fetch from thence the writings 

of EUCLID and works on natural science. One of his 

successors HAROUN AL RASCHID, celebrated in story, the 

contemporary of the Frankish Emperor CHARLEMAGNE 

with whom he had communications, imposed as the 

condition of peace after the defeat of the Byzantine 

Emperor NlCEPHORUS that manuscripts of Greek literary 

masterpieces should be delivered up to him. The treasures 

of this kind, also, which fell into his hands at Ancyra and 

other Greek towns as well as on the island of Cyprus were 

to him welcome prizes of war. He commanded that they 

should be translated into the Arabic language. In this 

work one of his doctors, JOHANNES MESUE (MASEWEIH) a 

Syrian Christian, who attained a prominent position 

under AL MAMUN, assisted him with advice and personal 

effort. 

This prince erected an establishment for translating 

where works were rendered into Arabic from foreign 

tongues. "To this end he brought together" as LEO 

AFRICANUS writes* "a great number of learned men 

acquainted with various languages, and made inquiries 

about the authors and writings in the Greek, Persian, 

Chaldaean, and Egyptian languages, many of which were 

known to himself. Thereupon he sent many of his 

servants to Syria, Armenia, and Egypt to buy the books 

indicated, and they brought together immense loads of 

them. And now AL MAMUN caused the useful books—such 

as dealt with medicine, physics, astronomy, music, cosmography 

and chronology to be selected, and appointed as 

•superintendent of the translators from the Greek, JOHANNES, 

son of MESUE, for at that time Greek studies flourished 

among the Christians; many others being placed under his 

direction. For Persian literature he appointed MAHAN 

and the above-mentioned MESUE. These and many other 

* LEO AFRICANUS in Fabricius Bibl. Graeca, Hamburg 1726, xiii, p. 261.— 

MEYER op. cit. iii, 115.

Ifjo THE MIDDLE AGES. 

learned men translated the Medicine of GALEN and after- ' 

wards all the works of ARISTOTLE." 

From the Byzantine emperors AL MAMUN obtained a# 

number of Greek manuscripts, the learned PHOTIUS who ( 

lived for a long time at the court of Baghdad transmitting 

them to him. Moreover Indian works—such as the*' 

treatise on poisons by CHANAK and the Ayur-Veda ofVj 

SUSRUTA and CHARAKA—were translated and, as it appears, 

first into Persian and then into Arabic. The Indian doctor's 

who, like MANKAH, SALEH BEN" BALEH and others, had 

settled in Baghdad, rendered in this way important services,.* 

Thus too certain literary productions of 4 the Chaldees found; 

their way to the Arabs. 

This establishment for translating continued to'exist ! 

under the successors of AL MAMUN ; among the men, of 

learning who were* appointed to it", HONEIN (JOHANNITIUS) j 

who translated the most important Greek authors, made •., 

himself especially remarkable. 

On these foundations an independent medical .literature ' 

gradually developed. The commencement of it reaches ' 

back into the ninth "century; but only in the eleventh* did it 

attain its prime. The progress of Arabian culture: was 

favourably influenced in an extraordinary degree by the 

disintegration of the empire,into numerous independent, 

states. The princely residences of the Samanides. at 

Bokhara, of the Ghasnawides at Ghasna, of the Buides'in 

Persia, of the Hamadanites in Mesopotamia and Syria, of** 

the Edrisites in Magreb, of. the Aglabites in Kairwan and t 

of the Fathimites in Egypt forined so many centres for, 

artistic and scientific efforts, like points of crystallization in* 

a saturated liquid. They found the most effectiveprotec-; 

tion however among the Ommiades. in Spain, who obtained 

dominion there after being driven from their home about 

the middle of the eighth century. ABDERRAHMAN, the 

* At the time of MUHAMMED there existed at Senaa in Southern Arabia a 

famous medical school, the Principal of -which, HARIT BEN KALDAH, had 

acquired his knowledge in India as LASSEN (Indische Alterlh. ii, 519) narrates^

ARABIAN CIVILIZATION. l6l 

first prince of this house, enlarged his seat at Cordova 

and adorned it with buildings the remains of which even 

now excite wonder. He planted there the first palm—an 

incident which he has celebrated in an elegy which gives 

touching . expression to the longing he felt for distant 

•Baghdad.* 

The brilliant period of the Arabian dominion in Spain 

began with ABDERRAHMAN III. He caused great buildings 

to.be erected, aqueducts and streets to be made, and 

induced men of learning from the East to come to Spain. 

Learned men stood in high respect at his Court, and held 

conferences, being separated into departments according 

to their respective sciences. His successor HAKIM II. 

devoted still greater attention to scientific effort. He was 

himself a man of learning and took a personal part in 

discussing the burning questions of the day. Above all, he 

bought up scarce books which he studied thoroughly and 

added notes to them. His library is said to have contained 

600,000 volumes and the catalogue alone to have filled 44 

volumes-. He founded in Cordova a sort of Academy, the 

members of which were entrusted with special researches 

on the history of the country, the history of literature and 

the natural sciences.t 

If the sciences flourished under circumstances such 

as these, it was due certainly in a great measure to the 

sympathetic assistance which was extended to them by 

the reigning sovereigns;' but, the memories of Roman 

culture still cherished in Spain, the care taken by the 

Visigothic conquerors for what remained of it, the settle- 

v ment iii the Country of industribus and enterprising Jews 

who built schools and spread education on all sides, and 

finally the happy coalescence of the Semitic character 

with Roman and Germanic elements, all exercised, with 

out doubt, a noteworthy influence in the same direction. 

% ,-. * • 

* v. HAMMER-PURGST ALL op. tit. iii, 31.—MEYER op. cit. iii, 126., 

4 Cf. R. DOZY : Geschichte der Mauren in Spanien, deutche Ubers., Leipzig 

1874, ii, S. 68 et\siq. ';., 

M


And thus it came about, that at a time when the rest 

of Europe was sunk in ignorance, superstition, and 

barbarism, on the Spanish peninsula an intellectual life 

was unfolding itself, rich and fruitful in every path of 

mental activity. In the twelfth century Spain possessed 70 

public libraries and 17 teaching institutions of a higher 

class. Cordova produced 150 authors, Almeria 52, Murcia 

61, Malaga 53* The performances of the Arabs in mathematicsf 

and physics,J especially in mechanics and optics, 

and again in chemistry,§ astronomy|| and geography! 

are well known. They were the first to introduce 

measurement and experiment into the investigation of 

Nature. The excellent work of ALHAZEN on refraction 

prepared the way for a rational comprehension of the 

physiology of vision, and GEBER was the founder of 

scientific chemistry.** 

MEDICAL SCIENCE AND MEDICAL TEACHING 

AMONG THE ARABS. 

ATTENTION and care were even in the earliest periods of 

Islam devoted to medicine, as ABULFARAG observes.ft And 

yet the Arabs made but little progress in this domain and no 

discoveries of primary importance. This is owing to the 

absence, in their nation, of an independent development 

of medical or indeed of any other science. Hence sprang 

also that unlimited belief in authority which both deterred 

them from testing the accuracy of scientific results 

* MICH. CASIRI : Bibl. Arab. Hisp. Escur., Madrid 1760, T. ii, p. 71. 

f M. CANTOR: Geschichte der Mathematik, Leipzig 1880, i, S. 593 et seq. 

X J. C. POGGENDORFF: Geschichte der Physik, Leipzig 1879, S. 56 et seq. - 

§ H. KOPP: Geschichte der Chemie, Braunschweig 1843, i, S. 51 et seq. 

|| W. WHKWELL: History of the Inductive Sciences. New Edition. London 

1847. Vo1 - *< P- 2 3*> et 5f -7- 

% O. PESCHEL: Geschichte der Erdkunde, Miinchen 1877. S. \04 et. seq. 

** H. KOPP: Beitrage zur Geschichte der Chemie, Braunschweig, 1875, iii, S. 

13 et seq, 

tt ABULFARAG op. cit. p. 160.—Cf. A. SPRENGER: De origin, med. arab., 

Leyden 1840, p. 6.

MEDICAL SCIENCE AMONG THE ARABS. 

as received by them, and also took away from them all 

courage for independent investigation. And then came 

social and religious prejudices, which nipped in the bud 

every attempt which was made in this direction. 

Anatomy and physiology remained, therefore, essentially 

at the standpoint they had reached under GALEN. The 

dissection of human subjects being forbidden by the 

religious creed of the Muhammedans, clearly any increase 

in anatomical knowledge was not to be thought of. Incidental 

observations, as those made by ABDEL-LETIF on the 

occasion of an epidemic in Egypt, in which by the examination 

of the skulls of the dead he succeeded in correcting* 

numerous osteological mistakes of GALEN, formed an exception 

to the rule. Generally speaking, anatomical 

literature was limited to abstracts and short compendiums 

founded upon the works of GALEN. In the same way his 

physiological theories were slavishly followed. Even the 

promising results, which physics and chemistry arrived at 

in the way of experiment, produced scarcely any reform in 

this matter. Students were not in the position to make 

them thoroughly profitable for the study of human physiology 

and failed to apply these methods of inquiry to that 

science. 

The Arabs manifested greater independence in practical 

medicine. Their numerous writings upon this subject are 

certainly also dependent upon the works of the ancients 

and consist for the most part of extracts, commentaries and 

translations of the same ; but here and there we do find an 

independent observation, a personal experience, which 

selves to show that the author was master of the subject 

and was in a position to advance the knowledge of it. The 

scientific work accomplished by such men as RHAZES, ALI 

ABBAS, ABULKASEM, AVICENNA, AVENZOAR, AVERROES, 

MAIMONIDES, IBN EL-BEITHAR, OSEIBIA and othersf holds 

an honourable position in the history of medicine, and 

* ABDOLLATIPHII Hist. JEgypt. ed. WHITE, Oxon. i8co, p. 277. 

t WUSTENFELD: Gesch. der Arab. Arzte u. Naturforscher, Gottingen 1840.


deserves recognition all the more, inasmuch as the authors 

lived at a time, when the development of medicine was 

nowhere making any progress. 

The Arabian doctors gave great attention to the examination 

of the body of the patient. They noted all the 

symptoms of disease, but attached most importance to the 

character of the pulse and the peculiarities of the urine. 

They attained to a remarkable ability in prognosis. They J 

paid' a fitting attention* to dietetics and enlarged the 

pharmacopoeia by the addition of numerous remedies. They 

were zealously anxious to discover the causes of disease 

and obtained some success in this quest. AVENZOAR drew 

attention to the Sarcoptes hominis, pointing out its relation 

to scabies.t ABULKASEM left behind him an excellent 

description of the Dracunculus medinensis and the conditions 

of disease arising therefrom.J Special pathologyhas 

to thank the Arabian doctors for many contributions: 

they gave valuable information as to the causes and 

character of certain diseases, for example, the malignant ; 

epidemics, small-pox, measles and other. exanthemata,^ 

F consumption, || face-ache^ etc. On the other hand, operative 

surgery certainly lost ground among the Arabs. The 

neglect of anatomy and the dislike peculiar to Orientals 

of any interference with the human body which is attended . 

with bleeding were to blame for this. Caustics and cauteries 

took the place of the knife. Where surgeons incised 

before, they now were satisfied with cauterizing and 

burning. Even ABULKASEM deplored the decline of 

* Cf. EL-ANTERI'S admirable verses in v. HAMMER-PURGSTALL op. cit. Bd. 

vii, S. 499. 

t RASPAIL: " Memoire sur l'histoire naturelle de 1 insecte de la gale in the 

Bull. gen. de therap., Paris 1834, T. vii, p. 169.—F. HEBRA (Acute Exantheme 

u. HaUtkrankheiten'in VIUCHOW'S Handbuch, Bd. iii, S. 413, Erlangen i860) 

did not "believe that AVENZOAR was acquainted with the Sarcoptes. 

X ABULKASEM; Chirurgie ii, 93, Edit. LECLERC, Paris i86i,p. 230. 

§ RHAZES: De variolis et morbillis, Edit. CHANNING, London 1766. 

|| WALDENBUHG: Die Tuberkulose, Berlin 1869, S. 25. 

•f AVICENNA: Canon iii, fen. 1, tract. 1, c. 12.

MEDICAL SCIENCE AMONG THE ARABS. 165 

surgery. "The operative Art" he writes "has disappeared 

from among us almost without leaving any trace 

behind. Only in the writings of the ancients do we find 

some references to it but these, by bad translations, by errors 

and alterations, have become nearly unintelligible and use 

less."* On this occasion he mentions numerous occurrences 

of practice which throw a strong light upon the ignorance 

of his surgical colleagues. Cauteries were the most fre 

quently used and most important instruments for the treat 

ment of wounds. The hot iron was recommendedf for 

the arrest of bleeding, besides compression, the application 

of cold, and the ligature; it was employed in a multitude of 

affections—for instance in palsies,J wounds and fistulae,§ 

gangrene, || cancer and other new growths,! in psoriasis,** 

for the opening of hepatic abscess,ft in carious inflamma 

tion of the hip joint, in the vertebral disease of children, J;]; 

and many more. The use of heated instruments in surgery 

was brought to a high stage of development by the Arabian 

doctors. A large number of the 151 surgical instruments, 

representations of which are added to the manuscripts of 

ABULKASEM, were used in this way. In contradistinction 

to the use of cauteries, the art of operative surgery receded 

into the back ground and was unable to maintain that stage 

of perfection which it had reached under the surgeons of 

the Roman Empire. Amputation was ventured upon only in 

the case of the forearm or leg or at most only just 

above, at the elbow or knee joint: never in the upper 

arm or thigh.§§ The skin was fixed by bandages above 

and below the place where it was purposed to make 

the incision and before the beginning of the operation 

was drawn up with the object of securing as large a flap as 

possible to cover the bone. The bleeding accompanying 

* ABULKASEM : Introd. op. cit. p. 1. fl id. op. cit. i, 50, 53, p. 53, 54. 

t Mem op. cit. i, 56 p. 56. ** id. op. tit. i, 47, p. 50. 

X Id. op. tit. i, 6, 9, p. 17, 19. ff id. 0p. cit. i, 28, p. 33. 

§ Id. op. cit. i, 17, 19, 36, p. 25, 27, 38. X% J't- p. tit. i, 43, p. '46. 

I Id. op. cit. i, 52, p. 54. §§ id. 0p. dt. ii, 89, p. 219.


the amputation ABULKASEM arrested by styptics and 

cauteries ; in describing the operation he says not a single 

word about tying the vessels. In another passage he 

narrates that he made a resection of part of the bone in a 

case of necrosis of the tibia* 

Tracheotomy was no longer practised in his time. He 

only knew it from the descriptions of the ancients, but 

considered it indicated in cases in which the danger of 

suffocation was imminent by reason of new growths.t 

AVENZOAR performed the operation on a goat, as he 

informs us, with the object of observing the result.J 

Lithotomy was described by ABULKASEM who in the same 

place alludes to lithotrity.^ MOSES MAIMONIDES improved 

the method of circumcision, which custom was in use among 

the Arabs, and introduced several precautionary measures 

to be observed in this operation. || In the treatment of 

fractures and dislocations which ABULKASEM considered in 

his third book, the approved principles of the doctors of 

antiquity were pursued.! It only deserves mention that 

AviCENNA recommended the reduction of the dislocated 

humerus by direct pressure, i.e. direct reposition.** 

Cataract was removed by depression of the lens into the 

vitreous.tf Extraction was considered, if not impossible, at 

least very dangerous.H ABULKASEM alludes, as RHAZES 

did before him, to the curing of cataract by suction and 

remarks that this procedure was practised in Persia.§§ So 

* Id. op. cit. ii, 88, p. 216. 

f Id. op. cit. ii, 43, p. 120. 

X AVENZOAR -. Altheisir., Lib. i, Tr. x, c. 14, Venet. 1542. 

§ ABULKASEM ii, 60 op. cit. p. 151 et seq. 

|| J. B. FRIEDREICH : Zur Bibel, Niirnberg 1848, ii, S. 46 et seq.—H. PLOSS: 

Geschichtliches und Ethnologisches iiber Knabenbeschneidung im Deutschen 

Arch. f. Gesch. d. Med. Leipzig 1885, viii, S. 324 et seq. 

^f ABULKASEM iii, op. cit. p. 270-342. 

** AVICENNA : Canon iv, fen. 5, tract. 1, c. 11, 14. 

tt ABULKASEM ii, 23 op. cit. p. 92 et seq. 

XX AVENZOAR: Altheisir., Lib. i, tract. 8, c. 19.—AVICENNA op. cit. iii, 3, 

tract. 4, c. 20. 

§§ ABULKASEM ii, 23 op. cit. p. 93.


too the ophthalmic surgeon ISA BEN ALI makes mention of 

this method of operating; a manuscript of his work gives 

on the margin an illustration of the hollow needle used for 

this purpose.* CANAMUSALl who frequently performed 

this operation, made a preliminary incision in the cornea so 

that the hollow needle could be more easily introduced.t 

Midwifery was the business of midwives, who rendered 

the required help in normal confinements and even 

undertook obstetric operations. The strict seclusion of 

women agreed to by the custom of society prevented 

doctors occupying themselves with practice of this kind. 

They had only occasional opportunities J in this respect; 

in their writings they concerned themselves chiefly with 

advising the midwives what remedies to employ for the 

relief of women seeking their aid and with giving them 

counsel in the performance of certain operations.§ Among 

the instruments specified by ABULKASEM as being used in 

the extraction of the dead foetus, we find a dilator, bearing 

some resemblance to midwifery forceps ;|| but it is clear, as 

MULDER has remarked, that it was never used for the 

extraction of a living child.% Another illustration shows 

the form of the cephalotribe used for a similar purpose.** 

One pleasing symptom is the active interest, which the 

Arabian doctors took in the history of their science. The 

works of IBN DSCHOLDSCHOL and of IBN ABU OSEIBIAff 

form a priceless source of information, though unfor 

tunately one but little used, for the study of the history of 

medicine, as indeed also for that of the history of civiliza 

tion in general. The taste for history which was instilled 

* SICHEL in the Archiv. f. Ophthalmol. 1868, Bd. xiv, 3, p. 9. 

t LECLERC op. cit. i, p. 535. 

X C. J. v. SIEBOLD : Geschichte der Geburtshilfe, Berlin 1839, i, S. 272, note. 

§ SIEBOLD op cit. i, S. 298 el seq. 

|| ABULKASEM ii, 76, 77, op. tit. p. 180 et seq. and Appendix Fig. 103. 

% J. MULDER : Geschichte der Zangen u. Hebel in der Geburtshilfe, Leipzig 

1798, S. 9.—SIEBOLD op. cit. i, S. 295, Note 1. 

** ABULKASEM op. cit. Fig. 106. 

tf WUSTENFELD op. cit. S. 132 et seq.—LECLERC op. cit. ii, 187 et seq.

l68 THE MIDDLE AGES. 

^~ —k' • **' " 

into the Arabs in their education, induced them to adorn 

their writings with a multitude of quotations through which 

many important matters have been saved from oblivion. 

What surprising disclosures on the civilization, and particularly 

on the medicine, of antiquity may we expect, as soon 

as the literary treasures of the Muhammedan seats of 

learning in the East and in North Africa, such as Kairwan, 

are thrown open to science ! 

Even in the earliest ages of Islam elementary schools 

were universally erected near the mosques, in which 

children learned to read the Koran. To this was added 

later on the reading of other compositions, besides 

grammar and instruction in writing. Attendance at school 

began in the sixth year of age.* Religion formed the 

basis of the higher teaching as well as of the more 

elementary. The higher teaching institutions, too, were at 

first in connection with the mosques. In the niches and 

cosridors of these or in adjacent halls, the learned gathered 

a circle of inquiring students around them and held discourses 

upon theological, philological, philosophical, legal 

and medical questions. During the first centuries any one 

might act as a teacher without being obliged to show his 

qualifications; from the teachers of theology and law only 

was it demanded that they should give account of their own 

education by a teacher of publicly recognized ability in the 

branch of knowledge they professed. Many teachers 

carried on some other calling as well: they worked as 

readers and preachers in the mosques, as officials, judges, 

secretaries, overseers at the markets, and even as tradesmen 

and mechanics.t The teachers of medical science were no 

doubt in most cases skilled as practical doctors. The 

lectures being gratis, it was natural that teachers not 

possessed of private means should be careful to get their 

* D. HANEBERG: Uber das Schul-und Lehrwesen der Muhamedaner im 

Mittelalter. Munchen 1850, S. 4 et seq. 

t F. WUSTENFELD : Die Academien der Araber und ihre Lehrer, Gottingen 

1837, S. 6.


' ~ ' **r j-c — 

'•f"' 

living by other pursuits. Many supplied the students with 

board and lodging, in order to earn, by the presents and 

money they received from them, something towards defray 

ing their expenses. Sometimes they selected a son-in-law 

from among them.* The lectures were delivered either 

with or without the use of a copy or notes. SAMACH- 

SCHARI made the witty remark: " The reputation of the 

learned man lies in his lecture-book like that of the 

merchant in his money-box." The words of the teacher 

were copied down by the students, and the latter 

even subjected themselves to reproof if they neglected 

this. The teacher ascertained for himself by questions 

whether the students had understood the substance of his 

discourse. Discussions often ensued, in which it occasionally 

happened that an able scholar, finding himself by chance 

among the listeners, achieved a victory over the teacher 

himself.f Entrance to the lectures was free to all, without 

distinction of nationality. In the lecture halls were to be 

seen youths, hardly outgrown their boyhood, beside middle- 

aged and even white-bearded old men. Many came from 

far off in order to learn the opinions of a noted teacher. 

Since Arabic was used in teaching in all countries subject 

to Islam, it was easy for the learned of the several nations 

to make themselves understood by one another,—to increase 

their own knowledge or to communicate it to others. The 

love of travel manifested by the Arabs, aroused by religious 

pilgrimages, was thus promoted among the men of learning 

and students. In their wanderings from one high school to 

another they effected an exchange of intellectual acquisitions 

and contributed in this way to produce an equal develop 

ment of culture in all countries subject to the Arab sway. 

The students often had drawn out for them by the teachers 

testimonials of attendance at their lectures and the permis 

sion was accorded them in writing to spread abroad by 

tongue or by pen the knowledge they had acquired. Some 

* HANEBERG op. cit. S. 31. t HANEBERG op. cit. S. 12.


teachers were in this respect very ready to come forward. j 

Of one of these it is said in a somewhat exaggerated strain 

that " he covered the earth with certificates of attendance 

and licenses to teach."* 

Many schools and mosques possessed large libraries. 

QUATREMERE has described 40 and v. HAMMER-PuRGSTALL 

made important additions to this number.t The love of 

possessing books was moreover widely spread among 

private people. The doctor ALGIZAR (IBN DSCHEZZAR) 

left behind him when he died in the year 1009 at Kirwan a 

library which weighed 25 hundredweight. J 

In the 1 rth-century the Madaris began to arise: these 

may be compared either to European Academies, according 

to WUSTENFELD or to Gymnasia as MEYER suggests. They 

most of all resembled English Colleges. They were, in fact | 

boarding establishments devoted to the higher teaching, in 

which teachers and pupils lived together. Some possessed J 

imposing buildings ; all were provided with libraries. The. 

most celebrated Madaris were at Baghdad, Basra, Bokhara, 

Nisabur, Damascus, Samarcand and Cairo ;§ Spain at the 

most flourishing period possessed 17 of such institutions. 

WUSTENFELD has described 37 of these places and has 

given detailed information about the conditions of life 

amongst the teachers engaged at them and their literary j 

works. If we peruse the copious list of their writings we 

find that they deal chiefly with theology, law, philosophy, 

and philology; only a few treat of mathematics, chemistry, 

the natural sciences, and other subjects, but not one with 

medicine. It appears therefore that these institutions 

served chiefly for education in the humanities, theology, and 

* HANEBERG op. cit. S. 22. 

f QUATREMERE : " Sur le gout des livres chez les Orientaux "' in the Journal- 

Asiat. Ser. iii, t. iv, p. 35, Paris 1838, and Ser. iv, t. xi, p. 187 et seq Paris 1848. 

-LECLERC op. cit. i, 583 et seq.—A. v. KREMER : Culturgeschichte des Orients- | 

unter den Khalifen, Wien 1877, ii, S. 434. 

X LECLERC op. cit. i, 584. 

§ WUSTENFELD op. cit. S. 6.

MEDICAL SCIENCE AMONG THE ARABS. I 7 I 

law, while other establishments were provided for instruction 

in the natural sciences and in the science of medicine. 

The Society of the "Brethren of Purity" which arose in 

the 10th century at Basra did not reckon teaching among 

its peculiar tasks. It certainly endeavoured to extend 

education by the publication of treatises in theology, philosophy, 

mathematics and the natural sciences; but the goal 

it had in view was the alliance of reason and faith and the 

establishment or purification of faith through knowledge. 

F DlETERlCl has illustrated their efforts and their performances 

in a series of valuable writings. 

The " House of Wisdom " founded by the Caliph HAKIM 

BllMRlLLAH in the year 1105 at Cairo exhibited in many 

respects the character of a University. There medicine 

was taught in conjunction with other sciences, and amongst 

the well paid teachers who were appointed to the institution 

were not only theologians, grammarians, philosophers, and 

lawyers but also mathematicians, astronomers, and doctors. 

Moreover, it was permitted to non-Muhammedans, for 

instance, Jews and Christians to attend the lectures which 

were given there and to make use of the library belonging 

to the institution which filled 18 rooms.* 

The study of medicine was conducted in various ways. 

Whoever wished to devote himself to the medical calling, 

could acquire the special knowledge by placing himself 

under the personal guidance of a senior doctor of experience, 

or else in the medical teaching establishments, or finally in 

the medical schools connected with many hospitals. Many 

may have combined all three methods in order to get a 

thorough education in the healing art. The medical lectures 

which were held in the higher teaching institutions attached 

to the Mosques and in similar establishments, for instance 

in the " House of Wisdom " dealt, in all probability, chiefly 

with theoretical subjects and made the students acquainted 

with literature, whereas practical medical knowledge was 

acquired principally in the hospitals. According to 

v. HAMMER-PURGSTALL op. cit. Bd. i, Einleit, S. lxiv.

iy2 THE MIDDLE AGES. 

MACRIZI* there were, even in the pre-Islamite time, 

hospitals in Egypt, provided with doctors and drugs. 

Amongst the Muhammedans the mosques and" the buildings 

belonging to them frequently served as shelters for poor 

strangers and as hospitals for the sick. Under the rule of 

Islam the first hospital for the sick was erected in the year 

707 by the Caliph EL WELID BEN ABD-EL-MALIK who took 

care that travellers without means if they fell ill should 

receive medical assistance. " He appointed doctors to the 

\ hospitals and defrayed their expenses : he commanded 

"-* that lepers should be shut up so that they should not go 

%' into the streets, and provided for their wants and also for 

those of blind people." 

- • . ' At a later period hospitals and infirmaries were erected 

in all.the larger towns, owing their foundation to pious 

legacies. The majority of them served also for medical 

teaching. The arrangements existing in the medical school 

at Gondisapur and in the medical teaching establishments 

connected with the hospitals of the Nestorians were taken 

for a pattern. The hospital doctors worked here as teachers 

of medicine, and gave their pupils instruction in the various 

branches of medical science. The information which has 

reached us concerning the hospitals of the Arabs gives us 

some insight into their condition and circumstances. The 

hospital at Gondisapur, which for many generations was under 

the direction of members of the BACHTISCHUA (BOCHTJESU) 

family, maintained its good reputation under the Arab 

dominion. It was connected with a well-managed dispen- 

•, s'ary over which the elder MESUE, the founder of another 

famous medical family, presided for more than 40 years. In 

the year 869 SABUR BEN SAHL, who rendered great services 

to materia medica, was the director of this establishment. It 

probably continued to exist down to a later period, passing, 

however, into the shade as the splendid, endowed hospitals 

* MACBIZI'S Description of hospitals in Cairo according to WUSTENFELD'S, 

translation in the Janus, Breslau 1846, i, S. 28 et seq.

MEDICAL SCIENCE AMONG THE ARABS. I 73 

of the Arabs in Baghdad and other places came into 

prominence. 

In Baghdad as early as the gth century there existed a 

hospital and medical school.* The Vizier An BEN 

ISSA in the year 914 founded a second. He learned 

to recognize the want of doctors and of medicines 

during an epidemic which prevailed among the 

troops and throughout the country, and decided to do 

something to improve this state of affairs. He commanded 

that the sick should be visited daily by the doctors, and 

should have medicine and food given them, and he caused!\a 

new hospital to be opened. When he was told that .•< 

certain villages, chiefly inhabited by Jews, were entirely *?{• 

without medical assistance, he replied that the unbelievers 

also must be cared for. At the instancet of SlNAN BEN- 

TSABET BEN CORRA yet other hospitals were erected in 

Baghdad. The rich bequests of SEDJAH, the mother of 

the Caliph MOTTAWAKL, which were intended for charitable 

purposes, afforded the means for this. The largest and most 

famous of these hospitals was established in the year 977 

by ADHAD ED DAULA, an Emir of the Buides dynasty, or 

perhaps having fallen into decline (being of earlier origin) 

was by him restored and its usefulness extended.J According 

to the statement of IBN ABU OSEIBIA, RHAZES is sai4 

to have assisted in its original foundation, inasmuch as he 

selected a situation for it suitable in hygienic respects.$ 

To this hospital 24 doctors were appointed, who ranked. 

according to their ability. There were specialists among 

them, some devoting themselves only to the treatment of 

fevers, others to the healing of wounds, to the reduction 

of dislocations, or to diseases of the eyes. The sick were**•/?. 

separated into different sections, according to the nature of 

their ailments. Noteworthy observations made by the 

•f - .*• 

* M. STEINSCHNEIDER in VIRCHOW'S Archiv, Bd. 52, S. 372. 

t From his biography in LECLERC, op. cit. i, 365, 559 et seq. 

_ X v. HAMMER-PURGSTALL, op. cit. iv., 358.—WUSTENFELD : Gesch. d. Arab. 

Arzte, S. 42, Anm.—LECLERC, op. cit. i., 561.

174 T H E MIDDLE AGES. 

doctors in particular cases of disease were written down 

and preserved. A high official—a kadi—carried on the 

administration of the hospital; under him was a treasurer. 

IBN EL MARISTANIA, who worked as doctor forsome time ^ 

at this institution, composed a history of it, which has unfortunately 

been lost. This hospital existed certainly up 

to the 13th century, perhaps to a still later time. 

There were hospitals also at Merv, at Ray, the birthplace 

of RHAZES, at Ispahan, Schiraz, Jerusalem, Antioch, 

Mecca, and Medina. In Damascus there were several; 

the largest, it is supposed, owed its origin to NUREDDIN. 

It served also as an institution for medical teaching. In 

the carpeted courtyard medical lectures were given after. 

the visits to the sick ; they often lasted for many hours. 

A medical library in this institution supplied the literary 

requirements of the teachers and the taught. The number 

of students was very large. In the list of teachers are . 

names among the most famous in Arabian medical science.* 

The sick were separated. according to their ailments: for 

instance there was a special department for those suffering 

from diseases of the eyes.f Such admirable care was 

taken of the sick that many, as ABD EL LETIF states,:]. 

feigned sickness so as to be allowed to remain in the 

institution; for there they were regaled "with tender 

chicken, pastry, sherbet, and fruits of all kinds." In 

Damascus there existed also other medical schools: some-* 

times the same professor taught at two such establishments.' 

The medical schools of Damascus-held the first rank in the 

13th century among their sister institutions, and surpassed 

in fame even those of Baghdad and Cairo. 

MACRIZI has left complete information concerning the 

hospitals of Egypt and their organization. He states that 

the first hospital was established by IBN TULUN about the 

v 

* If this hospital was first established by NUREDDIN, who died in 1173, some 

of the facts mentioned here probably refer to other hospitals of Baghdad. 

f LECLERC, op cit. i., 565 et seq.—ABULFARAG op. cit. p. 343. 

X ABD-ALLATIF: Relation del'Egypte, ed.'SILV. DE SACY, Paris 1810, p. 441.


year 875, and was provided with abundant means for its 

maintenance. " He made it a rule of the hospital that 

neither soldier nor slave should be received in it; he 

erected also two baths, one for men and the other 

for women, and bequeathed both of them to the hospital 

and other institutions. He commanded further, that when 

a patient was brought there, his clothes and money should 

be taken from him and given into the charge of the hospital 

steward, then that other clothes should be put on him, that 

he should be put to bed, have some food given him, and 

that he should have medicine, diet, and professional attendance 

until he recovered ; then after receiving a chicken and 

a cake to eat, he should be discharged, taking with him his 

money and clothes."* In the hospital there was a department 

for people of unsound mind. This institution does 

not seem to have existed for long; in MACRIZI'S time it 

w r as almost completely forgotten. 

He then mentions KAFUR'S hospital, which was erected 

in the town of Misr, in the year 957, and the one which 

was named after the street El Magafir and apparently only 

existed for a short time. A hospital existed in Fostath as 

early as the 10th century; another, to which for a short 

time IBN ABU OSEIBIA gave his medical services, owed its 

origin to NASR SALADIN. 

The most remarkable of all these foundations was the 

.'•- great Mansurian hospital at Cairo. The Sultan, EL 

MANSUR GlLAVUN constructed this at great expense 

by altering a noble castle which had up to that time 

served as the residence of a princess. The foundation 

walls, the stones and marble columns of that part of the 

castle which was pulled dowii, were used in building the 

hospital. All artificers of Misr and Cairo were compelled 

to work at it and were not allowed during the time it was 

being built to undertake other work. The Sultan rode 

daily to the site, inspected the workmen, even assisted 

* MACRIZI in WUSTENFELD'S translation, op. cit. S. 30.


with his own hands and compelled the passers-by to drag 

stones or to perform other services. He met, also, with A 

remarkable good fortune in the work: in excavating the 

ground a workman discovered a box filled with gold and ",ij 

precious stones the value of which was sufficient to cover 

the whole cost of building. Four large wards enclosed the 

court, in each of which was a fountain, fed by a reservoir 

situated in the middle of the court. At the completion of J 

the building the Sultan said : " I have founded this place' 1 

for those of my own station and for those of lower rank. 

I have intended it as an establishment for kings and for 

./servants, for soldiers and emirs, for the great and the little, 

i for freemen and for slaves, for men and for women." He '\ 

provided medicines, doctors, and everything else that anyone 

could require in any sickness whatsoever. The Sultan 

appointed male and female ward attendants for the service 

of the patients and furnished them with wages. He had 

beds constructed for the sick and provided them with every | 

kind of covering which was required in different kinds of i 

sickness. Each class of patients had a separate room. 

He designed the four wards of the hospital for those suffer- | 

ing from fevers or similar diseases, he appointed one court I 

for those suffering from diseases of the eyes, one for those J 

with wounds, one for those afflicted with diarrhoea, and one 

for women. A room for convalescents he divided into two 

compartments, one for men and the other for women. 

Water was laid on in all these places. A special room was 

appointed for cooking food and preparing drugs and syrups, J 

another for mixing confections, balsams, and ointments for | 

the eyes, and the like. The provisions were preserved in 

distinct places; the syrups and drugs in a room by themselves. 

The principal doctor had a room for himself where 1 

he could give lectures. The number of patients was not ;| 

limited, but every one in distress and poverty who came 

there found acceptance; nor was any limit fixed to the j 

time a patient might be kept there, and anything required! 

by those who lay sick at their own homes was sent to them


from the establishment.* This hospital, in course of 

time, underwent many improvements and enlargements. 

A large pavilion was erected in the garden, 

where the patients could take walking exercise in the 

shade. A cistern lying, at the door of the hospital, 

out of which animals were wont to drink, was removed, 

" since the people were injuriously affected by 

the offensive smell of the filth," and a water-conduit was 

laid down. The founder of the institution bequeathed it 

so much landed property that the yearly revenue belonging 

to it amounted nearly to one million dirhem. Two officials 

were commissioned to collect the money pouring in from 

the landed possessions of the institution : others had control 

over the expenses and superintendence over the buildings' 

and the kitchen. According to LECLERC,f at first only 

patients of unsound mind were admitted into this hospital 

and not till a later period sufferers from other ailments. 

They were well cared for there and enjoyed a comfortable 

existence. If they suffered from sleeplessness the time was 

passed with music, tale-telling, and other diversions. On 

leaving the institution each convalescent received five gold 

pieces so that he was not compelled to engage immediately 

in heavy work. Connected with the hospital was a mosque 

in which the Koran was constantly read and expounded. 

Moreover there was a library to which six eunuchs were 

appointed as servants, an orphan-asylum, with a school in 

connection, and an institution for the higher teaching. 

There could have been no charitable foundation at that 

time existing in the world able to vie in magnificence, 

grandeur, and extent with this structure. 

MACRIZI goes on to describe the Muajjid Hospital at 

Cairo which was opened about the year 1420, but only 

served for a short time as an institution for the sick. 

There were hospitals also in Fez, as we are told by LEO 

AFRICANUS : some had special departments for the insane. 

* MACRIZI in WUSTENFELD, op. cit., S. 34. 

f LECLERC op. tit. i, 570. 

N

178 

THE MIDDLE AGES. 

Spain is said to have been rich in hospitals ; but the infor 

mation concerning them is very meagre. There was a 

hospital in the 12th century at Algesiras and according to 

a report bearing the stamp of oriental exaggeration, Cor 

dova is said to have possessed as many as 50 of these 

institutions. 

The loving care which the Muhammedans took of the 

mentally afflicted, had its foundation in religion. They 

saw frequently in the hallucinations and disordered speech 

of these patients manifestations of a supernatural world, 

and paid a fitting respect to the recipients of such favours. 

The Christians embraced a similar opinion; only they dis 

cerned in these things the punishments of God and the 

workings of the Devil and of evil spirits. The insane 

found therefore in the countries subject to Islam friendly 

words and careful attention in the hospitals; whereas by 

the Christians they were treated as criminals, were cast 

into prison and beaten, or were exterminated with fire and 

sword as wizards and witches* In Baghdad and Cairo 

institutions for the insane existed long before it was thought 

of erecting them in the lands of Christendom, and the first 

in these lands arose in Spain, the intellectual development,f 

of which country was greatly influenced by Arabian civili 

zation. The balance inclines decidedly in favour of the 

Muhammedans, as regards the humane treatment of the » 

insane; Christianity here exhibits an ugly blemish, for which 

the religious zeal of its adherents must bear the blame. 

The Arabs had separate departments in their hospitals' 

for the various kinds of diseases afflicting mankind; there 

were even separate institutions for certain diseases, for 

instance those of the eyes. The students who visited these 

hospitals were, under the guidance of experienced doctors, 

initiated into the art of recognizing and treating diseases. 

They assisted at the performance of surgical operations 

and were frequently able to acquire a practical acquaint- 

* LECKY op. cit. ii, 68 et seq. DESMAISONS : Des Asiles d'alien6s en Espagne, 

Paris 1859.


ance with midwifery, as ALI BEN ABBAS advised them to 

do. In the apothecaries' shops they had the opportunity 

of becoming acquainted with the preparation of medicines. 

The Arabs introduced apothecaries' shops; it 

seems that they were made acquainted with them through 

the Nestorians.* The Arab apothecaries dealt not only 

in drugs (notably sandalwood, on which account they 

were also named Szandalani), perfumery, cosmetic, and 

other applications, but also were occupied in compounding 

drugs into medicines: and they introduced dispensaries. 

They deserve commendation for their systematic use of 

distillation and for the discovery of certain remedies. 

Their chemical and botanical studies were very useful to 

them in their work. Botany formed, as HADJI KHALFA 

says,f a science ancillary to medicine. Many doctors 

were zealous botanists; it is narrated of RACHID EDDIN 

IBN ASZURI that he was attended on his botanical excursions 

by a painter, who made pictures of the plants in 

their various stages of development.^ MUHAMMED BEN 

ALI BEN FARAK, the body-physician of the prince of 

Cadiz, is said even to have laid out a botanical garden.§ 

The Arabian doctors strove not only to acquire a thorough 

knowledge of medicine and natural science, but showed a 

keen interest in the teachings of the philosophers, and were 

at the head of all liberal intellectual efforts. 

The names of AVICENNA, of AVERROES, and of MOSES 

JVIAIMONIDES are almost more conspicuous in the history 

of philosophy than in that of medicine. The groundwork 

of their philosophical ideas was formed by the system of 

ARISTOTLE, which they carried to a further development in 

various directions. While AVICENNA was led by this path 

to a teleological Theism which recommended him to the 

* K. SPRENGEL: Geschichte der Botanik. Leipzig 1817, i, S. 205. 

f HADJI KHALFA: Lexicon bibliographicum et encyclopa:dicum ed. G. 

FLUGEL, London 1845, T - iv, p. 114. / 

X HADJI KHALFA : op. cit. T. i, p. 227, No. 36I.-LECLE.

T8O THE MIDDLE AGES. 

Christian schools of the Middle Ages, AvERROES attained 

to a pantheistic naturalism, which, on account of its rationalistic 

character, was not only condemned by the Christian 

Churches but also raised him up many adversaries among 

his own countrymen and co-religionists. When AVERROES 

declared that religion existed only for the benefit of the 

weaker intellect, that man could by his reason alone and 

without any revelation arrive at a knowledge of the essence 

of things ; when in the place of a creation brought about, 

by theâlmighty will of the Godhead, he set up Nature, 

which, by a kind of Aristotelian ivrekfyeui, he conceived 

to have been promoted from potentiality to actuality; when 

finally he preached the permanency of the world' and of 

matter, the mingling of God with Nature, and the consubstantiality 

of reason—in all this he shook the foundations 

of a monotheistic system of religion and was bound to 

expect bitter opposition from its'adherents* 

His pupil and disciple the Jewish doctor MOSES MAIMO- 

NIDES experienced this too when he made the attempt to 

reconcile the precepts of the Talmud with the demands of 

reason. He opened broader paths of intellectual activity 

for the Jews. As MUNK says: "From SPINOZA down 

to MENDELSSOHN, the Jews have produced no advanced 

thinker who has not received the first sanction for his 

philosophy in MAIMONIDES." 

A relio-ious toleration towards people of other faiths 

prevailed in the countries under Islam during the first 

centuries of its existence, such as was not found anywhere 

at that period among the Christians. The high teaching 

institutions and medical schools numbered among their 

teachers and students many Jews, Christians and followers 

of other religions. Not only Muhammedan, but Christian 

and Jewish doctors also were appointed to their hospitals, 

and patients who did not hold the prevailing belief found 

at them nevertheless welcome admittance and- kind 

attention. Even the prophet MUHAMMED himself had re- 

* E. RENAN : AVerroes et l'Averroisme, Paris i860.

MEDICAL SCIENCE AMONG THE ARABS. l8l 

commended an unbeliever to his adherents as a doctor.* 

Jews and Christians and especially Nestorians played 

an important part as body-physicians at the Courts of 

the Caliphs and Muhammedan princes; they were even 

advanced to influential positions in the sanitary service. 

Medical practice was at first free to all; it gradually, however, 

became customary that the doctors should obtain certificates 

from the teachers who had instructed them in the 

healing art, since they thus instilled greater confidence into 

the mind of the public.f A professional blunder which 

resulted in the death of a patient was the occasion, in the 

year 931, of calling upon all the doctors of Baghdad and 

the neighbourhood to submit themselves to examination ; 

this examination was waived only in the case of the Court 

doctors and of practitioners whose ability was generally 

recognized. All other practitioners, reaching 860 in number, 

had to prove their fitness for the medical calling by an 

examination, held by the body-physician of the Caliph, SlNAN 

BEN TSABET BEN CORRA.J MEYER§ thinks that this was 

a temporary police regulation directed against charlatanism, 

since no successor to this examiner is mentioned; but 

similar arrangements existed in Baghdad in the 12th century 

and in Cordova even at an earlier period. || To me it appears 

therefore that we cannot doubt that the beginnings of 

the system of medical examinations are to be sought for 

among the Arabs. 

It was a frequent occurrence amongst the Arabs, as 

amongst other Orientals, for the son to choose the profession 

of his father. Certain families, as the Bachtischua, 

whose pedigree has been arranged by MEYER,! the Corra,** 

* v. HAMMER-PURGSTALL op. tit. ii, S. 192.—ABULFARAG op. cit. p. 99. 

t LECLERC op. cit. i, 574. 

X CASIRI op. cit. T. i, p. 438/— LECLERC op. cit. i, 576. 

§ MEYER op. tit. iii, 122. 

|| LECLERC op. cit. i, 577. 

1f MEYER op. ait. iii, 109. 

** WUSTENFELD: Gesch. d. Arab. Arzte, S. 34 et seq.

l82 THE MIDDLE AGES. 

the Honein, and the Zohr* families, to the last of which 

AVENZOAR belonged, furnished doctors through many 

generations, among them some very celebrated. This was 

the case too in other departments of learning, as the 

example of the Sobki family adduced by WOSTENFELD,t 

proves. Many doctors confined their practice to a special . • 

department of medicine as for example ophthalmology. 

Even at an earlier period the regulation was made of nominating 

Proto-mediciJ who, unless this was merely a title, no 

doubt exercised supervision over the other doctors. Probably 

this office was always joined with that of bodyphysician. 

Are we at liberty to assume that it was connected 

with the introduction of medical examinations? - 

IBN BEITHAR, the author of the best Arabian work on 

materia medica, who was body-physician at the Egyptian 

Court was nominated the chief of all doctors and herba- | 

lists (apothecaries ?) of that country. 

The doctors enjoyed a superior position in social life: 

many acquired great influence as the friends and advisers 

of rulers. The physicians in ordinary at the Court of the 

Caliphs received higher pay and richer presents than the i 

other learned men and officials§ and were loaded with 

honours and distinctions. Not a few attained the dignity 

of Vizier which was equivalent to the rank, if not always of 

minister, in any case of privy counsellor or aulic coun 

sellor. || 

On the other hand there seems to have been by no 

means an absence of those members of the medical profession 

who decoy the public by the unclean means of 

charlatanism. RHAZES felt himself induced in consequence 

to compose a treatise " upon those conditions and circumstances 

of the medical art which turn the hearts of the 

* Id. op. cit. S. 88 et seq. 

f Id.: Akademien der Araber, S. 119. 

X LECLERC op. cit. i, 576. 

§ v. HAMMER-PURGSTALL op cit. Bd. i, Einleit., p. 1. 

|| LECLERC op. cit. i, 578.


majority away from the most respectable doctors and 

induce them to resort to the lowest class of practitioners."* 

The Arabian doctors gave full attention to the 

theoretical problems of their calling; but they entertained a 

temperate and modest conception of life and took things as 

they are, not as they ought to be. In the " Doctor's guide," 

the author of which is said to have been the Jew ISAAC 

ISRAELI, rules of life are laid down for them which bear 

testimony to this. There it is said : " The most important 

problem for the doctor is, how to avert illness." "The 

majority of diseases are cured by the help of Nature 

without the aid of the doctor." " If you can cure the 

patient by dietetic means, forbear to order drugs." " Never 

rely upon magic means in the treatment of a patient, since 

they mostly rest on folly and superstition." " Hold forth 

the prospect of recovery to patients, even when you are 

not assured of it yourself; so shall you at least second the 

efforts of Nature to cure them." " If a doctor has come 

from afar, and speaks a foreign language, then the multitude 

think him a clever man, come to him in crowds, and seek 

his advice." " Never speak unfavourably of other doctors ; 

for everyone has his successful and his unsuccessful 

times. Let your deeds speak your praises, not your 

tongue." "Visit your patient when he is at his worst. At 

that time come to an understanding with him about your 

fee: for if the patient is well he takes no thought of the 

matter." " Make your fee as high as possible, for what is 

done gratis is considered of little value." " Bestow the 

greatest attention upon the cure of princes and rich people ; 

for after their recovery they will be munificent to you, will 

always value and love you, whereas common people when 

they are cured hate you if they think of the fee."t Might 

we not readily believe that this book was written yesterday? 

* M. STEINSCHNEIDER in VIRCHOW'S Archiv, Bd. 36, S. 574 et seq. 

t SOAVE in the Giorn. Veneto di scienze mediche i86r, ser. ii, T. 18, p. 393 

et seq.—D. KAUFMANN in the Magazin f. d. "Wissensch. d. Judenthums, Berlin 

1884, S. 97 et seq.


Arabian culture fell from its high elevation almost as 

rapidly as it had climbed to it. The celebrated schools of 

the Nestorians were declining even in the 9th century* 

The higher teaching institutions of the Arabs lasted till the 

14th century and then disappeared more or less rapidly, 

and with them disappeared that scientific life which had 

borne such rich fruit for the human race. The religious 

wars which, in the East under the name of Crusades, were 

carried on by adventurers eager for booty, and in the West 

led Christian princes to the conquest of Spain and of the 

Italian islands in the Mediterranean, evokedt the religious 

fanaticism of the Muhammedans and paralyzed their intellectual 

efforts. The Mongolian and Turkoman tribes which 

in the 13th century burst in with fire and sword upon the 

Aryo-Semitic world crushed to fragments the ancient 

homes of civilization in Asia and turned flourishing towns 

into desolate wastes. The East never recovered from this 

blow and Turkish dominion became the symbol and sign 

of intellectual death. But in the Christian lands of the 

West the seeds of Arabian culture germinated into that 

vigorous growth of intellectual effort which showed its first 

high development in the Schools of Salerno and Montpellier. 

MEDICINE AMONG THE GERMANS 

AND TEACHING IN THE MONASTIC SCHOOLS. 

THE German tribes, which attained to power, after the socalled 

migration of the nations, in the western half of the 

Roman Empire had in the fifth century, already for some 

time past raised themselves above that low grade of civilization 

on which they stood when TACITUS wrote his 

description of them.J They had entered into relations 

with the Romans both in war and peace and had learnt to 

recognize their superiority in science and art. As soldiers 

* ASSEMANI op. cit. iii, pars ii, p. 940. 

•f v. KREMER: Ibn Chaldun und Seine Culturgeschichte, Wien 1879, S. 39. 

X TACITUS : Germania, c. 5, 19 et seq.—GIBBON op. cit. c. 9.—Rev. scient., 

Paris, Oct., 1873.

MEDICINE AMONG THE GERMANS. 185 

in the Roman Army, as joyfully welcomed allies, or as 

hostages, they had the opportunity of enjoying the advantages 

of Roman civilization and of acquiring knowledge 

which they transmitted to their countrymen who remained 

at home. The germs of a noble civilization in the German 

race, which excited the astonishment and praise of TACITUS, 

were brought to greater perfection and to further development 

by the higher education. 

When the tribes of the Goths and other German peoples 

were driven from their homes by hordes of Huns pressing 

in upon them from the East, and when, thirsting for 

action and longing for riches and power, they began their 

world-famed wanderings, they possessed already a literary 

language, an orderly system of government, an assured 

administration of justice, and manifold acquirements in 

the various spheres of intellectual life. In medicine they 

held the view that diseases are produced by supernatural 

powers, which should be propitiated by prayers and magic ; 

but they did not neglect the use of healing herbs and other 

means, the favourable action of which experience had taught. 

It was especially incumbent upon the women, who played a 

very prominent part in the life of the Germans, to bind up 

wounds and to nurse the sick.* Only by degrees and 

chiefly under the influence of Roman civilization a special 

medical profession became developed among this people. 

The Greek and Roman doctors, who in the capacity of 

military surgeons came among them or, like ORIBASIUS and 

ANTHIMUS, stayed in their country in exile or as envoys, 

must have contributed to this in no small degree. 

GuiZOT t remarks that it is difficult to picture the intellectual 

condition of the Germans before the migration of 

the nations, and we may add that in regard to their medical 

acquirements this is especially the case. It is clear from 

comparative philology however that they had special 

* TACITUS op. cit. c. 7, 8, 18. 

t GUIZOT : Cours d'histoire moderne. Histoire de la civilization en France, 

Bruxelles 1829, i, p. 204.


designations for particular diseases * and we are permitted 

to draw many inferences from the analogy of the development 

of civilization among other peoples and especially by 

looking to the contemporary condition of the Germans of 

the North. There too, wise women practised the healing 

art, and people went so far as to worship a goddess of 

medicine, ElR by name.f BRUNHILDA, "the doctoress," 

and the " Norns," % understood the art of delivering 

women. When SiGRDRlFA (BRUNHILDA) tells SiGURDR 

that he must know runes of a certain kind for the child to 

be delivered from the mother and when it is said of JARLS- 

SOHN KONR that he knew the runes and gave assistance to 

women in childbed, reference is obviously made to mystical :J 

formulas to which immense importance was attached in 

connection with the act of giving birth to a child. Even 

the hero G6NGUHROLF gave aid in child-birth by a laying * 

on of hands. Princes and heroes—indeed even ODIN 

himself, " the doctor"—were esteemed as especially 

experienced in medicine; § this indicates perhaps that it 

was practised chiefly by men of position who were the 

heads of large households, just as was the case in CATO'S •{ 

time at Rome. 

Among the named diseases, we find derangement of the 

mind, impotence, but most frequently chronic suppuration of 

the leg which frequently ended fatally. These people were* 

well acquainted with the treatment of wounds. Even amputation 

was performed and the loss of the leg was made good 

by an artificial limb of wood. Wooden legs were, as it 

appears, not uncommon. Mention is also made of gastroraphy. 

This information has its source however from the 

period of the voyages of the Vikings, when already com- 

* AD. PICTET: Die alten Krankheits-Namen bei den Indogermanen in der 

Zeitschr. f. vergl. sprachforschung, Bd. v, S. 321 et seq. 

f K. WEINHOLD: Altnordisches Leben, Berlin 1856, S. 385 et seq. 

X The three Fates in Northern Mythology. 

§ Sigurdhar-koida i, 17. Fafnismal 12. Sigrdrifumal 9. Rigsmal 40. 

Fornalda sogur iii, 276. Saxo Gramm. i, 1,25,33, 128. Prof. R. HEINZEL. 

of Vienna had the kindness to call my attention to these passages.

MEDICINE AMONG THE GERMANS. 

munication existed between the North Germans and the 

more highly developed civilization of other peoples. 

SNORRI STURLUSON and HRAFN SWEINBOIRNSSON obtained 

great reputation by their successful cures. The 

latter is even said to have performed lithotomy with 

success* The mystical VlTOLF passed as the patron of 

the surgeons of the North.f INGIGERD, daughter of the 

Russian King INGVAR, founded a small hospital and consigned 

the nursing of the patients to gentle-handed 

women.J 

In the ioth century there were already in Norway a 

number of doctors, who practised their art as a profession. 

Even at that early period people had private medical 

attendants who were highly paid.§ There existed also 

even then a medical tax. The amount of the medical 

honorarium depended upon the gravity of the suffering 

which was relieved. 

In the Sudermanian law-book which, although first published 

in 1327, rests upon the authority of ancient enactments 

it was ordained that he only should be recognized as 

a doctor who had cured an incised wound, a fractured bone, 

an internal injury, a mutilation or a deep stab. Midwifery 

was naturally delegated to women. Mention is already 

made however of Caesarean section. It would not be right 

to apply to the Germans of the first centuries, as many 

medical historians do, the accounts here given, some of 

which clearly bear the stamp of later periods of civilization. 

They, at the most, authorize us to make certain 

presumptions as to the state of medical science among 

them. 

The knowledge and customs brought by the Goths, 

* Sagenbibliothek des skandinav. Alterthums, herausg. von P. E. MULLER, 

iibers. von K. LACHMANN, Berlin 1816, S. 176.—L. FAYE : Rafn Sweinbjornsens 

liv og verksomhed, Kristiania 1878. 

+ GRIMM: Mytholog. 994, 1101. 

+ WEINHOLD op. cit. S. 390. 

§ Vapnfirdlinga saga, c. 13, 29.

l88 THE MIDDLE AGES. ..v., ,- 

Lombards, Franks, Burgundians, and other German races, 

from their homes into the countries subdued by them soo$ 

became mingled with all which had been bequeathed tQ 

these countries by former periods of civilizatiq|. The 

readiness with which the conquerors took to the higher 

education of the conquered shows that they were sufficiently I 

prepared and ripe to receive the same. Their medical 

science grew up into that system of medicine, which the 

Greeks and Romans had established. * Only among the 

people were certain traces preserved of the therapeutic | 

lore of the Celtic, Basque, Gaelic, Gothic, and Anglo- | 

Saxon races. 

In the laws of the Visigoths, which, partly committed ; 

to writing in the fifth century, contained without doubt 

much matter of Roman origin, it was laid down* how 

much the doctor should demand for different cases e.g. J 

the operation for cataract. Before undertaking such a 

case, he made an agreement with the patient or his % 

relatives, in which the professional fee was fixed ;^but he 

could only claim it if the treatment proved successful' 1 

In the other case he had to answer for an unfortunate 

issue. If the death of a slave resulted from his,treatment 

he was obliged to replace the loss; if it was a 

question of injury inflicted on the health or life of a free- J 

born citizen, he was condemned to a corresponding fine or 

given over for punishment to the relatives of the injured 

or dead. It is indicative of the social position of the 

doctor that he might see and examine females of the 

position of freewomen only in the presence of their 

relatives, for fear he should misuse such occasions by :• 

improper behaviour. 

The Visigothic law contains also rules concerning moral J 

responsibility, as to the punishment for crimes against the 

person e.g., wounding and mutilation, about cases of procuring 

abortion, and in regard to sexual transgressions^ 

* Leg. Wisigoth, lib. xi, tit. i, de medicis et segrotis.—F. DAHN : Westgothische 

Studien, Wurzburg 1874, S. 3, 61, 145, 220, 222, 230 etc.


Of especiaf interest is the rule contained therein, that the 

doctor w 7 as entitled to demand a fee of 12 solidi for the 

instruction in medicine which he gave his pupil; it is clear 

from this that doctors were educated in their art under the 

personal supervision of a master, just as was the case in 

ancient times. 

The law books of the Alemanni, the Salii, Ripuarii, Bur- 

gundians, Bajoari, Frisians, Saxons, and Lombards contained 

also regulations as to punishments for wounds inflicted upon, 

and other offences committed against, the person.* 

The training of doctors was consonant to the method of 

teaching a trade. The tyro in medicine resigned himself to 

a respectable doctor, who furnished him with medical infor 

mation. Many doctors sought to complete their knowledge 

in the large towns of the Byzantine empire and Italy. 

Many Greeks, Romans, and Jews were to be found among 

them, and were especially in request at the courts of 

princes. 

ThetGreek doctor, PETRUSt was physician in ordinary to 

the Visigothic King, THEODORIC II. MARILEIF of Poictiers 

filled this post at the court of the Merovingians, having 

raised himself to this position from the lowest social cir 

cumstances, and REOVAL, who had acquired his medical 

training in Constantinople, enjoyed the same honour.J 

The latter performed an operation for removal of the testes 

with success. 

The work of a physician in ordinary at the Ffankish 

Court was certainly very profitable, as the riches acquired 

by MARILEIF testify, but it was also attended with many 

dangers. When AUSTRIGILDIS the wife of King GuNTRAM 

was carried off by a pestilence which raged in the year 580, 

she expressed a wish before her death that after that event 

her two doctors, NlCOLAUS and DONATUS, should be 

executed as a punishment for riot having saved her ; and 

* Corpus juris German, antiq. ed., F. WALTER, Berbl. 1824, T. i. 

t FREDEGAR : Chron., C. 27, O. ABEL'S translation. 

X GREGORY of Tours v, 14. vii, 25. x, 15.


the pious GUNTRAM considered himself bound to give 

effect to the last wishes of his spouse.* 

CHARLEMAGNE is said to have consulted Arabian physicians, 

as is stated by BULÛS and FRElND:f but these 

assertions, although not sounding improbable considering 

the respect which Arabian medicine enjoyed at that 

time, are, nevertheless, not authenticated by reference to 

the sources from which they are derived. It is certain 

that one of his private physicians bore the German name 

of WINTARUS.J In the life of Louis THE Pious it is 

narrated, that the wife of CHARLES, HlLDEGARD by name, 

bore him two sons, of whom one died as soon as he was 

born, and the other, namely LOUIS, was taken from his 

mother's womb and reared by artificial nourishment^ It is 

uncertain whether allusion is here made to Caesarean section 

or to a labour completed by manual aid. CHARLEMAGNE 

had at any rate a mean opinion of medicine, || which 

is probably explained by the neglected condition of 

the medical science of his time. It was therefore intelligible, 

that he should be moved to raise up this science 

from its debased condition, and to spread the knowledge 

of it more widely. On this ground, at the capitulation of 

Diedenhofen (Thionville) in 806 he issued an order that boys 

should be instructed in the healing art.^f MEYER** thinks 

that they had only to receive an introduction to the art of 

nursing the sick, since one " does not let children study 

medicine." 

But the study of this science was in ancient times begun 

quite in early youth. And in the schools of this period 

* Idem v, 35. 

t FREIND: Hist, med., p. 148. 

X IMGIL'S Leben des Abtcs Sturm von Tulda, C. 25, ed. MIGNE, T. 105, p. 

443- 

§ J. L. W. SCHMIDT, im Progr. des hess. Gymnas. zu Giessen, 1872, S. 5. 

|| EINHARD: Vita Caroli Magni, C. 22, ed. PERTZ, Hannov. 1863. 

IT PERTZ: Mon. Germ, iii, p. 131, De medicinali arte ut infantes hanc 

discere mittantur. 

** MEYER op. cit. iii, 413.


boys of 14 or 15 years of age were to be found.* For the 

rest, this teaching may have almost entirely been limited 

to the reading of the medical writings of antiquity, and to 

explaining the meaning of these, as was also the case in 

many monastic schools. Later on, the students learnt how 

to recognize the medicinal plants, opportunities being 

afforded for this in the imperial gardens, t They seem to 

have drawn into the domain of teaching even the practice 

of medicine itself. The w*ords in ALCUIN'S poem on 

CHARLEMAGNE^: can hardly be understood otherwise than 

to imply that in the neighbourhood of the court there was 

a hospital in which doctors performed different functions. 

"One let the patients' blood, another mixed herbs in a 

pot, that one cooked some pap, while this one prepared a 

drink." 

Probably the infirmaries attached to many monasteries 

served as examples for such arrangements. The monks 

took a keen interest in the care of the sick. " Learn to 

know the properties of plants and the art of mixing 

remedies," said CASSIODORUS to them§ "but place all your 

hope on the Lord who preserves life eternally. If the 

language of the Greeks is not unknown to you, you have 

the book of herbs of DiOSKORiDES, who has described 

and pictured forth the plants of the field with surprising 

accuracy. Afterwards, read HIPPOKRATES and GALEN in 

the Latin translation, that is to say, the Therapeutics of 

the latter which he has addressed to the philosopher 

* J. CH. F. BAEHR : De literarum studiis a Carolo Magno revocatis ac schola 

Palatina instaurata, Heidelberg 1856, S. 26, Anm. 33. 

t Capit. de villis. Cf. MEYER op. tit. iii, S. 397 et seq. 

X Alcuinii carmina, ed. E. DUMMLER in Mon. Germ. Poet, lat., T. i, p. 245, 

No. xxvi, v. 12-16. 

Accurrunt medici mox Hippocratica secta ; 

Hie venas fundit herbas, hie miscet in olla, 

Ille coquit pultes, alter sed pocula praefert; 

Et tamen, 0 medici, cunctis impedite gratis 

Ut manibus vestris adsit benedictio Christi. 

If in the first line we read tecta for secta, the allusion to a hospital is still plainer 

§ CASSIODORUS: Inst, divin. lect. i, C. 31.


GLAUCON, and the work of an anonymous writer, which, 

as the examination of it shows, is compiled from various 

authors. Furthermore study the medicine of AURELIUS 

C/ELIUS, the book of HIPPOKRATES upon herbs and methods '. 

of cure, and various other writings on the healing art, J 

Y which I have installed in my library and have bequeathed j 

to you." Certain members of the Benedictine order came 

into profitable notoriety as doctors, like the Abbot BER- 

THARIUS at Monte-Casino in the 9th century* Perhaps 

even at an earlier period pious pilgrims and patients were 

admitted and cared for at that place ; ST. BENEDICT the J 

founder of the order having observed this custom in the East 

and having accordingly imposed it as a duty on his followers. J 

But the more certain information on this point namely that 

institutions of this kind existed in Monte-Casino, dates 

from the nth and 12th centuries and not before.f 

The custom of bringing helpless sufferers into the " 

Churches and Monasteries,.for the priests to sprinkle them 

with holy water and to offer up prayers for their recovery 

found universal acceptance in the first centuries of the 

Middle Ages. From this the rule gradually came into I 

existence of erecting institutions there in which the infirm .% 

and ailing found shelter. The priests and monks who 

superintended these, in addition to psychical means of cure, 

employed also healing herbs and other remedies the 

favourable action of which they had learnt to recognize J 

from medical literature or from private experience. In this 

way medical knowledge came to form an essential part of 

the education of the priest, of which he felt the need in 

the practice of his profession. 

The schools of the Middle Ages, regarding as they did 

the training of the cleric as their most important task, j 

endeavoured to satisfy this want when they accepted 1 

*" '"1 

* DE RENZI : Storia docum. della scuola - medica di Salerno, 2 Ed., Napoli 1 

1857, p. 64 et seq. 

t TOSTI : Storia della badia di Monte Casino, Napoli 1842, i, 229, 341 et seq. 

ii, p. 193, 209, 289.—Reg. S. Bened. 36 in MURATORI script, rer. Ital.

MEDICINE AMONG THE GERMANS. 

medical science as a part of their curriculum as far as it 

could be taught in a purely theoretical manner. This was 

the case in many monastic schools notably those of Gaul 

for instance at Rheims, Chartres, Fleury, Dijon, Bee in 

Normandy, and St. Denis.* Moreover, the stores of medical 

manuscripts possessed by many of these monasteries,! and 

the literary activity of the monks, all point to the fact that 

medicine was assiduously practised and studied at the 

places and by the persons in question. When the students, 

by teaching and by the reading of medical treatises had 

acquired some general knowledge of the healing art, they 

may perhaps also have received some practical training in 

the same, while seeking and collecting medicinal plants 

under the supervision of their teacher, or compounding 

medicines and giving their services during the treatment of 

the patients. It is very likely that these relations assumed 

some such form as the author of the Journal^ of Walafridus 

Strabo describes with fruitful imagination, and knowledge 

which must be recognized as valuable. 

Many teachers of medicine obtained great renown. Thus 

RICHER relates that in the year 991 he travelled to Chartres 

to hear HERIBRAND'S exposition of the Aphorisms of 

HIPPOKRATES. HERIBRAND gave him instruction also in 

the semeiology of diseases and taught him in what subjects 

HIPPOKRATES, GALEN, and SORANUS are agreed. He possessed 

considerable knowledge of materia medica, botany, 

and surgery as RICHER declares with high commendation.§ 

From the school of Chartres many celebrated doctors 

issued, among them JOHANN, the private physician of 

* J. B. L. CHOMEL: Essai historique sur la me'decine en France, Paris 1762. 

f The library at Tegernsee contained, for example, in 1500, 281 medical 

treatises, as we are told by LAMMERT (Volksmedicin u. medecin. Aberglaube in 

Bayern, Wiirzburg 1868, S. 4). •> 

X This was published (1856-57) in the yearly report of the training institu 

tion of the Benedictine Monastery at Maria-Einsiedeln. It is however an 

imaginative work of P. MARTIN MARTY and by no means true, as some 

authors have strangely thought. 

§ PERTZ : Monum. Germ., T. v. ^Script, iii), p. 643. 

O


HENRY I. of France.. GERBERT D'AURILLAC,—when Pope 

known as SYLVESTER II.—worked at the Episcopal School 

of Rheims for some time as teacher of medicine. 

At the Court of CHARLEMAGNE besides the Palace 

"School in which the children of the Emperor and of certain 

distinguished dignitaries were taught, there was a kind of 

Academy numbering among its members the chief men of 

learning of the time. In this capacity they bore special 

names; ALCUIN was called FLACCUS, CHARLES himself 

was KING DAVID. They devoted themselves to theology, 

philosophy, arithmetic, geometry, astronomy, Latin, Greek, 

history, geography, and poetry.* This Academy appears 

however to have existed only for a short time, whilst the 

Court-school was still flourishing in the middle of the 9th 

century. In the year 789 the Synod of Aix decided that 

at the monastery and cathedral of that town there should 

be formed a school in which boys might be able to learn|he 

Psalms, writing, singing, the reckoning of ecclesiastical 

festivals, and Latin grammar.t The pattern for this institution 

was the school at Tours, where ALCUIN lived from 796 

as Abbot of St. Martin's Monastery. There were celebrated 

schools of this kind at Fulda, Hersfeld, Corvey, Reichenau, 

St. Gallen, Mainz, Worms, Speyer, Koln, Miinster, Bremen, 

Hildesheim, Magdeburg, Paderborn, Halberstadt, at 

Salzburg, Freising, Passau, Tegernsee, Benedictbeuern, 

Regensburg, at Milan, Parma and other places in Italy, as 

also in many monasteries of France, in England, as at 

Canterbury, and in Ireland. 

The curriculum of the Roman schools formed the foundation 

of the teaching in these institutions. Instruction was' 

given in orderly succession and included in one department 

the three elocutionary subjects of grammar, rhetoric, 

and dialectics, and in the other arithmetic, geometry, 

* W. F. C. SCIIMEIDLER: Die Hofschule und die Hof-Akademie Karls des 

Gfossen, Breslau 1872. 

t F. A. SPECHT : Geschichte des Unterrichtswesens in Deutschland von den 

.altesten Zeiten bis zur Mitte des 13 Jahrhunderts, Stuttgart 1885, S. 21.


astronomy, and music. These were called the Trivium and 

the Quadrivium. The conceptions formed of these subjects 

of education did not however by any means correspond 

with those of to-day; thus, in rhetoric, for example, not 

only the elementary principles of oratory were taught, but 

the Latin official style was practised, for the priests of that 

time drew up documents and attended to the affairs of 

government offices. The study of jurisprudence and of 

the laws was frequently added to this. By geometry was 

understood chiefly geography and physical geography, a 

knowledge of which HRABANUS MAURUS considered 

especially useful for doctors, since they might thus be able 

to learn the special climatic conditions of different localities 

and the position of particular places, and to make use of 

such knowledge in giving directions to their patients* 

Instruction in the natural sciences was combined with 

these subjects, the most important of the matters 

known at that time in the three natural kingdoms, in 

anthropology, and in meteorology, being taught. Later 

on, schools were founded wherever there was a parish. 

The instruction was limited to elementary subjects. When 

towns began to come into a flourishing state, at the end of 

the 12th century, town-schools arose, aiming at the same 

objects in education as the monastic and religious schools 

and even surpassing them in performance. 

Such was the preliminary training, which the educated 

doctors of that time possessed, especially when they 

belonged to the priestly order. That alongside of these 

there were many practitioners who were devoid of such 

admits of no doubt. The great majority of empirics had 

no knowledge of medical literature and learned medicine 

as a handicraft. Scientific work in medicine was in an 

extremely low state. The treasures of knowledge, 

inherited from ancient times were not increased, nay, 

were not even preserved intact. No experimental investi- 

* SPECHT op. cit. S. 145.—ST. FELLNER: Compendium der Naturwissenschaften 

an der Schule zu Fulda im 10 Jahrhundert, Berlin 1879, s - 28.

196 


gation, hardly any observations of nature can be credited 

to this period. 

The literature of medicine and the natural sciences consisted 

chiefly of extracts from and commentaries on more 

ancient works. Independent ideas and experiences hardly 

ever found a place therein. To this category the following 

compositions belong: the book of recipes of the Milanese 

Archbishop BENEDICTUS CRISPUS, the encyclopaedic work 

of HRABANUS MAURUS, Archbishop of Mainz and primus 

preceptor Germanic which K. SCHMID translates as "the 

first schoolman of Germany," the description of plants by 

WALAFRIDUS STRABO, Abbot of Reichenau, the medical ., 

writino-s of the Abbot BERTHARIUS, the book on the healing 

virtues of plants by the enigmatical MACER FLORIDUS, the 

Lapidarius of Bishop MARBOD of Rennes, the Bestaanus of f 

the Englishman PHILLIP DE THAUN, the Natural Philosophy 

of his fellow-countryman ALEXANDER NECKAM, the Physica 

of ST. HlLDEGARD, Abbess of the monastery on the ,\ 

Rupertsberg near Bingen —" a treatise on materia medica 

unmistakably founded on popular traditions" as MEYER* , 

appropriately designates this work—and the far-famed 4 

Physiologus. 

The intellectual life of Christian Europe at that time 

resembled a landscape which fatigues by its uniform flatness 

and desolate sterility, while only at rare intervals 

there breaks upon the traveller's view a bit of scenery able 

to engage his eye. Then in the south of our portion of the' 

globe arose pictures, entrancing men with their gorgeous j 

colouring, giving courage new life, and filling all hearts with 

hope. The bright constellation of Arabian culture shed its 

light over these lands and sent some rays to the other parts 

of the Christian West—rays which served to foster intel- ; 

lectual development and at the same time to illuminate the 

path of its advance. 

> * MEYER op. cit. iii, 518.

THE SCHOOL OF SALERNO. 197 

THE SCHOOL OF SALERNO. 

AT Salerno, in Lower Italy, where the influence of the 

Arabs first made itself felt, in consequence of the neigh 

bourhood of Sicily which had for long been subject to their 

rule,* there arose a medical school which as early as the 

10th century enjoyed> a widely spread reputation. The 

origin of it is unknown although already much has been 

written on the subject. 

If we disregard the barren speculations which some 

authors have given utterance to on the subject, the following 

opinions come to the front. 

Some think that it existed as early as the 7th century 

and was associated with traditions of the Greek predomi- 

* *• 

nance which both in language and customs was maintained 

in that locality for a longer period than in other parts of 

Italy ;f others, as K. SPRENGEL, PUCCINOTTI J and for 

some time also S. DE RENZI, derive its origin from the 

Benedictines who had founded monasteries in Monte- 

Casino, in La Cava and Salerno; while HALLER and others 

ascribe its foundation to the Arabs. MEYER § proposed 

the hypothesis that in Salerno at first there existed a Guild 

or Corporation of Doctors who carried on their teaching 

secretly until it was made public by CONSTANTINUS AFRI- 

CANUS, and that in this way the foundation was laid for the 

development of a medical teaching institution in our sense 

of the word. 

Convincing evidence in support of these views has not 

been adduced by anyone. 

The historical facts connected with medicine in Salerno 

reach back to the middle of the 9th century; in documents 

of the years 848 and 855 JOSEPH and JOSHUA are named 

* Cf. A. F. v. SCHACK : Poesie und Kunst der Araber in Spanien und Sizilien, 

Berlin 1865, ii, 1-252. 

t G.. MOROSI : Studii sui dialetti greci della terra d'Otranto, Napoli 1870. 

X Storia della medicina, Livorno 1855, ii, p. 247 el "seq. 

§ Op. tit. iii, 451.


as doctors practising there* There in the year 900 lived 

RAGENIFRID, a Lombard as his name indicates ; who was 

private physician to the Prince WAIMAR of. Salerno ; and 

half a century later the doctor PETRUS who stood in high 

favour with Prince GlSULF and was raised to the bishopric 

of Salerno. In this period we meet with many doctors 

belonging to the priestly order, but alongside of these, 

Jewish doctors practised the healing art in Salerno, as is 

authenticated by historical testimony.! 

The doctors of Salerno had such a reputation in the 10th 

century that they were brought to foreign Courts to be 

made body-physicians to the rulers. One of these played 

a remarkable part at the court of LOUIS THE SIMPLE of 

France. He was doctor to the wife of this monarch when 

a scientific quarrel arose between him and his colleague 

DEROLDUS who-was serving as medical attendant to the 

king and was afterwards Bishop of Amiens : this dispute 

resulted, as RICHER narrates,! in a mutual attempt to 

poison one another out of envy. Patients of the higher 

class already at that time repaired to Salerno in order to 

obtain the advice of doctors residing there. For this purpose 

the Bishop ADALBERON went thither in the year 984 

from Verdun, but found no cure for his sufferings.§ Again, 

the Abbot DESIDERIUS, who afterwards ascended the papal 

throne under the name of VICTOR III., hoped to regain at 

this place his health shattered by night watches and fasts.|| 

The Duke GuiSCARD sent his son BOHEMUND there, that 

his wound received in war might be healed; for a similar 

reason WILLIAM THE CONQUEROR who became King of 

England passed some time in Salerno. 

* S. DE RENZI : Storia docum. della scuola med. di Salerno, Napoli 1857, 

p. 157 et seq. 

f S. DE RENZI : Collectio Salernitana iii, 325, Napoli 1852. 

X RICHER : Hist., lib. ii, c. 59 in PERTZ : Monum. German., T. v (script. Hi), 

p. 600. 

§ Gest. episcop. Virdun. in PERTZ : Mon. Germ., T. vi (script, iv), p. 47 & 

Hu&o FLAV. Chron., lib. i in PERTZ: Mon. Germ., T. x (script, viii), p. 367. 

|| DE RENZI: Storia doc. della scuola, p. 150.


The fame of its doctors increased more and more, and 

patients came from distant countries to be treated by them. 

The lyric poet HARTMANN VON DER AUE laid the scene of 

his famous poem " Der arme Heinrich " here but made his 

knight recover from his leprosy not through the skill of the 

doctors but by a miracle. 

Even as early as the nth century no certain information 

existed about the age and origin of the school of Salerno. 

ALPHANUS, well known both as poet and physician who 

afterwards was raised to the bishopric of Salerno, states that 

medicine flourished there even before GuAlMARUS II., that 

is in the 9th century.* The Norman historian ORDERICUS 

VlTALlS who lived about the year 1140 narrates that when 

the famous RODOLFUS known as MALA CORONA came to 

Salerno, even for a long time previously important medical 

schools had existed there, f On yet another occasion this 

author bears witness to the long existing reputation of the 

place. In the ancient Chronicle of Salerno, made use of 

by ANT. MAZZA and rediscovered by S. DE RENZI.J it is 

stated, that the medical school there was founded by four 

doctors, namely, the Jewish Rabbi ELINUS, the Greek 

PONTUS, the Saracen ADALA, and a native of Salerno, who 

lectured each in his native language. Amongst the first 

teachers are mentioned GuGLlELMUS DE BONONIA, MiCHAEL 

SCOTTUS, GUGLIELMUS DE RAVEGNA, ENRICUS DE PADUA, 

TETULUS GRiECUS, SALOMONUS EBRÛS, and ABDANA 

SARACENUS. 

It is clear that these reports should not be regarded as 

historical facts; but some grains of truth probably lie 

hidden in them. There was a desire to point out that 

persons belonging to different nations—Jews, Arabians, 

* DE RENZI : Collect. Salern. i, p. 95, note. 

t Ord. Vit. Hist, eccles. iii in Hist. Normann. scriptor. ed. DUCHESNE, Paris, 

1619, p. 477 " ubi maxima medicorum scholce ab untiquo tempore habentur." 

X MAZZA: Urbis Salern. hist, et antiq., Nap. 1681, printed in GRSV'IOS 

et PURMANN: Thesaur. antiq. et hist. Italia., Lugd. Bat. 1723, t. ix, pars 4. 

DE RENZI : Storia docum., p. xxvi et seq. & Collect. Salern. i, p, 106 et seq.


Greeks, and Latins contributed to the foundation of the 

school of Salerno, that the instruction there was at first 

given in different languages and that the medical doctrines 

of the Salernians were developed out of the scientific 

knowledge acquired by the Greeks and Romans, the 

Hebrews and the Arabs. Some of the names quoted are 

marred by incorrect calligraphy; it is easy to understand ., 

that ELINUS arose from ELIAS, and PONTUS must be 

improved into GARIO-PONTUS and ADALA into ABDALLAH. 

It is clear then from these considerations that we do not 

know, when and how the School of Salerno arose. The 

beginnings of it were either so unpretentious that they 

were unnoticed, or they reach so far back into antiquity f 

as to be beyond the historian's grasp. The political 

fortunes of this town, constantly changing as they were, 

and bringing its inhabitants into touch with the-Romans, 

the Greeks, the Lombards, the Arabs, and the Normans, 

were bound to leave deep traces in the development of 

their civilization and to exert a powerful influence on all 

1 departments of intellectual life. 

The custom usual in ancient times, of men of learning 

privately taking in pupils and instructing them in the 

sciences, obtained also in Italy in the middle ages* If the 

doctors followed this example there can never have been 

any dearth of students to live with them in Salerno, the 

mild climate and the noble situation of which, on the shores 

of a bay not far from shady woods and healing mineral • 

springs, attracted patients from far and wide. 

It is not known when the doctors who learned the \ 

healing art in Salerno joined together into a common 

activity and gave themselves an organization. At first, • 

as it appears, any doctor might act as a teacher of 

medicine without distinction of nationality or religious 

* W. GIESEBRECHT: De litterarum studiis apud Italos primis medii aevi ' 

sseculis, Berol. 1845, p. 15.—S. DE RENZI (Storia docum., p. 161) cites a great , 

' number of doctors who were practising in Italy during the time of the 

Lombards ; one of these was designated as Magister Scolce.


faith. At a later period many priests were found amongst 

the teachers of medicine there, of whom some attained 

to high dignity in the Church. But these never gained 

the exclusive right to teach as was the case in most 

of the other high schools of the middle ages. The institution 

throughout maintained that lay character which it had 

had from the beginning. 

In Salerno, women were admitted to the profession of 

teaching and some of them became prominent also as 

medical authors. Among the female doctors the best known 

was TROTULA the authoress of a frequently quoted work 

on the diseases of women and the treatment of them before 

during and after labours. In her writings she discusses all 

branches of pathology even the diseases of the male sexual 

organs—a truly painful subject for female sensibility. Her 

colleague ABELLA wrote de natura seminis humani. 

COSTANZA CALENDA the daughter of the Prior (Principal) 

of the medical school, distinguished alike for her beauty 

and her talents, and MERCURIADE and REBECCA GUARNA 

belong to a later period. 

In the early times of the School of Salerno the.teachers 

were probably dependent for their pay upon the fees which 

students gave them for instruction. Afterwards they received 

regular stipends, differing in amount and in some 

cases producing a yearly income of 12 ounces of gold ; in 

course of time the stipends were naturally increased. 

Teachers enjoyed freedom from taxes also and sometimes 

the usufruct of houses and ground property as well.* 

Many teachers were engaged in giving medical instruction 

at the same time, as is evident from the list of them given 

by S. DE RENZI.t To their lectures representatives of all 

nations had access; neither sex nor religion raised any 

impediment. Jewish students were very numerously 

* DE RENZI : Collect. Salern. i, 366 et seq.—Storia docum. op. cit. Appendix 

Docum. No. 296 et seq. 

t DE RENZI : Collect. Salernit. 1,517. iii, 326 el seq. It contains 340 names 

in a period of about 1000 years.


represented in the i ith century, as MAZZA informs us. 

When on the other hand the Jewish traveller. BENJAMIN 

VON TUDELA narrates that on visiting Salerno in 1160 he 

met not one single doctor among the numerous members of 

his faith living there, his assertion .contradicts all other 

reports, in which we either find it expressly s,tated that 

certain Salernian doctors did belong to the religion of 

MOSES, or else we are at liberty to assume this fact from 

the names.* 

Students came to Salerno from far and wide, even from 

Germany and France, to devote themselves to medicine. A 

student from Koln who had attended medical lectures in 

Salerno in the 12th century, but, owing to illness was 

obliged to return home, gives vent in a poem to complaints 

about the treacherous people of Salerno who were hateful to 

him.| Another student, ÊGIDIUS (GILLES) VON CORBEIL, 

who afterwards lived in Paris as canon and private 

physician to PHILIPPE AUGUSTE, King of France, proclaimed 

there with tongue and pen the fame of the 

medical school of Salerno. 

Of the kind of teaching in the several subjects the 

following is known : Anatomy was taught on the pig. 

In the Demonstratio Anatomica, proceeding from an 

anonymous author and which obviously formed a collegelecture, 

rules are given how to proceed. According to this 

the animal was killed by severing the vessels of the neck, 

then was hung up by the hind legs and after the blood had 

escaped the carcass was made use of for teaching. This, 

as it appears, was limited to opening the great cavities of 

the body and demonstrating the organs lying therein. 

Some remarks were added on the form and the. presumed 

* Cf. M. STEINSCHNEIDER in VIRCHOW'S Archiv, Bd. 38 (1867), S. 74 et seq. 

f Laudibus eternum nullus negat esse Salemum ; 

I Hue pro morbis lotus circiimftuit orbis. 

Nee debet sperni, fateor, doctrina Salerni 

Quamvis exosa mihi sit ge7is ilia dolosa. 

JAC. GRIMM: Gedichte des Mittelalters in Kleine Schriften, Berlin 1866, 

S. 64.


function of such organs in man ; reliance being placed 

upon the writings of GALEN, RUFUS, and THEOPHILUS 

PROTOSPATHARIUS, although the scientific elevation of 

these men was beyond the lecturer's reach. So too 

COPHO'S Anatomy of the Pig consists essentially only, of 

an enumeration of the most important parts of the body. 

And yet we find therein certain indications of more 

searching inquiry and some observations in pathological 

anatomy. Thus it is said, for instance, that it is possible to 

inflate the lungs by introducing a pipe into the trachea* 

Again, mention is made of effusions into the pericardium 

and pleura. 

More attention was devoted to practical medicine. As 

early as the year 820 a public hospital was founded in 

Salerno by the high priest ADELMUS, which was brought 

into connection with the Benedictine monastery. At a 

later period several other infirmaries and charitable institu 

tions arose, which were endowed with valuable property 

and conducted by members of charitable orders.f It is 

uncertain whether clinical instruction was imparted at 

these places or not. 

ARCHIMATTHÛS gives in a treatise J complete advice 

as to how a doctor should comport himself on visiting a 

patient. He should place himself under the protection of 

God, he says, and implore the assistance of the angel who 

guided TOBIAS. On the way to see the sick person he 

should question the messenger who has summoned him 

upon the circumstances and the conditions of the illness of 

the patient; then if not able to make any positive diagnosis 

after examining the pulse and the urine, he will at least 

excite the patient's astonishment by his accurate knowledge 

of the symptoms of the disease and thus win his confidence. 

The author also considers it a matter of great importance 

* DE RENZI : Collect. Salern. ii, 389. 

t DE RENZI : Storia docum. della scuola med. di Salerno, p. 563, Doc. 329. 

X Anomymi Salernitani de adventu medici ad segrotum ed. A. G. E. Tn. 

HENSCHEL, Vratist 1850.—DE RENZI : Collect. Salernit. ii, 74-81, v, 333-349.


that the patient should confess to the priest before the 

doctor comes to him ; for " if mention is afterwards made 

of this matter the patient believes that there is no hope for 

him." " When the doctor enters the dwelling of his patient 

he should appear neither haughty nor covetous, but must' 

greet him with a modest demeanour, and then seat himself 

near the sick man, accept the drink which is offered him 

and praise in a few words the beauty of the neighbourhood, 

the situation of the house, and the generosity of the family, 

if it should seem to him suitable so to do." Hereupon 

the way of examining the pulse and the urine is described. 

"When the doctor quits the patient, he should promise 

him that he will get quite well again, but should inform his 

friends that he is very ill; in this way if a cure is effected j 

the fame of the doctor will be so much the greater, but if 

the patient dies people will say that the doctor had fore 

seen the fatal event." 

The author then discusses the treatment of the patient 

and especially his diet, the employment of baths and bleeding 

and explains how the doctor should act if he is asked : 

to dinner by the patient " as is usual," and when he demands >] 

the fee for the services rendered. 

This treatise is a strange mixture of valuable medical 

experience, deep piety, and sly calculation. It is, as is 

clear from the way in which it is written, obviously 

intended for beginners in the healing art and throws a 

remarkable light on the social position of the medical 

practitioner of that period. 

The medical principles of the Salernian school rested , 

upon the theories of ancient times. The doctrine of juices 

of the Hippokratic writers, the "Communities" of the 

Methodists, and GALEN'S teaching formed their foundation; 

while the progress made in materia medica, for which 

thanks are due to the Arabs, maintained its place. The 

descriptions of diseases are true to nature and are illustrated 

by many original observations. The accounts given 

of intermittent fever, of disturbance of the mental faculties,-i 

"


of pneumonia, phthisis, psoriasis, lupus (malum mortuum) 

ulcers on the sexual organs (among which it is easy to 

recognize the chancre) especially deserve mention. 

The Salernian doctors were well acquainted with the evil 

significance of many symptoms in regard to prognosis; 

thus they declared that where diarrhoea supervened in 

phthisical cases the patients soon died. In treatment they 

laid great value upon a reasonably regulated manner of 

living and a suitable diet. If, for example, a commencing 

pulmonary phthisis was suspected, they ordered good and 

strengthening nourishment for the patient. People subject 

to pneumonia were directed to live in an atmosphere of 

even temperature; in winter, for example, in a heated 

room.* 

For cooling the air of the sick room AFFLACIUS recom 

mended that an arrangement should be made so that drops 

of water should continually fall to the ground and there 

evaporate.f Iron was ordered for enlargement of the 

spleen. 

Surgery had a position inferior to that occupied by it in 

the time of the Greeks and Romans. This was due partly 

to the neglect of anatomy, partly to the fact that surgery 

was practised less by educated doctors than by empirics, 

especially since many members of the medical profession 

belonged to the priesthood. 

In earlier times surgical knowledge was chiefly confined 

to the treatment of wounds, the cure of fractured bones, 

and the reduction of dislocations. 

It was not till the end of the 12th century that a doctor 

undertook to represent in writing the principles of surgery 

as they had been preserved by tradition. This work, the 

author of which was RUGGIERO, but which is generally 

named after ROLANDO, a later editor, shows that the 

surgeons of the Salernian school sought for instruction not 

* DE RENZI : Collect. Salern ii, 215 et seq. 

f DE RENZI : Collect. Salernit. ii, 741 (fiat etiam urtificialiter pluvialis aqua 

circa cegrum).


so much in the writings of the ancients as in their own 

experience. They were in this way saved indeed from 

that uncritical acceptance of the observations of strangers 

which is a frequent feature of Arabian literature, but at the 

same time they were deprived to a certain degree of those 

important suggestions and corrections which a knowledge 

of history affords in the study of any branch of knowledge. 

It is certainly noteworthy that among the means recommended 

for the arrest of haemorrhage, in addition to styptics 

mention is made of suturing and applying ligatures* The 

internal use of sea-sponge was recommended for the 

removal of bronchocele or the operation of excision was 

performed with the use of hair-ligatures; to avoid relapses, , 

the whole capsule was extirpated. Massage of the bron- . 

chocele was also employed.f 

Among other operations are mentioned trephining, the 

removal of nasal polypi, resection of the inferior maxilla,J 

the operation for hernia, which was performed according to 

the directions of PAULUS JEGINETA, and lithotomy according | 

to the precepts of CELSUS. The operation for cataract was 

performed by puncture of the sclerotic. Allusion is also 

made to ulcerative loss of substance in the palate and on 

the penis which refers to cancer and syphilis, and 

malignant tumours of the rectum and uterus are mentioned. 

The decline of operative surgery and the frequent"" 

employment of the cautery demonstrate the influence of 

Arabian medicine. 

It fared even worse with midwifery than with surgery « 

although this branch was practised by scientifically trained 

women. TROTULA alludes to turning in but one single 

* Chirurg. ROGERI in DE RENZI : Collect. Salern. ii, 436. 

T A. WOLFLER : Die chirurg. Behandlung des Kropfes, Berlin 1887, S. 10 et 

seq. 

X DE RENZI : Collect. Salernit. ii, 445, 513, 628, 650 (lib. ii, of the Commen-' 

taries of the four Masters). The mysterious four Masters remind one of the 

four Doctors of Law at Bologna, of whom SAVIGNY speaks' (Geschichte des 

romischen Rechts, Bd. iv, S. 68).


passage of her book* In a general way, midwifery consisted 

chiefly in the employment of internal remedies and 

psychical aids. 

The School of Salerno was the first to establish a fixed 

and exclusive organization by the introduction of examinations 

in obedience to the order of the civic authorities. 

King ROGER (RUGGIERO) as early as the year 1140 

promulgated the law: "Whoever from this time forth 

desires to practise medicine must present himself before 

our officials and judges, and be subject to their decision. 

Anyone audacious enough to neglect this shall be punished 

by imprisonment and confiscation of goods. This decree 

has for its object the protection of the subjects of our 

kingdom from the dangers arising from the ignorance of 

practitioners."f 

The Emperor FREDERICK II., of the Hohenstaufen 

family, confirmed this law and in the year 1240 gave to 

the medical school of Salerno complete rules in regard to 

the subjects studied there. He says in his orders : " Since 

it is possible for a man to understand medical science, only 

if he has previously learnt something of logic, we ordain 

that no one shall be permitted to study medicine, until 

he has given his attention to logic for three years. After 

these three years he may, if he wishes, proceed to the 

study of medicine. In this study he must spend five years 

during which period he must also acquire a knowledge of 

surgery, for this forms a part of medicine. After this, but 

not before, permission may be given him to practise, 

provided that he passes the examination prescribed by 

the authorities and at the same time produces a certificate 

showing that he has studied for the period required by the 

* DE RENZI : Collect. Salern. i, 149 et seq.—v. SIEBOLD op. cit. i, 317. 

t Quisquis admodo mederi voluerit, officialibus nostris et judicibus se presentet, 

eorum discutiendus judicio ; quod si sua temeritate presumpserit, carceri con- 

slrivgatur bonis suis omnibus publicutis. Hoc enim prospectum est, ne in regno 

nostro subjecti periclitenlur ex imperitia medicorum. Hist, diplom. Frid. II 

imperat. ed. HUILLARD-BREHOLLES, Paris 1854, T. iv, pars 1, p. 149, tit. 44.


law."* "The teachers must during this period of five years 

expound in their lectures the genuine writings of HIPPO 

KRATES and GALEN on the theory and practice of 

medicine." " But even when the prescribed five years 

of medical study are passed, the doctor should not forthwith 

practise on his own account but for a full year more 

he should habitually consult an older experienced practi 

tioner in the exercise of his profession." 

Concerning the motives which brought about the introduction 

of medical examinations it is said : " We further 

the cause of the individual, while caring for the public | 

good. Accordingly, in view of the grievous loss and ' 

irremediable injury which may arise from the ignorance | 

of doctors, we decree that in future no one is to assume 

the title of doctor or to proceed to practise or to take 

medical charge, unless he has previously been found 

competent in the judgment of teachers at a public meeting 4 

in Salerno, has moreover by the testimony in writing of his ! 

teachers and of our officials approved himself before us or 

our representatives in respect of his worthiness and 

scientific maturity, and in pursuance of this course has 

received the state-license to practise. Whoever transgresses 

this law and ventures to practise without a licence, 

is subject to punishment by confiscation, of property and i 

imprisonment for a year."f | 

In regard to the education of surgeons it was decreed, | 

"that no surgeon shall be allowed to practise, until he 

has submitted certificates in writing of the teachers of the 

Faculty of Medicine, that he has spent at least one year jj 

in the study of that part of medical, science which gives 

skill in the practise of surgery, that in the colleges he has j 

diligently and especially studied the anatomy of the human 

body, and is also thoroughly experienced in the way in , 

which operations are successfully performed and healing is* 

brought about afterwards."! ,* 

* Hist, diplom. Frid. II. op. cit. p. 235, lib. 3, tit. 46. 

f op. cit. p. .50, tit. 45. t °P- cit - P- 2 36- 'I


If the doctor had passed the examinations and received 

the state-license to practise, a diploma was made out for 

him which ran thus: "Notum fadmits fidelitati vestrse, 

quod fide lis noster N.N. ad curiam nostram accedens, 

examinatus, inventus fidelis et de genere jidelium ortus et 

sujfficiens ad artem medicinae exercendam, extitit pe 

nostram curiam approbatus. Propter quod de ipsius 

prudentia et legalitate confisi, recepto ab eo in curia 

nostra fidelitatis sacramento et de arte ipsa fideliter 

exercenda juxta consuetudinem juramento, dedimus ei 

licentiam exercendi artem medicinse in partibus ipsis : u 

admodo artem ipsam ad honorem et fidelitatem nostram et 

salutem eorum qui indigent, fideliter ibi debeat exercere. 

Quocirca fidelitati vestrse praecipiendo mandamus, 

quatenus nullussit, qui praedictum N.N. fidelem nostrum 

super arte ipsa medicinae in terris ipsis, ut dictum est, 

exercenda impediat de cetero vel perturbet."* 

In the oath which the young doctor had to take on this 

occasion, he was bound "to give advice to the poor, gratis, 

and to inform the magistrates of apothecaries who made up 

medicines not corresponding to prescriptions." It was. 

moreover, laid down by law how much he might demand 

for a visit to a patient. According to this the' highest payment 

for a visit in the daytime within the town amounted 

.* to half a gold tarenus ;f if the visit was outside the district 

the fee was three or at most four tareni exclusive of 

travelling expenses. 

The doctor was forbidden to enter into partnership with 

apothecaries, or himself to keep an apothecary's shop. 

The apothecaries were directed to prepare the medicine 

according to the prescription of the doctors, and to 

furnish it at a regular price. Before they were permitted 

* to practise their business they had to bind themselves by 

oath to provide drugs according to prescribed form, and to 

* PETE^DE VINEIS: Epist, lib. vi, c. 24, Basil 1740.—Hist. dipl. Frid. II, op. 

cit. p. 150, Note 2. 

t A gold tarenus was a gold coin weighing 20 grains. 

P

2IO THE MIDDLE AGES. 

be guilty of no fraud in this matter. At the same time it 

was specified what advance of price they might allow themselves 

to make on medicines which perhaps had to be kept 

in stock for a long time before being used, and a prospect 

was given of a law being made regulating the number 

of apothecaries' shops in the various towns of the country* 

Moreover inspectors were nominated who had to. supervise 

the preparation of medicines, and to attest the satisfactory 

character of this by their certificates; in Salerno itself the 

teachers of medicine exercised supervision in this matter, t 

"At the same time we ordain," it is said in the same passage, 

«that no one shall give lectures on medicine and surgery 

elsewhere than in Salerno, or assume the title of teacher, 

unless he has been carefully examined in the presence of 

our officials and of the teachers of these arts." The punish- , 

ment of death was imposed on the officials who violated 

their duties in giving effect to these laws. 

The rules of -the Emperor FREDERICK II. served as a 

pattern for succeeding arrangements in medical studies^ 

They formed the first attempts at a state organization for 

the same. Unfortunately in the following centuries the 

influence of the secular power was in this as in other 

domains thrust into the background by the increasing 

authority of the clergy. This fact gave a distinct colouring 

to civilization, and governed the development of univer 

sities up to the most recent times. 

The medical school of Salerno flourished in the i ith and 

12th centuries. In this period it displayed an important 

literary activity to which witness is borne by the works 

of GARIOPONTUS, PETRONCELLUS, ALPHANUS, the two 

COPHOS the Platearii, of CONSTANTINUS AFRICANUS, who 

by his translations contributed greatly to make Salernian 

doctors acquainted with Arabian medicine; by the Dispensatory 

of BARTHOLOMÛS, which soon after was translated 

into German,% the writings of AFFLACIUS, ARCHI- 

* Hist, diplom. Frid. II, op. cit. p. 236. t op. cit. p. 151, tit. 47. 

X Jos. HAUPT in den Sitzungsber. d. K. Akad. d. Wiss., Philos-histor. Kl., 

Wien 1872, Bd. 71, S. 451 ft seq.


MATTHOUS, MUSANDINUS, and ^GIDIUS VON CORBEIL, the 

collection of recipes of NICOLAUS PROPOSITUS, the Uro- 

scopie of MAURUS, but above all the famous Rules of Health 

of the school of Salerno, which were translated into all 

languages, and lived through more than 200 editions. 

In the year 1252 King CONRAD decided to enjarge the 

school of Salerno into a university in which law and the 

artes might be fostered. But his plan came only partially 

into effect. King MANFRED in the year 1258 restored 

the university of Naples, which had shortly before been 

abolished, and in Salerno only the medical school remained. 

Certainly the science of law was taught there along with 

that of medicine, but no academical honours were granted 

in that branch of learning.* 

When medical schools arose in Naples and in other 

towns of Italy and France the number of students in 

Salerno diminished. It came to this, that the quality of 

the teaching given there was gradually surpassed in excel 

lence by that of the other schools, and the scientific activity 

of Salerno declined. ÊGIDIUS VON CORBEIL complained of 

this, saying that there beardless, immature youths received 

the honours of doctors and dared to act as teachers of 

medicine. 

" Far from the height of thy fame art thou sunk to the depths, O Salerno! 

Once adorned with such fame, thou art sunk to the very foundation, 

Dost thou suffer that now on the site of thy past noble structure 

Seedlings should sprout prematurely : of medicine sons, but unworthy ? 

Schoolmaster's cane so persuasive and training severe of an elder 

Better would suit their case than, young as they are, to be mounting 

Steps of professorial chairs in pompous prpcession."f 

In the 14th century PETRARCH said : " The story goes 

that medicine took its rise in Salerno, but all alike falls 

a prey to withering age." Subsequently the school of 

Salerno declined more and more, and all attempts to 

* J- A. DE N.GR.S in J. C. G. ACKEUMANN'S Regimen sanitatis Salerni, 

Stendal 1790, p. 83. 

t -ffioiD.us v. CORBEIL : de medicam. compos., v, 569 et seq., nach H. 

HAESER in Nord u. Slid 1877, *», 7, S. 145.

212 


instil new life into it by privileges and endowments were 

in vain. A decree of the French Government, which for 

some time guided the destinies of the country, on the 29th 

of November, 1811, put an end to the oldest medical 

school in Europe. 

THE MEDICAL SCHOOL OF MONTPELLIER. 

THE origin of the medical school of Montpellier is also 

veiled in the obscurity of tradition. It is unknown at what | 

period the doctors there began to instruct students in the 

science of medicine. Among the doctors who practised 

medicine in the 10th and nth centuries at Montpellier 

there were probably many Jews and Arabs ; the fact that a ^ 

large proportion of the population of this town consisted ,: 

of members of these nations, and the vicinity of Spain, J 

where Jewish doctors existed in great numbers and in 

high respect under the dominion of the Arabs, justify this 

assumption. 

The Jews had a large. share in the triumphs which 

Arabian medicine celebrated in Spain. The names of 

MOSES MAIMONIDES, CHASDAI SCHAPROUT, JUDAH 

HALEVI, NACHMANIDES and others speak as to their 

work in the different paths of intellectual life. The 

Rabbis and learned men among the Jews interested them- •} 

selves in medicine, and the medical schools of the Jews at 

Toledo, Granada, and Cordova stood in high esteem'. The • 

Arabian princes of the Iberian peninsula as well as their 

Christian successors chose Jews, by preference, for their 

private doctors* But the Jewish doctors earned the 

greatest merit. in acting as mediators between ArabianJ 

medical science and Western Christendom. Partly by 

translations of Arabic works which they prepared, partly 

by word of mouth, they made the inhabitants of the adjoining 

Christian countries acquainted with the scientific 

acquisitions of that nearly related Semitic race. 

* J. M U N Z : Uber die jildischen Aizte im Mittelalter, Berlin 1877, S. 17 

tt seq.

THE MEDICAL SCHOOL OF MONTPELLIER. 21 

The Arab and Jewish schools of Spain preserved, for 

a long time even after the conquest of the country by the 

Christians, the reputation of learning. So late as in the 

nth and 12th centuries philosophers thirsting for knowledge 

made pilgrimages to Spain, especially to Toledo, 

there to be initiated into the wisdom of the Arabs. Such 

were GERBERT, known later as Pope SYLVESTER II., HER- 

MANNUS CONTRACTUS, DAVID MORLEY, PIETRO VON 

ABANO, ARNALD VON VILLANOVA and others. 

An important influence upon the origin and development 

of the school of Montpellier must, without doubt, 

be ascribed to these circumstances. There has even been 

an attempt to show that a Jewish doctor from Narbonne 

was the first to teach medicine there* When BENJAMIN 

of Tudela visited Montpellier in the year 1160 he found as 

he says many Jews amongst the inhabitants. But even 

then the reaction against the Jewish power was making 

itself felt. Count WILLIAM of Montpellier in 1121 made an 

order in his will that no Saracen or Jew should be admitted 

to the dignity of high bailiff (bailli), and in 1146 and 

1172 this interdiction was renewed in respect of the Jews, 

it probably appearing no longer necessary with regard to 

the Saracens. In any case the fact indicates that before 

that time the Arabs and Jews in Montpellier possessed 

rights like those of their Christian fellow citizens and 

ventured to lay claim to the most important posts. 

Up to the time of the conquest of Spain by the Christiansa 

spirit of toleration reigned there, furthering the best 

interests of humanity and of science : the foundation of 

the Montpellier medical school took place during this 

period, as history testifies. When Bishop ADALBERT of 

Mainz came thither in the year 1137 the school already 

existed and even already possessed buildings of its own as 

we learn from the words of Bishop ANSELM of Havelberg 

*' RAVEL in the Re'vue the'rapeut. du midi, Montpellier 1855.—CARMOLY : 

Histoire des mgdecins juifs, Bruxelles 1844, p. 77.—A. GERMAIN: Histoire de 

la commune de Montpellier, Montpellier 1851, T. i, p. Ixix.

214 


who lived at that time* Bishop ADALBERT obtained 

instruction, from the doctors who taught medicine in 

Montpellier, upon the causes of natural phenomena and 

of diseases, certainly " not with the object of making 

money from the knowledge of these matters but only in 

order to learn to understand the deeply hidden meaning of 

things " as his biographer adds. 

In a letter of ST. BERNARD written in 1153 it is 

narrated that the Archbishop of Lyons, being ill, repaired 

to Montpellier, to be under the treatment of the doctors 

there, and on this occasion not only spent what he had 

with him but ran into debt-t JEAN DE SALISBURY, who 

also belonged to that period, stated that those who wished 

to devote themselves to medicine acquired the knowledge 

necessary for this at Salerno or Montpellier. So too^ 

yEGIDIUS VON CORBEIL and HARTMANN VON DER AUE 

have borne witness to. the ancient renown of the school of 

Montpellier. ; 

The Monk CÊSARIUS VON HEISTERBACH called Montpellier 

the " Fountain of Medical Wisdom " and remarked 

with regret that the doctors of that school would not believe 

in miracle-healing even speaking of it in an ironical way. 

In the year 1180 WILLIAM IV., Count of Montpellier 

promulgated a decree that anyone " whoever or of what, 

ever origin he might be, should have the right of giving 

medical instruction there without being called to account 

by anyone." J Although as a result of this the medical 

school arose into great prominence, still unlimited freedom 

* Anselmi episcopi Havelbergensis vita Adelberti Moguntini in Bibl. rer. 

german. ed PH. JAFFE, Berol. 1866, iii, 592.—A. DUBOUCHET: Un document 

curieux sur l'ecole de medecine de Montpellier in the Gazette hebd. des sciences 

m&l. de Montpellier, 10 Juli 1886. 

f Expendit et quod habebat et quod non habebat in BERNARD. Epist. 307, 

according to ASTRUC: Memoires pour servir k l'histoire de la faculte de 

me'deeinede Montpellier, Paris 1767, p. 7. 

X Mando, volo, laudo aique concedo in perpetiium, quod omues homines quicunque 

sint vet undecunque sint sine aliqua interpellations regant scolas de Jisica 

in Montepessulano. ASTRUC op. cit. p. 34.


in teaching could not be supported, since by its means 

many undesirable persons were attracted. Teachers and 

students alike desired that to meet this difficulty certain 

rules should be laid down. It is indicative of the power 

which the clergy had in the meanwhile acquired that the 

papal legate was applied to, who in conjunction with the 

bishops of Maguelone and Avignon and others made the 

wished for regulations in the year 1220. 

Cardinal CONRAD, who laid the foundation for the larger 

development of the school of Montpellier, was a German, 

and descended from the Swabian family of the Counts of 

Urach. In the statutes devised by him he first of all 

referred to the fact that medical science had for a long 

time flourished and had acquired renown in Montpellier, 

and then he laid it down as a law that from that time forth 

no one should act as a teacher of this science who had 

not been examined in it and received the license at the 

hands of the Bishop of Maguelone with the assistance and 

by the interrogatories of his teachers; that no one should 

be regarded as a student who did not in his studies follow 

the direction of his teacher; that the Bishop of Maguelone 

in association with three respectable senior teachers should 

elect a Chancellor to preserve discipline and adjust 

differences between masters and students ; that the Bishop 

should support the Chancellor with his authority ; and that 

teachers and students should assist one another and take 

care that no harm, should come to the school* Many 

students, as we learn from section 14 of these statutes,f 

interrupted their studies in order to engage in practice, 

returning later to Montpellier to continue their studies. 

The students paid their teachers fees for the instruction 

they received. It is true no mention at all is made in the 

* ASTRUC op. cit. p. 37. 

t Quando scholaris redit a locis, in quibus practicaverit, libere sibi addicat, 

quemcunque voluent, magistrum, dum tamen priori sua magistro non teneatur 

ratiove salari vet allerius alicujus rei. ASTRUC op. cit. p. 39.—A. GERMAIN 

op. cit. T. iii, 424. 

.»


laws of CONRAD about excluding persons professing other 

than the Christian faith from the school; and yet such were 

doubtless to a certain extent repelled by the powerful 

influence which the bishop was allowed to possess there. 

Nevertheless there were still in the 13th and 14th centuries 

many Jewish students and doctors at this place, among 

them JACOB BEN MACHIR, better known under the name 

of PROFATIUS, who was probably even engaged as a 

teacher* In the year 1230 it was decided that no one 

should practise medicine until he had been examined and 

found competent by two masters in medical science, 

chosen as examiners by the bishop. The successful result 

of his examination was notified to him by a certificate 

bearing the signatures of the bishop and of the examiners. 

Whoever practised medicine without submitting to this 

examination was threatened with the punishment of excommunication. 

The surgeons however were not bound 

to submit themselves *to examination. The laws against 

quacks, it would seem, were not stringently observed ; yet " 

from time to time they must necessarily have been recalled 

to men's minds. 

The statutes and lists of lectures, which were issued in 

the year 1240, were framed upon the regulations of the 

Emperor FREDERICK II. published for Salerno.f The 

medical school was thus completely organized. 

Instruction was also given in law at Montpellier from 

' the end of the 13th century ; and in like manner there 

were as early as 1242 teachers of philosophy. Pope 

NICOLAS IV. in 1289 decided to erect there a Studium 

generate, i.e., a University. But he did not succeed in 

merging the medical school with the other faculties into 

one large establishment for teaching. It preserved its 

rights jealously and maintained its independence. And 

thus it came about that in Montpellier henceforth there 

* CARMOLY op. cit. S. qo. He mentions other Jewish teachers of medicine,! 

A « 

e.g., SAMUEL BEN TIBBON. 

•"- GEHMAIN op. cit. T. iii, p. 424.

THE MEDICAL SCHOOL OF MONTPELLIER. 21 7 

were, properly speaking, two distinct universities, one 

comprising the medical, the other the remaining faculties. 

Each formed a distinct institution, had its own Chancellor, 

and bore the name of a University. And each was entitled 

to such a name; for in the Middle Ages by the Studium 

generate was meant, not the union of all faculties in one 

place, but an institution for the higher teaching which was 

generally accessible, and gave certificates which were 

universally recognized* The expression Studium generale 

was in the 14th century replaced by that of University, 

with which was associated the idea of a corporation, of an 

organized society. And even at that time the terms 

" Gymnasium " and " Alma mater " were made use of to 

apply to the High Schools. While the bishop filled the 

dignity of Chancellor henceforth in the University at 

Montpellier, which represented the legal, philosophic and 

-theologic faculties, and which was first founded in 1421, the 

same office at the School of Medicine was conferred on one 

of its teachers. All attempts which were afterwards made 

to subject the medical school to clerical influence were 

fruitless. The medical faculty maintained its autonomy 

even under the centralizing power of the French kings, and 

Louis XIV. felt himself obliged to withdraw a decree 

ordering the union of the medical with the other faculties.f 

As the election of the chancellor by the bishop and three 

teachers appointed by him had many disadvantages 

attached to it, Pope CLEMENT V. in 1308 ordered that the 

candidate must secure from that time forth, in addition to 

the consent of the bishop, the votes of two-thirds of all the 

masters of the medical high school. 

It was at the same time laid down what books should 

* H. DENIFLE: Die Entstehung der Universitaten des Mittelalters bis 1400, 

Berlin 1885, S. 15 el seq.—Cf. on the other hand G. KAUFMANN : Geschichte der 

deutschen Universitaten, Stuttgart 1888, i, 98 et seq. 

t A. DUBOUCHET : Documents pour servir a l'histoire de l'universite de 

medecine de Montpellier in the Gaz. hebd. des sciences me'd. de Montpellier 

1887, No - 4-

2l8 THE MIDDLE AGES. 

form the foundation for teaching, and the order of study 

and examination in them was explained. Every student 

had to attend medical lectures for at least five years and to 

practise medicine for eight months or two summers* before 

being allowed to graduate. In 1350 it was laid down by 

law that no one should practise medicine before attaining 

the degree of Magister.f It is clear from the list sent to 

the Pope in 1362 that all students of medicine at Montpellier 

were graduates in artibus,% and consequently 

possessed a preliminary education in general knowledge. 

The statutes of this medical school for the year 1340 § 

afford us a glimpse into its condition. They deal with 

the high office of the Chancellor, who administered the 

government of the school; with the office of Dean,— 

which was conferred on him who had longest acted as 

teacher there, and was really an honorary post, the chief 

duty of its incumbent being to represent the Chancellor;— 

with the election of two Procurators from among the 

teachers, to superintend the management of the property ; 

and possessions of the university ; with the general 

meetings of teachers taking place twice every year, in 

which they took counsel together upon matters affecting --\ 

the teaching and the finances of the school; and with the 

duties of teachers and students. The latter were obliged 

to present themselves directly after their arrival to- the 

Procurators who entered in a book their names and the date 

of the commencement and termination of their studies, '« 

receiving a fee for this which varied in amount according 

to whether it was question of a Student or of a Bachelor: 

* In locis famosis quinque annos, si in artibus magistri existantidonei,alioquiit 

per sex annos, pro quolibet anno octo d'untaxat mensibus computalis ejusdem facul- , 

tatem oudiverint medicince, ac in similibus locis per octo menses aul per duas 

astates adminus ejusdem medicince praxim duxerint exercendam. ASTRUC op.cit. 

p. 46. 

f ASTRUC op. cit. p. 54. 

X DENIFLE op. cit. S. 355, note 562. 

§ A. DUBOUCHET op. cit. Gaz. hebd., No. 6 et seq.


this corresponded to the fees for immatriculation and exmatriculation 

of our times. 

The students on their acceptance into the society of 

the high school promised to observe conscientiously its 

laws. They were bound during the first three years of their 

student-life to attend medical lectures, holidays excepted, 

for 24 full months. Hereupon followed an examination, in 

which each of the teachers set a question, and then the 

degree of Bachelor. In this capacity the student con 

tinued his studies for at least two years, but delivered 

at the same time lectures upon certain extracts from the 

medical writings of the ancients. The candidature for the 

degree of Master of Medical Science formed the conclusion 

of study. 

He who gave regular instruction at least for the whole 

winter through was looked upon as a teacher in ordinary. 

The teachers chose in their meetings the subjects they 

wished to discourse upon ; the elder had precedence of the 

younger in this matter. Moreover, scrupulous care was 

taken, that a subject, which ought to be thoroughly con 

sidered within the space of a year, should not be spread 

over several. 

At first every Master and, within certain limitations, even 

every Bachelor was authorized to teach, without however 

receiving any remuneration at all for such teaching. It was 

not till the year 1498 that four regular chairs of medicine 

were founded, the incumbents of which for a stipend of 

one hundred livres had to lecture the whole year through 

without further pay ! The appointment to these professor 

ships was in the hands of the Bishop after nomination by 

the other teachers of the medical school. The stipend of 

the Professors was raised under CHARLES IX. to 400 and 

under HENRY IV. to 600 livres. Besides this they were, 

like other members of the University, free from taxes and 

many other burdens. 

The medical school of Montpellier passed the period of 

its greatest lustre in the 13th and 14th centuries. From


far and wide at that period came the sick, as the Bishop of 

Hereford from England and King JOHN of Bohemia, to seek 

help from the doctors there who were especially valued for 

their practical skill.* But a competition dangerous to 

their interests gradually waxed greater, as the universities, 

founded at that time in Italy, France and Germany arrived 

at a state of maturity. « j 

THE MOST ANCIENT ACADEMIES OF ITALY. 

THE Emperor FREDERICK II. created the academy at 

Naples f in the year 1224, in which all the sciences were to .•: 

be taught, iji order that young men, thirsting for knowledge, f 

should not, be compelled " like beggars to seek intellectual 

fpod away from their own country." % At first, as it appears, 

all the faculties were represented here ; but as early as 1231 

the medical disappeaied, since, by an imperial decree, 

medicine from that time forth might be taught only in 

Salerno. In 1252 the other faculties were also transferredJf 

to Salerno and united with the medical school there into a 

university. f 

Still, the* high school at Naples was restored in 125&VJ 

Situated, as it was, in the chief town of the country, | 

more easily accessible from the north and east and j 

endowed with greater privileges and more money than its 4 

elder sister at Salerno this institution afterwards surpassed! 

the latter in the number of its students as well as by its 

importance and its achievements. 

The story of the birth of the high school of Bologna like 

that of the schools at Salerno and Montpellier is lost in the 

* ARNALD VON VILLANOVA: Breviar. iv, 10.—GUY VON CHAULIAC: Chir., ' 

tr. vi, d. 2, c 2. 

f MUBATORI : Rer. It. script, viii, p. 496. 

X HUILLARD-BREHOLLES op. cit. T. ii, p. 450. Disponimus apud Napolim^ 

doceri arles cujiiscunque professionis et vigere sludia, ut jejuni et famelici doctrinarum 

in ipso regno inveniant unde ipsorum aviditati satisfacial, neque compellantnr 

ad invest igandas scie/iti'is peregrinas nationes expetere nee in alienis regionibu 

mendicare. • ,

THE MOST ANCIENT ACADEMIES OF ITALY. 221 

earlier ages.* The Emperor FREDERICK I. promised his 

protection to the university there in 1158, and bestowed 

upon it independent jurisdiction, f It was at that time 

really nothing but a school of law ; but other sciences were 

taught there in the 12th century, and the doctors were 

probably already associated in a college. J 

In the 13th century the medical and philosophical faculty 

was organized, as "a University of Artists." The school 

of law in the meanwhile continued to* maintain preponderance 

over the other faculties by the number of its 

teachers and students. 

It was only after 1280 that the medical faculty, when 

THADDÛS FLORENTINES was a teacher in it, became 

known and celebrated in wider circles. For the rest, the 

organization of the university at Bologna was centred not 

so much on its faculties as on the incorporation of it's 

students. These were at first divided into the Citramontani 

and the Ultramontani each division being composed 

of several " nations." These territorial societies of 

t students, the antitypes of which are found in the associations 

which existed in the high schools of antiquity, e.g., 

at Athens, sprang from the necessity felt by the students of 

joining themselves together in a foreign land with the 

mutual ties of a common home : they were organized after 

the fashion of the Italian corporations. 

At the head of each of the two student-corporations was 

a Rector, who was originally not exactly the head of the 

university but only managed the affairs of the students who 

had chosen him as their representative. At first, this 

dignity was bestowed on professors as well as on students, 

but alter the middle of the 13th century only on the latter 

* F.- C. v. SAVIGNV: Geschichte des romischen Rechts im Mittelalter 

Heidelberg 1834, Bd. iii, S. 164 et seq. 

t Cod. Auth. Habita.—GIESEBRECHT in den Sitzungsber. d. K. b. Akad. d. 

Wiss., histor. Klasse 1879, Bd - ii, S. 285. 

% M. MEDICI : Compendio storico della scuola ariatomica di Bologna 18*;-, 

P- 3-


and in the statutes of the university of the 14th century 

this was even officially recognized.* After the 16th 

century there was only one Rector for the two .student- 

corporations. 

As the Italian towns possessing high schools competed 

with one another, by the bestowal of privileges and distinctions, 

in attracting foreign students, the latter gradually 

acquired a position of extraordinary power and the 

professors came to hold a place of relative dependence. 

In Bologna and Padua the students even had the rightf 

to elect the Professors. In Montpellier their representatives, 

the Procurators, were allowed to stop the pay of 

Professors if they did not lecture with sufficient assiduity.J v| 

The Rector, chosen from among the students, who at 

first had jurisdiction only over the corporation to which he 

belonged, exercised it later over the whole university, even 

over the Professors and their families. It is true that hehad 

at hand a member of the legal faculty as Chancellor, 

and a state of things must have been developed similar to 

that which for a while existed in the 16th and 17th 

centuries at the German universities when the Rectorship 

was conferred on students of distinguished families. The " 

Rectors had no influence over the systems of study and 

examination ; this was left entirely to the Professors. The / 

latter received fees from the students for the instruction 

which they gave ; from the beginning of the 13th century i := 

the town also granted them a certain stipend. 

According to a report made in 1371 by the Cardinal- .) 

Legate ANGLICUS§ three Magistri were teaching at that 

time in Bologna the theory of medicine, three the practice 

* Ad recloralus igilur officium eligatur scolaris nostras universilalis, in the 

statutes of Bologna University. SAVIGNY op. cit. Bd. iii, S. 643. 

f C. MEINERS: Geschichte der Entstehung und Entwickelung der hohen • 

Schulen unseres Erdtheils, Gottingen 1802.—SAVIGNY op, cit. Bd. iii, S. 292 

et seq. 

X THOMAS U. FELIX PLATTER: Zwei Autobiographien her. v. Fechter, Basel ; 

1840, S. 155. 

§ DENIFLE op. cit. S. 208 et seq.


of medicine, and one surgery. They were paid by the 

town ; there were also with these other teachers who drew 

no pay. In 1388, 68 Professors were employed there, 14 

teaching medicine, 27 civil law, 12 canon law, and 15 the 

arts, grammar, and the business of the notary; in 1451 the 

number of teachers reached even more than 170, and as a 

result there was a reduction in the number of professorial 

chairs * Among the Professors engaged, there in the 

middle ages we're Frenchmen, Germans, Spaniards, 

Englishmen, Portuguese, Poles, and Greeks,f and among 

the students, too, all European nations were represented. 

The Professors, on entering on their duties, had to bind 

themselves by oath not to teach their science anywhere but 

in Bologna, and to contribute to the success of the high 

school of that place with all their powers.J This did not, 

however, prevent both students and teachers withdrawing 

on various occasions in considerable numbers from Bologna 

and seeking another place for their studies. This happened 

as early as 1222, and furnished an opportunity for the 

foundation or extension of the high school at Padua, where 

perhaps, long before this, schools for certain sciences had 

already existed. 

The university of Padua was formed after the pattern of 

that of Bologna. There, too, the Rector was at the head 

of the student-associations, of which there were four, distinguished 

by their nationalities, namely, those of the 

Italians, the French, the Provencals and the Germans. § 

There, also, the Rector was chosen from among the 

students ; it was only demanded of him that he should 

possess an unimpeachable reputation, should be at least 

22 years of age, and should have lived for a year in 

Padua upon his private means. The university of Padua, 

* E. COPPI : Le universita italiene nel medio evo, Firenze 1880, S. 257. 

t MAZETTI : Repertorio di tutti i professor! dell' universita di Bolo?na 

Bologna 1847. 

+ E. COPPI op.-tit. S. 78, note. 

§ F. C COLLE : Storia dello studio di Padova, 1824.


like that of .Bologna, was frequented chiefly by jurists. In 

1268 there were in Padua three teachers of medicine and 

of the natural sciences. It was really not until the 15th. 

and 16th centuries that medical science attained to a 

flourishing condition in Padua and BolOgna. 

The academy of Vercelli, which existed in 1220, owed, \ 

a sudden popularity to the fact that in consequence of. , 

quarrels in the year 1228 a number of professors and „ 

students of Padua left that town. The town council. J 

of Vercelli made an agreement* with them, and they were 

induced, by various advantages held out to them, to settle J 

down there. All branches of learning were represented ^ 

at Vercelli; medicine had two professorial chairs. Yet ;j 

the academy existed not much longer than one century. , , 

The university at Vicenza originated probably in a similar! 

manner, students and teachers coming thither j froml 

Bologna. It enjoyed a favourable reputation as a school 

of law in the beginning of the 13th century. In i26i.a 

teacher of medicine was appointed there for the first time, 

receiving a yearly stipend of 150 librae denariorOfn.. In 

Modena, where, as early as the 12th century, legal science 

was largely pursued, a teacher of medicine was appointed 

first in the 14th century. Reggio (Emilia) had a school 

of law, though one of no great importance, since 1188. 

The academy of Arezzo, in which medicine, among other 

subjects, was taught, existed as early as the 13th century,t 

but was formally declared a university only in I355> and 

decayed in the 16th century. 

Siena was known for its excellent school as early as 

1203. In 1241 medicine was taught there in addition to 

other sciences, and in 1247 there were already three teachers 

of this subject. When the appointing of foreign professors 

came to be discussed in the town council in 1285 an endeavour 

was made to secure RANUCCIUS, who had great 

experience in surgery ; moreover, a Magister ORLANDUS 

* COPPI op. cit. S. 109 et seq.—SAVIGNY op. cit. Bd. iii, S. 666 etseq. 

t SAVIGNY op. cit. Bd. iii, S. 312 el seq.


taught medicine there* In 1321 the university of Siena 

was enlarged, receiving accessions from Bologna. DINO 

DI GARBO, who at that time represented medicine at Siena, 

drew a yearly stipend of 1,155 lire. At a later period the 

university decayed, and its decline was not materially 

retarded in consequence of its official recognition by the 

Emperor CHARLES IV- in 1357 as a studium generate. It 

was not till the end of the 15th century that it recovered 

itself. 

Piacenza possessed a school of law at the end of the 

12th century, which was raised into a university in 1248. 

The Magister HUGO, a clergyman, taught medicine there 

at that time. The academy obtained first under GALEZZA 

VlSCO'NTl a certain reputation ; in 1399 it possessed 71 

teachers, 22 of them being medical. It was abolished in 

V H03- 

At the seat of the papal Court there arose in 1244 an 

institution for teaching, endowed with the privileges of a 

university, in which theology, law, oriental tongues, and 

afterwards medicine were taught. Situated first at 

Avignon and then at Rome, it was united with the academy 

which had existed in the latter place since 1303. Here, in 

1514, 88 Professors were engaged in teaching, namely, 

4 teachers of theology, 11 of canonical, 20 of civil, law, 15 

of medicine, and 38 of philosophy, mathematics, rhetoric 

and German; on the other hand/the number of students 

was relatively small. Under Pope ALEXANDER VI. the 

building of the Sapienza was begun, the halls of which 

serve for the seat of the university of Rome at the present 

day. 

In Perugia a school of law existed in the 13th century; 

but other sciences also and especially medicine were 

taught there. In 1308 the Pope proclaimed the school a 

university. Here at first one but, after 1314, two teachers 

of medicine were appointed, only however for a period of 

three years. In the roll of 1339, alongside of four doctors 

* DENIFLE op. cit. i, S. 437. 

Q

2§j& THE MIDDLE AGES. 

of canonical and three of civil law, one of philosophy, and 

one of logic, appear also three of medicine, and against 119 

students of law we find 23 medical students; these however 

were exclusively from distant parts; the native students 

were not counted* The majority certainly were of 

Italian origin, many however came from Germany. It isnoteworthy 

that the teachers and students of law bore the 

title of Dominus, those of medicine and philosophy that of '. 

Magister. In 1342 the number of teachers was increased 

and in the statutes of 1366 we find a regulation that there J 

should be at least seven teachers of medicine. In 1431 

there were eight, of whom one had to teach osteology as a | 

speciality. 

Treviso had in the.13th century an institution for the higher J 

teaching which was transformed into a studium generate , 

in 1314: this received the imperial favour in 1318. The 

town decided to found twelve scholarships, three of them 1 

being devoted to medicine. Only a short duration of life 

was' destined for this university ; as early as the beginning 

of the 15th century it had ceased to exist. j 

The academy at Pisa arose in 1343 out of a school of 

law. It had to contend with many adverse circumstances:'! 

thus, for instance, in 1359 all the professors were dis- ] 

charged, there being no money for their salaries. In i4 D 3)'| 

the university was broken up for a time and opened again 4 

only in 1473, under LORENZO DE MEDICI, who showed it 

great favour. From that time it made rapid advances and 

attained to a position of high importance at the end of the 

15th century. This was due in a large measure to the cir- j 

cumstance that the university of Florence which as early ; 

as the 14th century had renowned medical teachers on its j 

staff and possessed charters of foundation from the Pope .• 

and Emperor, was in 1473 removed to Pisa. 

The university of Pavia was also developed out of a 

school of law. It was raised into a studium generate ^1361 • 

by the Emperor CHARLES IV. Medical science was zealously 

* DENIFLE op. cit. i, S. 546.—COPPI op. cit. S. 127, note.

THE MOST ANCIENT ACADEMIES OF FRANCE. 227 

cultivated and promoted there.* Among the students were 

many Germans. In Ferrara there were in the 13th century 

celebrated schools for instruction in the liberal arts. They 

were united into a university in 1391 and care was taken, 

at the same time, that the sciences of law and medicine 

should be represented. In 1474, 51 professors were teach 

ing there, among them being several lecturers on medicine. 

Turin became* possessed of an academy in 1405, and 

Catania of one in 1445. In Parma also, in Cremona, Lucca, 

and other towns of Italy, instruction was given temporarily 

in certain sciences, for instance in law and medicine, without 

however the development in these places of regular universities 

endowed with legal privileges. 

THE MOST ANCIENT ACADEMIES OF FRANCE. 

IN France, at this period, a great number of academi 

arose.f At Orleans, Angers and Rheims there were, as 

early as the 13th century or even earlier, much-frequented 

schools of law which were afterwards proclaimed univer 

sities. The authorities were anxious to attract foreign 

students and on this ground bestowed on them many 

privileges. Thus the German students at Orleans were 

subject to special jurisdiction, had free entry to the theatre 

and were all treated as noblemen, without distinction of 

birth.J Instruction in medicine was given only excep 

tionally and at no time attained to any importance. For 

example, Angers in 1362 had among 44 teachers only one 

who lectured on. medicine. A similar state of affairs 

existed at Toulouse where in 1229 a studium generate was 

founded. Medicine was regarded with as little respect in 

the academies at Avignon, Cahors, Grenoble and Orange 

.. * ALF. CORRADI in the Memorie e documenti per la storia dell' university d 

Pavia, Pavia 1878, i, 99-145. 

t E. PASQUIER: Recherches de la France, Paris 1633, p. 888 et seq. 

X SAVIGNY op. cit. Bd. iii, S. 402 et seq. 

-

22g THE MIDDLE AGES. 

which were founded in the 14th century* Regarded 

singly, none of these academies had at any time many 

students. The witty remark was made about Orange, as 

we are told by Golnitz, that the whole university consisted 

of three persons, the Rector, the Secretary and the 

Beadle.t So too the academies at Perpignan, Aix, Dole, 

Caen, Poitiers, Valance, Lyons, Bordeaux, Bourges and 

Nantes which arose before or during the 16th century 

never attained to any greater importance. 

The political and social development of France was of 

such a nature as to cause the small provincial universities 

to give way on all sides to Paris which formed the centre of 

all intellectual life. This university arose from the union 

of the mutually independent schools for higher education in 

Paris in which, as early as the 12th century, law, medicine 

and several other sciences were taught. JOHN of Salisbury | 

has left us accurate information about the management of 

these schools, and the studies which were pursued at 

them.t It is not known how it came about that the 

teachers of these subjects entered into an alliance among 

themselves and formed an association. Probably it was 

in 1209, at the instance of Pope INNOCENT III., who 

ordered the masters in the various sciences to frame laws,; 

for their own use.§ In 1215 the Magistri of the four chief 

branches of learning represented corporations—faculties in 

our sense of the word—and had their own separate 

statutes. || It was not, however, until 1254 that they were 

united into a university. Besides being divided into faculties, 

another division into four "nations" existed at Pans j 

as early as the 13th century, an arrangement obviously] 

modelled upon that of the Italian universities. This 

appears to have exercised greater influence on academic 

* G. BAYLE: Les me'decins d'Avignon, Avignon 1882, p. 43 et seq. 

f A. GOLNITZ: Ulysses Belgico-Gallicus, Leyden 1631, p. 468. 

t JOHANNES SARESBERIENS.S: Metalog, lib. ii, c. 10, Ed. MIONB (Patrol. 

lat. Bd. 199, p. 867). 

§ A. F. THERY : Histoire de l'education en France, Paris 1858. 

|| BULHLUS: Historia universitatis Parisiensis, Paris• 1665-73, T. iii, p. 81.

THE MOST ANCIENT ACADEMIES OF FRANCE. 229 

administration than the division into faculties. The study 

of the artes liberates formed the preliminary step to the 

study of theology, law and medicine, the "philosophical 

faculty" forming, as it were, a foundation for the three 

others. 

By "medical faculty" was understood not only, as is 

now the case, the staff of teachers of the medical school, 

but the whole body of legally qualified doctors in Paris. 

Since originally every doctor who had passed the examination 

was at liberty to teach in the high school it was 

natural to identify the two classes, the more so that frequently 

the same persons played a leading part in both. 

But not every doctor was able or willing to act as teacher 

of his art. The medical corporation decided, therefore, 

to depute annually certain of its members to the duty 

of teaching. This, however, demanded knowledge and 

ability not possessed by everyone; it was, therefore, very 

natural that a class of doctors who made teaching their 

profession was gradually formed. These circumstances 

must be carefully considered if we wish rightly to understand 

the state of the university of Paris at this time and 

of the medical studies pursued there. They explain the 

independent position held by the medical faculty in regard 

to. the university, the influence exerted by the doctors who 

held themselves aloof from professorships upon medical 

teaching, and many other facts which, as they are transmitted 

by history, appear singular and enigmatical. In 

Paris, too, the Rector was originally the head of the associations 

of students—of the "nations." Since the 

members of these "nations," either as students or 

graduates, belonged to the philosophical faculty, or stood 

m relation to it, it ensued of its own accord that the Rector 

gradually came to have the management of this faculty. 

The faculty of the liberal arts, however, formed the, 

foundation of the whole university; thence came it that 

the Rector afterwards advanced to the head of this. As 

early as 1280 he was looked upon as head of the whole

23° 


university ; the theological faculty alone formed an exception 

; but in the middle of the 14th century this also came. 

under his authority. 

He alone could be elected to the office of Rector ,| 

who possessed an academical degree in the philosophical J 

faculty, in other words, a good general education. The 

usage gradually came into vogue of conferring this dignity 

upon a man in a prominent position of life, who sometimes 

if not always belonged to the teaching-staff. A similar 

arrangement prevailed afterwards at the academies at. : 

Vienna, Prague, and other places. A Dean of the medical | 

faculty is mentioned in the year 1267; this was PETRUS J 

LEMONENSIS* The Dean was elected by the medical g 

corporation, the President of which he was. He was not: 

allowed, at least in later times, to give lectures lest the. j 

administrative business which was entrusted to him should^ 

cause him to neglect them. '] 

The teachers in the faculty of medicine were divided | 

into those whose duty it was to give lectures and demon- j 

strations—thereby satisfying a definite want in the plan ;| 

of studies—and into those who lectured of their own free | 

will. The former presided at discussions and on solemn | 

occasions, and were called Doctores, or Magistri actu-i 

regentes ; their position corresponded nearly to that of our 

professors in ordinary. The other members of the teaching 

staff, the Doctores non regentes, were not bound to employ 

themselves actively as teachers, and in consequence had | 

no participation in the various privileges and sources of 

income which the class just mentioned enjoyed. ^ The 

teachers of the university generally gave instruction at : 

their dwellings. The medical faculty had a building of \ 

its own for the first time in 1505. Up to that time its meetings 

were held in the church of the Mathurins, or in the | 

cathedral of Notre Dame. We get information as to the| 

numerical relations of the several faculties from the fact- 

* BCCHEZ : Delafaculte de medecine de Paris in the Journal des progres des-* 

sciences et institutions me'dicales, Paris. 1822.

THE OTHER UNIVERSITIES OF EUROPE. 233 

that in the year 1348 there were in Paris 32 magistri of 

theology, 18 of canon law, 46 of .medicine, and 514 of artes 

liberates* The number of doctors belonging to the medical 

faculty of Paris, reached 29 in the year 1311, 31 in 1395, 

and 36 on an average from 1391 to 1431. When the 

English besieged Paris in 1442 there were only 10 or 12 

qualified doctors in the city; but around these a number 

of students were gathered who practised under their 

supervision. At a later period also the medical faculty 

did not .increase in the same proportions as the city 

of Paris; for in 1500 the former consisted of 72 doctors^ 

in 1566 of 81, in 1626 of 85, in 1634 of 101, in 1675 of 

105, and in 1768 of 148.f With these there were in 

Paris a great number of practitioners who had the right, 

it is true, to practise, but had not obtained the title 

of doctor, and consequently could not be members of 

the medical faculty ; so, too, there were numbers of sur* 

geons who had passed examinations, and other medical 

men recognized by the law. The organization and arrangements 

of the university of Paris formed the pattern for 

the majority of the academies which were founded in the 

following centuries in Germany, England, and other 

countries. 

THE OTHER UNIVERSITIES OF EUROPE EXISTING 

IN THE MIDDLE AGES. 

THE most ancient universities of Spain arose probab 

the influence of Arab traditions. At Palencia, even in the 

time of the Goths, there were celebrated schools: in the 

beginning of the 13th century ALPHONSO VIII. erected a 

university there in which however there was no medical 

* DENIFLE op. cit. i, ,S. 123, from, whom I borrow these figures, considers 

all these magistri to be regentes; but this assumption is contradicted by all 

other circumstances. 

t A. SPRINGER: Paris im 13. Jahrhundert, Leipzig 1856.—J. C. SABATIER: 

Recherches historiques sur la faculte'de medecine de Paris, 1835. • r ,


faculty. But this educational establishment existed only 

for a short time. The university of Salamanca which was 

founded in 1243 by FERDINAND III. was developed, as it 

appears, out of a cathedral-school. There all branches 

were represented with the exception of theology which 

was not added until the 14th century. Two teachers, as 

was the case also in other academies of that period, gave 

instruction in medicine. Salamanca acquired a reputation 

which spread far beyond the boundaries of Spain and was 

declared by Pope MARTIN V to be one of the four chief 

academies of Christendom, the others being Bologna, 

Naples and Paris.* 

The other universities of the Iberian peninsula were of 

less importance. In Seville the study of the Oriental i 

tongues, especially of Arabic, was chiefly pursued; the 

academy there served for the training of missionaries and 

was first provided with the other faculties in the beginning 

of the 16th century. The university of Lisbon was founded 

in 1288 but was removed to Coimbra in 1308. This fate 

befel it several times for it came back to Lisbon in 1338, 

was transferred to Coimbra again in 1354, then to Lisbon 

once more in 1377, to return to Coimbra in 1537. It almost 

gives one the impression that the two towns had agreed 

between them that the seat of the university should change 

from one to the other about every 20 years. All branches 

of knowledge were taught there ; yet in 1400 there was only 

one professorial chair for medicine. 

In addition to those above mentioned Spain possessed 

universities in the following places: about the year 1260 

there was one in Valladolid, in 1300 one at Lerida, in 1254 

at Huesca, in 1411 at Valencia, in 1446 at" Gerona (?), in 

1450 at Barcelona, in 1474 at Saragossa, about 1480 at 

Siguenza, in 1482 at Avila, in 1483 at Palma, in 1499 at 

Alcala. The faculty of medicine was not represented at 

some of them. The Spanish universities appeared as much 

* V. DE LA FUENTE: Historia de las universidades en Espaiia, Madrid 1884- 

85, 2 Vols.


by political events as by the geographical position of their 

country to be especially called to the great task of trans 

mitting the culture of the Arabs to Christian Europe; and 

they might well hope that as a result of the stimulating 

effect of the rich treasures of knowledge left them by their 

Semitic predecessors they would long sustain an important 

part amongst the establishments for advanced teaching. 

If, notwithstanding this, they produced no enduring in 

fluence on the development of the sciences and if, after a 

brief period of prosperity, which like a friendly gleam of 

light illuminates the history of the 16th century, they sank 

into a condition of intellectual torpidity which robbed them 

of the power of independent movement, the fault lies in that 

political and religious oppression which here reached an 

unexampled height. Even in the worst days of despotism 

and of superstition there was no lack of latent intellectual 

life ever ready to bloom afresh ; but the buds were crushed 

under foot and could only advance to maturity if removed 

from their native soil. 

The old English universities of Oxford and Cambridge 

were gradually developed out of the schools which existed 

in those places as early as the 12th century.* It is un 

certain when they assumed the academic character. In 

the first decades of the 13th century they appear already 

as organized corporations—in fact as universities. Medical 

science was certainly taught in these institutions along with 

other branches of knowledge, but only as part of a general 

philosophical education. For this purpose one teacher of 

the subject sufficed to point out to the students the most 

important facts in connection with it. The same conditions 

•obtained at the universities of St. Andrews founded in 

1411, Glasgow founded in 1450, and Aberdeen founded in 

1494. 

The first university on German soil was erected in the 

* H.C.MAXWELL LYTE : A History of the University of Oxford from the 

earliest times to 1530, London 1886.—JAMES BASS MULLINGER : The University 

of Cambridge, Cambridge 1873.


year 1348 at Prague, the residence of the Emperor CHARLES 

IV. An ardent friend and patron of all scientific and 

artistic effort, this prince was anxious to make the subjects 

of his empire and especially of his patrimonial possessions 

in Bohemia, acquainted with the advantages of Italian and 

French civilization. On this account, he created in his ' 

capital a studium generate which was arranged after the 

pattern of the university of Paris. It comprehended four 

faculties in all, and fixed stipends were assigned to the 

professors. The students, as in Paris and Bologna, were 

divided into four nations namely Bohemian, Bavarian, 

Saxon, and Polish. At their head was the Rector,, who 

had to belong to the clergy, though not to any monastic 

order, i.e., he was obliged to have received one of the lower 

forms of consecration; also to be of at least 25 years of 

age, of legitimate birth and to have passed a blameless 1 

life.* Even students could be elected to this dignity. The 

supreme control of the university was conferred on the 

Archbishop of Prague—on a high prelate, as was usual in 

many academies at that period. The university of Prague 

rose quickly into prominence. BENESCH DE WAITMUEL 

an author of the 14th century said that " in no place in 

Germany did the sciences receive such careful cultivation as 

in Prague, students coming thither from England, France,, 

Lombardy, Hungary, Poland and the adjacent countries, 

among them. being the sons of nobles and princes, and 

high prelates from the different parts of the world."t 

Even if the reports of the number of students, which the 

academy mustered at that time are exaggerated,%—and in 

* W. TOMEK : Geschichte der Prager Universitat, Prag. 1849. 

t DENIFLE op. cit. i, S. 600. 

X According to these there are said to have been in Prague at that time 

30,000 students; similar reports exist in the cases of Bologna, Oxfor.d, and 

Louvain. Probably not only the students and scholars who were being prepared 

for university studies, were included, but also all who had studied there in 

former years as well as the officials and artificers. who had business relations 

with the academy. Cf. PAULSEN in SYREL'S histor. Zeitschr. 1881, Bd. 45, S. 

2 9< etseq. . ; rt


any ease they are very uncertain,—still we are at liberty 

to assume that the number was not insignificant. 

In 1372 the faculty of law constituted itself a separate 

university and chose its own Rector; it consisted at that 

time of 37 members of the Bohemian, of 48 of the Bavarian, 

of 41 of the Polish, and of 29 of the Saxon nations. 

Medical study met by no means with its due recognition ; 

it was represented by one or at most two teachers. 

NlCOLAUS DE GEVICKA, BALTHASAR DE TUSCIA and 

WALTHER are mentioned as the first. 

The national and religious quarrels which afterwards 

broke out in Prague resulted in many foreign students 

quitting the university and in the neglect of study there. 

Thus its decline commenced, and in the sphere of medicine 

became somewhat marked as early as at the close of the 

15th century. 

The university of Vienna was founded in 1365, but really 

only in 1385 came into actual existence. It was organized 

in imitation of the university of Paris. Its members, like 

those of that university, divided themselves into four 

" nations " at the heads of which were Procurators, who 

elected the Rector. The Rector was the head of the 

whole university, representing it before the outside 

world and holding jurisdiction in it. The Provost of the 

Church of ST. STEPHEN filled the office of Chancellor. 

The general assembly of the doctors who had taken 

diplomas constituted the medical faculty; their principal, 

the Dean, was elected by them. All were entitled to teach ;, 

yet but few devoted themselves to teaching, indeed, seldom 

more than six or eight.* The Doctores regentes received 

regular stipends. The first teachers of medicine were 

JOHANN GALLICI of Breslau, HERMANN LURCZ of Niirn- 

berg, HERMANN VON TREYSA of Hessen, CONRAD VON 

SCHIVERSTADT and MARTIN VON WALLSEE. 

In the year 1364 King CASIMIR of Poland founded an 

* J. ASCHBACH : Geschichte der "Wiener Universitat, Wien 1865, i, S. 326.


academy in Cracow to which two professorial chairs of 

medicine were allotted. But these plans were not realized 

until 1400. 

A papal document of foundation was drawn out for 

Culm also in 1387, but the university appears never to have 

come into existence. The university of Heidelberg arose 

in 1386. It had at first only four professors for all the 

faculties. The first teacher of medicine was appointed in 

1390. He remained for long the only representative of this 

science.* At Koln on the Rhine an academy was founded 

in 1388, w T hich made a splendid start. It existed until 1798 

and was only abolished under the French rule at the same 

time as the universities of Treves and Mainz. The 

academy of Erfurt which as early as 1379 received the 

privileges of a studium generate and, in any case, existed 

as such from 1392 obtained a great reputation in the 15th 

century, especially for its attention to legal science. It 

existed till 1816. The two Hungarian academies of Fiinfkirchen 

and Ofen, which were founded in the 14th century, 

had but a short duration of life ; the latter was restored at 

the end of the 15th century. The university of Wurzburg 

only existed ten years after its foundation in 1403. Its 

history, which has an extraordinary importance in reference 

to medical science, really begins only in 1582 after it had 

been again opened at the conclusion of a long period of inactivity. 

In the 15th century the following universities also 

were founded at the dates given :f Leipzig (1409), Rostock 

{1419), Louvain (1426), Greifswald (1456), Freiburg-im- 

Brisgau (1457), Basel (1460), Treves and Ingolstadt (1472),. 

Tubingen and Mainz (1477), Upsala (1477) and Copenhagen 

(1479). Medical studies played a modest part at 

these academies. There were seldom more than one or. 

two teachers to instruct students in medical science and the 

number of the pupils was generally not much greater; 

* J. F. HAUTZ: Geschichte der Universitat Heidelberg, Mannheim 1862, 

2 vols. 

t Cf. PAULSEN in SYBEL'S histor. Zeitschr. 1881, Bd. 45, S. 266 el seq.

THE TRAINING OF DOCTORS IN GENERAL. 237 

THE TRAINING OF DOCTORS IN GENERAL. 

THE universities of the middle ages were institutions of a 

different kind to those of the present day. The conceptions 

which are associated with things change with the 

lapse of time just as the names do by which we designate 

them. The academies of that period, moreover, differed 

considerably among themselves according to the time and 

place of their origin. Those of Salerno and Montpellier 

appear to have been, as it were, technical schools of 

medicine, to which the other faculties were somewhat 

loosely linked. The academies at Bologna, Padua, and 

other places in Italy resembled wandering colonies of professors 

and students, who pitched upon a site wherever 

the best prospect of freedom and the greatest advantages 

were offered ; many associated themselves with one of the 

numerous schools of law existing in several towns from a 

remoter period. The university of Paris and the academies 

of England and Germany, which were modelled on it, give 

the impression of philosophical faculties which afforded 

medicine a place, along with other sciences, within the 

circle of the studies pursued within their walls ; at certain 

of these universities, such as Paris, Vienna, Prague, Basel 

and other places, medical teaching stood in close connection 

with the corporation of doctors, as was also originally the 

case in the oldest medical schools at Salerno and Montpellier. 

Just as artisans and artists in their guilds, so also 

the masters of medicine claimed the right of determining 

in their general meetings in what manner their art should 

be taught, and who possessed the requisite knowledge for 

independently practising it. So, too, in the other 

academies, the medical faculties had a somewhat different 

signification to that possessed by them to-day, for at that 

time they gave no complete technical education, but only 

the theoretical basis for this which depends upon literature;

238 THE MIDDLE AGES.- 

and.they left the students to acquire at a later period the 

requisite practical knowledge of the healing art under the 

guidance of a practising doctor, or in the hospitals. In ,; 

consequence of this, the centre of gravity of a doctor's , 

training was shifted away from the faculty and at the 

-same time from the university, and this was especially the 

case in England, while in Germany from a frequent absence 

of the necessary institutions, and from scarcity and limitation 

of means, the practical training of doctors was in 

general neglected. 

The course of medical studies, as a rule, was tolerably 

similar in the different universities, both from custom 

and in deference to the requirements of the law. The 

possession- of a general preliminary training, including the 

subjects which were taught at the monastic and cathedral J 

schools, and also at the town schools, was presupposed. If 

these institutions for the higher teaching existed in towns 

in which universities were afterwards established, they 

Were incorporated with the latter, as in Paris, Prague, 'j 

Vienna, and other places. Thus it came about that many. 

students acquired at the university itself that preliminary I 

training necessary for their future technical studies, the ; 

philosophical faculties almost taking the place of our , 

gymnasia. This arrangement obtained at the Austrian | 

academies in the form of the two yearly courses of 

philosophy, which had to be attended before the com* 

mencement of medical studies up till the year 1848, and in 

a modified form it exists at the present day in the univeivj 

sities of England. The Emperor FREDERICK II., we are 

told, issued an order that a general scientific educatiofi|| 

should precede the commencement of medical studies, and 

that three years should be devoted to the same. Gradually 

it became usual that in most academies the students before | 

beginning medical study should graduate in artibus, or, at 

all events, should attend lectures in the philosophical 

faculty for a certain number of years. In Paris, after ail 

attendance of two years at such lectures they could obtain :


t-he ; degree of bachelor, and after three and a half years the 

license and the degree«of master of philosophy.* 

: The period of studentship in the department of medicine 

lasted four or five years; but could be shortened by a half or 

a- whole year if the student possessed an academical degree 

in the faculty of philosophy. This time was divided into 

two portions, the first comprising the first two or three 

years and ending with the examination for the degree of 

bachelor, while the second, forming the two last years of 

studentship, was concluded with the acquisition of the 

license to practise. 

" : The medical teaching consisted chiefly of theoretical dis 

cpurses. The medical writings of the ancients and their 

Arabian and Italian commentators formed the foundation 

for these. The teacher added technical explanations and 

remarks on his own practice to the reading of these books. 

The various subjects were generally apportioned among 

the teachers so that each particular theme, as anatomy, 

fevers, blood-letting, dietetics, materia medica, special 

pathology, surgery, etc., was treated in an exhaustive way. 

The lecture rooms, as they appear in contemporary 

pictorial representations^ show us the teacher on a raised 

seat reading out of a bulky volume to his pupils, who are 

Seated on forms or stand near him, and are engaged in 

copying down his words. 

Concerning the subject-matter of medical lectures, a list 

of the studies of the medical faculty at Leipzig at the end of 

the 15th century gives us accurate information. It was 

there laid down as a rule that the first lecture in winter 

should begin at seven o'clock in the morning, in summer at 

six, and should deal with theoretical medicine. Three 

* L. HAHN : Das Unterrichtswesen in Frankreich, Breslau 1848. 

•f* Cod. Galeni Dresd., No. 92, fol. 20b, 30a, 39a, 296a. No. 93, fol. 587b, 

608b.—CH. MEAUX ST. MARC: L'ecole de Salerne, Paris 1880 (Vignette).— 

LACROIX: Science et lettres au moyen-age, Paris 1877.—L. GEIGER : Renaissance 

und Humanismus, Berlin 1882, S. 408 (after a ceiling-painting of 

LAURENTIUS DE VOLTOLINA).


years were spent upon this subject, and in such a way that" • 

for the first year's lectures the first Canon of Avicenna, 

with the explanations of JACOBUS FOROLIVIENSIS, served as 

a guide ; for the second year the ars parva of GALEN, with 

the commentary of TRUSIANUS; and for the third the) 

Aphorisms of HIPPOKRATES, with GALEN'S remarks, upon 

them. At one o'clock in the afternoon the lectures on\ 

practical medicine took place: these also claimed a three 

years' course. The foundation for the.first year's lectures* 

on this subject was the 9th book of the Liber Medicinalisf 

ad Almansorem of RHAZES which contained pathology, 

,with the remarks of JOH. ARCULANUS ; for the. second year -j 

•the subject of fevers ; and for the third general therapeutics, 

after the Canon of Avicenna, with the explanations of 4 

DINO DE GARBO and others. 

Along with these regular lectures, delivered by appointed | 

professors, certain doctors belonging to the medical faculty 

dealt with particular subjects in special lectures; the J 

subjects being chosen by them as they liked, and being of 

such a nature as, for example, the Prognostics of HlPPO- 1 

KRATES. 

The course of study recommended to the students in 

1520 by MARTIN STAINPEIS, professor in the medical*| 

faculty at Vienna, was of the same kind.* In his book he* 

enumerates the medical writings which they should readyj 

and arranges them according to their contents in such away 

that they appear, if studied in orderly succession, | 

calculated to make students acquainted by degrees with 

the several parts of medical science. Mention is there j 

made of the most important medical authors of antiquity; 

and amongst the Arabs, with their expounders, and also& 

of the works of a number of Italian doctors which had at , 

that time obtained a considerable notoriety. STAINPEIS 

discusses the use of this reading to the future doctor, M 

* MARTIN STAINPEIS: Liber de modo studeridi seu legendi in medicina, 

Vienn. 1520, f. vii et seq.—A. v. ROSAS: Geschichte der Wiener Hechschulgu.bes. 

der med. Facultat, Wien 1843, i, 149 et seq. ,.


and gives the advice that numerous students should 

always study together,, in order that they may set 

one another right on things not clearly understood by 

any of their number. "Before going to sleep every 

student must, like an ox, chew the cud of what he has 

learnt during the day" (fol. xvii). In this way the first 

three years of medical studentship were passed. During the 

second half of this period, and consequently after obtaining 

the degree of Bachelor, the students of medicine occupied 

themselves with hearing lectures on special subjects, taking % 

part in discussions which occurred every week under the *%• 

superintendence of the professors, assisting at anatomical - , 

dissections, visiting hospitals and learning the practical -; 

treatment of diseases. 

The discussions, which were usual even in the schools of 

the Iatrosophists of antiquity, and also were zealously 

carried on by the Arabs,- formed an essential part of 

medical teaching. They were in conformity with the 

entire method of education of the scholastic period, which 

aimed rather at dialectic versatility than at depth of knowledge, 

.more at dead scholarship than at that practical 

ability which life demands. Looking at their real effect, 

these discussions served as a useful completion of the 

theoretical lectures, for they gave the students an opportunity 

of showing whether they had, or to what extent they 

had, mastered the contents of the latter. They were also, 

as it were, examinations which the students subjected 

themselves to in the presence of their teachers and fellowstudents. 

The learners were thus made acquainted with 

deficiencies in their knowledge and the teachers with 

imperfections in their teaching. Unfortunately these discussions 

frequently degenerated into an empty display of 

words, which did not advance the matter, but only satisfied 

personal vanity. "The young people," said JOHN of 

Salisbury, " pride themselves on their knowledge of HIPPO 

KRATES and GALEN, make use of unfamiliar expressions 

and introduce, their aphorisms on every occasion." The 

R

242 


bachelors were also bound to teach the young students by 

translating and expounding extracts from the medical 

writings of the ancient authors, and by giving lectures 

on certain parts of medical science. Here, too, usage 

resulted in the formation of definite rules : thus it was 

established in Paris that there should be 50 lectures upon 

the Aphorisms of HIPPOKRATES, 30 upon the book de 

regimine, 38 on acute diseases, and 36 upon the Prognostics* 

There is no doubt that this method of teaching 

had many advantages for the students. The Jesuits, who 

introduced it afterwards into their schools, have to thank it 

in great measure for the successful results which they 

obtained. 

TEACHING IN ANATOMY. 

MEDICAL teaching in the universities bore thus essentially 

a theoretical character; only in certain subjects were 

attempts made to join with it practical demonstrations. 

k, For while anatomy was taught chiefly from books, it was 

•*• likewise illustrated by drawings and sketches, by the 

', examination of the living body, and by the dissection of 

"' dead animals and of the human subject. Unfortunately 

but few anatomical drawings of this period have been 

preserved. HENRI DE MONDEVILLE, who was first a professor 

in Montpellier, and afterwards physician in ordinary 

•'•» to PHILIP LE BEL of France (1285-1314) added thirteen' 

illustrations to his Anatomy, as GuiDO DE CAULIACO states.t , 

The royal library at Berlin possesses the college note-bookj 

of a student, who in 1304 copied down the lectures delivered 

there; on the margin are rough pen and ink sketches, 

for which H. DE MONDEVILLE'S drawings served probably 

as a copy. A parchment manuscript of the beginning of 

the 15th cefntury which is preserved in the Royal Library g 

* SABATIER op. cit. 

t GUY VON CHAULIAC : Chirurgia, Tract. 1, doctr. 2, c. 1.

TEACHING IN ANATOMY. 243 

at Dresden* contains initials with drawings illustrating 

incidents in a doctor's life, and also several anatomical 

demonstrations. It appears evident from this that in 

teaching, naked persons were brought forward on whom 

the particular parts of the human body were pointed out 

and explained. Perhaps the internal organs were indicated 

by outlines upon the skin. The dissection of animals 

formed the aid to anatomical teaching in most general use 

In Salerno, pigs were used, by preference, for this purpose ;' 

in other academies this example was imitated. Again,' 

bears, monkeys, but especially dogs were made use of.f 

In the pecuniary accounts of the medical departments of 

this period the purchase of pigs and other animals for 

anatomical investigation sometimes played a not inconsiderable 

part. The dissection of the bodies of the lower 

animals continued to be usual, after that of the human subject 

had become an established thing, since an opportunity 

for the latter was but seldom afforded. 

Dissection of the human subject was in the first centuries 

of the middle ages opposed by religious and political 

ordinances and also by social prejudices. It seems, that 

the doctors of that time were not entirely without this 

most important medium of medical education; but the ' 

anatomical knowledge of GALEN and his expounders 

satisfied them, and no desire for independent investigation 

was manifested by them. Doctors of intelligence certainly 

never failed to recognize the importance of anatomy to •'• 

medicine;{ but not before the 13th and 14th centuries' 

* Codex Galeni No. 92, 93, with the commenta.y of NICOL V. REGGIO NO 

92, fol. 19b, 26b, 34b, 50a, 59a, 83b, 93b, 96b, ,09a, ,Sla, 158a, ,64b, , V 

lK, 3 ° 4a 'r L ' CH ° ULANT: Geschichte und Bibliographic der anatomischen 

Abbildung, Leipzig 1852, S. 2. 

t MONDINO: de anatomia (matricis).-Mag. Richardus in HAESER op cit 

'' I :~H' ' Ver 2 an S enhdt u "d Gegenwart des Museums fur 

menschliche Anatomie an d. Wiener Universita:, Wien 1869, p : xii 

X Thus TADDEO ALDEROTTI (.223-1303), declared that'he could give no 

accurate information on the nature of pregnancy, since he had unfortunately 

never had an opportunity of dissecting a pregnant woman.-A. CORRADI •


were the obstacles removed which made its study difficult 

or impossible. 

The Emperor FREDERICK II. exhorted the students of 

Salerno to give their attention to anatomy, and ordered 

that no surgeon should be allowed to practise before he 

had given proofs that he had devoted himself to the study 

of anatomy for a whole year. On the suggestion of 

MARTIANUS, Protomedicus of Sicily, he issued an order 

in 1238 that every five years a corpse should be dissected 

in the presence of the physicians and surgeons* 

At Bologna dissections of the human subject were probably 

carried on as early as the 13th century. In 1302, by J 

command of the judge, even a medico-legal dissection was 

performed there, the suspicion having arisen that a man : 

had been poisoned; two physicians and three surgeons 

were appointed to make this examination. From the des-1 

cription of this event it is not to be inferred that it was the | 

first case of the kind but on the contrary that people 

already possessed some experience in such examinations 

and in the conclusions to be drawn from them.t For a 

similar reason GULIELMUS DE SALICETO is said to have | 

dissected the 'corpse of the nephew of the Marchese PAL- J 

LAVICINI.J The Franciscan monk SALIMBENI narrates that, 

during an epidemic which raged in Italy in 1286, a doctorf 

opened the corpses of many persons who had died from 1 

the disease in order to find out its cause. During the great 

plague of 1348 several doctors made this attempt ;§ unfor-| 

tunately the results obtained were not of much value. 

There was also no hesitation in preparing by boiling and J 

maceration the bodies of celebrated persons for transport, 

when they died far away from their homes. This was done j 

Dello studio et dell' insegnamento dell' anatomia in Italia nel medio evo in the 

Kendiconti del R. istit. Lombardo, Milano 1873, ser. ii, vol. vi, p. 634. 

* A. BURGGRAEVE: Pre'cis de l'histoire de l'anatomie, Ghent 1840, p. 47. 

•*- MEDICI op. cit. p. 5 et seq. 10. 

t PUCCINOTTI: Storia della medicina ii, pars ii, 357. 

§ A. CORRADI: Annali delle epidemie in Italia, Bologna pro a. 1286 and 

1348.

TEACHING IN ANATOMY 

245 

in the case of the bishops, princes and nobles who in 1167 

came with the army of FREDERICK BARBAROSSA to the neighbourhood 

of Rome and succumbed there to a pestilence * 

and in the case too of the Emperor himself when he was 

drowned near Jerusalem in the river Saleph.f The corpse 

of LOUIS IX. of France who died in 1270 near Tunisf was 

treated in the same way; as also were the bodies of PHILIP 

THE BOLD and his Consort.§ Pope BONIFACE VIII. forbade 

this practice in 1300 || and in so doing robbed anatomical 

inquiry, precisely when it was starting afresh, of an aid, 

the loss of which was sensibly felt. MONDINO wrote that 

certain bones can only be properly recognized, after they 

have been prepared by boiling but that he did not so prepare 

them himself as he was fearful of committing a sin.f 

His commentator BERENGER of Carpi, indeed, says of him 

that he did not always offer resistance to this sin and, in 

spite of it, sometimes boiled human bones.** 

MONDINO, who practised the profession of teaching in 

Bologna, performed a great number of dissections.tt He 

himself states, in speaking on a certain occasion of the 

comparative size of the uterus in the young female during 

menstruation and in pregnancy, that in 1315 he dissected 

two female subjects.JJ His prosector OTTO AGENIO of 

Lustrula and a young lady ALASSANDRA GILIANI of 

Persiceto are said to have assisted him in his work.§§ 

* G. H. PERTZ: Monum. Welforum ant. in Script, rer. German., Hannov. 

1869, p. 41. 

t BENEDTCTUS PETROBURG : Gesta regni Henrici II. in Script, rer. Brit. med. 

a>vi, London 1867, T. 49, Vol. ii, p. 89. 

X CORRADI op. tit. anno 1270. 

§ MURATORI: Rer. script, it. viii, 861. 

|| Deer, de sepulturis.—jTirf. also CORRADI: Dello studio dell* anatomia op. 

cit. p. 865. 

*|[ MONDINO : De anatomia auris. 

** Comment. Bonon. 1521, f. 510. 

tf Maltoties, as GUY VON CHAULIAC writes in his Surgery (i, 1, 1). 

XX MONDINO : de anatom. matricis. 

§§ Although AL. MACCHIAVELLI (Effemeridi sacro-civili, Bologna 1736, p. 60 

et seq.) says of the latter that she knew how to clean the blood-vessels even to


Practical instruction on the dead body was concluded in 

four lessons, as is stated by GuiDO DE CAULIACO, who 

had attended those of BERTUCCIO, a pupil of MONDINO. 

In the first lecture the organs of nutrition that is to say 

those of the abdomen were described "since these fall 

into decomposition most rapidly," in the second the membra 

spiritualia namely the thoracic organs, in the third 7 the 

membra animata (the brain) and in the fourth the extremities* 

In order to see and to study the ligaments, the 

cartilages, the joints, the larger nerves, etc., the bodies 

were dried for a considerable time in the sun, buried in the 

ground to putrify or placed in running water, sometimes 

in boiling water. Many anatomists, like the Magister 

RiCARDUS, considered such treatment of the human body 

to be " horrible " and preferred therefore to teach anatomy 

on the bodies of the lower animals. Others were induced 

to adopt a similar course not so much by a religious dread 

as by the circumstance that opportunities for dissection of 

human bodies occurred but seldom. 

Many doctors provided themselves with bodies, when they 

could not get them in a legitimate way, by theft. Thus a 

trial took place at Bologna in 1319 in which a teacher of 

medicine at that place and four of his pupils were charged 

with having taken home with them out of the grave the 

corpse of a man who had been hanged, for the purpose of 

dissecting it.f Such cases may pretty often have happened 

at that time. People countenanced this procedure, and ; 

while unwilling to give them freely, allowed the corpses to • 

be taken. " The laws against the desecration of graves 

were silent" as CORRADlJ says "without being abolished: | 

their minutest branches without tearing them and that she then filled them ; 

with a coloured fluid which after coagulating allowed the form of the vessels to 

be plainly seen, this statement is not confirmed by any ancient writer. It is 

ceitainly improbable that the art of injection was already known at a time when i 

anatomy was but little advanced. Cf. M. MEDICI op. cit. p. 28 et seq. 

* GUY v. CHAULIAC: Chirurgia op. cit. 

f MEDICI op. cit. p. 36, 427 et seq. 

X CORRADI op. cit. p. 642.

••*'W" "*"'"' 

TEACHING IN ANATOMY. 1 '* 

and the authorities interfered only if decided violence had 

been used or a great scandal raised." 

Only quite gradually was legal permission granted for 

dissection of the human body. The Senate of Venice 

in 1368 issued an order that a dissection should be per 

formed once a year in order that physicians and surgeons 

might inform themselves upon the relative position of 

the different parts of the body* The university of 

Montpellier was granted the right in 1375 of dissectingt 

every year the body of a criminal on whom the death 

sentence had been carried out, and the university of Lerida 

was in 1391 granted the same privilege by King JOHN 

I.| He decreed that the town authorities should deliver 

over for this purpose the corpse of -a criminal who had 

been put to death by forcible submersion in water, in order 

that the body should be completely uninjured. FERDINAND 

THE CATHOLIC permitted the physicians and surgeons at 

Saragossa to open the bodies of persons who died in the 

hospital there if they considered it would serve any useful 

purpose,§ and the Pope confirmed this permission in the 

case of the doctors of the Monastery della Guadelupe in 

Estremadura.|| The medical faculty at Tubingen received 

permission from Pope SlXTUS IV. in 1482 to dissect the 

bodies of executed criminals.^] In the statutes of the 

university of Bologna of the year 1405 it was enjoined 

"that no doctor or student of medicine, or anyone else, 

shall appropriate a corpse without permission of the 

Rector." On a dissection being held under the guidance 

of a professor, a definite number of students were invited 

* CORRADI op. tit. p. 635. 

t ASTRUC op. cit. p. 32. 

X GERMAIN op. cit. iii, 134.—DENIFLEO^. cit. i, S. 507. 

§ A. H. MOREJON: Historia bibliografica de la medicina espagnola, Madrid 

1842, i, 252. 

|| MOREJON op. cit. ii, 25. Unfortunately he does not say when this 

occurred. 

1 L. F. FRORIEP: Die anatomischen Anstalten zu Tubingen, Weimar 1811, 

Beil. i, 14.


to be present at it; no more than 20 might attend at the 

dissection of a male subject; at that of a female—a rarer 

event_no more than 30; so that everyone might see distinctly. 

No student was allowed to attend these demonstrations 

until he had attended medical lectures for two 

years. The Rector had to take care that all medical 

students in turn should have the opportunity of seeing 

dissections, and that the members of all student-corporations 

should be equally respected in receiving invitations 

to be present at them.. On this ground a rule was made,,; 

that no student who had seen the dissection of a male: j 

body should be invited a second time in the same year to a 

similar demonstration. If such took place in the following J 

year of studentship he was generally not again invited to 

the dissection of a male but only of a female subject, so 

that under favourable circumstances he might during his 

studentship assist at the dissection of two male subjects 

and one female. The students who were present had to , 

bear the expense of getting, removing, preparing and burying 

the corpse; this, however, was not allowed to exceed 

16 Bologna pounds for a male, and 20 for a female body. 

Of this sum the professor who performed the dissection 

received 100 solidi. The members of the Teachers' College 

relieved one another in this function; no teacher was at 

liberty to decline the demand of the students that he should 

undertake the dissection of a corpse.* 

In 1442 it was ordained by law that the authorities or 

magistrates of Bologna should deliver over to the university 

every year two corpses, one male and the other female, 

or when the latter could not be obtained both male, for 

anatomical dissection. It was not here prescribed that 

the bodies should be those of criminals who had been 

executed, but it was left to the judgment of the magistrates 

to procure them in whatever way it was possible (quo modo J 

cumque fieri poterit); only they were not allowed to make j 

* Statut. dell' univ. di Bologna v. 1405, Rubr. 96, in CORRADI : Dello studio 

dell' anat. in Italia op. cit. p. 638 etseq. 647.

TEACHING IN ANATOMY. 249 

such use of the bodies of persons whose homes had been in 

Bologna* The same conditions obtained in Padua, 

Ferrara, and Pisa.f In general, care was taken to devote 

to anatomical investigation the bodies of criminals on 

whom the punishment of death had been carried out. The 

populace, as in the ages of antiquity, regarded the mutilation 

and cutting to pieces of the dead body as a desecration, 

to which one was at liberty to expose only those 

persons who, by their execrable crimes, had drawn general 

contempt upon themselves. As the demands of science 

increased, this method of getting dead bodies did not 

suffice, and people were obliged to find out how to procure 

them in other ways. But even then the principle was 

adhered to of employing for this degrading purpose (as it 

was thought to be in the opinion of the publie) only the 

bodies of strangers, or, if of natives, then only those of 

lowly origin. If in Pisa the dead bodies of the burgesses 

of the town, and of the students and doctors, with the 

consent of their relatives, were used for this purpose it was 

an exception, and is probably explained by the democratic 

spirit which prevailed there at the time.J 

Practical teaching in anatomy was developed in the 

universities of other countries at a later period, and to a 

much smaller extent than in the academies of Italy. Not 

until the 15th century were such demonstrations commenced 

in Paris. In Prague, anatomical dissections took 

place from the year 1460, after the medical faculty there 

had, by a present, come into possession of a house of its 

own.§ In Vienna, Professor GALEAZZO DI S. SOFIA, who 

had been called thither from Padua, instituted in 1404 the 

first anatomical demonstration, a male subject being given 

up to him for this purpose. It took place in the town 

hospital, and lasted eight days. At the conclusion the 

* Statut. v. 1442, Rubr. 19, in CORRADI op. cit. p. 648. 

t CORRADI op. cit. p. 638. 

X FABRONI : Hist. Acad. Pisan., Pisa 1792, T. ii, 73. 

§ HYRTI. : Geschichte der Anatomic in Prag., 1841, S. 9.


professor collected money from the spectators, which was 

poured into the chest of the faculty* Twelve years 

passed before the next public anatomical dissection took 

place; it was repeated again in 1418. To this demonstration 

doctors and students of medicine, surgeons, 

apothecaries and other persons of learning or distinguished 

position were invited. In 1433 a special lecturer) on 

anatomy was appointed, Dr. JOH. AiGEL, of Niirnberg. 

The faculty was in 1440 disappointed in its expectation of . 

an anatomical dissection in a singular manner. The body 

of a criminal, who had been hanged, was for this purpose 

given over to it; but when they were about to begin dissecting, 

the man came to life again. As a result of this he 

was pardoned, and sent away in charge of the beadle of 

the university to Alt-Otting, his home, in Bavaria, where 

he afterwards on account of fresh crimes died on the 

gallows. In 1452 for the first time in Vienna a female j 

subject was dissected ; only physicians and surgeons were 

allowed to be present. In the 15th century an anatomical 4 

demonstration on a corpse took place about once in every 

eight years. The statutes of the medical faculty at 

Tubingen of the year 1497 decreed that every three or four 

years a human body should be publicly dissected; on these 

occasions a professor had to read the descriptive account ' 

from MONDINO'S Anatomy to the spectators. A similar 

course was adopted in the other German academies. 

It is not astonishing that under these conditions the 

science of anatomy made at that period no visible progress, j 

MONDINO'S anatomical work, the first produced since ancient 

times the author of which had dissected human bodies,, 

showed, nevertheless, no advance upon the position taken 

by GALEN. Resting on a teleological foundation, it gives 

about 80 pages of rather bare description to the position of 

the different parts of the body, i.e., the organs of the three 

great cavities of the body and to their presumed uses ; of the 

muscles, those only of the abdominal parietes are thoroughly 

* HYRTL : Vergangenheit und Gegenwart op. cit. S. viii.

PHARMACY AND MEDICAL PRACTICE. 251 

described; numerous notes upon diseases and operations 

on particular parts of the body, which are scattered about 

among the descriptions, indicate the purpose the book 

was intended to serve. At the same time it gained 

an extraordinary reputation, and formed for more than 

three hundred years the favourite text-book of anatomy. 

Neither did anatomical knowledge receive any noteworthy 

advancement from GuiDO DE CAULIACO, MATTHÛS DE 

GRADIBUS, PETRUS DE ARGELATA, and their successors. 

The rough woodcuts which the Leipzig professor MAGNUS 

HUNDT added* to his work on anatomy cast a lurid light 

on the condition of anatomy in the 15th century. The 

anatomical drawings in the work of JOHANNES DE KETHAM' 

occupy a higher position, proceeding as they do in part 

from the hands of skilful artists like B. MONTAGNA. 

TEACHING IN PHARMACY AND IN MEDICAL 

PRACTICE. 

OPPORTUNITY was afforded for the study of medicinal 

plants in the gardens adjoining many of the monasteries. 

Many doctors moreover laid out gardens of this kind, as 

MATTHÛS SYLVATICUS at Salerno, and the Magister 

WALTER in Venice, to whom the Senate assignedf a site 

for the purpose. But the universities at this period did not 

yet possess this valuable aid to teaching, and the knowledge 

of medicinal plants was chiefly communicated by 

theoretical teaching and by books which were sometimes 

embellished with botanical drawings. The students learned 

how to recognize drugs and how to prepare remedies in 

the dispensaries, which arose in all the larger towns from 

the 13th century onwards. STAINPEIS recommended 

students and young practitioners frequently to visit dispensaries 

with this object. FELIX PLATTERJ narrates 

* CHOCLANT op. cit. S. 24. t MEYER op. tit. iv, 255. 

X PLATTER op. cit. S. 151.


" that in addition to continual studying and attending of 

lessons in Montpellier he made a frequent practice of 

observing the preparation of all kinds of medicines at the 

dispensary," and he collected many herbs which he "neatly " 

wrapped in paper. 

The apothecaries got the greater part of their drugs 

from abroad, and a stirring trade developed in these articles 

in the middle ages, travelling from the East through Italy* 

In addition to medicaments, the apothecaries' shops contained 

other articles for sale, as various spices and aromatics, 

wax candles, paper, sugar, and sweets; in many . 

places, especially in Germany, the apothecaries carried on 

at the same time the trade of ginger-bread bakers, and 

were bound to send every year in Lent as a present to the 

councillors all kinds of dainties.f A contract dating from 

1424, in which an apothecary undertook to supply the 

necessary medicaments for the ducal Court at Este, gives;J 

us information concerning the drugs which at that time 

were kept in store in the dispensaries and were chiefly 

used.J This information is supported and completed by 

certain statements made upon the contents of a dispensary 

at Kosel, in Silesia, in 1417,§ and upon the drugs and 

medicaments which the apothecaries in Frankfort-on-the- 

Main sold in 1450.|| Certain drawings in the already « 

mentioned Dresden Codex, and in various early editions of 

medical works, give a clear picture of the arrangements of 

the dispensaries of that period. \] 

A 

* W. HEYD : Geschichte des Levantehandels, Stuttgart 1879, ii, 550 et ssq. 

t A. PHILIPPE: Geschichte der Apotheker, iibers. v. H. LUDWIG, Jena 1859, ,j 

i, S. 87. 

X A. CORRADI : Su i documenti storici spett. alia medicina, chirurgia, farmaceutica, 

in Annal. univ. di med., Vol. 273, Milano 1885. 

§ HENSCHEL in the Janus, Breslau 1847, "1 I S 2 - 

|| J. C FLUCKIGER: Die Frankfurter Liste, Halle 1873. 

If Cod. Galeni No. 92, fol. 181b, 182a, 193a, 265a, 266a.—CHOULANT in 

NAUMANN'S Arch. f. d. zeichnenden Kiinste, Leipzig 1855, Bd. i, 2, S. 264.— 

H. PETERS : Mittelalterliche Apotheken im Anzeiger des germ. Nationalmuseums, 

Niirnberg 1885, Bd. i, H. 1-2.—A. ESSENWEIN in d. Beil. z. Anz. d, 

germ. Nat., Bd. i, No. 11-12.


The apothecaries in Italy and France as early as the 13th 

century formed confederacies, which framed their own 

laws and kept a strict watch to see that their rights were 

not encroached upon* In Germany the first apothecaries' 

shops are said to have been erected at Wetzlar in 1233, at 

Schweidnitz in 1248, at Wiirzburg in 1276, at Augsburg in 

1285, at Esslingen in 1300, and'at Frankfort-on-the-Main 

in 1343. In the 15th century, not only every considerable 

town, but many also of the middle-sized and small ones, 

had apothecaries' shops, as, for example, Znaim, Pressburg, 

Krems, Budweis, Olmiitz, Briinn, and Kuttenberg.f The 

education of the apothecaries was that of men training for 

a handicraft.! The works of NiCOLAUS MYREPSOS 

NICOLAUS PROPOSITUS, CHRISTOPHOR DE HONESTIS,' 

SALADIN of Asculum, QUIRICUS DE AUGUSTIS, and others 

served chiefly as the text-books. 

Before permission to practise their business was granted 

to apothecaries they had to undergo an examination in 

which their masters and some doctors put the questions. 

Superintendence of the apothecaries' shops and visits of 

inspection were duties assigned to the doctors, and at a 

later period were especially performed by the townphysicians. 

Instruction of a practical nature in the treatment of the 

sick was also, like practical treaching in materia medica, a 

task which the universities did not impose upon themselves. 

But we must not from this at once draw the conclusion 

that the students of that time as a general rule 

received no clinical instruction. Celebrated historians 

have formed this erroneous opinion because in the accounts 

which deal with the more ancient history of the academies 

and medical faculties little or nothing is said on the subject. 

Practical instruction in the treatment of the sick was inde- 

* A. CORRADI : Gli antichi statuti degli speziali in Annali univ. di med., 

Vol. 277, Milano 1886. 

t STAINPEIS op. cit. f, 29. 

X STAINPEIS op, cit. f. 29b.


pendent of the universities "because the latter were not in 

connection with hospitals. When the student of medicine 

had passed his bachelor's examination he endeavoured to» '. 

educate himself in medical practice under the guidance of 

the teacher whose theoretical lectures he had attended, or 

of some other experienced doctor. For this purpose he 

accompanied him when he visited his patients, and took 

pains to get an opportunity at the hospitals of seeing how 

people were relieved in their sufferings, and of learning the 

art of giving such relief. As soon as he had acquired some 

knowledge of this subject he was allowed to assist and represent 

his master, and might begin, under the supervision and ^ 

•on the responsibility of the latter, himself to treat the patie$£s. , 

This method of medical education, which resembles that of . 

to-day, was recommended in the arrangement of. medical.* 

studies made by the Emperor FREDERICK II. 

The young doctors at Salerno were placed, as has been 

said, at the conclusion of the period of studentship. as ; * prescribed 

by law, under the supervision of an older pi» 

titioner for another year, as a necessary preliminary tqp.thl 

independent exercise of their calling. 

In the manuscript of GALEN belonging to the' 15th 

-century, preserved at Dresden, which has already been 

mentioned several times, numerous initial miniatures are 

found which refer to clinical teaching. Thus No. 93 fol. 

461b shows a picture of a patient suffering from marasmus, J 

and lying in bed ; near him stands a doctor dictating a pre-,;| 

scription to his pupils; two nurses are also present. The | 

illustration on fol. 565b represents a doctor demonstrating > 

to his pupils two patients whose legs are covered with ^ 

ulcers. Fol. 468b shows a surgical operation on the leffJ 

which the pupil is performing in presence of his teacher^ 

500b, the opening of an abscess in the axilla. In Co^TQg. 

fol. 268b is seen a clinical visit to children, and on fol. i*58al 

and fol. 295b naked pregnant women are represented!* ,. 

* Cf. also Cod. Galeni No. 92, fol. 7b, 17b, 43a, 75b, 121a, 128a, 208a, 224a. 1 

No. 93, fol. 458a, 471b, 475b, 482b, 496a, 504a, 535b, 560b.


In Montpellier, where a hospital existed as early as the 

year 1198, it was usual for the students of medicine, after 

obtaining the bachelor's degree, to practise medicine under 

the guidance of an experienced physician. ASTRUC* brings 

forward several instances in the biographies of the earlier 

teachers of medicine at the school of Montpellier, where this 

system was observed and by no means looks upon them: as 

exceptions but as the general rule. The medical faculty of 

Paris in 1449 required of the bachelors that they should 

diligently visit the hospitals or accompany a skilful practitioner 

in his visits to patients and refused to grant them 

the license when this rule was not observed.f 

In the oldest statutes of the medical faculty of Vienna 

dating from the 14th century the rule is laid down that 

bachelors of medicine must practise the healing art within 

the walls of Vienna only with the knowledge and under the 

guidance of their teacher or of some other doctor of the 

fatuity of Vienna.J STEINPEIS gave the students excellent 

tîce as to how they should act on these occasions.§ 

o>ve all things, he says, it is important to find out the 

cause,of the disease ; then the ailing part of the body may 

be carefully inspected and finally the rest of the body submitted 

to a careful examination. 

At the university of Ingolstadt the bachelors of medicine, 

according to the statutes of 1472, were obliged to take an 

oath before the Dean that within the city and for six miles 

round they would visit the sick and practise only if sent as 

* ASTRUC op. cit. p. 236 (apres son baccalaureat it alia en Provence pour y 

exercer la medecine, suivant Vusage de ce temps-la), p. 243 (apres quoi it alia 

passer le temps, qu'il eloit alors destine pour s'exercer a. la pratique apres le 

baccalauriat), etc.— Cf. PLATTER op. cit. S. 154.—In the statutes of 1240 is 

fjpîd : Item nullus magisler presenlet aliquem (for the License) nisi We 

itekarit in practica extra villam Montispessulani per dimidium annum (in 

G^R^'AIN op. cit. iii, 424). 

:. t HAZON: Eloge historique de la faculte' de medecine de Paris, 1770, p. 20 

(qu'ils suivissent les hopitaux ou la pratique de quelque maitre pendant le cours 

de la licence, faule de quoi its n'etoient point admis a ce degre). 

\ J. ZEISL: Chronol. dipl. universit. Vindob. Vienn. 1755, Statut. p. 80. 

§ STAINPEI-S op. tit. f. 102b et seq.


the representatives of their teacher or of some other doctor > 

of the faculty of that place* They thus performed nearly 

the same functions as practitioners of our day at the poli- 

clinical institutions of many academies. 

In the middle ages there was no lack of hospitals in which fi| 

bachelors of medicine could find opportunities for acquiring, ^J 

practical education in the healing art. The great number of v 

these institutions must excite in us the more astonishment' 

inasmuch as only a certain proportion of them is known to us* 

The information which has reached us concerning them is in- 

complete and defective. So much of it as refers to Germany, 

or as deals with leper-houses has been collected by VlR- 

CHOW.t Besides this, rich material lies scattered in archives 

and libraries: many sources of knowledge are probably as 

yet undiscovered. It would be a thankworthy task, to write 

a history of the foundation and development of hospitals in 

the middle ages, and would cast many a ray of light upon 

the history of medicine and the general history of civiliza 

tion. Christianity had called into existence a number*of 

charitable institutions, as I have explained on a previous 

page. Wherever its doctrines were made known and found 

adherents, houses for the poor and infirm of all kinds arose 

by the side of churches and monasteries. The Christian 

missionaries, who travelled from Italy and France to the 

countries of Northern and Eastern Europe were carriers of | 

civilization, preaching humanity and spreading knowledge*f| 

—at least in so far as it did not come into conflict with 

their own interests. Christian charity celebrated imperish 

able triumphs in founding numerous clerical and lay Orders 

the members of which made the care of the sick the task of 

their lives. An enthusiasm of philanthropy filled all hearts • 

in a way seen but once in the history of the world. High 

born princesses and poor peasants, knights and burghers vied 1 

* C. PRANTL : Geschichte der Ludwig Maximilians-Universitat zu Ingolj?|| 

stadt, Landshut, Miinchen 1872, i, 50. ii, 43. 

f VIRCHOW'S Archiv.»Bd*i8, S, I38r(l62>, 273-329.—Bd. 19, S. 43-93,-Bd. 

20., S. 166-197, 459-51 2 ' ,'C s


with one another in works of mercy. It is quite possible 

that many were induced to consecrate their lives to the 

service of mankind, not so much by ideal love as by hopes 

of reward in the world to come, and other less noble influences; 

but is this a reason why their good deeds should 

have conferred fewer blessings ? The longing and striving 

after ideals, which men, discontented with the present 

believed to be realized in the supersensuous world of the' 

future, had an ennobling effect upon character, tempered 

harshness of manner and threw a charm round many an 

undertaking which otherwise might have seemed foolish or 

despicable. This feature of romance was peculiarly impressed 

on the aspect of the Crusades, in which a wild 

craving for adventures and low covetousness were associated 

with piety and simple faith. Even if the particular 

object of these military expeditions was not, or only tem 

porarily, attained,—the object namely of emancipating from 

the Muhammedan dominion that land, once the cradle of 

Christianity,—yet many results advantageous to the development 

of civilization accrued therefrom; for by means of 

, these wars commercial relations were opened up between 

the Orient and the Occident, the intellectual horizon of 

Europe was enlarged, and the feeling of mutual dependence 

was awakened among the Christians in their intercourse 

with people professing another faith. This feeling manifested 

itself in the foundation of hospitals and of Orders and 

united people differing in creed in a common work for the 

welfare of the sick. 

The large hospital which the Knights of St. John possessed 

in the 12th century in Jerusalem was able to accommodate 

2,000 patients. It consisted of numerous buildings supported 

by 124 marble columns as we are informed by the Knight 

Sir JOHN MANDEVILLE. Five physicians and three surgeons, 

who were appointed to this hospital, took charge of 

the medical service* In 1236 the Order possessed 4,000 

lodges which were distributed over the different countries 

* F. v. RAUMER : .Geschichte der Hohenstaufen, Leipzig 1858, vi, 439.

258 


of Christendom; but only a century later Pope CLEMENT 

VI complained that the distinguished Knights of the Order 

took more pleasure in beautiful horses and dogs, in banquets, 

fine clothes, gold and silver vessels and valuables of all 

kinds, and generally in the accumulation of riches than in 

the care of the sick and the giving of alms* 

The German Order also, having erected a large number 

of hospitals, disregarded, after the 14th century, more and 

more the care of the sick and preferred gaining political 

power by conquests in war. 

The Order of the Lazarists, which arose in Palestine and 

undertook the task of attending to the wants of lepers, 

founded a multitude of leper-houses.t When leprosy, as 

the result of improvements in hygiene and a more correct, 

diagnosis of the various ailments which people had up to 

that time included under the name, gradually diminished 

and become wholly extinct in certain countries- as early as 

the 16th century, the Knights of St. Lazarus felt themselves 

excused from their duty of nursing the sick. 

The civil societies for the care of the sick attached themselves 

more loyally to this task, even if some of these too 

degenerated at a later period. 

The Order of the Holy Ghost was a creation of Pope 

INNOCENT III., who had formed it as an instrument for -fl 

enabling him to bestow upon sick-nursing an organization j 

embracing the whole of Christendom.% As VlRCHOW says, it , 

must needs impress us favourably and may help, at the same | 

time, to reconcile us to " this strong man who humbled the | 

Emperor and deposed kings; the unappeasable persecutor ; 

of the Albigenses," to note that he " yet looked mercifully 

upon the poor and the sick, and sought out the helpless , 

and miserable." § The Order of the Holy Ghost is first 

* J. TAAFFE: The history of the holy military sovereign order of St. JOHN 

of Jerusalem, London 1852, ad ann. 1343. 

•j- F. v. RAUMER op. cit. vi, 534. 

t HURTER: Geschichte des Pabstes InnocenzIII., Hamburg 1842. 

§ VIRCHOW : Gesammelte Abhandlungen, Berlin 1879, ii, S. 24.'


mentioned in a document of the year 1198 ; already at that 

time lt possessed two hospitals in Rome, one in Montpellier 

and seven others elsewhere in France. In 1204 the 

Hospital of the Holy Spirit, built by INNOCENT III was 

consecrated at Rome; the site on which it was erected is 

said to have borne the old Saxon Hospice at so remote a 

time as the 6th century under Pope SYMMACHUS * The 

Order of the Holy Ghost displayed extraordinary activity 

Even soon after its origin it erected hospitals at various 

places, as, for example, at Zurich, Halberstadt, Vienna 

Spandau, Breslau, Riga, Liibeck, Bremen, and Hamburg 

or undertook the direction of those, which previously 

existed as at Memmingen, Freiburg-im-Brisgau, Mainz, and 

Ulm. VlRCHOW has collected information concerning 1,4 

.hospitals of this Order in Germany, which, with a few 

exceptions, were founded in the 13th and 14th centuries f 

There existed, besides, many other hospitals conducted by 

other societies for nursing the sick. 

The foundation of charitable institutions followed the 

path taken by advancing civilization in Europe Italy 

France, Southern and Western Germany took the lead and 

the Northern and Eastern countries of our continent 

followed them. In order to form an opinion on this movement 

and its results in particular cases, it is best to fix one's 

eyes on a limited district. Thtiringen, Saxony, Brandenburg 

Pomerania, and Silesia-those countries, in fact 

which at that time formed approximately the boundaries of 

civilization-were, as early as in the 13th century, richly 

provided with hospitals and leper-houses ;J even small 

places, the names of which are scarcely mentioned in 

history, possessed institutions of this kind. In Silesia we 

hnd them in the following towns at the dates given — 

Breslau (1214), Kloster-Trebnitz, Neisse (1226), Neumarkt 

* C L. MORICHINI: Degli istituti di carita, Roma 1870 p QO-rn., 

vius: Geschichte der Stadt Rom im Mittela.ter, Stuttgart^ f 4 6 ^ " ° ' 

f VIRCHOW op. cit. ii, 45 et seql 

4 '' 

X VIRCHOW'S Archiv, Bd. ,8, S. 150 H seq., 275 et seq., 3IO H seq, fc

260 


(1334), Bunzlau (1261), Brieg .(1273), Glatz (1275), 

Miinsterberg (1276), Liegnitz (ia8o), Sagan (1283) Steuum 

(I29o), Ratibor (1295), G, Glogau (1296), Gorhtz (1298 , 

Sprottau and Schweidnitz (1299), Beuthen (1302), Oels 

(l P 3o7), Frankenstein (1319), Freistadt 1320) Lowenberg 

1322 Leubus (1330), Strehlen (1347), Goldberg (1348), 

etc Certainly the references made to these are incomplete • 

and unprecise, but they give us a picture of the abundant 

preparation which had been made for the care of the sick. * 

It may be fairly assumed that in countries the civilization 

of which was older and of more advanced development, and | 

the wealth of which was greater, the arrangements made 

were certainly not worse, but probably better. Frankfort- J 

on-the-Main possessed in the 13th century three or four 

hospitals* The Katharinen-Hospital at Regensburg, | 

erected for the sick and infirm, had 250 patients m the , 

middle of the 13th .century. Such a number formed 

certainly an exception at that time, for most of the hospitals, 

were small, and could take in only a few persons The, 

directors of the Regensburg institution drew attention to 

the fact that it was over-crowded, and that as a result he 

air was polluted and diseases were communicated to the 

healthy The extent to which want of cleanliness and 

unsanitary conditions prevailed in the 15th century at 

certain hospitals is indicated by the severe remarks which 

THOMAS PLATTER made concerning his sojourn in the 

hospital at Breslau.t , . j 

As yet, unfortunately, but little investigation has beenf 

made to what extent and in what way the hospitals 0 

the middle ages approached the subject of teaching medical , 

students and young doctors. The erection of institutions j 

for the sick in many places was effected before the settle- -, 

ment in such places of scientifically trained doctors. bicK .- 

nursing thus generally precedes medical treatment. 

* G L KRIEGK : Deutsches Burgerthum im Mittelalter, Frankfurt a M. 

J868, i, S. 76 et seq.-W. STRICKER : Geschichte der Heilkunde in Frankfurt, 

**•» a. M. 1847, S. 129. ,gj^ 

•j- PLATTER op. cit. S. 22. * ;vy

MEDICAL EXAMINATIONS. 26l 

MEDICAL EXAMINATIONS. 

THE medical examinations, which students of medicine 

had to pass, before being permitted to practise, had their 

prototype in the arrangements made by the Emperor 

FREDERICK II. at Salerno. In course of time however the 

place of the single examination, occurring at the conclusion 

of the studies, was taken by examinations for the degree 

of Bachelor, for the license, and for the degree of Magister 

or of Doctor. These academical degrees were apparently 

first introduced at Bologna and Paris. In Salerno and 

Naples they were instituted by CHARLES of Anjou in 1278 

and 1280, as appears from the documents cited by S. DE 

RENZI* All candidates for the degree of bachelor of 

medicine, were obliged to have attended medical lectures 

for two or three years and then to give proofs in an oral 

examination held before members of the medical faculty 

That they had acquired a general theoretical knowledge 

of the several branches of medical science. By a 

solemn act, the ''determination," in which the candidate 

discussed a scientific question which had been propounded 

to him, he was transferred from the class of the scholars 

into that of the " baccalarii " as they were called in the 

corrupt Latin of the middle ages. The word is by some 

commentators, associated with baculum, a stick, which is 

said to have been handed to the bachelors presumably as a 

token of their new dignity, f It may with greater prob 

ability be derived from bacca lauri: it recalls the crowning of 

poets with the laurel-wreath, of which mention is made in the 

history of the middle ages. After an interval of two or 

three years, which the candidate made use of to acquire 

more extensive education in his department of learning and 

especially practical training, the examinations which pre 

ceded the conferring of the license followed the bachelor's 

* S. DE RENZI : Storia docum. della scuola med. di Salerno, Doc. No 28*7 

291. ' " 

t DE RENZI :%>ria docum. della scuola med. di Salerno, p. 556.


degree. Before granting this it was required that the 

bachelor besides having attended lectures should have 

taken part in discussions, and should have been catechized 

by the professors on more than one occasion, should have 

given lectures himself, have assisted at anatomical demonstrations 

and have thoroughly trained himself in the 

practical art of healing. The examinations were moreover 

held by the medical faculty and consisted of the exposition 

of one of the aphorisms of HIPPOKRATES, the description , 

of certain diseases and the answering of questions connected 

with these subjects. If the result was favourable,J 

the candidate was presented by two members of the 

faculty to the Chancellor of the University, who conferred 

the license upon him in a solemn manner. 

,. As the dignity of Chancellor was always vested in a high 

ecclesiastic who looked upon himself as the representative 

Of the Pope, the highest patron of teaching, it resulted that. 

this act took place in the Church. It bore therefore some-,. 

what of a religious character, which excluded members of 

other faiths, as for example Jews, from obtaining the license: 

but even at a very early period a way out of this difficulty 

seems to have been found, the granting of the license in 

such cases being transferred to the faculty* _ The doctors, 

who had in the examinations shown their fitness for 

medical practice and had received permission to practise, 

were called Masters or Magistri. 

After the title of Doctor had become usual among the 

jurists at Bologna t and had found entrance into all schools 

of law, the medical faculties began also to make use 

of it. The word "Doctor" occurs even in the litera 

ture of antiquity J and there indicates a teacher ( fron > 

docere). In this sense the title of Doctor was given also| 

i 

* DE RENZI op. cit. p. 558, 572. ., * 

t SAVIGNY op. cit. i, 476.—GRUNER'S Almanach fur Arzte, Jena 1789, b. | 

• 250 et seq. jj 

X CICERO : de orat. i, 19.—SUETON.: Caesar c. 42.—Valer. Maxim, n, 3--P 

QUINTILIAN : Instit.orat. xi, 3, xii, 2.—ERSQH and GRU&ER: Encyklop. sect. I, ; 

i Th.2-s,S.23fetseq. "*•

MEDICAL EXAMINATIONS. 263 

by the medical faculty to those who were actively engaged 

as teachers of medical science. This was the case at most 

of the academies as early as the 13th century. And as 

the right to teach was possessed by every medical man who 

was legally qualified for the practice of his profession, so 

also was the title of Doctor gradually conferred upon all 

legally qualified practitioners. When people began to 

distinguish between the Doctores legentes et non legentes, 

—between those who made a practice of teaching and 

those who neglected to do so—the custom arose of calling 

the former Professors. 

This expression also draws its origin from ancient times;* 

it comes from profiten "to practise or teach publicly an art 

or science." At the German universities the title "Professor" 

came first into vogue in the 16th century and only 

those academical teachers were designated by it who were 

commissioned to hold lectures and for the instruction they 

imparted in this way drew a salary or remuneration. They 

were in fact members of the College of Teachers, called, 

at an earlier time, Doctores legentes. 

The change in the significance of titles and forms of 

politeness, which is effected in course of time, has its 

foundation for the most part in human vanity. At the 

present time it is the case with the title of Professor as it 

formerly was with that of Doctor; it is bestowed on 

members of the medical profession who hold themselves 

quite aloof from the function of teaching, whereas many 

academic teachers are already less inclined to bea.r the 

title of Professor than such titles as Geheimrath, Hofrath, 

or Regierungsrath. 

Anyone who possessed a qualification to practise 

medicine could obtain the dignity of Doctor of Medicine. 

No special examinations were necessary for this ; on the 

other hand it was demanded that the candidate should be 

* CELSUS: Prsef. and ii, 6.—SUETON : Rhetor. 5.—QUINTIUAN : Inst. orat. 

Prooem, and i, 9. xii, 11.—SAVIGNY op. cit. i, 396.—H. CONRING: Antiq. 

acad. i, 24. - , >


of honourable and legitimate descent, of irreproachable 

character and respectability, at least 26 years old, without 

bodily defect or deformity. In some universities the age 

was fixed at 28 years, and a concession in respect of 

age was only allowed if the candidate did not look too 

effeminate and young. Persons who were misshapen or 

repulsively ugly were not allowed to take this degree, 

and, truly, for a singular reason, namely lest pregnant 

women seeing them might bear children with marks to 

correspond. 

The act of promotion was associated with a public discussion 

and various ceremonies which were intended to 

typify the acceptance of-the candidate into the medical. 

corporation, and to bring plainly before his eyes the high' 

significance of his new dignity. The ceremony was performed 

with the co-operation of the whole faculty, and 

amid the ringing of bells. It began with a discourse by 

the candidate for the doctor's degree, the merits of which 

were reviewed in a speech by the professor, who conducted 

the proceedings. The candidate then took an oath that he 

would always fulfil his duties to the faculty and the 

medical profession generally; hereupon the so-called ? 

' doctor's hat' was placed upon his head, a ring put on his * 

finger as a token of the knightly rank, to which the dignity j 

of doctor was considered equivalent, a golden belt fastened | 

on him, and a book of HIPPOKRATES opened before him. He | 

was then invited to sit down by the side of the President, j 

who, embracing him, conferred a blessing upon him. The 

ceremony closed with the thanks of the new doctor, andfj 

was followed by a banquet in which all members of the ] 

faculty took part. The expenses of this, in addition to . 

the fees which were paid and the presents which were i 

given to various persons, made the promotion to the degree , 

of doctor a rather costly affair. In Vienna the candidate! 

was under the obligation of presenting one doctor of 

the medical faculty with a complete attire ; 14 ells of good 

cloth had to be used for this. For the rest, he was by no j

MEDICAL EXAMINATIONS. 

means forbidden to gratify several of his colleagues in this 

way. Moreover, every doctor of the faculty received a 

cap and a pair of woven gloves, every licentiate and 

bachelor a pair of ordinary gloves "in choosing which, 

however, the reputation and honour of the faculty are to 

be respected." * 

Similar demands were made at other universities. The 

expenses caused by the promotion to the higher degree in 

Paris reached the largest amount. Poor candidates for the 

Doctorate, if distinguished for their learning, were 

exceptionally excused the high charges and at certain 

academies this practice was carried out regularly at stated 

intervals, t Many were repelled by the charges connected 

with promotion from taking it, and were content to practise 

medicine as licentiates. The latter enjoyed in respect of 

medical practice the same rights as the doctors. The only 

difference between them consisted in this, that the doctors 

were accredited members of the faculty in the enjoyment of 

full rights, consulted together upon the business matters con 

nected with it, determined its laws, and shared in certain 

privileges. It was a characteristic feature of the Studium 

generate that the degree of doctor was of recognized value 

'in all countries of Christendom. It is true, that even in 

earlier times some limitations were imposed on this 

privilege; they, however, restricted not so much the 

right of practising medicine as a calling, in any and 

every locality, as they did the claim of an alien doctor 

to be received as a member enjoying full rights in the 

medical faculty of a university not his own. The faculties 

saw in promotion an important source of income, which 

was encroached upon if doctors who had received the 

higher degree in a foreign academy were without any 

further ceremony regarded as members of their own. 

Thus the doctors of Bologna in 1298 refused to receive a 

colleague—the son of a citizen of that town—into their 

* ROSAS op. cit. i, S. 35.—HAUTZ op. tit. i, 160. 

t COPPI op. cit. p. 204.


own society, because he had taken the degree of Doctor of 

Medicine in Salerno and was not yet 30 years old. He 

answered with some self-importance that he made up for 

the scarcity of his years by the abundance of his know- - ?| 

ledge* Between Paris and Montpellier continual quarrels j 

of this kind prevailed and such also was the case with other 

high schools. An end was only put to this state of things 

when it was arranged that doctors seeking admission into a ; 

faculty other than the one at which they had taken their • 

academical degree, should pass certain examinations, which | 

were for the main part mere formalities, and pay the ; 

regulated fees. Thus the medical men entitled to practise, 

who had received their theoretical education at the | 

universities, were divided into doctors and licentiates and 

were distinguished from one another not by attainments,lj 

but only by title. 

SURGERY AND MIDWIFERY. 

I 

IN the practice of their profession doctors were divided into | 

two classes, viz., those who dealt chiefly with internal, and 

those who preferred to treat, external diseases. The separa|j 

tion of surgery from internal medicine existed, as has been J 

explained on an earlier page, even in ancient times. This 

separation may therefore have been maintained also during 

the first centuries of the middle ages, without at the same 

time any absolute divorce existing between the representatives 

of the two branches. Being each equal to the 

other in the knowledge and skill required for practising 

them, so certainly they may have enjoyed in social life: 

an equal degree of respect. In the curriculum of study 

arranged by the Emperor FREDERICK II., the interdependence 

of these two branches of the healing art was prominently 

set forth and the medical schools of Salerno and; 

Montpellier gave due attention to surgery in their scheme of 

teaching and educated both categories of doctors. People 

MEINERS : Geschichte der hohen Schulen, Bd.ii, S. 267.

SURGERY AND MIDWIFERY. 267 

distinguished medical men as medici physici and medici 

chirurgi and by this probably wished to indicate that both 

classes possessed an equivalent technical education. The 

title physici was also used in the place of medici. Unfortunately, 

at a later period, most universities, following the 

example of Paris, neglected teaching in practical medicine 

and especially in surgery. Since at the same time the 

practice of surgery was' forbidden to the doctors who 

belonged to the priestly calling, the need of a class of 

practitioners, especially devoting their attention to the treatment 

of wounds, became very manifest. To this was added 

the fact that the wars and standing feuds between small 

territorial lords, the Crusades, and especially the great 

pestilences which devastated countries in the middle ages, 

afforded the proof that the doctors at hand were neither 

in numbers nor knowledge equal to the requirements. These 

circumstances favoured the formation of a surgical profession, 

which really only in the 13th century assumed a 

decided shape.* It was composed of doctors and licentiates 

of medicine, who had strongly pronounced inclinations 

or gifts for surgery, of practitioners to whom the 

acquisition of an academical degree was denied on religious 

or social grounds and of a multitude of empirics who had 

acquired a remarkable dexterity in the treatment of surgical 

ailments. Concealed in its ranks were individuals of widelyvarying 

scientific attainments. 

The surgeons of Italy and France as a general rule stood 

on an equal footing with the physicians of their native 

countries, respectively. They attended for some time the 

lectures at the university f and acquired a general scientific 

and practical training, which answered the requirements of 

the time. Many had at the same time the right of treating 

internal diseases and distinguished themselves in this branch 

as much as in surgery. The names of HUGO and THEO- 

* A. CHIAPELLI : Studii sull' esercizio della medicina in Italia negli ultimi 

tre secoli del medio evo, Milano 1885, p. 5. 

f COPPI op. cit. p. 199.

,268 THE MIDDLE AGES. 

DORICO BORGOGNONI, BRUNUS LONGOBURGENSIS, GULIEL- 

MUS DE SALICETO, LANFRANCHI, HENRI DE MONDEVILLE, 1 

GUIDO DE CAULIACO, PETER of Argelata, MARCELLO j 

CUMANO, L. BERTAPAGLIA and others belong to the most ] 

distinguished which the surgical literature of that time or • 

the history of medicine in general can show. 

The surgeons of Paris as early as about the middle of , 

the 13th century formed a society, organized after the 

pattern of the medical faculty. It was named St. C6me 

after ST. COSMAS who was chosen for its patron saint.| 

The members of this society held meetings regularly atwhich 

they discussed business connected with the pro- j 

fession and the teaching of it, and imparted to their pupils \ 

instruction in their art. The teaching was apparently for" 

the most part of a practical nature, the pupils accompanying 

their instructors in their visits to the sick, and there^ 

learning the technical details of surgery. LANFRANCHI,-j 

who taught at the college of St. Come, performed opera-.| 

tions in the presence of his pupils and received their.| 

assistance in them. The pupils also assisted in the public , 

and gratuitous relief of the sick which the members of J 

the college presided over, and visited the hospitals where 

their teachers held appointments. Certain of the pupils 

probably executed there the duties now performed by our 1 

sick-attendants and male-nurses. Besides this, they werefj 

admitted to anatomical demonstrations, if an opportunity : j{ 

for such occurred. The students had, at the conclusion of : 

their studies, to undergo an examination, and as early as the j 

year 1254 the surgeons requested that examiners should be | 

appointed for this purpose. k 

An edict of PHILIP LE BEL of the year 1311 ordained j 

that nobody should engage in the practice of surgery whb| 

was not considered competent by the masters, and had? 

received a license permitting him to practise from thej 

king's body-surgeon.* Afterwards the students of surgery 

were obliged to take the degree of Magister Artium atthe^ 

* BUCHEZ: De la faculte de meM. de Paris, op. cit. 1822.


university, and to attend some lectures of the medical 

faculty. 

In the year 1416 the College de St. Come was incor 

porated as a separate faculty of the university of Paris. Its 

pupils thus obtained a scientific education which was in no 

way inferior to that of the physicians. In spite of this 

they were not regarded as equal to them in social position. 

This tendency to place the surgical profession in the 

background, which was first apparent in Paris, originated 

partly in the already-mentioned circumstance that the 

clergy—who laid claim at that time to the highest position 

in social life —kept themselves aloof from it, partly in the 

fact that many uneducated people of the lower class were 

associated with the surgeons, but above all was the result 

of petty jealousies and quarrels with the medical faculty, 

which asserted an unwarrantable claim to a superiority in 

scientific attainments. The struggle between the physicians 

and surgeons continued until the beginning of the 18th 

century, and was prosecuted with a bitterness which 

resulted in deplorable excesses on both sides. The medical 

faculty of Paris in the year 1350 made it obligatory on its 

members and students to abstain from the practice of surgery 

and expelled those who contravened this prohibition* 

Finding too little humility and subjection among the sur 

geons, the faculty in 1372 brought to effect their design of 

giving barbers the right not only of letting blood but also of 

practising all so-called minor surgery—of treating ulcers 

and wounds, so long as they were not dangerous to life. 

And, indeed, the want may have arisen of a class of 

assistants to stand at the service of the physicians of that 

time, for the purpose of performing those minor services of 

surgery in almost daily request; for the specialists for 

wounds who had technical training were few in number and 

consequently much occupied. By these arrangements the 

boundary between the surgeons and the barbers, at no time, 

probably, insurmountable, was still further broken down. 

* A. F. THERY : Histoire de l'education en France, Paris 1858.

270 


The medical faculty of Paris endeavoured to render it easier I 

for the latter to become trained surgeons by inaugurating I 

lectures for them in 1491, which were delivered in the 

French language, and dealt with the various parts of surgery | 

and the art of operating* In fact, out of the condition of * 

barbers there arose a great number of surgeons, some of « 

whom by the introduction of improvements have rendered 

imperishable services to the healing art. 

In the other countries of Christian Europe surgery was in 

a more debased condition than in Italy and France. If the ; 

' "i 

Netherlander, JEHAN YPERMAN, in the 13th, and the English- \ 

man, JOHN ARDERN, in the 14th 'century, far excelled in 

knowledge their colleagues in their respective countries, 

they owed this entirely to the circumstance that they had ,' 

received their technical education in France. In Spain only 

do more favourable conditions appear to have prevailed ' 

for some time. In Saragossa the doctors were examined 

in surgery, and received the title of Medico-Surgeons; an 

arrangement which was not abolished until 1585^ 

What kind of practitioners practised surgery in Germany, 

certain facts which are reported as having occurred at the 

end of the 12th century sufficiently indicate. When the 

Margrave DEDO VON ROCHLITZ UND GROIX had to accompany 

the Emperor HENRY VI., in 1190, to Italy, he feared 

the hot climate and the fatigues of the journey on account 

of his corpulence ; he summoned a doctor who straightway! 

laid open his body in order to extract the fat. It is notsur-| 

prising that the Margrave sank under this singular operation.J ; 

In 1195 LEOPOLD V., Duke of Austria, broke his leg through 

a fall from his horse, and in such a way that the broken ends 

of the bone protruded through the skin. His doctors treated 

him with plasters and medicines until mortification set in.; 

They refused to submit the limb to amputation, although;' 

* HAZON : op. cit. 

t V. DE LA FUENTE: op. cit. ii., p. 479. 

X Chron. mont. seren, ed. ECKSTEIN in the Progr. d. latein. Hauptschule zu 

Halle, Halle 1844, p. 53.


the patient desired it. One of his servants at last performed 

the operation, but the result, as might have been expected, 

was- unfavourable. The duke died on the following day* 

Temerity and cowardice, the offspring of ignorance, were 

the peculiarities which distinguished the great majority of 

the German surgeons of that time. Even the Biindth- 

Erzney of the German knight, HEINRICH VON PFOLSPRUNDT, 

the most prominent surgeon produced by the Fatherland in 

the 15th century, cannot be compared with the surgical 

works of the Italians and French; for it was really nothing 

more than an introduction to bandaging and to the treatment 

of wounds and external injuries. 

In no country was surgery during the middle ages able 

to rise to the height it attained in ancient times. We certainly 

find in the writings of certain surgeons remarks 

which display a correct knowledge of the tasks of surgery, 

an excellent gift of observation and a rich experience, but 

the keynote of these works was that intellectual feebleness 

which characterized the whole age. T. BORGOGNONI 

recommended a treatment of as simple a "kind as possible 

and referred to healing per primam (by first intention).f 

Among the methods of arresting haemorrhage, ligature was 

mentioned by LANFRANCHI and others. LANFRANCHI 

endeavoured to advance the diagnosis of fractures of the 

skull and confined the operation of trephining to those 

cases in which the brain was implicated in consequence of 

depressed fragments. J GuiDO DE CAULIACO (Gui de Chauliac) 

wrote that the wounded man on holding a metal rod 

between his teeth and touching it feels a pain in the skull at 

the situation of the fracture. He also gave the precise indications 

for trephining and described the operation.§ He 

avoided amputation : if mortification invaded an extremity, 

* WILLIAM OF NEWBURGH: Hist. rer. Angl. lib. v., c. 8, in Rer. brit. med. 

aevi script., Vol. 82, Pt. 2, p. 432 et seq., London 1885. 

t Chirurg. ii, c. 27. 

X LANFRANCHI : Chir. parva, c. 7. 

§ G. DE CAULIAC: Ars chirurg. tr. iii, doctr. 2, cap. 1, Venet. 1546.

272 l ric ;c...,c,.. ... 

he Waited until aline of demarcation was formed at the next j 

'joint and the mortified part separated itself from the limb of'l 

its own accord* In the treatment of fracture of the thigh.1 

he employed long-continued extension of the limb which he 

sought to effect by means of a weight suspended to a cord 

which ran over rollers.t The bandages which were used to 

apply to broken extremities were smeared with white of,, 

egg which after coagulating gave fixation—of a kind—to',-1 

the limb.J The cesophagus-tube was known and was 

used for artificial feeding.§ Fistulae were enlarged by 

gentian root or converted by the knife into open wounds.|| 

In the operation for rectal fistula JOHN ARDERN enjoyed a 

great reputation.^ Ruptures were treated by long-continued 

lying on the back or by trusses.** Herniology 

underwent essential improvement at the hands of GuiDO 

DE CAUL1ACO who distinguished the various forms of 

* hernia according V the outlet involved, and separated! 

varicocele, hydrocele and sarcocele from hernia of every, 

kind.tt Endeavours were made to effect the radical cure by 

cauterizing the outlets after the replacement of the pro. 

lapsed intestine. The removal of the testis which was 

resorted to in scrotal hernia was only undertaken by the, 

wandering empirics: .Even lithotomy, which was performed! 

after the method of CELSUS, lay in the hands of specialists j 

of this kind. In strictures of the urethra bougies of wax, 

tin or silver were employed. In diseases of the bladder^ 

and in gonorrhoea JOHN ARDERN ordered injections^ Cer^l 

tain descriptions of ulcers and gangrenous destruction of| 

* Id. op. cit. tr. vi, d." I, c. 8. j 

+ Id. op. cit. tr. v, d. i, c. 7 (adpedem ligo pondus plumbo transeundo ckordam^ 

super parvam polfgeam'; itaque tenebit tibiam in sua longitudine.) 

X Id. op. cit.tr. v, d. i, c. i. 

§ M. C. BROEKX : La Chirurgie de M. J. YPERMAN in the Annal. de 1 acad. 

d'arche'ol. de Belgique, Anvers 1863, p. 128-326. 

|| G. DF. CAULIAC op. cit. tract, iv, d. 1, c. 5. 

If A. GORE in the Dublin Journal of Medical Science, 1883, p. 269 et seq. ' | 

** BROEKX : YPERMAN op. cit., p. 178. 

tt G. DE CAULIAC op. cit. tr. vi, d. 2, c. 6, 7.—E. ALBERT : Die Herniologie'd. 

Alten, S. 161 et seq.


4 the sexual organs refer most probably to syphilis and 

-Venereal affections. The story that. YPERMAN healed 

numerous " leprous '.' persons with a mercurial ointment 

throws a strong light on the more ancient history of syphilis, 

as to ,which it was erroneously assumed for a long, time 

that it came into general prevalence only at the end of 

the 15th century* Indeed this remedy was then generally 

used for ulcers and skin diseases.t GuiDO DE CAULIACO 

advised that intractable ulcers should be treated by laying 

on them a plate of lead on which mercury had been rubbed. 

In carcinoma he recommended the actual cautery and 

sublimated arsenic! 

.Surgery gained an important advantage by the revival of 

plastic operations which, as has been stated previously, were 

known in ancient times. At Norcia and Preci in Calabria the 

members of several families gave constant attention to the 

1 " performance of particular surgical operations for instance 

herniotomy, lithotomy, the operations for cataract, etc. 

Here arose the -first knowledge of the rhinoplastic operation. 

The surgeon BRANCA, who practised at Catania in 

Sicily at the commencement of the 15th century, excited 

a legitimate astonishment by the art with which he 

.replaced lost noses and lips by adaptation of neighbouring 

parts of the skin of the face.§ His son ANTONIO, also, 

possessed considerable skill in the same art; but, afterwards, 

instead" of the skin of the face a suitable portion of 

the skin of the arm was used to replace the loss of sub- 

, Stance. This, procedure came by degrees to be known 

among surgeons and even reached Germany, as is clear 

t from PFOLSPRUNDT'S book. 

Mention must not be omitted of the fact that already at 

* BROEKX: YPERMAN op. cit. p. 145. 

f Annals of Waverley in ALF. CORRADI: Nuovi documenti per la storia' 

delle malattie veneree in Ann. univ. di med. Milano 1884, vol. 269, p. 289. 

X G. DE CAULIAC. : op. cit. tr. iv, doctr. 2, c. 6. 

BARTH. FACIUS: Devirisillustr. Florent. 1745^.38.—E. ZEIS: Geschichte 

der plast.. Chirurgie, Leipzig 1863, S. 188 et seq. 

T

274 


this time anaesthetic inhalations were made use of in great j 

surgical operations. They are mentioned first in the Antidotarium 

of NlCOLAUS PROPOSITUS; for this purpose a 

new sponge was used, which having been saturated with 

solutions of narcotic substances, for instance, opium, hyoscyamus, 

etc., was dried in the sun and before use was placed 

in hot water; it was then held to the nose of the patient j 

when the rising vapours reduced him to a condition of 

stupefaction and unconsciousness of pain.* 

The-treatment of diseases of the eyes lay for the most 

part in the hands of empirics who attempted by ointments 

and medicaments to effect their cure. The best ophthalmic ^ 

surgeons belonged, as A. BENEDETTI says, to the Eastjf 

from thence BENVENUTUS GRAPHEUS and others came to 

Europe and by their art achieved great success. The 

operation for cataract was carried out by depression of 

the affected lens as in ancient times : GUIDO DE CAULIACO 

says that, in order to prevent it rising again the lens should ; 

be held down during the recital of three paternosters or 

one miserere.% 

In the middle ages it fared even worse with midwifery 

than it did with ophthalmic practice. The doctors who 

belonged to the priesthood, did not venture to engage in it, j 

that they might be preserved from undue familiarity with ; 

women, and other practitioners did not concern themselves 

with it. Ignorance, idleness, and other causes prevented-\ 

the doctors from practising midwifery. They were called 

to parturient women only when it was a question of removing 

a dead foetus from the uterus or of extracting a 

retained placenta. Medical interference was as a general 

rule limited to these two tasks, in this province. GuiDtij 

DE CAULIACO says in his work upon surgery that he is 

unwilling to dwell at length upon midwifery, seeing that as 

* G. DE CAULIAC.: Chirurg., tr. i, doct. i, c. 8.—A. CORRADI : Escursioni 

d'un medico nel Decamerone, inAtti dell'istituto Lombardo, 1878, p. 127 etseq. 

•(• A. HIRSCH : Geschichte der Augenheilkunde op. cit. S. 295. 

J G. DE CAULIAC op. cit. Ir. vi, doctr. 2, c. 2.


a rule it is practised by women. It is true that in the work 

on natural science by THOMAS CANTIMPRATENSIS and in 

the Breviarium attributed, perhaps incorrectly, to ARNALDUS 

DE VlLLANOVA, allusion is made to turning by the head 

and feet,* and GUY also speaks of the conversion of an 

abnormal presentation into a normal one ; but it is impossible 

to decide how far these remarks rest upon literary 

reminiscences or how far they are the result of private 

experience. If the mother died before delivery Cesarean 

.section was performed in order if possible to save the life 

of the child. In certain cases the operation was even performed 

during the mother's life. The bishop PAUL of 

Merida, celebrated for his medical skill, who lived as 

early as in the 6th century, removed a dead child by an 

incision in the abdomen in a case of extra-uterine fcetation.f 

In 1350 a pregnant woman of Medingen in Swabia was 

condemned to death for having, as was supposed, stolen 

three consecrated hosts to sell to the Jews ; Csesarean 

section was performed on her before she was burnt.J As 

a rule, midwives undertook the duties of midwifery and the 

manual interference required during the birth of a child. 

They probably learned their art as a handicraft. Their 

medical knowledge differed much in different countries. In 

Italy and France some among them elevated themselves 

into becoming female doctors, and extended their knowledge 

over the whole field of medical science ; in Germany 

they were seldom more than well-practised nurses, who 

had amassed some experience iri midwifery. At first it 

was not demanded of them that they should submit to 

examinations. Public opinion, in this case represented by 

the most respectable women of the place, pronounced 

judgment upon their ability. These also exercised a 

certain control over the midwives. Afterwards, the mid- 

* ARNALD DE VILLANOVA: Breviarium, lib. iii, c. 4. 

t C. F. HEUSINGER in the Janus i, 764 et seq. 

X G. LAMMERT : Volksmedicin u. medicin. Aberglaube in Bayern, "Wiirzburg 

1868, S. 12.

MEDICAL PROFESSION AND LITERATURE. 277 

that in the exercise of his calling he puts an end in a 

summary manner to all the afflictions a man has to bear, 

but as a matter of fact the hangman, performed medical 

services, in dressing the wounds inflicted by the rack, 

reducing the joints which had suffered dislocation, etc. In 

most countries, certainly, medical practice was only 

permitted in the case of those who had given proof of 

their ability by successfully passing examinations. 

Quackery was forbidden in Paris as early as in the year 

1220. Infringements of this law were severely dealt with as 

the reports of a trial, in the year 1311, which originated in 

circumstances of this nature, sufficiently indicate.* It was 

a matter of excommunication. In Vienna also, people of 

this kind were excluded from participation in the sacraments, 

f At the same there was no lack of charlatans of 

either sex. And, indeed, it occurred not unfrequently that 

empirics who had received no systematic medical education 

received testimonials and diplomas from high lords and 

magistrates, if they attained to success in practice, and a 

scarcity of doctors prevailed. 

A probable estimate may be formed of the value of 

medical fees if we take note of the payments sanctioned 

by law which were prevalent in certain localities. Thus in 

the 14th and 15th centuries at Venice, for each professional 

visit in ordinary cases of sickness 10 soldi were paid; in 

Milan the doctor might demand for every day of treatment 

12-20 soldi, for a night visit one ducat, and if called outr 

side the city, for each day 4-6 lire. J JOHN ARDERN 

demanded for the. operation for rectal fistula a fee of at 

least 100 gold sols. Rich and distinguished patients pre-? 

sented their doctors with large sums and estates, while the 

poor sought to pay their debt by a pair of fowls, eggs, or 

fruit. § The salaries which the physicians in ordinary and 

the medical officers of towns received, show, what a high 

value was placed upon medical services at that time. The 

* HAZON op. cit. X CHIAPELLI op. tit. p.- 29."' 

f ROSAS op. cit.i, 124 et seq. t § CHIAPELLI op. tit. p. 28.


dukes of Savoy, who, as is well known, cannot be classed 

amongst rich princes, gave their physicians in ordinary a 

yearly stipend of from 40 to 60 gulden; at the court of 

Naples they received, on the other hand, from 100 to 300 

ducats. In Prague the usufruct of several estates was 

assigned to the royal physicians in ordinary. 

The institution of the Archiatri populares, the paid 

medical officers of towns, was probably kept up in many 

towns of Italy without interruption from ancient times 

through the entire period of the middle ages. The Ostrogoths 

and Lombards received it from the Romans and most 

likely handed it on unchanged to their successors in the 

dominion of Italy. In Rome, as also in Denmark and 

Sweden, the name of archiater was used as a title for a high 

medical official even up to the most recent times. 

The duties of the town medical officers were these: to 

attend gratis the officials of the town and the poor of the 

town, to provide medical service for the town hospitals, to 

assist the magistrates as experts, and to accompany the 

citizens into the field in time of war; they also exercised 

control over the apothecaries' shops and licensed houses, 

and conducted the public sanitary service. At a later 

period in many places they also undertook the teaching of 

the lower class of attendants on the sick and examined 

them. In Venice there .were 12 physicians and 12 

surgeons appointed by the town; the former receiving 

from 15 to 100 ducats annual pay and the latter from 10 to 

130. Even smaller places devoted a regular sum to this 

purpose in their budget of expenditure. Treviso paid its 

three public medical officers 728 lire a year, Conegliano -J 

350 lire to physicians, 250 to surgeons, and Palermo granted 

to its two town doctors 50 ounces of gold a year.* In J 

Germany public medical officers were first appointed in the 

14th century. In an order of the Emperor SlGlSMUND, 

of the year 1426, it is said: "In every imperial town ;| 

there is to be a cnief-doctor; he is to be paid 100 gulden. \ 

* CHIAPELLI op. cit. pp. 22, 31.


A church must provide him with them. He is to physic 

when necessary each and everyone gratis and he must 

earn his pay by true and faithful service/'* Frankforton-the-Main 

had in 1348 a town doctor who received 

clothing and 30 curnocks of corn ;f there were afterwards 

three, their pay ranging between 10 and 100 

gulden. Doctors were also appointed for the troops, the 

hospitals, the monasteries, and particular prisons, and 

received regular pay. 

Doctors, especially medical officers of towns, enjoyed in 

many places freedom from taxation and other privileges. 

Some received, free of charge, the freedom of the city they 

had settled in. In social position they ranked with the 

nobility. The members of the medical profession belonged 

for the most part to the wealthy classes; among them we 

find names representative of the most distinguished families 

of Italy. On the other hand the surgeons, especially in 

Germany, as a rule had a tendency to issue from the poorer 

classes. 

Among doctors the Jews were very numerously represented. 

While, during the first centuries of the middle 

ages medical study languished in the Christian States 

of the West, it was the privilege of the Jews to derive 

instruction from their contact with Arabian civilization 

and from the investigation of learned Rabbis. It was 

not therefore surprising if they excelled their Christian 

colleagues in knowledge and skill. And thus it came 

about that especially in countries in which, as in Germany, 

medicine was very much neglected, the Jews were in 

the greatest request as doctors. Not only princes and 

ruling lords but even bishops and popes had Jewish physicians 

in ordinary; at most monasteries Jews were appointed 

as doctors, as ARNALDUS DE VlLLANOVA declares.^ 

* MOEHSEN : Geschichte der Wissenschaften in Brandenburg, Berlin 1783, S. 

564.—P. FRANK : System der medicin. Polizei, Wien 1817, vi, 1, S. 174. 

t KRIEGK op. tit. S. 8. 

J.GUDEMANN : Geschichte des Enziehungswesens der Juden, Wien, i, S. 155.

280 THE MIDDLE; AGES. 

In Prague in the 12th century nearly all medical practicewas 

in the hands of Jewish doctors; and the same 

appears to have been the case at Avignon * In Frankforton-the-Main 

ADAM LONICERUS was the only Christiandoctor 

; all his colleagues at that place belonging to the 

faith of Israel.f This is partly explained by the fact that' 

most of the other learned careers were closed to the Jews. 

It is true, that at several Church Councils it was decreed 

that Christians should not seek advice from Jewish doctors ; 

the priests however did not regard themselves as included 

in this prohibition, which, for the rest, had but little effect,'if 

there was an absence or scarcity of doctors belonging to* 

the Christian faith at any particular place. When the waves 

of religious passion rose higher and the persecutions of the 

Jews began, the results became remarkable even in this 

walk of life. In the statutes of the medical faculty at 

Ingolstadt of the year 1472 the Christian doctors were forbidden 

to hold consultations with their Jewish colleagues^ 

and in the regulations for midwives issued at Regensburg cj 

in 1451 it was set forth that" they might go to any woman 

in need of their assistance " except to a Jewess to-whom . 

they must not go." § ^ 

The clergy were more and more deterred from medical* | 

practice both by the laws of the Church and by the increasing 

professional competition which confronted them' 

after the foundation of the universities. At the Councils 

of Rheims (1131), Montpellier (1162), Tours (1163), Paris 

(1212), at those of the Lateran (1139 and 1215) and also'by 

the decretals of the Popes ALEXANDER III. (1180) and 

HONORIUS III. (1219) medical practice and especially 

surgery were forbidden to priests. This prohibition was 

probably not obeyed, as it had so often to be repeated, or 

* J. v. HASNER in the Prager Vierteljahrsschrift 1866, Bd. 90.—G. BAYLE op. 

oit.\>. 68. 

f W, STRICKER: Geschichte der Heilkunde in Frankfurt-a-M., 1847, S. 68.',**, 

X PRANTL. op. cit. ii, 47. 

" §1 G. LAMMERT : Geschichte des biirgerlichen Lebens, Regensburg a880,. S. 2.89. 

: :


in any case it was frequently eluded, stipends, dispensations 

* and many other arrangements offering even a direct 

invitation to ignore it. All the same, this much was accom 

plished, that priests at least held themselves aloof from per 

forming surgical operations and treating women..' On the 

other hand medical teaching was still at many academies 

left for some time in their hands. The reason being that 

sometimes benefices were associated with the position of 

teacher, and the tenure of these benefices presupposed the 

priestly character of, the incumbent. Thus for example H. 

LURCZ, professor of medicine at the University of'Vienna, 

was at the same time minister of Hohlfeld in Bavaria; he 

kept a substitute there and gave lectures himself in Vienna.t 

As a result of such conditions at many universities celibacy 

was demanded of the teachers of medicine. When in 1479 

the Elector PHILIP wished to install a layman as Professor 

of medical science in Heidelberg, the Academy protested 

because he was not a clergyman. This matter was only 

carried through after the Pope in 1482 had given per 

mission that laymen, even when married, might be created 

Professors of Medicine. J In Paris, where so much import 

ance was attached to celibacy that JEAN DE POIS was de 

prived of his license in 1395 because he had married, these 

rules were abolished in 1452 by Cardinal D'ESTOUTEVILLE. 

In many cases the matter was passed over in silence and the 

benefices given to candidates who could not satisfy all the 

provisions of the canonical law.§ 

Clericalism made its predominating influence felt in 

every walk of public and private life. It triumphantly 

associated itself with all the intellectual efforts, which so 

numerously manifested themselves during the period of 

scholasticism. It dominated even the literature of natural 

* A. CORRADI in Rend. d. R. ist. Lomb. 1873, Ser. ii, v. vi, p. 863. 

f ASCHBACH op. cit. i, S. 410. 

X J. F. HAUTZ op. cit. 

§ PAULSEN in SYBEL'S histor. Zeitschr. Bd. 45, S. 310, 434.—HEFELE: Conciliengeschichte 

vii, 355. y-


science and of medicine. One purpose alone did this • 

literature serve—that namely of making science the foundation 

and support of theological dogma. The works on 

natural science of the 13th century bore an encyclopaedic 

character. The most prominent authors were ALBERTUS 

MAGNUS, Dominican monk and afterwards Bishop* of 

Regensburg, the Minorite BARTHOLOMÛS ANGLICUS, 

the Frenchmen THOMAS. DE CANTIMPRE and VINCENT 

DE BEAUVAIS, the Italians BRUNETTO LATINI, the teacher 

of DANTE, and RiSTORiO D'AREZZO, and the German 

KUNRAT VON MEGENBERG. The Natural Philosophy composed 

by the monks of the Mainau Monastery belongs 

to this period. Medical literature in the strict sense was 

chiefly composed of writings explanatory of the works of 

the ancients and of the Arabian authors known by their 

Latin translations. Of this nature were the works of 

the following: TADDEO ALDEROTTI called FLORENTINUS, 

DINO and TOMMASO DI GARBO, BARTOLOMEO VARIGNANA, 

TORRIGIANO, GlACOMO DELLA TORRE, GIOVANNI and j 

MARSILIO DI S. SOFIA, GIACOMO DE DONDI, FRANCESCO 

DI PIEDIMONTE and JACQUES DESPARS of Tournay. Short 

extracts from the comprehensive therapeutic works of the 

Arabs arranged for the instruction of students and the use 

of doctors, and comparative tables, in a concise form, of the 

drugs in most frequent use, answered the requirements 

of the day. To this period belong the Clavis Sanationis 

of SiMON of Genoa, the medical Pandects of MATTHÛS 

SYLVATICUS, the Aggregator Brixianus of GUGLIELMO 

CORVI, the Medical Compendiums of GlLBERTUS ANGLICUS 

and of the Scotchman GORDON and the writings of 

JOHANNES DE TORNAMIRA, of the Portuguese VALESCUS 

DE TARANTA, of NiCCOLO FALCUCCI, the Florentine, of 

MICHELE SAVONAROLA, ANTONIO GUARNERI and others. 

PETRUS DE ABANO, celebrated for his knowledge in natural 

science, took up a more independent position and in his 

Conciliator diferentiarum delivered a severe and, in some 

places, most destructive criticism upon the prevalent 

theories of medical science.


About the same time the Englishman ROGER BACON and 

the Catalonian ARNALDUS DE ViLLANOVA asserted the 

claims of freedom in investigation and declared that the 

natural sciences and medicine had no assured foundation 

except in observation and experience. They opened thus 

a more independent and direct path for medical science, 

which became manifest in the writings of their disciples, 

especially at the schools of Montpellier and Prague and 

was shown in the numerous collections of clinical cases, 

which were composed in the 14th and 15th centuries. 

While holding fast to the prevailing doctrines they yet 

brought forward many a valuable observation of their own 

which served to enrich the science of medicine. Thus 

HUGO BENCIO described cases of periodical insanity, of 

spermatorrhoea, and of syphilis. MATTEO FERRARI DE 

GRADIBUS treated a student who suffered from writer's 

cramp, and observed paralysis of the facial nerve associated 

with distortion of the face, hallucinations of the sight and 

obstinate salivation. BAVARIUS reported upon a paralysis 

of the upper extremities combined with disturbance of 

speech and weakness of memory which was said to have 

followed a violent inflammation of the throat* HENRI DE 

MONDEVILLE and GuiDO DE CAULIACO saw cases of 

wounds of the brain with loss of its substance, without 

permanent disturbance of the intellectual faculties resulting.t 

Corresponding with the revival of an independent 

observation of clinical cases, there ensued a more 

energetic study of anatomy and more successful enterprise 

in surgery, as has been explained on a previous page. 

Other branches of medical science also underwent improvement. 

A remarkably rich balneological literature 

arose, which treated of most of the baths known at that 

time. Germany was dealt with among other countries. 

HANNS FOLZ, the barber and minstrel of Ntirnberg, in 1400 

* CH. DAREMBERG op.cit. i, p. 338 et'seq. 

f G. DE CAULIAC. op. cit. tract, iii, doctr. 1, c. 1.

THE MIDDLE AGES." 

composed a " little book of all the baths which are naturally 

hot." Many popular medical writings appeared at the 

same time, especially in Germany; such were the collections 

of recipes intended for household use or the; direct 

tions and rules for diet which were worked up after the 

pattern of the Regimen Salernitanum, as the Dispensatory 

of ORTOLF of Bavaria, the Garden of Health, which issued 

from Mainz, etc. 

The middle ages were, therefore, by no means' so destitute 

and devoid of intellectual equipment as they are represented 

to have been by many authors. A stirring life prevailed in 

all provinces of mental activity. If the results gained did 

not correspond to the pains and labour bestowed, the reason 

lay in the fact that the efforts to advance were made in a 

wrong direction or encountered obstacles they could not 

surmount. The yoke of scholasticism weighed heavily: 

upon science, and the authority of the Church pointed out 

to it goals which lay remote from its essential aims and 

which were not to be reached. 

END OF PART II.

III. MEDICAL TEACHING IN RECENT, TIMES. 

THE , CHARACTER OF THE SIXTEENTH 

J. . . CENTURY. 

IN proportion to the increase of knowledge and its 

.more extensive prevalence, the conviction gained ground 

that thought must be freed from the fetters which held it 

in check. What in the 13th century had been felt by only 

;a few select spirits and proclaimed by them with dauntless 

-.courage, at the end of the 15th century filled the hearts of 

•all- cultivated men. The impulse towards freedom and 

independence exerted an influence on all provinces of in 

tellectual life and formed the fundamental note which 

resounded in art as well as. in science, in religion no less 

than in politics. 

In the history of civilization movements of mighty import 

like those of the 16th century, do not arise suddenly but 

are the outcome of a long preceding activity. They exist 

long before they appear, they escape superficial observation 

and are recognizable only by the eye of knowledge. Like 

the seeds of plants which crowd the soil, they germinate in 

obscurity and shoot up only when their time has come. 

The origin of the efforts for reform of the 16th century 

dates far back in the middle ages. The history of this 

.struggle tells us of unsuccessful attempts, of fruitless toil, 

of hopes trampled underfoot, and of sacrifices sealed by 

blood. Even in the earlier centuries enthusiastic and 

devoted men fought for freedom of thought: but 

the combatants were isolated and were overpowered by 

their opponents. LUTHER and MELANCHTHON had their 

forerunners who suffered death for their convictions.

286 RECENT TIMES. 

The suppression of robber bands and attacks on the 

feudal system were prepared for and favoured by the 

development of an independent and well-to-do burgherclass. 

Art and science were recalled to the investigation 

of antiquity and the observation of Nature by the study of 

humane learning cultivated in Italy since the time, of 

PETRARCH. The artists freed themselves from the traditions 

of the middle ages and gave to the forms they 

portrayed a freer expression, which having been learnt in 

Nature's own school, was true and warmed men's hearts 

by sympathy. 

What the early times of the Renaissance did for art, 

was accomplished for science by the study of the original 

works of the Greeks and Romans and the commencement 

of an independent investigation of nature. In the schools 

of the middle ages the writings of the Roman classic 

authors had seldom been studied in the original texts; those 

of the Greek, never. The Latin which was spoken in 

teaching and in the daily intercourse between teachers and 

pupils was very different from the language of ClCERO or 

QuiNTiLlAN. The Greek language was nowhere brought 

into the domain of teaching and the knowledge of it was 

so rare that PETRARCH in 1360 was able to name scarcely 

ten men of learning in Italy who were acquainted with it.* 

In other countries there was at least no improvement upon 

this state of things. The literary works of antiquity were 

made accessible to the middle ages chiefly by Latin 

translations, commentaries, and abridgements which were 

generally prepared not from the originals but from renderings 

of these into Arabic. People attached little importance 

here to form and expression of speech; for these were not 

looked upon as means for education of the mind but were 

esteemed to be nothing but the worthless shell containing 

the rich treasure—the real object of pursuit. Even this 

however was not maintained pure and unadulterated ; for 

* G. VOIGHT : Die Wiederbelebung des classischen Alterthums, Berlin 1881, 

ii, 107.

THE SIXTEENTH -CENTURY. 287 

it underwent such alterations.*" as were in the age of 

scholasticism considered indispensable for preserving the 

sanction of the Church and the spiritual welfare of the 

-faithful. When people recognized that in this manner 

they did not attain to the full, unrestricted possession of 

the rich legacies of knowledge which ancient times had left 

behind them, they began once more to study the writings of 

antiquity in the form in which they were originally transmitted 

to posterity. The classical authors of ancient 

heathendom awoke to new life and in words of flame made 

known the greatness and the glory of the past. This 

occurred first in Italy where numerous remains of buildings, 

statues, and inscriptions reminded men of the civilization 

of the Romans. In that land a knowledge of true Latinity 

was again acquired, and from thence spread to other 

countries, in the 15th century. 

At the German academies professorial chairs for Latin 

eloquence and rhetoric were founded, the incumbents of 

which excited by their successful efforts in prose and verse 

the astonishment and envy of their contemporaries. At the 

same time the knowledge of the Greek language obtained a 

general prevalence in the circles of the learned. For this 

thanks are to a large extent due to the Greek refugees, who, 

after the conquest of their native country by the Turks, 

came to Italy and founded there a new home. CHRYSO- 

LARAS, GEORGIOS of Trebezond, THEODOROS GAZA, BES- 

SARION, CONSTANTINE LASKARIS, and others brought many 

valuable Greek manuscripts with them, and collected round 

them a circle of select pupils. At the courts of the 

Medici, those princes of Italy so pre-eminently susceptible 

to the attractions of art and science, a worship of Hellenism 

became developed which gathered around it the most prominent 

men of the state. Learned societies which were 

called Platonic Academies* made the cultivation of Greek 

literature the task of their lives. The bright forms of 

P. VILLARI : Nicolo Macchiavelli und seine Zeit, Deutsche Ubers., 

Rudolstadt 1882, i, 147 et seq.

288 ... ..RECENT TIMES.; 

Greek life caused magical pictures to pass .before their 

minds' eyes of the serene felicity, of' man, and drew them 

away from the contemplation of the m ournfuL seriousness, of, 

Christian, renunciation which hated and condemned plea^ 

sure. They elevated themselves to the ideals of. freedom ' 

and of ancient heroic greatness, even if in regarding the 

wretched political circumstances of the. present they wepe,. 

pressed again to the earth. Thei writings, of. the wise ^ 

men of. antiquity afforded them. abundant inspiration and j 

instruction ; .it was in these they discovered the foundation^. + 

of philosophy, law, mathematics, astronomy, geography, 

and physics, of the natural sciences and of medicine. , With 

the restoration of Greek and Roman literature there wa|| 

disclosed a world of ideas and of endeavours which seem^cr 

fitted to step into the place of the now defunct forms of Jfe 

of the middle ages. The spirit of the age strugglingHo- 1 

wards a.modern development of civilization thought to §j|d # 

in it a serviceable wreapon for the great struggle with the 

Church and with scholasticism,—and was not deceived. # 

Certainly, humane learning was limited to a small circle; ' 

but this circle comprised the intellectual elite of the nations.^ 

The ideas of humane learning soon seized upon the minds. 

,of men with such force that no one could escape from them, *, 

not even those, who like the representatives of the Church . 

and of ecclesiasticism, must have discerned in them their * 

natural enemies. They found a friendly reception even at 

the Papal Court. NICHOLAS V- was their well-wishing 

friend and patron,, though probably more from personal 

vanity than from inward conviction. PlUS II., before* 

ascending;the Throne, and while still bearing the name of * 

../ENEAS SYLVIUS, had worked zealously in favour of their 

extension in Germany, and remained at all times their true 

disciple and their advocate both with tongue and pen. To 

be sure, their influence was manifested less in religion than a 

it was in art and in science. The Humanists, as a rule, 

avoided direct assaults upon the dogmas of the, Churchy 

And there was no fear that the jovial and sometimes even 

*.*

THE SIXTEENTH CENTURY. 

289 

rather frivolous gods of Greece would supplant the object 

of Christian worship as had perhaps been the wish of many 

representatives of humane learning, like PETER LUDER, 

BUSCHIUS, or ULRICH VON HUTTEN. The influence exerted 

by humane letters upon the Christian religion consisted 

chiefly in the fact that they provoked a comparison with 

the supernatural and ethical conceptions of antiquity, and 

thus rendered possible a more unbiassed judgment of the 

Christian doctrines. 

Art owed to antiquity a rich inspiration. The strictly 

limited circle of ideas belonging to the Jewish-Christian 

legend, which up to this time had almost exclusively formed 

material for artists, and which, by its continual repetition, 

gradually became monotonous, now received a welcome 

enrichment in the mythology of the Greeks and in the heroic 

history of Rome. The treatment of form now showed an 

unconstrained and bold character contrasting agreeably 

with the stiffness and clumsiness of the earlier periods. The 

figures—even those borrowed from the transcendental worlds 

of religious mysticism—now appeared in nearer sympathy 

with the feelings of mankind. Reflecting glory from ideal 

conceptions of the good, the beautiful, and the true, they no 

longer appeared to the eye as powers darkly threatening 

290 

RECENT TIMES. 

influence on other countries, especially upon Germany and 

the Netherlands as the names of ALBRECHT DURER, HANS 

HOLBEIN and LUCAS CRANACH testify. At Niirnberg the 

arts of the wood carver and the goldsmith reached high 

perfection. The free towns of Germany produced a race 

of citizens manifesting taste and intelligence in art and 

combining a more cheerful enjoyment of life with moral 

seriousness. Among them artistic and scientific efforts 

' found zealous disciples and representatives. In the field of 

science humane learning was cultivated chiefly by the 

learned societies which arose on all sides after the pattern 

of the so-called Platonic Academies. The Rhenish Society 

was the best known of them, among its members being 

such men as the learned Abbot TRITHEMIUS and WiLLiBALD 

PIRKHEIMER the patrician of Niirnberg, besides RUDOLF 

AGRICOLA, the poet CONRAD CELTES, JOH. REUCHLIN, 

ERASMUS of Rotterdam and others. 

The first result of the growing interest taken in Greek 

and Roman Literature was, that the manuscripts which had 

been handed down from former times were compared, and 

a text was furnished resting upon considerations of grammar^ 

and of sense, which seems to have answered all requirements. 

This formed the commencement of the scientific 

treatment of philology which exerted such a very far-* 

reaching influence upon the development of the culture of 

the following periods. Philology played the part of the 

magician who set free the Dormant Beauty of science, 

locked in a sleep of a thousand years, and afterwards 

remained to her a fatherly protector watching her first 

steps with anxipus care. The sciences, and by no means 

least of all the natural sciences, have to thank philology 

that they hit upon the right method of investigation : for 

they learnt from it painful accuracy in sifting scientific 

material and severe criticism of results won. 

Td medicine also in its new form philology afforded 

essential service. -Editions of most of the medical authors 

of antiquity were prepared.. The doctors who devoted

THE SIXTEENTH CENTURY. 2£1 

themselves to this branch of literary activity, prepared 

themselves for it by a sound philological training; not a 

few of them were teachers of the ancient languages before 

they attached themselves to medicine. The knowledge of 

Greek passed in those days as a necessary piece of 

intellectual equipment for anyone laying claim to be called 

an educated doctor; just as to-day such an one is expected 

to understand the use of the microscope. 

If the literary activity of the doctors, kindled by the 

study of humane letters, developed in an unexpected manner 

and contributed to the extension of medical knowledge, 

thanks are in a large measure due to the art of printing 

books which was invented in the 15th century. This art 

came suddenly into existence, but not without a history of 

derivation from antecedent sources : for it was prepared for 

by the arts of wood-carving and copper-engraving and by 

the somewhat imperfect method of impression from fixed 

types perhaps introduced into Europe from China, and by 

other things. Nevertheless it was an extraordinary advance, 

when moveable type was first brought into use about the 

year 1440. By this the impression of extensive works 

and trade on a large scale were first rendered possible. 

To be sure printing had at first to contend with many 

drawbacks. It was a very tedious process and, consequently 

very costly. Thus for example the impression of 

the Bible—the first great work which proceeded from the 

Mainz press founded by GUTTENBERG and afterwards 

belonging to FUST-SCHOFFER—took n years and cost 

4,000 gulden before the 12th sheet was completed. 

Printing gradually attained to a wider prevalence in proportion 

to the improvements introduced into the art. 

DAREMBERG estimates the number of medical writings 

printed up to the year 1500 as about 800.* 

The new discovery exerted a mighty influence upon the 

intellectual movements of the 16th century. The pulpit, 

which up to this time had been the only place from which 

* CH. DAREMBERG: Histoire des sciences me'dicales, T. i, 313.

292 

RECENT TIMES. 

the people were addressed, now found a rival, ready to 

become, on occasion, an adversary. Liberal ideas here 

found an ally, and the struggle against the hitherto dominant 

authorities was carried on with serviceable weapons. 

But. the fullest significance of printing was in aiding the 

development of science ; for the acquisitions of the intellect 

could now be made easily accessible and become the common 

property of all. The study of the treasures of knowledge 

handed down from ancient times incited to a critical 

examination of their real foundation, and the special ) 

investigation required led to the correction of old errors 

and the discovery of new facts. 

The reformation of science thus effected forms, with the 

corresponding change in religious and political life, the 

most remarkable phenomenon of an age characterized by 

the emancipation of individual opinion. These aims 

received unexpected furtherance by the discovery of 

America which at the end of the 15th century excited the 

wonder and astonishment of mankind. A population was 

there discovered like the inhabitants of Europe in bodily 

form and in spiritual nature, together with a civilization 

which bore many points of resemblance to the manners 

and customs of the old world. Neither the Church nor 

Antiquity had possessed any knowledge of these things,J 

any more than of the fauna and flora of the new continent. 

Disappointed in the two highest authorities known at that 

time, thinkers and philosophers became suddenly independent 

and compelled to trust to their own observations. 

Some decades after the discovery of America the first circumnavigation 

of the earth was made and with it incontestable 

proof was furnished that the earth was round. The 

Greek philosophers had already conjectured that its shape 

was spherical and ARISTOTLE considered it as certain; but 

LACTANTIUS and other Fathers of the Church * had contested 

this view and declared it absurd. Their authority 

sustained with this a serious defeat. The prestige of the 

* O. PESCHEL op. cit. S*. 96 et seq.—W. WHEWELL op. cit. i, 226 et seq.

THE SIXTEENTH CENTURY. 293 

Church was still more shaken when the heliocentric theory 

—said already to have been put forward by PYTHAGORAS— 

was established by COPERNICUS and KEPLER* The 

theologians combated this theory, knowing right well that 

with its acceptance, the earth would appear as nothing 

more than one of the countless luminaries which crowd the 

.firmament and that man—its inhabitant—would lose the 

dominant position claimed for him under the mode of 

regarding the universe professed by the Christians. The 

rivalry between the heliocentric and geocentric doctrines 

was also decided against the Church. It can be easily 

understood how by these events the belief in the inadequacy 

of the human understanding—a doctrine preached by 

scholasticism and supported by the authority of the 

Church—was undermined. Protestantism went farthest, 

by extending the right of man to form an opinion even in 

matters of theological dogma. On no department of 

intellectual work did the independence of mind thus 

acquired cause a deeper or more lasting impression than 

on the natural sciences and medicine. 

Mineralogy received scientific consideration for the first 

time. The doctor GEORGIUS AGRICOLA made an attempt 

to classify minerals into different groups on the basis of 

their external characteristics. Botany began to rise out of 

the dependent relations in which it stood with regard to 

materia medica and dietetics, and to assume the form of a 

science worthy of cultivation for its own sake. It was 

enriched by a multitude of descriptions of plants, and the 

flora of Europe, as well as that of the newly-discovered 

trans-oceanic countries, underwent close examination. Certain 

botanists undertook to separate plants into different 

departments according to definite points of resemblance, 

in order to facilitate the study of them. CONRAD 

GESSNER and A. CESALP1NI made use of the flowers and 

* WHEWELL op. cit. i, 381 et seq.—J. W. DRAPER : Geschichte der geistigen 

Entwickelung Europas, Leipzig 1871, S. 521 et seq. (' History of the intellectual 

development of Europe.')

294 

RECENT TIMES. 

fruit foi? this purpose, and were in consequence the precursors 

of LINNJ^-US. A new period also began in the 

history of zoology, inaugurated by the great work of the ;< 

. learned GESSNER. This not only contained all the facts 

which had been ascertained in this department of science 

during the preceding periods, but also a number of fresh 

observations. Other investigators chose certain classes of 

the animal kingdom as the objects of their study, as, for 

example, B. BELON in the case of birds, and RONDELET in 

that of fishes, and some again occupied themselves with 

the fauna of foreign countries. So, too, in physics and 

chemistry energetic activity prevailed. NICOLAS CuSANUS, 

the free-thinking Bishop of Brixen, and the great artist 

LEONARDO DA VINCI had already worked at physics with 

success* While mathematical science under HlERONY- 

MUS CARDANUS, TARTAGLIA—who discovered how to solve 

cubic equations—and others was improved, optics had made 

also material progress, for which thanks are due chiefly to 

GiAMBATTlSTA PORTA, the discoverer of the camera obscura, 

and to JOHANN KEPLER. Physics and chemistry, however, 

first achieved really important successes in the 17th 

century ; then first did they become invested with great 

significance in relation to medicine. 

EMANCIPATION FROM THE BELIEF IN. f 

AUTHORITIES IN THE SPHERE OF MEDICINE, 

AND THE PROGRESS OF SCIENCE. ^ 

MEDICAL science underwent the same process of development 

as the other arts and sciences, as civilization advanced.. 

It shook off the yoke of authority which rested only on 

tradition, and became independent. This fact appears 

natural and conceivable only in connection with the efforts.! 

which were then crowding the history of the time; apart 

from these it may, indeed, be impressed on the memory, 

but not on the understanding. The movements in the 

* POGGENDORF, op. cit. S. 113 et seq. 

H

THE PROGRESS OF SCIENCE. " 295 

direction of freedom were manifest ip all branches of 

medicine, and in some subjects, especially in anatomy, 

materia medica, surgery, and midwifery, obtained even in 

the 16th century remarkable results. 

In anatomy, men ceased to rely upon the infallibility of 

GALEN, and began to make independent investigations on 

,the dead body. GABRIELE ZERBI, in his anatomical 

description of the human body, already treated separately of 

bones, muscles, and vessels. He made mention of the oblique 

and circular muscular fibres of the stomach, and alluded to 

the puncta lachrymalia, the ligamenta uteri, etc.* AL. 

ACHILLINI noticed the ductus choledochus opening into the 

duodenum, and also the ileocaecal valves.t BERENGAR, of 

Carpi, corrected several mistakes of MONDINO, and is 

looked upon as the discoverer of the foramina of the 

sphenoid bone, and of the vermiform appendix ; moreover 

he referred to the fact that the thorax in men and the 

pelvis in women are in each case proportionately wider 

than in the other sex.J CANANI furnished an excellent 

description of the muscles, and was the first "to observe the 

valves of veins in the vena azygos.\ 

All these investigators were surpassed in richness of discovery 

by ANDREAS VESALIUS, who may be called the reformer 

,of anatomy. He was descended from a German family which 

originally bore the name of WlTlNG, and transferred its home 

f from Wesel to Brussels. The investigations of VESALIUS 

^ embraced all parts of anatomy, and formed the basis for a new 

^system of anatomical teaching. || He explained the nutrition 

of the bones by means of the vessels of the periosteum and 

the vasa nutrientia, and was the first to point out that 

nerves penetrate muscles. In the vascular coats he distinguished 

two layers, of which the inner one was of firmer 

* MEDICI, op. cit. p. 43. 

+ BURGGRJEVE op. cit. p. 55.—MEDICI op. cit. p. 51. 

X CARPI : Commentaria cum ampl. addition, super Anat. Mundini, Bonon. 

IS 21 - 

§ AMATUS LUSITANUS: Curat, med. cent., Basil 1556, p. 84. 

|| BURGGRJ-EVE op. cit. p. 72 et seq.


consistence than the outer, and composed of muscular fasciculi. 

He described the heart fairly accurately, its position,, j 

movements, and changes of form, and also the apparatus of 

the valves ; yet he was never able completely to get rid of 

the old mistake that the blood passes through the septum 

of the heart. But whereas in the first issue of his chief 

anatomical work in 1543 he expressed as yet ho doubt 1 

whatever on the subject, in the second edition of 1555 he, 

declared, being perhaps influenced by SERVET, that he 

could not understand how it was possible for the blood, even 

in very small quantity, to transude from the right to the 

left side of the heart through the thick, firm substance of the 

septum.* Important progress is shown in his description 

of the abdominal walls and of the stomach, the liver, and 

the male and female sexual organs. He was acquainted'. 

with the corpora cavernosa and the seminal ducts, refers 

to the vesiculae seminales, and discussed the changes which. 

the uterus undergoes in pregnancy. He devoted great care 

to the examination of the brain, drew attention to the 

distinction between the gray and white substance, and ,: 

noticed the corpus callosum, the septum lucidum, the A 

pineal gland, and the corpora quadrigemina. 

The discoveries of VESALIUS aroused an unprecedented 

amount of attention. Not only in medical circles was 

astonishment felt at the boldness with which he pointed out 

the erroneousness of what people had hitherto considered to * 

be true. Those who revered the ancients, and pinned their 

faith upon received authority, persecuted him in the most %; 

violent manner, headed by his former teacher SYLVIUS, 

who, making a poor enough joke upon his name, called 4 

him VESANUS,—a madman, who was contaminating Europe 

wdth his poisonous blasts.f The discoveries of VESALIUS , * 

were improved upon and extended in many directions by 

his contemporaries EUSTACH1US and FALOPPIUS. The 

* H. TOLI.IN in the Biolog. Centralblatt 1885, Bd. 5, S. 474 et seq. 

t JACOB. SYLVIUS: Vesani cujusdam calumniarum in Hipp, et Galen j 

depalsio, Paris 1551.

A 

i 

THE PROGRESS OF SCIENCE. 

former occupied himself with the structure of the kidneys, 

and made mention of the excretory tubes (ducts of 

BELLINI).* On the other hand, the discovery of the valve 

named after him at the opening of the vena cava inferior 

into the auricle is wrongly ascribed to him, for it was 

known at an earlier period. But he improved the knowledge 

of the organ of hearing, observed the tympanic 

muscles, the spiral form of the cochlea, and the trumpetshaped 

tube which bears his name to the present day; he 

also left an excellent description of the base of the brain. 

FALOPPIUS, the gifted pupil of VESALIUS checked with 

scrupulous care the discoveries of his teacher, correcting 

and 'completing them by a multitude of new facts. 

With VESALIUS he was the greatest contributor to the 

reformation of anatomy. He furnished valuable information 

upon the development of the bones and teeth, described 

the petrous bone more accurately, enriched myology by 

admirable descriptions of the muscles of the external ear, of 

the face, of the palate, and of the tongue, made explicit 

statements upon the anastomotic connections of certain 

blood-vessels, for instance of the carotid and vertebral 

arteries, and discovered the nervus trochlearis. We owe 

to him some advance in the anatomy of the organs of sense. 

He instituted accurate investigations upon particular parts 

of the organ of hearing and of the eye, by which he was able 

to give fuller information upon the ligamentum ciliare, the 

tunica hyaloidea, the lens, and other anatomical points. So 

too in the case of the female sexual organs ; the oviduct 

(known in anthropotomy as the Fallopian tube) has immortalized 

his name in anatomical terminology. 

Of the remaining anatomists of this period the following 

rendered services to the development of their science: 

INGRASSIAS, by his labours in osteology especially by his 

discovery of the stapes and of the inferior turbinated bone, 

ARANZIO, who made researches into the anatomy of the 

foetus, VAROLIO, of whom the pons reminds us, by his 

* BURGGR^VE op. cit. p. 2Qi et seq.


examinations of the brain and nervous system, VOLCHER 

KOYTER by his contributions to the history of development 

and to pathological anatomy, FABRIZIO AB AQUAPENDENTE 

by the first complete description of the valves of the veins, 

CASSERIO by his labours upon the organs of voice and of 

hearing, ADRIAN VAN DEN SPIGEL who gave his attention 

chiefly to the liver, a lobulus of which still bears his name, 

SALOMON ALBERTI by his description of the lachrymal 

apparatus, and PETER PAAW who was the first to draw 

attention to the racial varieties of the skull.* 

The progress made by physiology at this period was not 

so great: which was but natural; for the existing facts of 

anatomy had to be firmly grasped before men could venture 

to ask the meaning of them. But at least, the fruitlessness 

of mere speculation was recognized and recourse was again 

had to the method of inductive investigation, already 

pointed out by ARISTOTLE. Thus EUSTACHIUS injected ; 

water into the renal arteries, with the object of studying 

the formation of urine.t 

Highly indicative of the complete change effected in the 

way of thinking among medical investigators are the words 

of REALDO COLOMBO, that a man learns more in one day by 

the dissection of a dog than by continually feeling the pulse 

and studying GALEN'S writings for many months together.J 

MICHAEL SERVET and REALDO COLOMBO, the prosector 

and of VESALIUS his successor in the professorship of Padua, 

were the first to correct the old mistake that the blood 

passes through the septum of the heart from the right side 

to the left, and hinted at the passage through the lungs. 

To which of the two the priority of this discovery belongs 

cannot be decided with certainty, although innumerable ; 

probabilities point to SERVET. § For the rest, neither the 

* K. SPRENGEL: Versuch einer pragmat. Geschichte der Arzneikunde,. 

Halle 1827, iii, 64 etseq. 

t BARTH. EUSTACHIUS: De renum structura, Vend. 1564, c. 37, 46. 

+ REALDO COLOMBO : De re anatomica, Venet. 1559, lib. xiv, p. 258. 

§ H. TOLLIN in the Deutschen Archiv f. Gesch. d. Med., Bd. vii, i88^,S. 

171 et seq., and in VIRCHOW'S Archiv, Bd. 91, S. 39 et seq.

THE PROGRESS OF SCIENCE. 299, 

one nor the other stated clearly and unequivocally how the 

passage of the blood is effected from the • pulmonary artery 

to the pulmonary veins. The triumphs of physiology did 

not begin until the 17th century, when experimental investigation 

was crowned with success by the discovery of the 

circulation of the blood. 

The progress made in anatomy was bound to exert a 

stimulating and helpful influence upon surgery, as being the 

branch of medicine chiefly concerned with the structure of 

the human body. The methods of operating employed by the 

surgeons of antiquity were partly forgotten, or only practised 

by a few who preserved the knowledge of them as a secret which 

they transmitted to the narrowestcircle of theirfriends. Itwas 

thus necessary that they should be discovered afresh, which 

task was accomplished by certain gifted practitioners who 

were led to this work by the need of improvement in the 

methods hitherto used. The revival of the study of ancient 

writings had but a limited effect in this direction, for the 

unlearned wound-doctors were, as a general rule, not at all 

in touch with literature, and the educated doctors frequently 

lacked the practical knowledge necessary to form an opinion 

upon the experiences bequeathed by the ancients. 

The introduction of fire-arms into warfare was of extraordinary 

importance in its effect on the development of 

surgery. While up to this time the wounds to be treated 

were chiefly cuts or stabs, now gunshot wounds stepped 

into the foreground. Symptoms hitherto entirely unknown 

resulted from wounds produced in this way. 

The writings of the ancients naturally gave no information 

upon these matters. Surgeons were, therefore, 

obliged to make observations for themselves, and to 

accumulate experience; to form opinions of the nature 

of gunshot wounds and of the way to treat them. This 

had a most powerful influence in promoting their emancipation 

from traditional authority and their intellectual 

independence. The excessive amount of * disturbance 

induced by gunshot wounds and many complications and

3°° 

RECENT TIMES. 

sequelae which were observed to attend them, aroused the. 

suspicion that other circumstances, besides the mechanical. 

wound, were operative in these cases. So the surgeons 

came to form the conjecture that the serious results of gunshot 

wounds were produced by burning and poisoning, and 

they explained this by the nature of the materials, namely \ 

powder and lead, which were the immediate agents in 

causing the wounds. In order to render the supposed '-\ 

influence innocuous they treated gunshot wounds with 

stimulating and caustic applications. This method of cure 

obtained general acceptance until a lucky accident smoothed 

the way for more correct knowledge. After a battle there 

happened to be a scarcity of hot oil for cauterizing the 

wounded. The famous French surgeon AMBROISE PARE 

who has described the fact in a very clear manner,* used 

instead of it merely a dressing of simple soothing oint-- J 

ment and awaited with anxiety the result which should ' 

follow this procedure. Who can describe his astonishment 

when on the next morning he found the wounds he had 

treated in this way present a good appearance, being 

neither painful nor inflamed nor swollen, whereas other • 

wounds, which had been cauterized in the old way, had 

become so? Repeated trials confirmed this experience 

and the successes which were obtained by this simple ; 

method of treatment led to cauterization—inconvenient J 

alike to the patient and the doctor—being gradually laid 

aside. PARE and MAGGI also made the statement that gunshot 

wounds are not attended with burning since musket 

balls can be fired on to sacks filled with gunpowder with- ; 

out causing its ignition.f 

In any case, however, the kind of wounds caused by the 

new method of carrying on war was essentially changed. 

The missiles produced great destruction of the bones which 

* CEuvres D'AMBROISE PARE ed. par J. F. MALOAIGNE, Paris 184*0, T. ii, p. 

127 el seq.— LE PAULMIER: Ambroise Pare' d'apres de nouveaux documents, 

Paris 1885. 

f CEuvres D'AMBR. PARS op. cit. T. ii, 134.

THE PROGRESS OF SCIENCE. 301 

were seldom if ever implicated in wounds caused by. the 

weapons in use at an earlier period. Amputation, but 

seldom practised before, was now frequently required. 

With increased experience the surgeons acquired great 

certainty in performing these operations and began to 

improve upon the methods till then in use. The chief 

mistakes made were that surgeons had a tendency to postpone 

them too long, to perform them when the soft parts 

were unhealthy or gangrenous and to cauterize the stump 

with the hot iron or with hot oil in order to arrest the 

bleeding, and to remove the necrotic tissue. Important steps 

in advance were therefore made, when BOTALLO demanded 

the prompt performance of amputation, as soon as signs of 

threatening gangrene presented themselves, and again when 

surgeons once more began to make the separation in the 

healthy parts, and finally when HANS VON GERSDORF, who 

was able to boast that he had performed about 200 amputations, 

covered the stump with moistened bladders and 

applied cooling dressings, in this way securing for the 

stump a sufficient covering of skin and soft parts which by 

the employment of the hot iron used to be too extensively 

destroyed. To prevent the danger of profuse haemorrhage 

during the operation, the limb was constricted with bandages 

above the line of incision. By the pressure on the 

blood-vessels and nerves caused by the bandages, it was 

hoped, as A. PARE states,* not only to prevent haemorrhage, 

but also to diminish the pain and to bring about a local 

anaesthesia. Ligature of the arteries which was again 

recommended by A. PARI2 t afforded the greatest security 

against the threatening haemorrhage. 

This method, as has been said, was already known to the 

surgeons of ancient times; in the middle ages also it was 

occasionally employed by certain distinguished operators. 

* CEuvres D'AMBR. PARE op. cit. T. ii, p. 222. 

t CEuvres D'AMBR. PARE op. cit. T. ii, 226 et seq.- ADAMKIEWICZ : Die 

mechanischen Blutstillungsmittel bei verletzten Arterien von Pare bis auf die 

neueste Zeit, Wurzburg. 1872.


PARE states that he was led to the attempt to ligature 

vessels by the study of GALEN : he reintroduced this procedure 

for the first time in an amputation in the lower part 

of the thigh, in the year 1552. He afterwards adopted 

ligature en masse in place of that of isolated arteries, tying 

the nerves along with the vessels. The belief was that in 

this way the discharge of the " nervous spirit" was pre- . 

vented. For secondary haemorrhage the arterial trunks 

were compressed by the external application of the fingers; 

mention is also made of a method which, in the somewhat 

Obscure description of it by A. PARE, appears to answer to 

ligature in continuity. 

Among the diseases liable to occur as the result of 

wounds erysipelas, hospital gangrene, diphtheria, pyaemia, 

trismus, and tetanus were noticed* 

The technical procedure in lithotomy underwent a marked 

improvement in the 16th century. The method in use up to 

that time, described by CELSUS and simplified by PAULUS 

AEGINETA, was amended by passing into the urethra, before 

the operation, a curved hollow sound shaped like a catheter, ,..: 

the convexity of which abutted on the perineum. As the 

incision in the pars membranacea was made on the groove 

of this sound, the hand of the operator took a more certain 

direction—a matter of great importance for the result. 

This procedure was called the operation with the large 

instrument, and BERNARDO DI RAPALLO was looked upon 

as its discoverer. It became more generally known through. 

MARIANO SANTO. The disadvantages which sometimes 

accompanied perineal lithotomy, namely, suppuration of 

the prostate and of the ejaculatory ducts with the 

impotence arising therefrom, but above all things the 

impossibility of removing by the perineal wound either 

very large or encysted stones, suggested the idea of 

* 

* F. WURTZ : Practica der Wundartzney, Basel 1642, S. 271, 538, 645 et seq;. 

—TH. BILLROTH: Historische Studien iiber die Beurtheilung und Behandlung 

der Schusswunden, Berlin 1859, s - "5 et seo -—WOLZENDOKFF im Deutschea 

Archiv f. Gesch. d. Medicin, Bd. ii, S. 23 et seq.; Leipzig 1879.


going in search of the stone from above by an incision 

over the pubic symphysis* PIERRE FRANCO performed 

high lithotomy for the first time in 1560 with success 

on a child aged two years after having made a vain 

attempt to remove the stone, which was the size of a 

hen's egg, by the old method. He felt himself especially 

induced to operate in this way as the bladder protruded 

forwards with some firmness. ROUSSET gave afterwards 

the very reasonable advice, that the bladder should be filled 

with water before proceeding to the operation. The high 

operation had also many dangers attached to it, which 

rendered its success questionable. PlERRE FRANCO 

recognized this fact and in consequence practised perineal 

lithotomy again, introducing a new method. In this the 

incision upon the curved staff introduced into the bladder 

was carried sideways from the raphe and prolonged through 

the prostate. Lateral lithotomy, as this procedure was 

called, had at least the advantage that by it stones of considerable 

size could be removed. P. FRANCO made the 

remark, that calculi in the female sex are frequently 

removed by simple dilatation of the urethra. Lithotrity 

had nearly fallen into oblivion. A. BENEDETTI stated that 

some surgeons crushed the calculus with iron instruments 

without making any incision, but he did not treat of this 

procedure at any length, t PROSPER ALPINI J described 

a particular method which he had learnt in Egypt. It consisted 

of squeezing the stone by pressure from outside into 

the urethra, which had been dilated. 

Surgeons sought to effect the cure of hernia by long 

continued lying on the back or by trusses: and not unfrequently 

the operation for radical cure was decided upon. 

For this, in inguinal hernia the sides of the opening were, 

* C. B. GDNTHER: Der hohe Steinschnitt seit seinem Ursprunge, Leipzig 

1851. 

t AL. BENEDICTUS : Omnium h vertice ad calcem morborum signa, causae 

etc., Basil. 1508, lib. xxii, C. 48: 

X De medicina-iEgyptorum iii, C. 14.

304 RECENT TIMES. , 

after returning the prolapsed bowel, sewn together with 

gold or lead wire or thread. Great credit is due to J 

AMBROISE PARE in that he limited as, far as possible % 

operative interference to- cases of strangulated hernia. 

Only in such cases did he perform regular herniotomy, 

It is true that other surgeons, as P FRANCO and RoussEf, 

did the same operation before him ; but the procedure * 

was laid upon a scientific foundation first by A. PAR:E »; 

and a prospect was, in consequence, held out * to 

patients with this affection of being cured, whereas at an 

earlier time they were generally left to their fate * The H 

operative relief of urethral stricture by forcible division 

with a knife, known at an earlier period to surgeons of the *« 

time of the Roman Empire, was rescued from oblivion by /* 

A. PARE. Bougies, also, were made use of in these affections, 

and were smeared with appropriate medicaments;^ 

these were especially recommended by LAGUNA. 

The knowledge of plastic operations had in the 16th * 

century long ceased to be a secret of the empirics of 

Norcia and Preci. Several able surgeons devoted them-; >| 

selves to them, and acquired great skill in performing them. 

GASPARE TAGLIACOZZI, Professor at Bologna, obtained the 

greatest success in this branch of surgery and has left a 

thorough description of the procedure.f To replace the 

loss of substance he employed the skin of the upper part •'! 

of the arm, like A. BRANCA before him. From all parts of 

Europe patients came to him to be operated on. The i 

story that he had at one time in his hospital 12 German 

Counts, ig French Marquises, 100 Spanish Grandees and* 

one English Esquire, who had all lost their noses through 

dissolute living and desired fresh ones from him,J if only a 

witty anecdote yet shows how widely spread his fame as an 

operator was. TAGLIACOZZI earned but small thanks fo| 

* E.ALBERT: Die'Herniologie der Alten, S. 180 et seq.—A. GYERGYAI in 

the Deutschen Arch. f. Gesch. d. Medicin, Leipzig 1880, Bd. iii, S. 326 et seq. 

t De chirurgia curtoium per insitionem, Ed. TROSCHEL, Berol. 1831. ,| 

X J. BICKERSTAFF: The Tattler, Lcndon 1723, iv, No. 260.


305 

his philanthropic actions. A narrow fanaticism saw in his 

attempts to restore the loss of nose or lips a presumptuous 

interference with the rights of the Creator. After his 

death, the pious sisters of the monastery, in which his 

earthly remains had been laid, heard during several weeks 

a voice crying " TAGLIACOZZI is damned ! " At the instance 

of the clergy of Bologna his corpse was taken from the 

grave and reinterred in unconsecrated ground.* Silliness in 

matters of faith such as that manifested in the 16th century 

finds an excuse in the low state of civilization of the period. 

We of the 19th century however are not at liberty to treat 

such displays with laughter and contempt; for when, about 

40 years ago, the employment of ether was suggested in 

difficult labours to produce anaesthesia the English zealots 

rose angrily to oppose it, appealing to the words of the 

Bible in reference to woman, "In sorrow shalt thou bring 

forth children ! " 

Besides TAGLIACOZZI, other surgeons like GRIFFON of 

Lausanne and CORTESI of Bologna made themselves known 

by their successful rhinoplastic operations. The loss of 

the nose was not only the result of disease, generally 

syphilis, but sometimes was consequent upon an order of the 

magistrates. This punishment was by an edict of the 

Eniperor FREDERICK III. imposed upon adulteresses and 

mothers who prostituted their daughters. The Municipal 

law of Augsburg of the year 1276 decreed that " vagrant 

girls or ' Hiibschlerinnen,' " as they were called, should 

have their noses cut off if they roamed about the streets 

during Lent or on Saturday night, except when distinguished 

foreigners were present in the town.f 

Ophthalmic surgery did not take any remarkable share 

in the progress made by other branches of surgery at this 

period. It lay almost entirely in the hands of itinerant 

* A. CORRADI : Dell' anticaautoplasticaitaliana, Sep.-Abdr. 1874. 

t HUILLARD-BREHOLLES : Hist. dipl. Fried. II, op. cit. iv, p. 168, 170, lib. 

iii, tit. 74, 80.—LAMMERT : Zur Geschichte des biirgerlichen Lebens op. cit. 

S. 76. 

X

306 

RECENT TIMES'. 

quacks who often undertook with audacious boldness the 

most serious operations without possessing any knowledge 

of the structure of the eye or of the nature of the diseases 

they were treating. When one of these gentry, who 

shortly before had been a serving man, was asked how he 

could be so confident as to operate on cataract, he replied 

that the patient had nothing to lose for if the operation 

miscarried he only remained blind as he was before. 

Midwifery also was during the first half of the 16th 

century completely neglected. How small the knowledge^! 

of doctors on this subject was at that time is shown by the " 

text-book for midwives published by EuCHARiUS R6SLIN in 

1512 under the title " The Pregnant Woman's Rosegarden," 

This contains incredible mistakes and representations of 

various positions of the foetus in utero which can only have 

been fabricated by a fertile fancy, and never actually 

observed. His imitators, WALTHER REIFF and JACOB 

RUEFF, citizens and engravers of Zurich, known too as 

authors of religious dramas, were in much the same 

position. Even more insignificant was the. work of L 

BONACCIUOLI, professor at Ferrara, which was dedicated to 

LuCREZiA BORGIA and in which among other things it is 

stated that sometimes 70 or more foetuses escape at the same 

time from pregnant women; the author appears to have 

confounded them with intestinal worms* With the im 

provement of anatomy and surgery a prospect was opened 

up-of midwifery also being for the first time placed on a 

scientific foundation. Here again it was AMBROISE PARE 

who initiated more correct views and better methods oi 

treatment. He settled what should be considered indications 

for turning—a procedure known in ancient times though 

hitherto but little used—and gave directions for its per- 

formance.f It was owing to him that from henceforth it 

secured for itself a permanent position in operative mid 

wifery. His doctrines received a wider development and 

* E. C. J. v. SIE.BO.LD op. cit. ii, 17. 

+ CEuvres D'AMBROISE PARE, ed. MALGAIGNE, T. ii, 628 et seq.


307 

a firmer foundation at the hands of PIERRE FRANCO and 

JAQUES GUILLEMEAU. The former recommended for 

extracting the child, that a speculum having three branches 

should be introduced into the vagina : into this he endeavoured 

to guide the head or the feet of the child. He 

thus came near to the discovery of the midwifery forceps * 

GUILLEMEAU was acquainted with placenta previa without 

however understanding how it arose and he performed an 

accouchement force on the daughter of A. PARE. Caesarean 

section was undertaken on the living; but it appears in 

several cases, of which mention is made, to have been a 

question merely of abdominal section in extra-uterine 

fcetation. Thus BAUHIN relates that JACOB NUFER, a 

Swiss gelder, in the year 1500 opened the abdomen of his 

wife who was pregnant " in the manner in which he was 

accustomed to do it in the case of swine "—and this after 

13 midwives and numerous surgeons had attempted in vain 

to deliver her in the natural way.f In this case he is said 

to have given exit to a living child after the first incision. 

But on the other hand some cases must be referred to 

.Caesarean section proper.^ Recourse seems to have been 

had to this operation even more frequently than was 

necessary; A. PARE cautioned surgeons against this and 

referred to the dangers of the operation. But people were 

not sufficiently advanced in knowledge to be able to define 

the conditions under which it is proper to undertake 

Caesarean section although the works of ARANZIO on contraction 

of the pelvis perhaps afforded to doctors some 

suggestions upon the subject. 

The spirit of criticism was aroused also in other departments 

of medicine and shook men's faith in doctrines and 

processes which relied for their support upon prevailing 

authorities. PIERRE BRISSOT pronounced it to be wrong, in 

* SIEBOLD op. cit. ii, 83. 

f SIEBOLD op. cit. ii, 94 et seq. 

X SIEBOLD op. cit. ii, 106 et seq.—O. WACHS : DerWittenberger Kaiserschnitt 

von 1610, Leipzig 1868.

3o8 

RECENT TIMES. 

inflammatory diseases, to bleed at a point remote from the 

affected part, as was customary at that time, and on the 

contrary performed the operation in its vicinity. His 

opponents, holding fast to the old opinions, attacked him 

vehemently on this account and affirmed that his innovation 

was as dangerous for the body as the religious belief of 

LUTHER was for the soul.* More important than all these 

disputes about the method of bleeding was the fact that in 

consequence of them doubts arose whether bleeding itself 

was always requisite in particular cases. About the same 

time MICHAEL SERVET combated the erroneous doctrines 

concerning the concoction of the juices. Moreover the 

exaggerated importance which men attached to the pulse 

;*'and to the character of the urine, experienced a reasonable 

•'•* and necessary limitation. Unprincipled adventurers and 

/ignorant empirics made such things the means of intoler- 

: able abuses. The urine-glass formed, as it were,the token 

of the doctor as may be seen in the pictures of the Dutch 

".school and was said to give information upon the most 

secret and wonderful things. It was only likely that 

honourable doctors and men of intelligence not in the 

profession, like the Bishop DUDITH of Horekowicz, should 

turn from these practices and strive to obtain a scientific 

treatment of the subject of the urine. But in truth any 

such treatment could only be undertaken with success 

when chemistry had attained to a higher development. 

No one effected more in this direction during the 16th 

r century, than THEOPHRASTUS BOMBASTUS PARACELSUS,* 

-.. of Hohenheim. This man, who forms one of the most 

V> remarkable figures in the history of civilization, by some 

unduly honoured and by others overwhelmed with scorn 

and hatred, has but seldom been judged correctly and 

without prejudice. He was of a nature like FAUST'S: 

While fastening his eyes on the highest and noblest objects, 

he suffered shipwreck in consequence of his bold, ambitious 

* K. SyRENGEi.: Geschichte der Arzneikunde iii, 176 after MOREAU : De 

miss, sanguis, in jpleurit., Paris 1630, p. 102.


3°9 

plans and, in the strife with the conditions which surrounded 

him, lost all; lost even himself. But these sad facts 

cannot rob him of the credit of having rendered a great 

service to medicine in combating the theory of juices 

as held by the ancients, and in being the first to give ex 

pression to the thought that the processes of life are of a 

chemical nature, and that chemical changes form the con 

ditions of health and disease. He recognized the falsity of 

the doctrine derived from ancient times that the heart is the 

source of heat, and said that every part of the body con 

tains its own source of heat.* He referred to the analogy 

between gout and calculous diseases, saying that both are 

characterised by the deposit of solid material, and he 

recommended the use of alkaline waters in these cases. 

The internal employment of various chemical, and especially 

mineral, substances was first attempted by him. To this 

category belong mercury in different forms, several combi 

nations of lead, antimonial medicines, precipitated sulphur, 

sulphate of copper, ferric oxide, and other preparations of 

iron. PARACELSUS declared that the task of chemistry 1 

was not the fabrication of gold, but the production, of 

medicines. He devoted diligent study to that science,t 

and was the first to avail himself of tincture of galls for 

determining the presence of iron in mineral waters. 

The evil results entailed by the too long continued use 

of certain minerals—as, for instance, mercury—did not 

escape his notice. He had learnt to recognize them among 

the workmen in the mines of Idria. In the same way he .,, 

described the effects of arsenic, and the diseases to which 

miners are exposed in smelting many metals. In taking ,;,' 

chemistry out of the hands of the alchemists, and in making 

it useful to medical science, he gave an incentive to the 

treatment of it in a scientific manner, and to the foundation 

of a medical chemistry. 

The effects of these circumstances were seen in pharma- 

* PARACELSUS : Paramirum, Lib. i. 

t KOPP : Gesch. der Chemie op. cit. i., 96.


cology. Numerous remedies which had been almost or 

completely forgotten were once more called to mind, and 

new ones were discovered. At the same time the pharmacopoeia 

was much enriched by.the addition of drugs introduced 

from America. The Emperor CHARLES V., by the 

advice of VESALIUS, made use of a decoction of china 

root (smilax china) when he lay ill with the gout. Guaiacum 

enjoyed a great reputation as a specific remedy for 

syphilis. ULRICH VON HuTTEN, who himself suffered for 

many years from this disease, has given a complete description 

of the effects of guaiacum* 

In the domain of internal medicine, the spirit of independence 

awakened by the struggle against the faith in 

authority brought forward a number of observations which 

contributed largely to the knowledge of diseases. Syphilis, 

which at this period was of unwonted virulence, and spread 

like an epidemic—on this account being considered a new 

"disease which had reached Europe from the newly discovered 

countries across the ocean —had a startling light 

thrown upon its real nature by the establishment of genetic.; 

relations between the primary local affection on the one • 

hand, and the ensuing secondary and tertiary symptoms on 

the other. Numerous treatises dealt with the course, 

symptoms, and treatment of this affection, and took into 

consideration every aspect presented by the disease. 

The first contributions upon scurvy date from the same 

period. VASCO DE GAM A in his expedition of 1498 lost no 

less than 55 of his ship's company, who succumbed to this 

disease.f The appearance of it was also observed in the 

maritime countries bordering on the North Sea and Baltic 

and in certain other districts. 

So too, at the end of the 16th century the earliest 

* U. v. HUTTEN : De Guajaci medicina, Mogunt. 1519.—F. F. A. POTTON : 

Livre du chevalier allemand Ulrich de Hutten sur la maladie francaise, 

Lyon, 1865. 

f A. H'RSCH: Handbuch derhistorisch-geographischen Pathologie, Stuttgart 

1883, ii, 358 et seq.


accounts are given of spasmodic ergotism—Ergotismus 

convulsivus—which was distinguished both by its symptoms 

and by its geographical distribution from the gangrenous 

form of the same toxic affection and which in earlier times 

was commonly designated Ignis sacer. 

In consequence of the careful study of the symptoms of 

disease and the progress of medical science it gradually 

became possible to separate the multifarious nosological 

conceptions commonly formed of leprosy and plague and 

to apportion them to the various diseases from which they 

had been taken. As a result of this, along with various 

affections characterized by eruptions on the skin, the typhus 

and typhoid fevers gained an independent place in scientific 

pathology. FRESCATORIUS, the most distinguished epidemiologist 

of the 16th century, published the first description 

of exanthematic typhus. BAILLOU left the first unmistakable 

account of whooping-cough and croup. Besides these 

works of fundamental importance, the literature dealing 

with individual cases deserves to be mentioned, being of 

great significance in the development of medical science. 

Particular observations are even now full of interest, such 

as those upon gallstones by A. BENEDETTI; the description, 

illustrated by a drawing, of the renal calculi of the 

DUKE ALBERT V. of Bavaria to which popular superstition 

assigned the form of Jesuits' heads ;* the case narrated by 

F. VALLERIOLA, in which a pistol-ball, which had penetrated 

the abdomen, was after a certain period passed per anum 

without producing any further complications ;f the report 

of a case by DODONÊUS, who at the post-mortem examination 

of a French prince, for long a sufferer from urethral 

discharge and pain in the region of the kidneys, found 

suppuration of the ureters and induration of the kidneys ; % 

the experiences of FELIX PLATTER in the treatment of 

mental diseases and his outspoken expressions against 

* CREDE and DISTEL in VIRCHOW'S Archiv, Bd. 96, S. 501 et seq. 

t Observat. medicin. lib., iv, c. 9. Lugd. 1605. 

X Medic, observat. exempla rara, Harderwyk 1521, p. 72, c. 41.

3I2 

RECENT TIMES. 

coercive measures and the confinement of the insane in 

prisons ; and many others. 

It has been possible here only to glance at the rich , 

acquisitions made by medical science in the 16th century: 

for a complete description of particular lines of progress 

would carry us too far and is not the task of the writer, of 

this work. The examples adduced are sufficient to indicate 

how the spirit of the age was reflected in the development 

of medicine. 

THE UNIVERSITIES IN THE SIXTEENTH 

CENTURY. 

THE intellectual life, thus developing itself with unexp 

energy, resulted in the foundation of numerous universities. | 

In Spain and Portugal, which countries in consequence of 

the discoveries across the ocean were .pressed into the fore- f 

ground among places of public interest, academies were 

founded at Toledo (1520), Baeza (1533), Compostella (1534), 

Granada (1540), Ossuna and Gandia (1549), Almagro (1552), 

Orchuela (1555), Tarragona (1572), and Oviedo (1580); 

universities arose even in the new world, at Lima (1551) 

and Mexico (1553). But in the evolution of science the J 

importance of these was but small. They quickly sank : 

into oblivion when Spain, destined by fate to play the part J 

of the leading maritime power, had, through the short- ; 

sighted ecclesiastical policy of her rulers and the narrow- . 

minded priest-ridden character of her people, fallen precipitately 

from the political height which she had attained. I 

England and the Netherlands, stepping into the place of 

Spain, soon came to rule the trade and intercourse with 

the countries across the ocean, and knew better how to 

make use of the advantages of their position. Their prosperity 

grew apace, and they became the wealthiest countries | 

of the world. They united in their possession the riches of 

America and the treasures of Asia; for even the Oriental 

trade, which had hitherto found its way across Italy, now

THE UNIVERSITIES IN THE l6TH CENTURY. 313 

adopted another route and reached the coasts of Great 

Britain, Holland, and North Germany by sea. These facts 

afford the explanation of the remarkable phenomenon that 

the last mentioned countries from this time forth played an 

important part also in the scenes of intellectual life, in art 

and science, while, on the other hand, they throw light upon 

the decline of Italy, which began at this period, and became 

clearly evident at the conclusion of the 17th century. Italy 

contained in the 16th century only two academies, those of 

Macerata (1540) and Messina (1548). 

In France universities were founded at Rheims (1558); 

Douai (1561), Besancon- (1564), and Pont-a-Mousson 

(1572).* To these, the universities of Lausanne (1536) 

and Geneva (1569), situated in French Switzerland, were 

added. Moreover, King FRANCIS I. founded the College 

de France, where lectures were delivered gratis, which 

everyone was free to attend. Among the twelve richlyendowed 

professorships one was devoted to medicine. 

In the British islands Edinburgh (1583) and Dublin (1591) 

possessed each a university. Similar institutions arose in 

the Netherlands at Leyden (1575) and Franecker (1585). 

On the eastern boundaries of civilization Wilna (1597) was 

made the seat of an academy. The number of German 

universities was also considerably increased. As early as 

at the Diet of Worms in 1495 tne Emperor MAXIMILIAN I. 

issued an order to the Electors that each should found an 

academy in his own country. What the Electors effected, that 

also the other territorial lords desired to achieve if it was in 

any way possible. And in this manner a number of universities 

were created, many of which were scarcely in possession 

of the barest necessaries for their existence. In 

1502 the Elector FREDERICK THE WlSE of Saxony 

founded, with the Emperor's permission, the academy 

at Wittenberg, which in the following decades formed 

* TOURDES: Origine de l'enseignement me'd. au Lorraine. La faculte de 

me'd. de Pont-a-Mousson, Paris, 1876.—LEGRAND : L'universite de Douai, 

Douai 1888.


the centre of the movements connected with religious 

reform. The foundation of the university at Frankforton-the-Oder 

for the Margraviate of Brandenburg followed 

in 1506. The first academy which came into 

existence after the Reformation, and bore a decidedly 

Protestant character, was that of Marburg, in Hessen, 

which was founded in 1527, but which only in 1541 

received the sanction of the Emperor. And like the 

Marburg university there arose that of Konigsberg, in 

Prussia (1544), under the influence of MELANCHTHON, 

whose son-in-law, SABINUS, was its first Rector* In 1549, 

O. VON TRUCHSESS, Bishop of Augsburg, founded at 

Dillingen an educational establishment for the clergy, 

which in 1554 was invested by the Pope with the rights of 

a university. Afterwards it was conducted by the Jesuits, 

and was abolished in i8o4.f The university of Jena. 

(1558) arose from the circumstance that the Elector JOHN 

FREDERICK of Saxony desired to have a university in the 

neighbourhood of his residence, when, after the unfortunate 

battle of Mvihlberg he was compelled to exchange his. 

country for that of his cousin MORITZ. His example was 

followed by the Duke JULIUS of Brunswick, who in 1576. 

created the university of Helmstadt, which existed up tothe 

year 1809. The medical faculty of this university bore 

on its coat of arms a crowned ox under a star.J 

Academies in the dominions of the Hapsburg dynasty 

were founded at Olmiitz (1573) and Graz (1585), and bore 

the stamp of Catholicism; they were, however, not provided 

with all the faculties. The university of Wiirzburg, 

reopened in 1582 by the Prince Bishop JULIUS 

ECHTER, alone possessed a richer equipment for the 

advancement of medical studies. For the rest, the other 

newly-arisen universities had seldom more than one 

medical professor. Theology always as yet occupied the 

* M. TOPPEN : Die Griindung der Universitat zu Konigsberg, 1844. 

t PAULSEN : Geschichte des gelehrten Unterrichts op. cit. S. 268. 

X Geschichte der ehemaligen Hochschule zu Helmstadt, Helmstadt 1876.

THE UNIVERSITIES IN THE l6TH CENTURY. 315 

foreground. The Protestant academies fought no less 

zealously for the new faith than did the Catholic universities, 

under the guidance of Jesuits, defend the authority 

of the Pope. No one who did not adhere to the Lutheran 

belief was tolerated at the academy of Helmstadt. The 

Duke of Brunswick, in 1584, declared to the General 

Consistory that it was better that such people should " go 

straightway to the devil than that they should sully and 

contaminate his churches and schools."* However, it was 

already a great advance in the direction of tolerance that 

he only wished those of another faith, in the world to come, 

and did not use force to help them on the road thither. 

Unfortunately this occurred only too often even under the 

rule of Protestantism, as, not to mention the cruel and 

bloody persecutions of which England and the countries 

subject to her were the scene, the example of the unfortunate 

MICHAEL SERVET testifies, who, on the prosecution 

of CALVIN, came to the stake at Geneva owing to his failure 

to comprehend the doctrine of the Trinity in Unity of the 

Godhead.t 

The effect of the split in the Church upon the universities, 

which attached themselves to the movements of 

religious reform, manifested itself first by the act of shaking 

off the yoke of Rome and by a removal of direct papal 

interference. But ecclesiastical influence was not thus 

abolished ; Protestant theologians merely stepped into the 

place of their Catholic predecessors, making their rule 

oppressively felt in many countries—for example, in 

England—and extending their control in an unjustifiable 

manner over all possible paths of intellectual life. A freer 

spirit animated the Protestant academies of Germany. 

The priesthood of the new Church here won less power 

and developed gradually into an organ of the State Govern- 

* PAULSEN op. cit. S. 178 following E. L. T. HENKE: Georg Calixtus 

und seine Zeit, Halle 1853. 

t W. E. H. LECKY: History of the Rise and Influence of the Spirit of 

Rationalism in Europe.


ment, which, on grounds of political expediency, was 

obliged to avoid brutal outbreaks of religious intolerance. 

In France the control of the universities and generally of 

the whole system of education by the State was gradually 

introduced by the energy of the governments, just as in 

the Protestant countries of Germany it came about under 

the influence of the Reformation. 

In the Catholic countries of Germany this process 

was only accomplished in the 18th century, and in 

other States, as in Italy, only in the 19th. It resulted,; 

in the introduction of many changes in the organization 

of the universities. The dignity of Chancellor, if 

not entirely abolished, was conferred upon high officials 

or trusted friends of the Government, and the charter was 

no longer conferred by the Church but by the State. The 

cosmopolitan character of the universities ceased to exist 

at the same time; henceforth they were no more than the 

highest educational establishments of the State, and their 

academical degrees were no longer, as formerly, of value in 

all countries of Christendom, but only in a narrowly-defined 

political district. The unlimited freedom which the learned 

professions enjoyed in the middle ages was done away 

with, and a system of tests gradually became developed 

which recognized knowledge only when it had been acquired 

in particular training grounds. The financial condition of 

the universities of Germany and of several other countries 

which attached themselves to Protestantism sustained as a 

general rule a great revolution. The Professors lost the 

prospect of an increase of their incomes by the acquisition 

of fat benefices. The slight rise in their stipends which 

resulted from the secularization of the Church property 

afforded but a poor compensation. Everywhere it was 

felt that the secure support afforded heretofore by the rich 

pecuniary possessions of the Church now no longer existed. 

How insignificant was the amount demanded at that time 

for the support of a university is shown by the annual 

budget of the academy of Tubingen for 1541-42. The

THE UNIVERSITIES IN THE 16TH CENTURY. 317 

income reached 5,176 florins, the expenditure 4,853 florins ; 

in the latter were included the stipends of three professors 

of theology, six of law, two of medicine, and ten of the 

liberal arts, the amounts varying from 4ofl. to 20ofl., in all 

2,394ft* 

The requirements of a small university of that period 

were not great, as is seen by the example of Greifswald 

where the whole extent of the university was included in a 

single house. It consisted of three lecture-rooms, the 

senate-chamber, a stall for the trade in academical books, 

the library, the chamber for the records, dwelling rooms for 

two professors, several apartments where students lived, 

and the prison in the basement.f The Catholic academies 

were in a more favourable position in this respect. Pope 

JULIUS III., in the year 1553 promulgated a bull by which 

it was made legal to grant spiritual benefices to secular 

professors,—a practice, indeed, which had long been sanctioned 

by usage and passed over in silence. The celibacy 

of university teachers became, in consequence of this, 

objectless, and gradually ceased to be observed even in 

Catholic countries. In Protestant academies it was naturally 

done away with; yet custom had such a powerful effect 

that in Tubingen, for example, the usage was still adhered 

to, and celibacy was demanded even of the professor of 

medicine, long after the university had become Protestant. 

The salaries of the professors differed in different 

countries and in the various faculties ; those of the professors 

of medicine, as a rule, were on a lower scale than 

in the case of the theologians and jurists. In Paris each 

professor of medicine received in 1505 twelve livres a 

year.| In Konigsberg, in the year 1544, salaries of 200 and 

of 150 florins were given to the two teachers of medicine.§ 

* F. PAULSEN in SYBEL'S histor. Zeitschr. 1881, Bd. 45, S. 278 et seq. 

t F. PAULSEN op. cit. S. 304, 407. 

X HAZON op. cit. 

§ D. H. ARNOLDT: Historie der Konigsbergischen Universitat, Konigsberg 

1746.


k_, r 

, . - - 

In Heidelberg before the Reformation the three professors! 

of medicine drew the yearly stipends of 180, 160 and 140 

florins. In 1588 these were raised to 270, 180 and 170 fL, 

and in addition, each professor received free lodging, a 

tun of wine and twelve measures of corn a year* The 

Duke WILLIAM of Bavaria in 1537 established in Ingolstadt 

a teacher of law with the stipend of 300 fl. This 

was the highest salary paid at that time at a German 

university.t 

The students, as a body, were in like manner powerfully 

influenced by the great events of the time. The struggle 

against authority opened up along all lines of attack, the 

study of humane learning seeing its ideals in the unconstrained 

life of the ancient world, but above all the division 

in the Church, engendered a spirit of freedom and liberty 

which sometimes rose in revolt against every interference 

with complete independence. The records of the Senate 

of the university of Tubingen contain remarkable notes for 

the history of manners among the students of the 16th 

century. Thus in a letter of the year 1564 addressed to 

the Senate the nuns of Silchen complained that they were 

molested by the frerquent and importunate visits of the 

students. Many students in Tubingen were married and 

fathers of families. In 1575 the young students were forbidden 

to marry without the consent of their parents. Ir 

1589 the Senate was informed that a widow misconductec 

herself with the students ; as a punishment for this she wa: 

11 chained up in a little room."J Similar excesses occurrec 

at Wittenburg.§ Among the students also of Catholii 

universities, as we learn from information to hand concern 

* HAUTZ op cit. 

t MEINERS : Geschichte der Entstehung der hohen Schulen, Gottingen 1801 

X R. v. MOHL: Nachweisungen iiber die Sitten und das Betragen der Tubii 

ger Studierenden wahrend des 16 Jahrhunderts, Tubingen 1871.—JOH. HUBEI 

Deutches Studentenleben in Kleine Schriften, Leipzig 1871, S. 364 et seq.-- 

GEBHARDT in the Zeitschr f. allgem. Gesch. edited by ZWIEDINECK-SODB: 

HORST, Bd. iv, 1887, S, 962. 

§ j. F. A. GILLET: Crato von Crafftheim, Frankfurt-a-M. i860, i, 101.

THE UNIVERSITIES IN, THE 16TH CENTURY 319 

ing that of Ingolstadt, a rough, violent tone prevailed.* The 

students lived partly in " Bursen " or boarding-houses, as they 

existed in the middle ages, partly at the houses of private 

people or professors. The latter found a sometimes highly 

desirable source of income in housing and attending to 

students. The son of MARTIN LUTHER kept a boarding- 

house for students in Wittenberg which was much fre- 

quented.t In Heidelberg it not unfrequently occurred that 

the professors caused the wine which formed a portion of 

their pay, to be publicly retailed : they might safely calcu 

late upon their pupils devoting themselves to it with at 

least as much assiduity as to their lectures. Poor students 

were exposed to the bitterest want. THOMAS PLATTER 

, has given a touching picture of their miserable existence in 

his autobiography. Cold and hungry, clothed in rags and 

begging for alms, he, with his companions, traversed Swit 

zerland and Germany. The travelling students formed a 

vagabond class which put credulity and ignorance under 

contribution and in many places became a serious annoy 

ance to the country. A deep social gap divided these 

beggar-students from the rich and distinguished young 

men to whom, at most universities where they studied, a 

privileged position was assigned. These frequently sought 

to cut a figure by costly feasts and banquets, by an appear 

ance of prodigality and by excessive luxury in dress. The 

pantaloons, "for example, of some students used to cost 

above 100 fl.: a sum, the value of which we begin to grasp 

when we consider that the midday meal of the Tubingen 

students of that period, consisting of three courses and 

a quart of wine, was paid for at the rate of 38 florins a 

year. Laws, sermons and books inveighed against the 

prodigality of the students but, as it seems, without result. 

Professor Museums, of Frankfort-on-the-Oder, criticized 

severely the fashion of pantaloons in a tractate hearing the 

< title: " An Exhortation and Admonition against the decoy- 

* B. GEBHARDT op. cit. S. 957. 

t PAULSEN ; Gesch. d. gel. Unterrichts S. 16.1.

o2Q 

RECENT TIMES. 

ing, manners- and honour-compromising, pantalooning 

Trousers-devil" (Frankfort-on-the-Oder, 1556). A resolution 

of the Senate of the Tubingen Academy of the year 

1554 cautioned "the noblemen, so lately arrived here, in 

respect of their unrefined and indelicate trousers" and. 

called upon them "to lay aside such an objectionable and 

soldiering garment." 

MEDICAL TEACHING. 

THE changes, brought about in medical science, exercise 

an influence upon medical teaching inasmuch as the 

quantity of subject matter as well as the number of .pro-? 

fessorships and the means of instruction were augmented:! 

the method, also, of medical education, in response to the | 

importance acquired by anatomy and surgery, took by j 

degrees a somewhat more practical direction. Events! 3 

which had occurred in the history of civilization, discoveries 

and inventions of many kinds, likewise exercised ;j 

a powerful influence upon the system of education. 

Before the discovery of the art of printing, libraries were j 

the rarest and costliest things. The medical faculty of fe 

Paris possessed in 1395 no more than nine works, among _ 

which the Continens of RHAZES was the most highlyf 

prized. When King LOUIS XI. in 1471 wished to borrow 

this work, in order to have it copied, long consultations 

were held by the faculty upon the subject and they only 

granted permission after the King had deposited as caution- 

money 12 marks in silver and had granted a loan of 100 ' 

thalers in gold* Private persons could make collections 

of books only by the expenditure of large sums of money. 

Even so prominent and wealthy a doctor as TADDE0 . 

ALDEROTTI, left at his death only four books; in thej 

property bequeathed by the doctor FREIDANK we find no 

* J. C. SABATIER op. cit— KOSEGARTEN (Geschichte derUniversitat Greifswald, 

Greifswald 1857, ii, 232) g^s a catalogue of the books which in 1482 were 

in the possession of the medical faculty of Griefswald.

MEDICAL TEACHING. 32 1 

more than three* The preparation of a copy of a work 

claimed years of strenuous application and demanded 

attainments at that time by no means common. With the 

discovery of printing a revolution was effected in this 

t respect, similar to that which in the most recent times has 

been brought about by the substitution of machine- for 

hand-work in the preparation of goods. The foundation 

and improvement of academical libraries were by this 

facilitated or, properly speaking, for the first time made 

possible. The universities in this way gained an aid to 

teaching which promoted the development, at once, of the 

intellect and of the character. They recognized its importance 

thoroughly, and took pains to procure the money 

necessary for the acquisition of books and to regulate the 

use of these collections by judicious arrangements and 

instructions.t The rules of the medical faculty of Montpellier 

in 1534 provided, that the library should be opened 

-at 6 a.m. in summer and at 8 a.m. in winter, and should 

be closed at 4 p.m. The students were held responsible 

for any injury occurring either by loss or disfigurement 

of the books, t 

ft 1 "*" 

In the 16th century the practice was also commenced of 

providing the universities with botanical gardens. The 

republic of Venice set a good example, in this respect, to 

all other states by causing a botanical garden to be laid 

out at Padua in 1545.§ Then arose those at Pisa (1547) 

and Bologna (1568) where afterwards A. CESALPINI "the 

greatest botanist of his century " taught and worked. In 

1577 LEYDEN acquired a botanical garden ; Montpellier in 

1593. In the German academies the earliest were founded 

at Leipzig (1580), Breslau (1587), Basel (1588) and Heidel- 

* KRIEGK op. cit. i, 17. 

t PRANTL op. cit. i, 215. 

J DUBOUCHET in the Gaz. hebd. des scienc. me'd. de Montpellier 1887, Noil, 

p. 124. Compare also the very detailed Rules for the Library of the ficole 

de Medecine of Paris for the year 1395 in SABATIER op. cit. 

§ MEYER op. cit. iv, 256 et seq. 

Y

322 

RECENT TIMES. 

bere (1593)* At first the y ° nly * SerVed t0 P r0m0te 

the study of medicinal plants. The teaching of botany 

was combined with demonstrations on the plants a 

procedure which facilitated the comprehension of the jj 

lectures in an extraordinary degree. Moreover, herbaria •* 

or collections of dried plants, probably introduced since the i 

middle of the 16th century,t were applied to the same purpose, 

as also were drawings of plants. Even in ancient 

times care was taken to embellish botanical works with 

drawings Those of the manuscripts of DiOSKORiDES, 

which are now possessed by the Imperial Court Library at 

Vienna, date from the 5th century. From later times, also, 

especially from the 15th century, numerous drawings of 

plants have been preserved.* By the invention of woodand 

copper-engraving it became possible to multiply he 

drawings at pleasure. Distinguished artists, nay, even the , J 

master-hand of a GuiDO RENI, made drawings for the engraver. 

Botanical literature was in the 15th and 16th 

centuries enriched with a great number of illustrated works 

of this kind. . . 

Anatomy owed still more to the art of painting, lne 

most celebrated painters of this period devoted diligent 

study to the anatomy of the human body. LEONARDO DA 

VINCI received instruction from his friend, the anatomist 

MARC ANTONIO DELLA TORRE, upon the course and form | 

of the muscles and upon the position of particular parts of ! 

the human body. He supplied the latter with drawings for 1 

an anatomical work, which he desired to publish, but which { 

never appeared. These came afterwards for the most part 

into the possession of the Biblioteca Ambrosiana at Milan . 

and then reached Paris; certain of them became the property | 

of the English Royal Family and were published by means of ^ 

engraving in the case of some of the drawings, in the easel 

of others by photography.§ MICHELANGELO, too, occupied | 

* HAUTZ op. cit. :„ 

t MEYER op. cit. iv, 266 et seq. X MEYER op. cit. iv, 273 «* se f ' 

VASARI : Leben der ausgezeichneten Maler, Bildhauer und Baumeister. 

Deutsche Ubersetzung, Stuttgart, 1843, Bd. iii, S. 26.-R. KNOX : Great ArustsJ

• 

MEDICAL TEACHING. 323 

himself for many years with anatomical studies, and during 

his sojourn in Rome was assisted in these by the anatomist 

REALDO COLOMBO who provided him with the body of a 

wonderfully handsome young negro to study.* He made 

observations upon the structure of man in the vaults of S. 

Spirito at Florence, and followed with great attention the 

dissections at which he had the opportunity of assisting. 

The report even went abroad that he made use of a 

living man as model when he had to represent the 

Saviour upon the Cross exactly as in ancient times 

a similar tale, as is well known, was told of PARRHASIOS 

when he painted PROMETHEUS torn by the vulture.f 

Among the anatomical drawings of MICHELANGELO 

mention may be made of the sketch of a dissection, and of 

the picture of a human body the muscles of which are 

shown after removal of the skin : the latter is characterized 

by close accuracy in its proportions. The skeleton studies 

•of RAFAEL also are drawn strictly after nature; they 

produce a powerful effect by their essential truth and by 

their fidelity of expression. Rosso DE Rossi, a pupil of 

ANDREA DEL SARTO, produced some excellent representations 

of the muscles and of the human skeleton, which 

were multiplied by means of copper-engravings.^ 

Sculpture was influenced also by studies in this direction 

as is clear from the statue of ST. BARTHOLOMEW preserved 

in Milan Cathedral in which the muscles are shown laid 

bare: this was the work of MARCO AGRATE. The 

anatomical plates of VESALIUS and the drawings accompanying 

his two larger works came from the school oi 

TITIAN and were probably chiefly the work of JAN VAN 

and Great Anatomists, London 1852.—CHOULANT op. tit. p. 6 et seq.—K. F. 

H. MARX: Uber Marc Antonio della Torre und Lionardo da Vinci in Abhdlgn. 

der Gottinger Soc. d. Wissensch., Bd. iv, 177 et seq.-C. LANOEB in the Situngsber'. 

d. k. k. Akad. d. Wiss. Math.-Naturwiss. Kl., Wien 1867, Bd. 55, i, 637. 

* A. CORRADI inRendic. del R. 1st. Lomb. di sc. e.lett., Vol. vi, ser. ii, p. 643. 

t HAESER op. tit. ii, 27.—CHOULANT op. til. p. 10 et seq.—Ann. SENECA": 

Controvers., lib. x, c. 5 (No. '34). 

X CHOULANT op. cit. S. 16 et seq.

3 2 4 

RECENT TIMES. 

CALCKER, certain sheets and certain improvements in other 

sheets being perhaps by TITIAN himself. It is quite' 

possible that, in addition to the two well-known figures * 

of a man and woman, he had a hand also in the title 

page where VESALIUS appears performing the dissection J 

of a corpse in the anatomical theatre in the presence 

of a large concourse of spectators. The anatomical ',| 

plates of the pre-Vesalian period have a lower value, s 

as, for example that of B. PASSAROTTI—a representation 

of' blood-letting—which, it would appear, served for the . 

instruction of surgeons and barbers* ALBRECHT DURER | 

and LEONARDO DA VINCI published works on the pro-1 

portions of the human body f which were translated into 

foreign languages and exercised a great influence^ as 

is evident from the productions of several Spanish artists. | 

Certain anatomists, also, produced valuable anatomical 

drawings. The picture which VAROLiUS made of the 

base of the brain displays contours, correct indeed if also 

rather coarse, and was obviously intended for teaching.J 

BERENGER of Carpi was, according to the testimony of 

BENVENUTO CELLINI, not only an experienced physician and 

anatomist, but also a skilful draughtsman. He embellished J 

his anatomical works with woodcuts, which kept in view the 

interests of the artists as much as those of the doctors^ 

So too, the myology of CANNANI and the anatomical;?! 

writings'of CHARLES ESTIENNE (STEPHANUS), EUSTACHIUSJ 

and VOLCHER KOYTER, who himself made many anatomical 

drawings, of the Spaniard VALVERDE DE HAMUSCO, and 

again of GUIDI (VlDIUS), JACQUES GUILLEMEAU, FELIX 

PLATTER, SALOMON ALBERTI, GIULIO CASSERIO, and 

ADRIAN VAN DEN SPIGEL were all provided with illustra-? 

tions. 

Besides the anatomical drawings, which doubtless were 

* CHOULANT op. cit. S. 39 e* seq. 

t A. W. BECKEH : Kunst und Kiinstler des 16 Jahrhunderts, Leipzig 1863, 

Bd. i, 341. iv > l6 3- 

X CHOULANT, op. cit. 3. 69.


3 2 5 

of great value in the education of doctors, and besides 

the theoretical lectures, the means of teaching most * 

resorted to consisted of practical demonstrations for which 

opportunity was afforded by the dissection of corpses. 

These demonstrations were, in the course of the 16th 

century, introduced at all universities with which medical 

faculties were associated. At first they were performed in 

this manner:—the professor delivered from the chair 

descriptions and explanations of the various parts of the 

body, while the dissection itself was being made by a 

surgeon or a barber. The learned doctors were frequently 

of opinion that their dignity would be lowered if they 

meddled personally with dissection of corpses. When 

VESALIUS was studying at Paris anatomical teaching was, 

at that place, entirely in the hands " of ignorant beard- 

shavers," as he says,* " who confined themselves to showing 

the muscles of abdomen in a torn and shamefully mangled 

state, but did not demonstrate any other muscles or any 

bones ; still less did they review, in any regular manner, 

the arteries, veins, or nerves." GUINTER of Andernach,t 

who taught anatomy in Paris, held aloof from practical 

work. VESALIUS says of him that he never used the 

knife for any other purpose than that of cutting up roast 

meat. 

The Italian anatomists adopted a more correct method, in 

performing the dissections themselves. It was no doubt 

chiefly owing to this circumstance that nearly all the great 

anatomical discoveries of that period proceeded from Italy. 

The anatomical schools of that country were the best 

in the world. All the prominent anatomists of the 16th 

century received their education at them; among their 

professors are found the most glorious names in the history 

of science. In electing teachers there was no condition im 

posed as to their being natives of Italy; but the ablest 

* VESALIUS : Epist. dedicat. to De corp. hum. fabrica. 

f Concerning this teacher see E. TURNER in the Gaz. hebdom. de Med., 

Paris 1881, No. 27, 28, 32.


teaching power was accepted from any and everyôuntry 

Many Dutchmen and Germans were teachers Of anatomy 

in Italian academies. At the suggestion of A. BENEDETTI * 

an anatomical theatre was founded at Bologna in the year 

1490. Similar institutions on the same plan arose also 

later in Padua (1548), Amsterdam (1555) and at other 

academies* A great drawback to the development of,, 

anatomical teaching was occasioned by the scarcity of subjects, 

a state of things which was only very gradually K 

improved. Even VESALIUS declared that he had so seldom 

had an opportunity of dissecting the uterus of a pregnant 

woman that he was really quite ignorant of the differences 

existing between it and the same organ in a similar condi- A 

tion in the canine race.f As a student in Paris and afterwards 

at Louvain he, with his companions, visited they 

churchyards by night in order to dig up and collect humaff 

bones; once he is said on such an expedition to have | 

mounted the gallows and to have taken down the 

- skeleton of the criminal who had been hanged there.:j. 

It was the same in other places as well. FELIX 

PLATTER narrates how he when a student at Mont- 

' ,•'•>. pellier, along with friends,..among whom was a "daring 

'% monk of the Augustine Monastery," dug up bodies 

\\ Vby night in the churchyard "after having had a good 

"fcdeep drink," and Clandestinely conveyed the bones into the 

" ; 'town.§ Not only the students, however, but the professors. * 

also, complained of the scarcity of subjects. RONDELET of 

Montpellier is said for this reason to have even dissected the 

body of his own son who hadtdied. It is further said of him 

that when his colleague FONTANO was lying very ill he 

begged to be allowed, after his death, to devote his body to 

anatomical purposes. || Certainly in the statutes of the 

-


medical faculties rules were laid down that every year one or 

more anatomical demonstrations should take place, and that 

the authorities should provide the bodies required. But the 

authorities were not always equal to their duties in this 

respect and, even when this was the case, the material used 

for study was scarcely sufficient for teaching purposes, and 

still less did it supply the wants of anatomical investigators 

in the pursuit of their researches. 

It was therefore not unnatural that, baffled in obtaining 

material in a legal way, anatomists sought to provide it in 

another. Purchase and theft of bodies became consequently 

a not uncommon practice and one regarded by the magis 

trates with a certain toleration, when the objects in view were 

connected with science. But it seems to have been some 

times carried on too openly and also to have led to abuses 

with which it was necessary to interfere. In 1550 the 

people of Padua demanded that the laws against the dese 

cration of graves and the stealing of bodies should be more 

^strictly administered.* Religious now took the place of 

social prejudices in opposing the practice of dissection. 

Only through the good will of intelligent magistrates 

and the powerful support of the distinguished lords who 

interested themselves in anatomy, was it possible for 

investigators to find the material necessary for their 

studies. FALLOPIUS had the opportunity, in a single year, 

of dissecting seven human bodies; REALDO COLOMBO 

brought the number up to 14T FELIX PLATTER states 

that in the course of thirty years' work he dissected more 

than 50 bodies;| a number unusually large for that time. 

VESALIUS during his successful activity in the academies 

of Padua, Pisa and Bologna had as many subjects as he 

wished; they were delivered to him from the scaffolds and 

from^ the hospitals. The judges had the kindness to 

* CORRADI op. cit. p. 642. 

f R. COLOMBO op. cit. xv, p. 262. 

J F. PLATERUS: De corp. hum. structura et usu, Basil. 1583, in the dedication 

after the title-page.

328 

RECENT TIMES. 

choose a mode of death for the condemned, proposed by^ 

VESALIUS, with the object of preserving the bodies uninjured, 

or they put off the executions at his desire till 

such time as a scarcity of bodies prevailed. This obliging 

disposition was carried so far that when VESALIUS, wishing 

to solve the, at that time, undecided problem * as to the ;4 

existence of the hymen virginitatis, was in a state of embarrassment 

as to where he could get a suitable female ;,.| 

subject, COSMO DE MEDICI placed at his disposal the 

corpse of a pious nun who had died a short time before. Jf 

As a result of this, as HYRTL remarks, it was possible to 

give its due weight to this important attribute of virginity, 

which it had hitherto been impossible to do, since the 

bodies of the maidens brought from the gallows as a rule : 

were no longer in possession of this structure. 

Practical teaching in anatomy consisted chiefly in the 

demonstration of parts of the body; the students only :jj 

exceptionally had the opportunity of taking part in dissections 

themselves. It can be seen however from the 

statutes of the medical faculties that the number of 

dissections made every year for* the purpose of educating; 

the doctors gradually increased. In 1519 the rule was 

made that every year a body should be publicly dissected, | 

since without anatomical dissection a knowledge of the^ 

human body and its diseases was unattainable.! A similar -| 

order is found in the statutes which the Duke ULRICH pro- • 

mulgated for Tubingen. 

In Prague not only were anatomical studies in a very j 

low condition, but the whole university had sunk into dis- 1 

repute. The Priest JACOB in 1517 called it at the Teynkirchea 

"rusty ornament."J Medicine had almost ceased to 

be taught there in the 15th and 16th centuries. Anatomical 

demonstrations were- first introduced at this university by i 

JOHANN JESENSKY (JESSENIUS) who at the conclusion of 

* H.TOLLIN in the Biolog. Centralbl. v, 347. 

t ZARNCKE: Statutenbiicher der Uni\Tersftijtt Leipzig, 1861, S. 39. 

X W. TOMEK: Geschichte der Prager Universitat, 1849.

MEDICAL TEACHING. 3 2 9 

the 16th century undertook there a professorship of medicine.* 

Things were not much better in Vienna during the first 

half of the 16th century. Only after AlCHHOLTZ assumed 

the teaching of anatomy were public dissections held there 

at least once in every winter. But these were afterwards 

discontinued. Then in 1567 the medical students requested 

that a dissection should once again be made, since this had 

not been done for many years. Their petition was, how 

ever, refused ; they therefore repeated it the following 

year, but with the same result; only in 1571 was their 

wish gratified.f 

About 1542 VESALIUS performed the first dissection of a 

human subject in Basel. The skeleton of it is still pre 

served, along with that prepared by FELIX PLATTER, in 

the anatomical museum of that university.J The latter 

undertook in the years 1559, 1563, and 1571 public dissec 

tions in the presence of the doctors, surgeons, and other 

spectators. Regular anatomical demonstrations were, how 

ever, only introduced after C. BAUHIN had been made pro 

cessor of anatomy and botany. 

In Edinburgh the Corporation of Surgeons obtained per 

mission in the year 1505 to dissect the body of an executed 

-criminal once a year. 

The statutes of the medical faculty of Montpellier of the 

year 1534 contain detailed information as to how the 

students were to proceed in dissecting, and how much they 

were to pay for the privilege. In 1598 an anatomical 

theatre was founded there and a prosector appointed with 

a stipend of 100 thalers.§ In Paris the post of prosector 

. was instituted as early as 1576 : it was filled by a surgeon 

who carried out the practical arrangements, while a bache- 

* J. HYRTL : Geschichte der Anatomie in Prag, Prag 1841, p. 11. 

f ROSAS op. cit. ii, 85, 89, 104. 

X His in the Correspond.-Blatt der Schweizer Arzte, 1879, S. 121 et seq. 

§ DUBOUCHET in the Gaz. hebd. d. scienc. me'd. de Montpellier, 1887, No. ir 

-and 17.—ASTRUC op. cit. p. 66 et seq..

RECENT TIMES. 

lor of medicine who was distinguished for his anatomical 

knowledge, had to compile from literature, and deliver 

orally, the theoretical explanations. The latter bore the 

title of Archidiaconus. The prosector had a very dependent 

position. He was under the supervision of the 

professor of anatomy who, as was said in the statutes 

of 1598, must take care that the prosector does not idle 

about, but occupies himself diligently with anatomical 

dissections and demonstrations (non sinat dissectorem 

divagari, sed contineat in officio dissecandi et demon 

strandi). It was further resolved, that every year at least 

two public dissections should take place. At the same 

time, the authorities were directed never to hand over a 

body for anatomical purposes without the cognizance of 

the dean of the medical faculty, and in delivering bodies 

up to have regard first to the requirements of the pro- I 

fessors and doctors of medicine and, only in the event of 

these resigning all claims to them, to let the surgeons 

have them* The expenses connected with the anatomical 

demonstrations were in all cases borne by the spectators,! 

that is to say by the students, whereas the theoretical, 

lectures of the professors since the beginning of the 16th 

century were given gratis. 

Practical teaching in materia medica and the treatment 

of diseases was adopted by the universities long after* 

that in anatomical dissection. The students learnt the 

properties of drugs and the methods of compounding 

them in the apothecaries' shops. In 1536 it was ordained 

by law in Paris "that the bachelors of medicine shoukL 

accompany the doctors in their visits to the apothe?-| 

caries' shops, in order that they might be able to inform 

themselves concerning drugs." J Already at that time 

* D. PUYLON: Statuts de la faculte' de medecine en i'universite de Paris 1672,. 

Art. 56 and supplement Art 5.—A. PINET : Lois, de"crets. reglements et circulaires 

cone, les facultgs et les gcoles pr^paratoires de medecine, Paris 1880, i> 

Art. 56, supplement Art. 8. 

f Cf. CERVETTO op. cit. p. 139. 

X PHILIPPE op. cit. S. 153.

MEDICAL TEACHING. 33 r 

there were apothecaries' shops in nearly all towns. They 

were furnished with distilling apparatus, fire places and 

furnaces for chemical and pharmaceutical operations, 

druggists' wares and various surgical utensils, which were 

there stored for sale* By an edict-of Louis XII. of the 

year 1514 the apothecaries of Paris were liberated from 

association with the grocers, with whom they had hitherto 

been joined in a guild. Whoever devoted himself to the 

business of an apothecary was obliged, in accordance with 

the statutes issued by FRANCIS I., to have received a good 

school-education and to have learrit as much as would' 

enable him to understand the text-books written in the Latin 

tongue and the pharmacopoeias ; and then to have gone 

through a four-years' training in an apothecary's shop. 

In Paris an arrangement was made that during the space 

of a year students of pharmacy should attend two lectures 

in every week upon the apothecary's art which should be 

given by a specially competent and respectable member of 

the medical faculty. The examination was held before a 

commission composed of doctors and apothecaries and 

consisted of a theoretical and a practical part; in the 

latter the candidate was obliged to show knowledge and 

experience on the subject of medicinal plants and, as a final 

test of his ability, to make up five prescriptions.f 

Clinical instruction also lay outside the scheme of uni 

versity teaching. The students of medicine betook them 

selves, for this, to their teacher or to some other doctor busily 

engaged in practice who was able to give them opportuni 

ties either amongst his private patients or at a hospital at 

which he was employed, of observing the sick and of learning 

how to treat them. At some academies the professors 

were required by law to give their pupils the necessary 

introduction. At Vienna, Heidelberg, Wiirzburg, Ingol- 

stadt and other places they were charged to take their 

* H. PETERS: AUS pharmaceutischer Vorzeit, Berlin 1886, S. 25 et seq., u 1 

et seq. 

f PHILIPPE op. cit. S. 165 et seq.


pupils occasionally to the bedsides of their patients provided 

that the latter were not annoyed by such a proceeding. In 

Basel, the medical officer of the town, who also held the . 

appointment of teacher of practical medicine and was head 

of the town hospital, was bound to afford the students of 

medicine access to this hospital and to demonstrate to 

them the patients who were being treated there* In, 

Paris the bachelors of medicine were allowed to engage in 

practice under the supervision and as the representatives 

of the members of the faculty.f 

But there was no systematic introduction to the treat- i 

ment of the sick; this want could not be supplied by 

occasional observations and casual experiences. Not only 

the doctors, as for example, the Swedish court-physician 

W. LEMNius,J y saw this, but intelligent laymen as well.j 

The philosopher P. RAMUS in 1562 in a letter to CHARLES , 

IX. of France, in which he proposed various reforms in the 

system of education, asked that institutions should be 

arranged for clinical teaching.§ This idea had already at 

that time been carried into effect, namely in Padua. 

GIAMBATTISTA DA MONTE (MONTANUS), who taught there 

at the same time as VESALIUS, is said to have employed the 

clinical method of teaching as early as the year 1543d! 

But after his death in 1551 this arrangement ceased and 

was only renewed in 1578. About this time the professors 

ALBERTINO BOTTONI and MARCO ODDO—of whom one 

conducted the division for men and the other that for 

women in the hospital of St. Franciscus—began to give. 

* O. BECKER : Zur Geschichte der medicin. Facultat in Heidelberg, 1876.— 

A. v. KOLLIKER: Zur Geschichte der medicin. Facultat in Wiirzburg, 1871.— 

F. MIESCHER : Die medicin. Facultat in Basel, i860, S. 32 et seq.—W. VISCHER: 

Gesch. d. Univ. Basel, Basel i860. 

f PINET op. cit. and PUYTON op. cit. Art. 59. 

X P. FRANK op cit. vi, 2, S. 189. 

§ CH. JOURDAIN: Histoiie de 1'university de Paris au 17 et au 18 siecle, 

Paris 1862-66, T. i, p. 3. 

|| G. CERVETTO: Di Giambattista da Monte e della medicina italiana nel 

secolo xvi, Verona 1839, p. 51.


clinical instruction at the request of the German students ; 

moreover the corpses of the patients who died in the 

hospital were opened, if the time of year was suitable, in 

order that the students should have pointed out to them 

the sites and causes of disease (sed cum in fine Octobris 

coeli constitutio frigidior esset, professores cad aver a 

aperiunt et loca ajfecta auditoribus demonstrant). Unfortunately, 

the necropsies were forbidden after a short 

time, since improprieties had occurred and parts of bodies 

had been secretly conveyed away from the institution.* 

With the deaths of BOTTONI and ODDO the zeal of teachers 

and pupils relaxed and instruction was at last chiefly confined 

to investigation of the pulse and urine. The attempts 

to place teaching in medicine upon a practical basis had, 

however, to yield, in the curricula of the medical faculties, 

to the theoretical lectures which claimed the place of 

chief importance. According to the statutes of the medical 

faculty of Wiirzburg of the year 1587, there were there 

three professorial chairs of medicine. The incumbent of the 

first, the Professor of the Theory of Medicine, had to read 

publicly in the first year the primam primi libri Avicennae 

et libros Galeni de morborum differentiis, causis et symptomatibus 

; in the second year, the Galeni artem medicinalem 

cum Hippocratis prognosticis; in the third year, to 

lecture de pulsibus et urinis according to ACTUARIUS, 

de victus ratione in morbis acutis after HIPPOKRATES, 

Galeni de alimentorum facultatibus and to read Avicennae 

tertiam primi; the Professor of the Practice of Medicine had 

in the first year to comment upon general therapeutics, and 

to discuss blood-letting and purging and the nature of fever 

according to AVICENNA; in the second and third years the 

subjects of his lectures were special pathology and thera- 

* A. COMPARETTI : Saggio della scuola clinica nello spedale di Padova 1793, 

p. 6 et seq.—C. NEUBERT in d. Beitragen zur prakt. Heilkunde, her. v. Clarus u. 

Radius, Leipzig 1836, ii, 148 et seq.—On the other hand, P. A. O. MAHON 

(Histoire de la medecine clinique, Paris 18C4) brings forward nothing upon 

clinical teaching.

334 RECENT TIMES. •I 

peutics of individual diseases. The Professor of Surgery 

had in the first year to speak de tumoribus according to 

GALEN, in the second, on ulcers and wounds after GALEN, 

HIPPOKRATES, and the Arabs, and in the third, on fractures 

and dislocations according to GALEN and HIPPOKRATES, 

Besides this, in summer he had to treat the subject of 

materia medica and to demonstrate the officinal plants, and 

in winter to teach anatomy and physiology. The list of 

lectures was more accurately settled by the professors in the 

midsummer holidays so that it could be committed to paper i 

and published in the catalogue with the arrangement of 

lectures of the other faculties.* In an official report, which 

was drawn up in 1569 upon the lectures delivered by the pro- 

\iifi fessors of medicine at Heidelberg, it is said: 1. Professor 

lf- :•-. ••>•*' CURIO is reading de generibus morborum ex Galeno, is 

explaining Hippocratis de morborum signis, and has an 

audience of three or four. 2. Professor ERASTUS gives no 

lectures, as he is attending the fair at Frankfort-on-the- 

Main. 3. Professor SiEGMUND MELANCHTHON is lecturing 

upon the art of medicine according to GALEN, and has 

some five pupils.f This report casts a light also upon;the 

numbers belonging to the medical faculties at that time. 

They appear very small compared with to-day. Medicine 

was seldom represented at Leipzig by more than from foijr 

to six persons. The academy at Basel numbered, in 1,556, 

two professors and two students of medicine.J At Erfurt, 

between the years 1392 and 1520, only five doctors of 

medicine were created, as against 120 of theology and 40' 

of law. Many Germans frequented universities abroad^, 

especially those of Paris, Bologna, Padua, and Montpellier. 

In Padua there were, in the year 1564, about 200 Germans 

studying law.§ Medical students sought out by preference 

* A. v. KOLLIKER op. cit. S. 58. F. v. WECELE : Geschichte der University 

Wiirzburg, 1885, ii, 191-199. 

f J. F. HAUTZ op. cit. 

X PLATTEH op. cit. S. 169. 

§ MEINERS: Geschichte der Entstehung u. Entwickelung der hohen Schulen, 

Gottingen 1802.


Montpellier and Padua, as is apparent from numerous 

biographies of celebrated physicians of the 16th century.* 

A doctor of Gottingen, in 1420, left a legacy of 600 florins 

on the interest of which a poor student of medicine was to 

be maintained for four years at Montpellier.f FELIX 

PLATTER also betook himself thither from Basel to complete 

his medical studies. 

THE MEDICAL PROFESSION AND ITS ATTITUDE 

TOWARDS THE MOVEMENTS OF THE 

SIXTEENTH CENTURY. 

THE medical examinations were of the same pattern as 

before. But the academical degrees sank much in value, in. • 

consequence of the easy terms upon which they were,'.; 

granted at many academies. As early as the year 1502 

complaints were made that " horse-dealers, traders in cattle, 

and other common people, who have not the slightest 

acquaintance with ARISTOTLE and are ignorant of even the 

first elements of grammar " obtained the title of Magister in 

the philosophical faculty of Paris.J At some French' * 

universities the degree of Doctor of Medicine was even 

sold for money. King FRANCIS I. on this account felt himself 

obliged to extend his recognition to the medical 

diplomas of Paris and Montpellier only.§ In Padua the 

singular custom arose of the candidates bringing with them 

assistants to the examination who whispered to them the 

answers to the questions which were put. The convenience 

of the candidates was still further consulted if, as AUGUSTIN 

LEYSER states, the questions with the answers annexed 

* MELCHIOR ADAM: Vitae Germanorum Medicorum, Heidelberg 1620.—A. 

BUDINSZKY : Die Universitat Paris und die Fremden an derselben im Mittelalter, 

Berlin 1876,8. 115 et seq. 

t SCHMIDT: Gottinger Urkundenbuch ii, 20. 

X BUL£US : Hist. Universitat. Paris 1673,T. vi, p. n. 

§ H. TOLLIN in VIRCHOW'S Archiv 1880, Bd. 8o, S. 66, and in the Biol. 

Ccntralblatt, Bd. v, S. 341.

, # ' 'f 


_ _ ^ ; MiP 

were previously written out and supplied to them* Then, 

too, it must be remembered that the title of doctor was 

conferred not only by the universities but also by the 

Pope and the Emperor. In the 14th century even the ; 

Counts Palatine obtained the right to grant the title of 

doctor just as they were also competent, as is 

well known, to legitimate bastards. To such a state, 

of affairs the caustic description which PETRARCH has 

left of the ceremony of taking the doctor's degree 

might sometimes fitly apply. " Now the young man appears, 

puts on an air of importance and mutters some unintelligible 

stuff while the people stare at him with astonishment, 

and his friends congratulate and applaud him. The bells 

are rung, trumpets sounded, rings and kisses exchanged,!, 

and the round cap of the Master is placed on his head. 

Whereupon he, who had mounted the ceremonial chair a 

blockhead, descends from it a wise man. This is a meta-A 

morphosis of which, OviD knew nothing."* Many students 

refused to take the degree of doctor at all on account of 

the expense and of the small estimation in which it was 

held. In this, perhaps, lies the explanation of the failure to | 

trace the diplomas of several celebrated doctors such as 1 

J. SYLVIUS, VESALIUS, M. SERVET, J, THIBAULT and 1 

others. | 

The surgeons were as a rule excluded from the privilege J 

of obtaining the degree of doctor of medicine. In Italy* t 

only, where the separation of surgery from "the rest of J 

medicine was at no time so complete as in other countries, | 

an exception was made to this rule. In France also the | 

surgeons received a scientific education. The College de j 

St. C6me, in 1545, obtained the right to grant academical 1 

degrees. Its students had to study for four years and at-1 

tend lectures not only on surgery but also on anatomy,"* 

*^ y,- 

* C. MEINERS: Uber die Verfassung und Verwaltung deutscher Universitaten, | 

Gottingen 1801, i, 328 et seq.; and C. MEINERS: Geschichte der Entstehung U. 

Entwickelung der hohen Schulen, i, 188. 

f PETRARCA : De vera sapienta, Dial. i. (Op. ed. Basil. 1554, p. 365).

THE MEDICAL PROFESSION. 

337 

materia medica, and many other subjects. Unfortunately, 

at this period also, petty jealousies and quarrels continued 

to exist between the surgical faculty, as the College de St. 

C6me may be called, and the medical faculty, to the injury 

of science in general. The doctors gave themselves pains 

to provide the surgeons with opponents endowed with 

privileges equal to their, own, in the so-called barber- 

surgeons: they, with this object, took care that the latter 

should acquire a larger amount of general and technical 

knowledge. Although this led to many unsatisfactory 

occurrences between the two classes of practitioners it 

had yet this good effect that the possibility was afforded to 

highly-gifted members of the inferior class of surgeons 

of becoming operating surgeons in our sense of the 

words. The example of an AMBROISE PARE shows how 

much surgery and with it medicine in general owes to this 

circumstance. It is only fair to say that the members of 

the faculty of medicine in their procedure had not this 

laudable end in view but washed rather to lower the credit 

of surgery and make its representatives their humble 

servants, willing to recognize their own intellectual superi 

ority. This way of looking at the subject is clearly indi 

cated by the words of M. SERVIN who wrote in 1607, 

"que la science n'est pour ceux qui n'ont que la main, 

qu'ils doivent laisser a juger aux mddecins."* When one 

of the professors, ROBERT LE SECQ, in an examination of 

surgeons in the year 1606, alluded to physiology and 

entered upon the subject of the action of the muscles, the 

mechanism of respiration and many other matters, the 

faculty of medicine entered a protest, on the ground that 

these things were points of controversy in science.f In 

Germany and other countries surgery seldom raised itself 

above a handicraft. It was only taught at some univer 

sities/' At Vienna, a Professor of Surgery was appointed 

with the annual stipend of 52 florins.J The German 

* D. PUYLON : Statuts de la faculte' de me'decine, Paris 1672. 

t HAZON op. cit. X ROSAS op. tit. ii, 51. 

Z

338 

RECENT TIMES. 

surgeons arose almost exclusively from the position of 

barbers or bagnio-keepers. They learnt from a master the 

treatment of wounds and ulcers, of fractures and dislocations, 

and obtained afterwards some further training in 

hospitals and in military medical service. Some, such as 

HIERONYMUS BRUNSCHWYG, HANNS VON GERSDORF and 

FELIX WORTZ acquired considerable operative ability. 

The scarcity of educated doctors, which prevailed in 

Germany, and the numerous wars and pestilences which, j 

that country had to endure in the 16th century, caused j 

surgeons to be looked upon as indispensable; it must also 

be remembered that besides the treatment of external ailments 

that also of diseases affecting the sexual organs fell • 

into their hands. Since they frequently surpassed the 

physicians in practical dexterity and experience, were in a 

position of nearer social relationship with the people, andjf 

demanded smaller sums of money for their services, much 

favour was shown them. Many were employed as private 

medical attendants at the courts of princes, in the public 

service, or in prominent positions in the medical service of j 

the army. ^ 

The doctors took a lively share in the intellectual movej 

ments of the 16th century. Then, as always, the grea| 

majority of them embraced the cause of freedom. It was 

but natural that PARACELSUS, inclining as he did to radicalism, 

should follow with enthusiasm all currents of thought 

which were opposed to existing authorities, and that he 

should long to see them increase into a devastating flood. 

But men of reflection and cool judgment were also led by 

their convictions into- the camp of the Reformation, and 

this because they saw that its limits did not exceed the 

boundaries marked out by a process of natural development. 

The captains of Protestantism bestowed upon 

medicine a lively interest. MARTIN LUTHER caused 

his son PAUL to study medical science; the latter 

afterwards was employed as a physician-in-ordinary at 

Gotha, Berlin, and Dresden, and also became known as

THE MEDICAL PROFESSION. 339 

a medical author. The son-in-law of MELANCHTHON 

CASPAR PEUCER, was Professor of Medicine at Wittenberg ; 

his nephew SIEGMUND, at Heidelberg. ADAM VON BODENbTEIN 

the son of the theologian KARLSTADT, practised 

medicine at Basel. CRATO VON CRAFFTHEIM by the 

advice of MARTIN LUTHER exchanged the study of 

theology, which he had begun under LUTHER'S guidance, 

for that of medical science; in this he gained great 

success and performed distinguished services at Vienna 

as doctor-in-ordinary to three emperors. He was the chief 

tfigure of Protestantism at Breslau and afterwards its most 

zealous representative at the court of Vienna.* His 

colleague, also, DIOMEDES CORNARUS (HAGENBUTT) doctordn-ordinary 

to the Emperor MAXIMILIAN II. probably 

belonged to this faith. At Vienna in 1584 three doctors 

shortly before dying declared themselves to be opposed to 

the confessional, and a fourth forbade the tolling of bells 

at his funeral, and demanded that his corpse should be 

interred in unconsecrated ground. CASPAR PlRCHPACH 

doctor of medicine, when in 1268 he filled the post of 

i Rector of the university of Vienna, was instrumental in 

.getting the requirement of the statutes that the academical 

teachers should subscribe to the Roman Catholic Faith set 

asfde, and the word Catholicae replaced by Christiana? 

(fidei). It was at the same time decided that, those who 

subscribed to the Augsburg Confession might be admitted 

to the degree of Doctor.f Even in Ingolstadt, the headquarters 

of the reaction in favour of the Church, several 

professors of the medical faculty embraced a freer opinion 

in religious matters : they were on this account through the 

influence of the fesuits, who soon after came into considerable 

power there, deposed from their offices.^ At the 

conclusion of the 16th century the intellectual movements 

* J. F. A. GILLET: Crato von Crafftheim u. seine Freunde, Frankfurt-a- 

M. i86o,ii, 14. 

t PAULSEN : Geschichte des gelehrten Unterrichts, S. 272. 

+ PRANTL op. cit. i, 319.

34° 

RECENT TIMES. 

with which it commenced, had nearly everywhere achieved 

victory. In so far as they bore a revolutionary character 

they were certainly unsuccessful; but they attained 

their goal while confining their activity within the bounds 

of reasonable reform. Their chief success lay in the 

fact that even those opposed to them were compelled to 

recognize their propriety, inasmuch as they abandoned the 

paths they had trodden hitherto and found new roads to 

advance in. Nowhere indeed had the ploughshare of 

intellectual work traced deeper furrows than on the soil of 

the natural sciences and of medicine. Yet the significance 

of this activity must be sought for not so much in what 

was achieved, as in what the future of scientific inquiry 

promised. 

Enlightened spirits, like FRANCIS BACON Lord VERU- 

LAM, began to recognize what- an important part was 

assigned to the natural sciences in the development of 

civilization. This distinguished English statesman and 

philosopher, who, as it were, represented in himself the 

total of the intellectual efforts of the 16th century, declared 

that induction from experience and experiment could alone 

give a solution to the questions which scientific investigators. 

were striving to understand. Though himself not in a 

position to enrich science by new discoveries, he nevertheless 

pointed out to her the paths which led to them. He 

certainly foresaw correctly the inter-dependence of many 

phenomena, the clear comprehension of which was reserved 

for later centuries. Thus he already gave plain utterance' \ 

to the conjecture that the atmosphere subserves the • 

nutrition of plants, that colour is a modification of light, ! 

and heat a form of motion, and that some day it would be | 

possible to produce mineral waters artificially.* He referred j 

to the value of vivisection, to the importance of pathologi-1 

cal anatomy, and of statistics of the results of the treat- - 

ment of disease. But his most meritorious services lay ia| 

* H. v. BAMBERGER: Uber BACON VON VERULAM, Wiirzburg 1865, S 15,21 ; 

et seq.

THE SEVENTEENTH CENTURY. 341 

the domain of theoretical knowledge: he brought the 

method of investigation to such a clear and complete 

development as, before his time, had never been accomplished. 

BACON was neither the shallow vain prattler, 

without any originality of thought, that he has been represented 

by some, nor the creative genius out of whose head 

science sprang in complete beauty, that others have 

depicted him. He was, as it were, a hand on'the face of a 

clock pointing out to us the progress made by time. 

THE EXPERIMENTAL DIRECTION TAKEN BY THE 

NATURAL SCIENCES, PHYSICS, AND CHEMISTRY 

DURING THE SEVENTEENTH CENTURY. 

THE expectations raised by the startling progress of the 

natural sciences in the 16th, were most abundantly fulfilled 

in the following, century. If men had hitherto confined 

themselves to observing facts in nature and to taking a 

firm mental grasp of the existence of things, they now 

began to investigate their causes and to fathom their 

reciprocal relations. They desired to become acquainted 

with the processes of organic life in their development and 

with this object they instituted experiments by which they 

might imitate the workings of nature by artificial means. 

Experiment advanced into the foreground and gave a 

characteristic colouring to the mode of thought of the 17th 

century. No path of intellectual activity was more influenced 

by this than that of the natural sciences and medicine. 

They have to thank this bias in favour of experiment for 

the stimulus which led to new investigations and by it 

they attained to that certainty of doctrine which is of the 

essence of science. Physics, chemistry and physiology 

those subjects, in fine, which are principally founded on 

experiment—were at this period enriched with a great 

number of discoveries. A new period of their history 

began. Mineralogy, botany, zoology and anatomy also

342 

RECENT TIMES. 

made important progress. Crystallography was advanced 

by the observations of NICHOLAS STENO and GULIELMINI 

upon the markings and construction of crystals and the 

immutability of their angles. ROBERT BOYLE noticed the , 

crystallization of bismuth out of the molten flux of the I 

furnace, and the Danish doctor ERASMUS BARTHOLINUS,j 

discovered double refraction in Icelandic calcspar (1670), a 

subject more closely investigated by HUYGENS and which 

had an important bearing upon the undulatory theory of 

light* 

At the same time botany was experiencing important 

changes. While the knowledge of the different species of 1 

plants was increased by numerous works upon the floras 

of particular regions and countries, the various attempts to ,J 

classify plants according to the similarity of their organs 

into families and groups contributed to the more accurate 

study of their structure. But the foundation of phytotomy 

by MALPIGHI and GREW, their excellent investigations 

into the minuter structure of plants, and especially their 

labours upon the blossoms, fruits, and seeds of plants, 

together with the experimental demonstration of sexuality ^ 

in the vegetable kingdom by R. J. CAMERARIUS, first*j 

rendered it possible to formulate a system corresponding to ? 

the demands of science. LiNNÛS, who accomplished this* 

task, gave a definite and complete form to botany by the 

methodical arrangement and characterization of his genera 

and species combined with his persistent use of the binary 

nomenclature: the discovery of a natural system being 

reserved to satisfy the just requirements of future times-f 

With the application of the magnifying-glass and micro 

scope to scientific investigations, a new world of life 

was opened to zoology of the existence of which none 

had hitherto entertained a presentiment. LEEUWENHOEK 

discovered infusoria, described certain rotifera, observed 

* F. v. KOBELL: Geschichte der Mineralogie, Miinchen 1864, S. 8 et seq. J 

f J. SACHS : Geschichte der Botanik. Miinchen 1875, S. 84 et seq., 246 etseq., 

41 7 et seq.


the faceted eyes of insects, and studied the origin and 

development of several of the lower forms of animal life. 

MALPIGHI imparted valuable information upon the structure 

and composition of the organs of the animal body and, even 

thus early, gave utterance to the thought that the compli 

cated structure of the more highly developed organisms is 

analogous to the more simple structure of the lower forms 

of life, and by such is to be explained. He even came 

tolerably near the discovery of the animal cell, while 

ROBERT HOOKE drew attention to the cellular structure of 

plants. The zootomical labours of SWAMMERDAM, whose 

accuracy is evidenced by his investigations on numerous 

mollusca, on the uro-genital organs of the frog, on the 

anatomy of the bee, etc., served naturally to throw much 

light on the views of men of science, as did also the 

observations of F. REDI upon generation, as a result of 

which he made the statement that in decomposing meat no 

maggots develop if flies are kept away. Supported by 

these results, JOHN RAY, J. T. KLEIN, LINNAEUS and others 

were able to facilitate the study of animals by classifying 

them systematically, and to represent zoological science 

in a comprehensive way.* 

Physics and chemistry however experienced at this 

period transformations of the highest significance. When 

chemistry, by the influence of PARACELSUS and his dis 

ciples, was diverted from alchemy and turned into the 

direction of materia medica, it started afresh with a vigour 

which promised to be full of benefit to itself and to medi 

cine alike. A large number of new medicines were dis 

covered, and the technical methods of preparing them were 

improved in manifold ways. Perhaps no less important 

was the effect which chemical views and knowledge exerted 

on physiology and pathology. A certain number of doctors 

saw in every occurrence in the organism processes of fer 

mentation and decomposition, and were willing to explain 

moft phenomena of the body in health and disease by 

V. CARUS: Geschichte der Zoologie, Miinchen 1872, S. 386 et seq.

344 

RECENT TIMES. 

means of chemical reactions. This intro-chemical bent was 

sometimes carried too far, for under its influence mpn im- j 

posed upon themselves problems, the solutions of which 

were not discoverable, owing to the slight development , 

reached by chemistry at that time. But these views had 

this great merit, that they accustomed doctors to the thought 

that they might expect but little from 'speculation, much 

however, if not everything, from an examination cf facts. 

Chemistry owed to the perception of this circumstance 

many discoveries and an important enlargement of its sub 

ject matter. 

The doctor LlBAVlUS invented the method of preparing 

sulphuric acid from sulphur and saltpetre, and recognized | 

that the product was identical with that formed from metallic : 

sulphates or alum. He first produced the bichloride of tin -| 

>; 

by the distillation of bichloride of mercury (corrosive sub- J 

limate) with tin, and was acquainted with the process of > 

colouring the glassy flux by the addition of gold. TURQUET 

DE MAYERNE taught the preparation of benzoic acid cry- | 

stalsby sublimation. J. B. VAN HELMONT, also, enriched ' 

chemistry bv a multitude of new facts. He stated the pro-;| 

position that only such metals are separated from a solution j 

as were previously contained in it, giving thus the death-J 

blow to the goldmaker's art. He discovered carbonic acid | 

gas, and introduced into chemistry the conception of gases 

as being of the nature of air, but not identical with atmos-J 

pheric air. The attempt which he made to study the parts 

played by soil, water, and air in the nutrition of plants I 

affords clear proof of the experimental method of his inquiry. J 

In the writings of GLAUBER, who furnished more accurate^ 

information upon sulphate of soda and numerous other salts, ; 

we already find a crude, but promising, appreciation of : 

chemical affinity* 

A deeper foundation was here laid by ROBERT BOYLE^j 

who, by his corpuscular theory, sought to explain the separation 

of chemical combinations into their constituent parts 

* KOPP op. cit. i, in, 114, 120 et seq., 130.

THE SEVENTEENTH CENTURY 345 

and the union of these parts with those of other combinations 

by the attractions and repulsions which they exerted 

upon one another. W r ith BOYLE commenced the time of 

the study of chemistry for its own sake, when it was no 

longer looked upon as mere means of finding the philosopher's 

stone, as was the case with the Alchemists, or of 

furnishing new medicines as was the case with the Iatrochemists. 

He discovered phosphoric acid, chloride of 

copper, fuming sulphide of ammonium, and was the first to 

observe the opposite reactions of acids and alkalies respectively 

with certain vegetable colours. From him is derived 

the practice of impregnating strips of paper with vegetable 

colouring matter and using them as reagents. BOYLE 

rendered great services by founding analytical chemistry, 

and by applying chemistry to the purposes of the arts.* 

Among those who took an important part in building up 

the structure of scientific chemistry we find the following:— 

KUNKEL, BECHER, W. HOMBERG, LEMERY, STAHL, F- 

HOFFMANN, the last of whom gave his chief attention to 

the chemical investigation of mineral springs and found 

sulphate of magnesia in the mineral water of Seidlitz ; 

MARGGRAF, who founded the beetroot sugar industry; 

DU HAMEL, who drew attention to the difference between 

soda and potash, taught how to prepare soda and referred 

to its existence in the ashes of plants growing on the sea 

•coast; H. CAVENDISH, whose researches on hydrogen 

(which he unfortunately took for the much-sought-for, but 

non-existent, phlogiston), and on the properties, specific 

.gravity, and the absorbability in water, oil, and alcohol 

respectively of carbonic acid gas deserve mention here ; 

BERGMANN, who worked at the doctrine of chemical affinity ; 

and, finally, SCHEELE, who did good work in organic 

•chemistry, discovered lactic and uric acids, besides various 

vegetable acids, and also advanced inorganic chemistry by 

the discovery of several new elements, such as chlorine and 

manganese. Many of these were also doctors, and conse- 

* KOPP op. cit. i, 165 et seq.

34 6 RECENT TIMES. 

quently devoted special attention to the relations of 

chemistry to medicine. 

Unfortunately the progress of chemistry was hampered J 

by erroneous opinions which had been preconceived, and J 

which had developed into dogmas generally accepted.! 

Thus people assumed that the process of combustion is j 

dependent upon the presence of a material called phlogiston, 

and the greater or less combustibility of a body, upon the | 

quantity of this burning-material contained in it. The J 

phlogistic theory—according to the analogy of which the j 

origin of the acids was ascribed to an acid material, the so- \ 

called primitive acid, and that of the caustic alkalies to a. 

caustic material—was paramount in men's minds for nearly 

a century, and was only exploded by LAVOISIER. 

A luckier star presided over the destiny of physics * for J 

philosophers were here not influenced in their judgment by J 

untenable and baseless hypotheses, but used all their| 

intellectual powers in collecting material which could be| 

employed in building up a firm structure of doctrine. 

GALILEO whose achievements in astronomy, and whose ^ 

martyrdom for his convictions are better known than his-1 

service to physics, discovered the laws of falling bodies and J 

of the pendulum. He recognized the importance of the pro-j 

position of the parallelogram of forces and sought by its 

help to determine the course of projectiles. Concurrently 

with STEVINUS he worked also at hydrostatics and hydrodynamics. 

" If any single person can lay claim to the 

honour of founding such a many-branched science as thati 

of physics," says POGGENDORFF (op. cit. p. 268), "that 

honour is, without hesitation, GALILEO'S; for he laid thej 

foundation of scientific mechanics, which runs like a nerve 

through almost every part of physics." As early as 1597' 

GALILEO constructed a thermometer, with the production of 

which instrument R. FLUDD, SANCTORIUS, and C. DREBBEL, 

' also occupied themselves. GALILEO'S highly gifted pupil 

TORRICELLI determined the laws of the outflow of liquids 

* J. C. POGGENDORFF, Geschichte der Physik, Leipzig 1879, S. 204 et seq. 1


through tubes, invented the barometer (1643) and explained 

that the rise and fall of the mercury are due to changes of 

atmospheric pressure. PASCAL made some irrefutable 

statements on this subject and pointed out that with the 

help of the barometer the difference in height between 

two places can be determined. MARIOTTE, J. PECQUET, 

and SINCLAIR rendered these ideas more complete and 

brought the practical application of them nearer. PASCAL 

constructed a wine-barometer, while BERTI and O. V 

GUERICKE enclosed water instead of mercury in the tube- 

OTTO VON GUERICKE, burgomaster of Magdeburg and 

formerly engineer of the fortress of Erfurt, devised the 

air-pump and considerably astonished the princes assembled 

in the imperial diet at Regensburg in 1654, by the experi 

ments he performed with it. He made excellent observa 

tions on the weight of air and constructed the first 

manometer for measuring the density and weight of the 

atmosphere. He also referred to the fact that in spaces 

from which the air has been removed no sound can be pro 

duced and no combustion take place.s His observations 

were completed by BOYLE, who studied more closely the 

elasticity of air and discovered the law, erroneously named 

after MARIOTTE, that the volumes of equal weights of air 

stand in inverse ratio to the pressures to which they are 

subjected. About the same time attempts were made to 

determine the velocity of sound. GASSENDI asserted that 

it travels 1,473 * eet i n a second. MERSENNE came somewhat 

nearer the truth in estimating the number of feet at 

1,380. Even if the results they arrived at were incorrect, 

they nevertheless hit upon the right method of investiga 

tion and this was already an extraordinary advance. Even 

a NEWTON was unable to avoid every source of error; he 

calculated the velocity of sound at 906 Paris feet in a 

second, not making a sufficient allowance, as LAPLACE has 

pointed out, for the influence of temperature. 

The most important advances were made in optics, 

favoured, and, to some extent indeed, rendered for the first

348 

RECENT TIMES. 

time possible, by the invention of various instruments 

which took place at that time. The telescope enabled the ", 

eye to see into the distance : the microscope opened out f 

into view the world of small things. By these two optical % 

aids the power of human vision was strengthened in an 

unexpected manner and paths were opened to investiga- j 

tion, which had before been beyond the boundaries of 

human knowledge. The seat of these inventions was 

Holland. It is doubtful to whom priority belongs in these 

discoveries : but it appears that the brothers JANSSEN, who 

in the beginning of the 17th century lived in Middelburg 

as glass cutters, have the best claims, at least in respect of 

the compound microscope. 

It is not my business to go more closely in this place 

into the history of this discovery and it is also unnecessary - 

since it has already been discussed by HARTING in a fairly 

exhaustive manner.* The extraordinary importance of the 

microscope in the study of natural sciences cannot be 

described in words. 

The instruments were gradually improved and rendered 

more complete in numberless ways. The discovery of the 

reflecting telescope by JAMES GREGORY, that of the 

micrometer (crossed threads) by ROBERT HOOKE, the 

construction for the first time by M. HALL of achromatic 

lenses by a combination of crown and flint glass, etc., were 

added afterwards. 

Even then men ventured to attack the difficult problems 

of light and colour. The great philosopher DESCARTES 

(CARTESIUS), to whom mathematics owes the recognition 

of the meaning of the negative roots of equations and the 

foundation of analytical geometry, sought for an explanation 

of the rainbow and in this way worked out the law of incident 

and reflected rays, and the angles formed by them, i 

SNELL established the relations between different media 

and the refraction of light in them, and GRIMALDI dis- 

* P. HARTING: Das Mikroskop, ins deutsche iibers. v. THEILE, iii. TheiL 

Braunschweig 1866.


covered diffraction or inflection of light as well as its dis 

persion or splitting up into its constituent colours. The 

last-mentioned, and HOOKE in even greater degree, when 

he published his observations on the colours of thin films, 

had suspicions of the undulatory movement of light which 

HUYGENS, supported by the phenomenon of double refrac 

tion, raised by his undulatory theory into one of the facts of 

science. It is true that it had to wait more than a century 

before receiving general recognition; for NEWTON had 

asserted that light consists of concrete particles which are 

emitted from luminous bodies with great velocity, and his 

authority w r as so powerful that all attempts which were at 

variance with it were unavailing, for a time, to make truth 

victorious. Not till 1815 did success crown the persevering 

efforts of FRESNEL and ARAGO to secure a general accept 

ance for the undulatory theory. 

The first contributions, also, upon the phenomena of 

polarization — observed indeed by NEWTON but which 

he was unable to explain intelligibly — date from the 

end of the 17th century. On the other hand, in his 

experiments upon the dispersion of sunlight, undertaken 

by him after the method already adopted by GRIMALDI and, 

before GRIMALDI, by the Prague doctor MARCUS MARCI of 

Kronland, NEWTON arrived at the important result that 

white light is composed of an infinite number of coloured 

rays of different refrangibility and that to each degree of 

refrangibility a particular colour corresponds. NEWTON'S 

views upon the origin and essence of colours were not 

correct; it appears that L. EULER in 1746 was the first who 

had correct coherent notions on this subject. Many more 

discoveries in physics belong to the 17th century,—dis 

coveries which have advanced civilization very greatly in 

many directions. HOOKE improved the watch by inventing 

the spiral spring, and HUYGENS was the first to construct a 

pendulum-clock. 

The Marquess of WORCESTER, Captain SAVERY, MORE- 

LAND, PAPIN and others studied the power of steam very

35° 

RECENT TIMES. 

carefully and contrived machines for making a practical test 

of its value ; an operation which had at first to contend 

with many inconveniences. Thus the opening and shutting 

of the stopcocks of the injecting-pipe and steam-pipe had 

to be done by hand. But one day a clever fellow, to whom ^ 

this duty was entrusted, remarked that the turning of the 

cocks tallied with the movement of the beam. He there- +| 

upon bound them together with string and saw that the 1 

machine forthwith worked by itself. PAPIN even proposed 

to make use of steam power for driving ships. 

So also the first observations of electrical phenomenal 

date from this period* The Englishman GILBERT, who ''[ 

discovered telluric magnetism, found that electricity is pro-1 

duced by friction, but cannot be generated in all bodies j 

and is distinct from magnetism. O. V. GUERICKE, by \ 

the help of an apparatus constructed by himself and which*! 

led up directly to the electrical machine, observed besides^ 

the already known electrical attraction, other phenomena 

of which nothing was previously known, namely 

electrical repulsion, and light and crackling sounds pro-| 

duced by electrical means. Then the English philosopher 

WALL in 1698 described the real electric spark and com-?| 

pared it and the crackling sounds, arising under electrification, 

with lightning and thunder. 

STEPHEN GRAY in 1729 established by experiment the I 

distinction between conductors and non-conductors of 

electricity; he pointed out that electricity may be com- \ 

municated from one body to another and that, for this, 

direct contact is not always required, but that approximation 

is sufficient; he moreover referred to the fact that in 

the electrification of bodies it is not a question of their mass 

but of the extent of surface presented by them; he was 

also the first to electrify water and the human body and for 

this purpose even made use of the insulating stool. Soonc 

after this DUFAY made the important discovery that there; 

* E. HOPPE: Geschichte der Elektricitat, Leipzig 1884.


are two distinct kinds of electricity one of which clings to 

glass and the other to resin. Upon this followed improvements 

of the apparatus for generating electricity brought 

about by BOSE, J. H. WlNKLER and others and which led 

to the construction of the electrical machine; the discovery 

of the Leyden Jar made almost simultaneously 

by. MUSSCHENBROEK at Leyden and Baron KLEIST in 

Pomerania; the discovery of atmospheric electricity by LE 

MONNIER; the invention of the lightning conductor by 

BENJAMIN FRANKLIN; and the construction of the first 

electrometer by JOHN CANTON. 

Finally, certain other advances in physics must be mentioned 

here, which belong to the same period. The thermometerwas 

improved at the instigation of FERDINAND II. of the 

Medici family. Already the differential thermometer was 

invented. AMONTONS, who devised the hygroscope and 

studied the influence of heat on the barometer, constructed 

the first effective air-thermometer. By graduating and 

adding a scale to the thermometer, for which FAHRENHEIT 

of Danzig deserves special credit, its practical applicability 

was largely extended. At Florence, the first observations 

on specific heat were made ; it was called heat-capacity. 

ALF. BORELLI threw more light upon the phenomena of 

capillarity, a subject known to LEONARDO DA VlNCi. 

But all these things yielded in importance to ISAAC 

NEWTON'S discovery of general gravitation,* by which the 

infinitely complicated movements of the heavenly bodies 

were explained through the all-binding laws of mathematics 

and physics and the proof was given that such laws hold 

good for the entire universe. This conception exerted the 

greatest influence in the emancipation of man's intellect 

from the dominion of mystic transcendental powers, giving 

it a grasp which seemed to reach beyond the boundaries of 

this world. Even if NEWTON had rendered no other ser- 

* W. WHEWELL ; History of the Inductive Sciences (Germ, trans.), Stuttgart 

1840, ii, 158 el seq.


35 

vices to physics, the theory of gravitation was enough to' | 

place his name among the first in the history of this , 

science. He was one of the greatest mathematicians and 

physicists that ever lived. If we wish to indicate in one 

word the intellectual tendency of that time, fruitful as it 

was, to an uncommon degree, in results and discoveries 

bearing upon physics, we need only recall the name of 

NEWTON—its most prominent representative. 

What a mighty revolution in thought had been effected 

in the interval of time between GALILEO and NEWTONl, J 

The natural sciences, which still in the 16th century were 

oppressed and controlled by the ruling authorities, regarded ,| 

with indifference or disdain by the public, cherished and.'^ 

actively" advanced only by a few, stood now in the focus of 

intellectual interest and were permitted fearlessly to draw ? 

within the range of their investigations the highest proV : 

blems of man's existence. 

Natural philosophy proceeded to its tasks with the fiery 

zeal of youth and the successes achieved, rapid as they 

were and exceeding all expectations as they did, seemed to 

justify the hope that no limit was fixed to its progress. 

When this hope was not fulfilled and insurmountable 

obstacles opposed themselves to human knowledge, industry 

slackened and work began to stop. Men turned.| 

again to other efforts which promised greater results than • 

the pursuit of the natural sciences. To the victorious 

advances made by the natural sciences in the 16th and 17th 

centuries there succeeded in the 18th century a retreat or 

at least a halt. This period contributed no essential increase 

to the sum of knowledge, but, under the influence 

of a tendency in men's minds towards encyclopaedic literature, 

led to a collecting and sifting of such results as had 

been gained—a proceeding useful and necessary for their 

further development.

MICROSCOPICAL INVESTIGATION. 353 

MICROSCOPICAL INVESTIGATION IN ANATOMY 

AND EXPERIMENT IN PHYSIOLOGY. 

THE 16th century witnessed the splendid triumphs of 

anatomists, who investigated the structure of the human 

body; physiological experiment, which created a science 

founded on facts, impressed its mark upon the 17th century. 

Anatomy was an established science already in the 16th 

century, in its essential outlines at least, and so far as was 

possible by investigation with the unaided eye. The 

following periods had the tasks assigned to them of testing 

the scientific results already won, of correcting and of completing 

them by examination of details, and of extending and 

enlarging them. Investigation acquired by the aid of the 

magnifying glass and the microscope a depth and a solidity 

hitherto unattainable. The anatomists devoted their attention 

chiefly to the finer structure of organs, a study more 

successfully pursued by means of the newly-discovered 

optical instruments. 

LEEUWENHOEK possessed the best microscope of his time, 

constructed by himself. It magnified 160-270 times, whereas 

the instruments used by other investigators magnified at' 

most 143 times.' LEEUWENHOEK described the tubular 

structure of the bones, and noticed the bone-corpuscles, 

which afterwards were rediscovered and more accurately 

described by PURKINJE.* He referred also to the enamel 

of the teeth, while other particulars of their structure were 

explained by MALPIGHI. CLOPTON HAVERS discovered 

the canals in bones, which still bear his name ;f DU HAMEL 

studied the formation of bony tissue, and recognized that 

it is developed by the help of the periosteum out of 

cartilage, the vessels bringing the formative material 

required according to the pattern laid down in cartilage; 

J. T. KLINKOSCH, of Prague, taught the origin of bone 

* P. J. HAAXMANN in the Nederl. Tijdschr. v. Geneesk 1871, ii, 1-86. 

f CL. HAVERS: Observationes de ossibus, Amstelod. 1731, p. 63. 

A A

354 

RECENT TIMES. 

from connective tissue, while HALLER held fast to its 

development from cartilage and considered the change to 

proceed from the vessels which surround with bony tissue 

the primordial bone-granules discovered by him. 

At the same time the macroscopical knowledge of 

osteology was also enriched. NATHANIEL HIGHMORE 

discovered the antrum in the upper jaw; OLAUS WORM 

described the sutural bones named after him, but known 

already to EUSTACHIUS; T. KERCKRING studied the 

development of the skeleton in the foetus ; and FRIEDRICH , 

RUYSCH drew attention to the differences between the 

male and female skeleton, especially to the distinction 

in the form of the pelvis and thorax in the two sexes. The 

knowledge of the ligaments was improved by the careful | 

work of JOSIAS WEITBRECHT.* The structure of the skinwas 

investigated by MALPIGHI, of whom the rete mucosum ] 

reminds us to the present day, and by LEEUWENHOEK, who I 

observed the smooth scales of the epidermis, the changes 

in the skin produced by the formation of callosities and 1 

scars, and the deposit of pigment in the coloured races of 

men. C. V SCHNEIDER afforded some information upon 

the structure and function of the nasal mucous membrane.! 

The structure of muscular tissue occupied the attention of 

A. BORELLI, R. HOOKE, and above all of NICHOLAS STENO, 

who referred to the similarity of its construction in man 

and the lower animals, and pointed out that vessels and 

nerves enter muscles, and that the latter are composed ^ 

of fasciculi, and are surrounded by an investment which I 

sends processes between the fasciculi. LEEUWENHOEK 

noticed the transverse striation of muscular fibres, and 

taught that the growth of muscles results not from-an 

increase in number but from an increase in size of the 

primitive fasciculi. He declared that muscular tissue is 

* Jos. WEITBRECHT : Syndesmologie, Deutsche Ausgabe, Strassburg 

1779779t K. F. H. MARX, in the Abhandlungen d. kgl. Ges. d. Wiss. zu Gottingen, 

Bd. 19, 1873.

MICROSCOPICAL INVESTIGATION. 

built up of little spheres. R. HOOKE considered the bodies 

observed to be prisms. 

The study of angeiology was facilitated in an extraordinary 

degree by the newly-discovered process of injection* 

in the improvement of which SWAMMERDAM and 

•RUYSCH rendered the greatest services. For injections 

they used coloured, easily coagulating, resinous liquids. 

RUYSCH, of whom it is said that he possessed the hands of 

.a fairy and the eyes of a lynx, was able thus to determine 

the presence and distribution of blood vessels in parts of the 

body which had previously been considered non-vascular. 

He described also the bronchial vessels and the coronary 

vessels of the heart; KERCKRING discovered on the portal 

vein of the horse the vasa vasorum, and LEEUWENHOEK 

threw light upon the structure of the vascular coats. The 

anatomy of the heart was illustrated by STENO, LOWER, 

and VlEUSSENS. To their work the labours of WlNSLOW 

and.SENAC were added at a later period. 

The lungs were carefully examined by MALPIGHI ; he 

stated that they are composed of little sacks the partitions 

between which are richly provided with vessels.f GLISSON 

gave an exemplary description of the anatomy of the liver, J 

while MALPIGHI devoted his attention to the spleen and 

was also the first to recognize that glands are built up of 

acini.§ JAMES DOUGLAS, whose name has been preserved 

in the history of anatomy through other observations which 

he made, described the relative position of organs in the 

abdominal cavity. The Swiss doctors PEYER and BRUNNER 

discovered the glands of the intestinal canal, G. WlRSUNG 

the ductus pancreaticus, STENO the duct of the parotid 

gland, WHARTON that of the submaxillary gland and 

•QUIRINUS RIVINUS those of the sublingual gland. MAL- 

* BURGGR-EVE op. cit. p. 294 et seq. 

t De pulmonibus epist. duae in MALPIGH'I : Op. omnia, London 1686, iii, 133 

•et seq. 

, »-» 

+ F. GLISSON: Anatomia hepatis, Amstelod. 1659. 

§ M. MALPIGHI : De structura glandularum conglob., London 1697.


PIGHI, BELLINI and BERTIN investigated the structure of 

the kidneys; while the knowledge of the sexual organs t 

was advanced by W. COWPER who described the gland 

named after him but known previously, by REINIER DE 

GRAAF who described the follicles of the ovary, by D. 

SANTORINI who submitted the corpora lutea to a more 

careful examination, and especially by WILLIAM HUNTER 

who made public the best observations upon the anatomy 

of the testis and the first correct representations of the 

changes undergone by the uterus during pregnancy. 

Neurology remained on a lower level. STENO frankly ': 

confessed that he knew nothing of the structure of the : 

brain and opined that other anatomists were in much the, J 

same position. He looked forward to nerve fibres being J 

traced through the substance of the brain, but was himself;! 

at the same time conscious of the difficulty of this invest!-j 

gation and doubted whether such a thing would ever be ^ 

accomplished without special apparatus* WILLIS, the J 

discoverer of the nervus accessorius, SYLVIUS, and HUM-1 

PHREY RIDLEY furnished their contemporaries with good J 

descriptions of the brain; J. J. WEPFER illustrated the 

distribution of its blood-vessels; ViEUSSENS noticed the : 

pyramids and the olivary bodies of the medulla oblongata,| 

and made the discovery that the dura mater receives nerve 1 * 

fibres from the trigeminus ;\ LANCISI drew attention to. 

the distribution of fibres in the corpus callosum and 

examined the structure of the pineal gland; MALPlGHr 

made some remarks upon the distribution of the grey and*] 

white substance of the brain and observed the passage 

into the brain of collections of fibres from the spinal cord.J 

With regard to the more minute structure of the substance^ 

of the brain no clear view was arrived at. As a rutef 

anatomists embraced the hypothesis that the grey sub-| 

* W. PLENKERS in the Maria-Laacher Stimmen 1884, vii, H. 25, 26.—TH. 

PUSCHMANN in the Vienna Neue Freie Presse 1886, 26 November. 

f R. VIEUSSENS: Neurographia universalis, Lugd. 1685, p. 82, 170. 

X M. MALPIGHI : De cerebro in Op. omnia iii, 1 et seq.


stance of the brain is composed of blood vessels and small 

follicles from which white nerve fibres arise. The peripheral 

nerves were more minutely described and several 

ganglia were discovered as, for example, the Gasserian 

ganglion on the nervus trigeminus* 

The anatomy of the sense-organs was worked at with 

greater success. RUYSCH discovered that part of the 

choroid coat of the eye named after him ; LEEUWENHOEK 

described the structure of the lens as being of fibres united 

into membranes; MEIBOM in 1666 pointed out the glands 

imbedded in the substance of the tarsal cartilages and 

STENO described the lachrymal apparatus ;t POURFOUR 

DU PETIT discovered the canal running between the two 

layers of the membrana hyaloidea of the vitreous humour 

round the margin of the lens capsule. ZlNN drew attention 

to the zonula ciliaris; DEMOURS observed the membrane 

bearing his name on the posterior surface of the 

cornea. DUVERNEY, VIEUSSENS, VALSALVA, CASSEBOHM, 

COTUGNO and others occupied themselves with the anatomy 

of the organ of hearing, while the structure of the organs 

of voice and especially of the larynx was illustrated by 

the investigations of DRELINCOURT, SANTORINI and WRIS- 

BERG. 

Physiological inquiry achieved the greatest success. The 

age of experiment, as we may call the 17th century, brought 

about a complete revolution in the views hitherto held on 

this subject, and raised physiology into a science. The 

discovery of the circulation of the blood formed the foundation 

stone upon which the structure of this science was 

erected. Already SERVET and REALDO COLOMBO had 

taught that the blood passes from the right side of the 

heart through the pulmonary artery and the pulmonary 

veins to the left side of the heart; but WILLIAM HARVEY 

* A. B. R. HIRSCH: Paris quinti nervorum encephali disquisitio anatomica, 

Vienn. 1765, p. 20. 

+ H. MEIBOM: De vasis palpebrarum novis, Lugd. Batav. 1723, p. 135 et 

seq.

•358 

RECENT TIMES. 

was the first to furnish the proof of this, inasmuch as he 

caused water to flow by this route from the pulmonary 

artery into the left heart. It seems but an easy step to 

have ascribed an analogous course to the blood in the other 

vessels of the body. But the doctrine which then prevailed, 

that the arteries chiefly contained air and only but 

a little blood and that the blood flowed in a centrifugal 

direction in the veins as well as in the arteries, was opposed 

to the acceptation of this view. HARVEY corrected these 

mistakes* He opened arteries under water and saw that 

no bubbles of air rose to the surface. He cut into them 

and observed what a quantity of blood they contained. He. 

studied moreover the mechanism of the then recently.discovered 

valves of veins and made attempts to blow air into 

the trunks of veins provided with valves. In this manner 

hed iscovered that the valves are so formed that they impede' 

and check the blood-stream from the trunks to the peri-, 

phery but on the other hand offer every facility to its flow 

in the opposite—that is to say the centripetal—direction. 1 ,* 

Assuming this to be true, the question arose—from whence,I 

comes the blood in the minute ramifications of the veins? 

As it was impossible to think that the arterial blood is completely 

used up in the organs, the explanation presented 

itself spontaneously that it passes from the arteries into 

the veins as had been established to be the case in the 

pulmonary circulation. 

The exact way in which this passage is made was first 

explained by MALPIGHI, who discovered the capillaries, 

and was the first to observe with the microscope the passage 

of the blood from the arteries into the veins. 

HARVEY held fast to the erroneous view that the liver is 

the seat of the formation of blood. The true conditions of 

this matter were not known until the discovery of the 

lacteals by GASPARE ASELLI, of the ductus thoracicus by 

JEAN PECQUET, and of the lymphatic vascular system by 

O. RUDBECK and T. BARTHOLINUS, nor until the establish- 

* W. HARVEY: Works ed. by R. WILLIS, London 1847.


ment by these observers of the importance of the vessels 

above mentioned in the preparation of the blood. 

A series of investigations on the vascular system, on 

the blood, its composition, elaboration, movement, etc., 

was soon added to the discovery of the circulation of 

the blood. A. BORELLI was the first to formulate 

the thought that the vascular system resembles a hydraulic 

apparatus, and he attempted to calculate the force with 

which the blood flows through the vessels. It must be 

confessed that he arrived at inaccurate results, for the 

circumstances which have to be considered in this 

investigation were then not sufficiently known. Thus, for 

instance, his estimation of the resistance offered by the 

continually narrowing arteries was unduly high.* WILLIAM 

COLE hereupon drew attention to the fact that the sum of 

the transverse sections of the vessels increases with their 

distance from the heart, and that the vascular system may 

be represented as a cone, the base of which is the periphery 

of the body and the apex the heart.f BELLINI showed that 

the blood flows with less velocity in proportion as the 

vessels become more and more divided into branches. 

STEPHEN HALES sought to determine the force of the 

blood-pressure and the velocity of the blood-current by a 

series of experiments, and introduced for this purpose a 

glass tube into the divided artery of a living animal, so 

that he might observe how high the blood was raised in it. J 

MOLYNEUX and LEEUWENHOEK observed under the micro 

scope the velocity of the blood-current.§ The Irish doctor, 

ALLEN MOULIN, made the first attempt to determine the 

quantity of blood contained in the body. He opened the 

hearts of animals by vivisection, and from the quantity of 

blood which they contained, and from the velocity of the 

* ALF. BORELLI : De motu animalium, Lugd. Bat., 1685, i, p. 94 et seq. 

t WILL. COLE: De'secretione animali, Genev. 1696,0. 7, p. 26. 

X STEPHEN HALES: Haemostatique ou la statique des animaux ; a French 

transl., with notes by DE SAUVAGE, Geneva 1744, of "Statical Essays." 

§ Philos.Transactions, London 1685, No. 177, p. 1236.


blood-current, he calculated the quantity of blood contained 

in the body. By this somewhat imperfect method he arrived 

at the result that the weight of the blood constitutes about 

the twentieth part of the body-weight.* The discovery of 

the blood-corpuscles, which were first detected by MAL 

PIGHI, threw great light upon the composition of the blood. 

They were described by SWAMMERDAM as egg-shaped 

structures, by MALPIGHI as coralloidal strings, and by 

LEEUWENHOEK, who studied their form in different classes 

of animals, as small, oval, flattened spheroids. HEWSON 

thought that they contained each a small vesicle, and expressed 

an opinion that they originated chiefly in the 

spleen. 

VlEUSSENS and CHIRAC were then already contemplating 

a chemical examination of the blood. A. BADIA and 

MENGHINI showed conclusively that the blood contains 

iron. F. QUESNAY—who, as the founder of the physio- J 

cratic system, rendered the highest services to political J 

economy—taught that the blood contains the following | 

constituent parts:—1. Water; 2. Albuminous matters 

which coagulate by heat, and when putrid develop an 

alkaline, acrid quality ; 3. Fats which solidify in the cold, 

but at a higher temperature are fluid, and generate a rancid | 

acridity; 4. Gelatinous matters; and 5. Bitter saponaceous | 

substances.t HEWSON continued to investigate the 

physical and chemical properties of the blood, and gave 

very great attention to the subject of its coagulation, the 

causes of which he was at pains to work out by means of 

various experiments.^ An opportunity was often afforded | 

during venesection of observing that blood takes on a 

redder colour when it comes into contact with air ; and the 

ancients even were aware of the fact that arterial blood is 

* Philosophical Transactions, London 1687, Decemb., No. 191, p. 433 «f 

seq. 

t F. QUESNAY: Essai physique sur l'economie animale, Paris 1747, ii, .34*2 

et seq., iii, 31 el seq.—HAESER op. cit. ii, 592. 

X WILL. HEWSON : On the Blood, G>.rm. transl., Niirnberg, 1870.—E. 1 

BRUCKE : Vorlesungen iiber Physiologie, Wien 1885, i, 81 et seq.


•of a clearer colour than venous blood. The Iatrophysicists 

such as MALPIGHI, PITCAIRN, and others explained the 

phenomenon by saying that in consequence of the inspired 

air the blood is subjected to a finer division, while the Iatrochemists 

ascribed a chemical influence to the air. The 

attempts to come to a conclusion as to what constituent 

part of the air it is which produces this effect w-ere naturally 

unsuccessful. R. BATHURST and N. HENSHAW expressed 

an opinion that it was the same substance that has a prominent 

place in the composition of nitric acid. The real 

-action of air upon blood was more closely examined by D. 

MlSTlCHELLi. He inflated the lungs of dying animals with 

air, and in this way was able, not only to cause the blood to 

change colour, but at the same time to revive the movements 

•of the heart.* About the same time PEYER and HARDER 

instituted experiments with the hearts of dead animals 

and of men who had been hanged, and restored cardiac 

movements by inflating the lungs with air.f 

SANTORIO, who made himself known by the invention of 

various physical instruments,^ wished to determine the 

relation between the ingesta and excreta of the body, and 

with this object during 30 years submitted the nourishment 

he took and the refuse material which passed from him to 

-accurate weighing; he then compared the results with his 

body-weight, and found that a portion of the nourishment 

taken leaves the body in the invisible form of gas and vapour 

(perspiratio insensibilis).\ DENYS DODART repeated these 

-experiments, and remarked that with increasing age the 

visible excretory products are increased. The processes 

of digestion, nutrition, and secretion were judged of in 

•quite different ways by the Iatrophysicists and the Iatrochemists. 

While the former embraced the opinion that 

* Philosophical experiments and observations of ROB. HOOKE, etc., published 

•by W. DERHAM, London 1726, p. 372 et seq. 

t PEYER : Parerga anatom. et medica, Genev. 1681, p. 198. 

X K. SPRENGEL op. tit. iv, 422 et seq. 

§ SANCT. SANCTORIUS: De statica medicina, Venet. 1614, Sect. 1.


the stomach exercises a subdividing, triturating effect upon 

the food, the latter thought that in consequence of the 

chemical powers of the saliva, the gastric juice, the pancreatic 

juice, and the bile the food is converted into a pap. 

The ingenious experiments upon digestion, which SPALLAN- 

ZANI and CARMINATI afterwards instituted, showed how far 

both agencies enter into the question* Similar diversity 

of views prevailed in reference to such subjects as the 

secretion and nutrition of organs and tissues ; but there 

was no doubt that the explanations of the Iatrophysicists ,/*• 

in reference to blood-pressure, to the form, ramification, ; 

and tortuosity of vessels, and to the porosity of the 

capillaries, started from a firmer basis of facts than did* 

those of the Iatrochemists. 

The discovery of the circulation of the blood turned the 

attention of inquirers to the subject of animal motion in 

p-eneral. NICHOLAS STENO made the first attempt to % 

explain muscular action by the laws of mechanics, which J 

are of such general validity.f He took this opportunity of 

publishing his observations on the changes, of form and 

consistence which the muscles undergo in contraction and J 

relaxation. 

Some years after, in 1680, A. BORELLfS celebrated work, j 

De Motu Animalium, appeared, in which the complicated^ 

movements executed by particular muscles were analyzed.^ 

In it the author compared the bones and the muscles 

attached to them to physical apparatus for demonstrating 

levers. To determine the strength of a muscle he sus- j 

pended weights to it until its fibres were torn. STENO| 

even made the observation that muscular tissue has the 

power of being stimulated to movement independently of 

the influence of vessels and nerves, though DE MARCHETTIS 

* SPALLANZANI : Versuche iiber das Verdauungsgeschaft des Menschen und. 

Verschiedener Thierarten, Deutsche Ubers., Leipzig 1785. 

t Nic. STENONIS elementorum myologies specimen seu musculi descriptio- 

geometrica, Flor. 1667. 

X op. cit. i, p. 19 etseq.


had admitted independent irritability only for the muscular 

tissue of the heart and intestine. It was established 

by experiments on frogs and tortoises that power of 

movement exists after removal of the brain. STENO drew 

attention to the part played by the blood in muscular 

action; he ligatured the descending aorta in the frog, and 

showed that paralysis of the muscles of the posterior part 

of the body ensues. BAGLIVI also sought for the cause of 

the inherent contractility of muscular tissue in the blood, 

and considered the nerves to be only the exciters of move 

ment; and he made on this occasion certain remarks which 

may be taken as alluding to the distinction between plain 

and transversely striated muscular fibres* MAYOW, on 

the other hand, attached great importance to the influence 

of the atmospheric air upon the activity of muscle. GLISSON 

regarded irritability as a propertyf belonging to matter in 

general; WlLLlS considered it to belong only to muscles. 

Afterwards A. HALLER, as the result of a great number 

of researches and vivisections, established on a firm basis 

the different degrees of sensibility and irritability possessed 

by the various tissues and organs of the body. He came 

to the conclusion that sensibility is associated with the 

existence of nerves and irritability with that of muscular 

tissue. 

The nerves were held to be filled with a fluid, and 

GLISSON even spoke of currents flowing to and fro in 

nerves. Clearly, these have only the name in common 

with those electrical currents which at the present day are 

known to manifest themselves in nerves. In the explana 

tion of the action of nerve force the Iatrophysicists and 

the Iatrochemists were opposed to one another ; for while 

the former, with NEWTON, assumed the presence of vibra 

tions, of tensions, and relaxations, the latter considered 

* G. BAGLIVI: De fibra motrice et morbosa in his Opera omnia medicopract. 

et anatom., Antwerpen 1719. 

f GLISSON: De ventriculo et intestinis, Amstelod. 1677, p. 168 et seq. 

according to G. H. MEYER in HAESER'S Archiv, Jena 1843, v > P- 1 et seq.

3 6 4 

RECENT TIMES. 

the force in question to be attended with chemical changes 

in the nerve-contents. Those who were dissatisfied with j 

both explanations, had recourse to the hypothetical " vital 

spirits," which gave the wished-for answer to all questions. | 

The brain was generally accepted as the centre of intellectual 

activity. WILLIS ventured even to localize the | 

different psychical faculties in particular parts of the brain; , 

thus he seated sensation in the corpora striata, memory in / 

the medullary substance, and the animal functions in the . | 

cerebellum. R. WHYTT came to the conclusion after J 

numerous vivisections that the capacity for movement is 

preserved for some time after death, and referred to the fact 

that decapitated frogs " move in a co-ordinated manner, 

and, as it were, with intelligence." He concluded from 

this that the brain cannot be the only centre of ^ 

intellectual activity* CALDANI made attempts to j 

investigate the physiological functions of the spinal cord, 

and with this object destroyed different parts of it. 

The great astronomer KEPLER drew the outlines of a 

correct theory of vision, remarked upon the difference in 

the curvatures of the anterior and posterior surfaces of the ] 

lens, explained that this organ is by no means the seat of 

vision, as had hitherto been thought, but serves the purposefj 

of refracting the incident rays of light into the direction 

required. He followed the course of these rays until they 

impinge upon the retina,t and pointed out that myopia and j 

hypermetropia depend upon abnormalities in the refracting 

media, and that with suitable spectacles, fitted with concave 

or convex glasses, a correct image of an object is produced. 

Father SCHEINER, of Vienna, completed these investigations, 

and showed by the experiment named after him that 

an object is only clearly seen when removed to a certain 

definite distance from the eye. He at the same time 

* ROB. WHYTT : An essay on the vital and involuntary motions cf animals,>i 

Edinburgh 1751, p. 344 f t seq., 384 et seq.— R. WHYTT : Physiological essays, 

Edinburgh 1755, p. 107 et seq.-, 214 et seq. 

t POGGENDORFF op. cit., S. 168 et stq.

MICROSCOPICAL INVESTIGATION. 365. 

observed that the pupils contract when the eyes are fixed 

upon near objects. The Prior of the Monastery of St. 

Martin, E. MARIOTTE, made the discovery that the place 

where the optic nerve enters the globe is insensible to rays 

of light* 

The foundation of the physiology of hearing was laid 

by CLAUDE PERRAULT, the famous physician and architect, 

the builder of the Louvre at Paris. He was the first to see 

the nerve-fibres distributed upon the lamina spiralis of the 

cochlea, and declared them to be the seat of the sense of 

hearing.t He also recognized the part played by the 

labyrinth and the semi-circular canals in the conduction of 

sound. DUVERNEY followed the distribution of the auditory 

nerve in the internal ear more closely, and rendered PER- 

RAULTS results more conclusive on certain points. Then 

followed VALSALVA'S excellent work. 

CLAUDE PERRAULT also attempted to throw light upon the 

origin of the voice, while drawing attention to the structure 

of the larynx. DENYS DODART was of opinion that vocal 

sounds are produced by the constriction or widening of the 

glottis in association with the passage of air to and fro. 

ANTOINE FERREIN recognized the fact that vibrations of the 

vocal cords are of the greatest importance in phonation.J 

P. CAMPER tried to explain the different character of the 

voice in various classes of animals by the differences in the 

structure of their vocal organs. AMMANN, W. V. KEMPELEN, 

and KRATZENSTEIN studied the physiology of speech, and 

constructed the first specimens of an apparatus for imitating 

human articulation. The papillae of the tongue were 

declared by MALPIGHI and BELLINI to be concerned with 

* Lettres ecrites par MARIOTTE, PECQUET ft PERRAULT sur le sujet d'une 

nouvelle de'couverte touchant la veue par MARIOTTE in the Recueil de pleusieurs 

traitez de mathematique de l'Acad. Royale des Sciences, Paris 1676. 

t CEuvres diverses de physique et de mechanique, Leyden 1721, Vol. i, p. 

247 et seq. (du bruit, partie iii). 

X Histoire de l'Acad. Royale des Sciences avec les me'moires, etc., Paris 1700, 

p. 244 et seq.; 1706, p. 136 el seq.; 388 et seq.; 1707, p. 66 et seq. ; 1741, p. 

409 etseq.

2,66 RECENT TIMES. 

the sense of taste. MALPIGHI located the sense of touch 

in the papillae of the skin. BOHN referred to the distinction 

between the senses of touch and of temperature, and the 

Genevese philosopher, BONNET, already raised the question 

whether the tongue possesses different nerves for every 

kind of flavour, and the ear different fibres for every 

note* 

Amongst the most weighty questions engaging the atten- '% 

tion of the natural philosophers of the 17th and 18th 

centuries may be reckoned the theory of the generation and 

development of the animal embryo. Here, too, it was 

WILLIAMHARVEY who gave to these investigations a firm $ 

basis in enunciating the proposition, Omne animal ex ovo. 

He taught that the embryo developed from the ovum which 

took its origin from the mother, the semen of the male only 

setting the process in motion. The opinion was maintained 

that during coition the ovum is released from the ovary; 

but KERCHRING remarks that women had told him that an* 

ovum may be expelled at each menstruation.f The ovum 

theory was put on a still firmer foundation by SwAMMER- i 

DAM, MALPIGHI, and REDI, who gave a wider significance 

to the HARVEIAN dictum by changing it into Omne vivum 

ex ovo, and even applied it to plants. This doctrine sus- | 

tained a great shock in consequence of the discovery of-'the i 

spermatozoa, which J. HAM was the first to notice in 1677. 

LEEUWENHOEK confirmed this observation, and described | 

the spermatozoa as extraordinarily small creatures, each • 

provided with a tail and a rounded head, and engaged in 

continual movement; and in view of these facts he put ,1 

forward the hypothesis that the spermatozoa and not the ova 

form the real germs of the embryo. HARTSOEKER thought | 

he recognized a resemblance between the spermatozoon and i 

the human form, and looked upon each as a primitive "J 

embryo. The witty LEIBNITZ even spoke of the immortality 

of spermatozoa. ANTONIO VALLISNERI put an end J 

* Letter of BONNET to HALLER, in HAESER. op. cit. ii, 596. 

t TH. KERCKRING: Anthropogenia ichnographica, Amstelod. 1671, p. 3.


to these dreams by confirming the -view of the high import 

ance of the ovum for the development of the human 

embryo; and yet he committed the error of considering the 

spermatozoa as an unessential accidental constituent of the 

semen, and of declaring them to be without effect in 

generation. This view was also countenanced by BUFFON, 

HALLER, and others, and obtained almost universal accept 

ance. SPALLANZANI was the first once more to submit to a 

closer investigation the problem of the real cause of im 

pregnation, and with this object undertook a series of 

experiments in artificial impregnation with the spermatic 

fluid of the male.* HALLER afforded valuable information 

upon the development of the embryo, especially upon the 

formation of the vascular system. The fcetal circulation 

was thoroughly explained by DuVERNEY. 

Most philosophers gave credence to the old theological 

theory of development, according to which the germs of 

organic beings are preformed from the time of the creation 

of the first, and lie embedded in one another like a series of 

boxes, each enclosing a smaller one. This view of things 

was replaced by the doctrine of Epigenesis, in which 

CASPAR FRIEDRICH WOLFF, as the result of a great number 

of careful observations, delivered his opinion that organs 

have not existed in their mature shape from the beginning 

of things, but that the particular parts of the body assume 

gradually their fully-developed form as the result of a series 

of differentiations.! With great penetration he referred to 

the analogous development of plants and animals, and in 

this connection even pointed to the doctrine of metamor 

phosis in the vegetable kingdom further developed by 

GOETHE. He also made the observation that the nervous 

system, the alimentary canal, and the vasculo-muscular 

* SPALLANZANI : Versuche uber die Erzeugung der Thiere und Pflanzen, 

Deutsche Ubers., Leipzig 1786. 

t C.F.WOLFF: Theoria generationis, Halle 1759.—C. F. WOLFF: Uber die 

Bildung des Darmkanals im bebruteten Huhnchen, Berlin 1812 S sv 12K 

148. 

S '

368 RECENT'TIMES. 

structures arise from . distinct embrybnic layers. He 

declared the ultimate constituents of the body to be 

spherules or vesicles. May we not look upon this as a 

foreboding of the discovery of the cell ? 

PROGRESS IN THE OTHER BRANCHES OF 

MEDICAL SCIENCE DURING THE SEVENTEENTH 

AND EIGHTEENTH CENTURIES. 

THE opposition between the Iatrophysicists and the Iatro- ; , 

chemists was manifested as much in pathology as in , 

physiology. They sought to explain diseases, on the one 

hand by mechanical disturbances such as stagnation of the ,* 

blood or of the contents of the nerves, on the other hand J 

by chemical processes such as fermentation and decom- :f 

position. Prominent thinkers among the doctors, like i' 

BORELLI, PlTCAIRN, HELMONT, SYLVIUS, WlLLIS, BOER-,'j 

HAAVE and F HOFFMANN built upon these theories f 

elegant structures of pathological doctrine, the instability 

of which became apparent as science advanced. The 

deficiencies and mistakes and especially the one-sidedness 

manifested by some of these medical systems led to the 

blending of them with dynamic hypotheses : PARACELSUS J 

had previously made this attempt and HELMONT and 

WlLLIS had repeated it. But the dynamic theory, which 

in many respects recalled the doctrines of the Pneumatists| 

of antiquity—remodelled however, of course, in conformity 

with the Christian faith—was at first only employed to 

explain the ultimate causes of organic phenomena. STAHL 

developed it into an animism which suggested the view 

that all scientific investigation in medicine must be superfluous. 

The same conclusion, at least in respect of the 

theoretical foundation of medicine, was arrived at by those, 

doctors who, like SYDENHAM, dissatisfied with attempts to 

reconcile theory with practice, despaired of the solution of 

the problem, and declared the final goal of their efforts to

Mft' 

OTHER BRANCHES OF MEDICAL SCIENCE. 369 

be an art of healing resting upon experience. The artificial 

systems of the schools, founded on ingenuity and 

imagination, enjoyed but a short existence and resembled 

soap bubbles with their changing prismatic hues, dazzling 

for a moment with the richness of their colour and gone 

the next without leaving a trace behind. Of this period, 

only the knowledge which experience gained or scientific 

observation disclosed, has remained a possession of later 

times, forming one among the many building-stones in the 

firm structure of medical science. 

A rich clinical literature advanced the knowledge of 

disease as seen in individual cases, and turned the attention 

of doctors to groups of symptoms,—a subject which 

had been little, if at all, studied before. At the 

same time diagnosis was improved by the introduction 

of new appliances, and a scientific advance in morbid 

anatomy was prepared for by the collection of reports of 

pathological changes noted at post-mortem examinations. 

SYLVIUS described the deposit of tubercles in the lungs, 

and considered consumption to be due to the purulent 

breaking up of such deposits * WlLLIS drew a picture of 

diabetes mellitus and remarked upon the sweet taste of the 

urine in this disease which he was unable to account for f 

WERLHOF gave the first description of purpura haemorrhagica.% 

The earliest communications upon the subject of 

rickets date also from the 17th century: the symptoms of 

this disease were sketched in outline by B. REUSNER, but 

more thoroughly portrayed by WHISTLER, A. DE BOOT, 

and GLISSON. During the same period we find various 

reports upon the endemic incidence of cretinism, which 

PARACELSUS had already observed in certain Alpine 

localities, and also the earliest treatises upon the epidemic 

* FR. DE LE BOE SYLVII Opera Medica, Traject. ad Rhenum et Amstelod. 

1695, p. 692 et seq. 

'" TH. WILLIS : De minis in Op. omnia, Amstelod. 1663, p. 333 et seq. 

X P- G. WERLHOF: Opera Medica ed. WICHMANN,- Hannover 177c,'ji u 

624,761. ,,s ' ' y ' 

B B

37° 

RECENT TIMES.*, 

appearance of syphilitic affections known,in Scotland under 

the name of Sibbens and under that of Radesyge in 

Scandinavia. 

Remarkable progress in certain directions was also made 

during this period in the diagnosis of disease, but its full 

significance was certainly not recognized until later. On 

the examination of the urine as a means of diagnosis 

SOLANO DE LUQUES, T. BORDEU and others imparted some 

new and valuable information although they also made 

many singular and even ridiculous statements upon the 

same subject. Other means of diagnosis also began to be 

used. SANTORIO made use of the thermometer to determine 

the temperature of the body, and BOERHAAVE, COCK- 

BURN and others made extensive use of that instrument in 

their practice* ANTON DE HAEN in this way established 

the fact that in the rigors of fever the temperature of the 

body is not reduced, as was then generally assumed to be 

the case, but, on the contrary, raised: he also first drew 

attention to the remarkable phenomenon of post-mortem . 

elevation of temperature, and observed that the subjective 

feeling of warmth by no means always corresponds to the 

real temperature, and that the temperature of paralyzed 

limbs is lower than that of healthy ones.f 

Diseases of the heart excited great interest. LANCISI 

connected pulsation in the jugular veins, with dilatation of 

the right side of the heart resulting from incompetence of 

the tricuspid valve.J ALBERTINI remarked very appropriately 

that the difficulty of diagnosis in heart disease 

depends in great measure upon the fact that in it pathological 

conditions of various kinds coexist and he advised 

that in examining the heart the hand of the doctor should 

be laid upon the cardiac region of the patient.§ By far 

* WUNDERI.ICH: Das Verhalten der Eigenwarme in Krankheiten, Leipzig 

1870. 

t TH. PUSCHMANN : Die Medicin in Wien, 1884, S. 19. 

X LANCISI : De motu cordis et aneurysmatibus, Lugd.. Batav. 1740, p. 306, 

pars, ii., cap. 6, prop. 60. 

§ ALBERTINI : Opuscula ed. M. H. ROMBERG, Berol. 1828. 

a

OTHER BRANCHES OF,MEDICAL SCIENCE. 371 

. "'4lfc'Mfyj. 

the greatest acquisition which diagnosis owes to this 

period, was the discovery of the art of percussion by the 

Viennese doctor AUENBRUGGER* Unfortunately this 

remained almost unnoticed : only in the 19th century did 

it become, as C. G. LUDWIG of Leipzig said in the year 

1763, "a torch which brought light into the gloom which 

hrooded over the diseases of the thorax." 

Morbid anatomy also made a great step in advance. 

Men ceased to look upon pathological changes observed in 

the dead body as nothing but curiosities which satisfied the 

spectacular cravings of collectors ever ready to grasp at 

rarities, and began to suspect, and to examine into, their 

•connection with clinical symptoms. W HARVEY declared 

that a man can learn more from the necropsy of one human 

being who has died of consumption than he can from the 

dissection of ten who have been killed by hanging. 

BENEVIENI, T. BARTHOLINUS, BONET, RIDLEY, LANCISI, 

VALSALVA and others deposited in their writings a number 

of valuable observations. WEPFER made the first attempt 

to set free the subject of cerebral diseases from the chaos 

•of mystical-transcendental speculation in which it was lost, 

and to explain such diseases by pathological changes 

in the brain. He observed the seat of apoplectic lesions 

healed into cicatricial tissue and described the affection 

named afterwards by FOTHERGILL " a painful affection of the 

face" i.e. tic douloureux. In the 18th century FONTANA 

made the important discovery that the "staggers" in 

sheep is a disease caused by hydatids in the brain. 

The pathology of the vascular system owed substantial 

progress to the labours of VlEUSSENS, LANCISI and SENAC 

VlEUSSENS f observed instances of adhesion of the pericar 

dium to the heart and described hydrops pericardii and 

pericarditis. He portrayed with astonishing clearness 

the relations between the pathological changes in the dead 

body and the symptoms during life in a case in which he 

* AUENBRUGGER: Inventum novum, Vindob. 1761. 

f J. PHILIPP in the Janus ii, 580-598. iii, 316-326.


attributed dilatation of the pulmonary veins, oedema of the 

lungs, enlargement of the right side of the heart, dropsical 

swelling of the feet, and smallness of the pulse, all to 

stenosis of the left ostium venosum, i.e., auriculo-ventricular 

orifice; and also on another occasion when he ob* 

served calcareous degeneration of the aorta ascendens and 

of the semilunar valves with insufficiency of the latter and 

declared this had resulted in a partial regurgitation of 

blood into the left side of the heart and cardiac palpitation. 

LANCISI gave more detailed information concerning these 

pathological changes especially as to so-called ossification, 

that is calcareous degeneration of the valves, and as to dilatation 

and hypertrophy of the heart* SENAC first drew 

attention to the abnormal position sometimes occupied by 

the heart on the right side in consequence of pathological 

conditions.! Unfortunately the erroneous views of doctors 

firmly resisted the correct interpretation of facts in regard 

to the significance of the so-called polypi of the heart, 

although KERCKRING had already declared them to be due 

to post-mortem changes.^ 

Pathological anatomy reached the highest point attained 

at this period in J. B. MORGAGNI who, in possession of all the 

knowledge which had been accumulated in this field, verified 

and completed the results gained by numerous observations 

of his own and for the first time gave clear and defined 

expression to the problems and tasks of this branch of 

science.§ In his investigations he also sought the aid of 

experiment.|| STEPHEN HALES did likewise and produced 

artificial dropsy by injecting water into the vascular system.. 

HALLER'S labours upon sensibility and irritability were 

supported chiefly by experiments on animals and by vivisections. 

He knew well the use of these aids and 

declared : "• One single experiment of this kind has often 

* PHILIPP in the Janus iii, 318 el seq. 

X SENAC : Traite de la structure du coeur, Paris 1749. 

X TH. KERCKUING: Spicilegium anatomicum, Amstelod. 1670, p. 145. 

§ F. FALK: Die pathol. Anatomie des J. B. MORGAGNI, Berlin 1887. 

|| PHILIPP in der deutschen Klinik, 1853, No. 45.


, * • •& • W % # 

^F — 

removed the disappointments occasioned by the work of 

whole years. This cruel proceeding has been of more use 

to physiology than almost all the other arts, the co-opera 

tion of which has given strength to our science."* 

SPALLANZANl's experiments upon the reproduction of lost 

limbs in the lower animals excited great attention.f JOHN 

HUNTER contributed more than any other to introduce the 

experimental method into pathology. 

Not only do the first beginnings of experimental pathology 

belong to this period but the same may also be said of 

bacteriology. LEEUWENHOEK described micro-organisms 

of rounded, staff-shaped, thread-like and spiral form which 

he asserted that he had found in the human mouth between 

the teeth.J In consequence of these discoveries the theory 

arose that many diseases are caused by these " animalcules." 

This view did not, certainly, admit of demonstration at that 

period, but for all that, certain distinguished naturalists 

such as LlNN/EUS and PLENCICZ held fast to the doctrine of 

contagium animatum. 

Valuable preliminary work in founding a science of 

hygiene was done by LANCISI who studied the exhalation 

from marshes and the means of improving the unhealthy 

condition of the Roman Campagna,§ and by PRINGLE who 

rendered great service to military sanitation and instituted 

investigations upon septic and antiseptic substances. 

The pharmacopoeia was enriched by many remedies. The 

value of Peruvian bark in fever was recognized ; ipecacuanha 

root was found to furnish a powerful emetic and the use of 

arsenic was recommended in cancer. Efforts were also 

made to arrive at correct views as to the causes of the 

beneficial effects of medicines and the most suitable 

method of employing them. WlLLIS invited an inquiry into 

* Cf. AD. VALENTIN in the Memoir on. A. v. HALLER, Berne 1877, P- 78. 

SPALLANZANI : Sopra le riproduzioni animali, Modena 1768. 

X F. LOFFI.ER: Vorlesungen iiber die geschichtliche Entwickelung der Lehre 

von den Bakterien, Leipzig 1887, Th. i. 

§ C. LANGER in den Mitth. d, Ver. d. Arzte in Nieder-Osterreich 1875, N «- 2.

374 

RECENT TIMES. 

the changes which the drugs bring about in the stomach, 

the blood and the different organs. This suggestion was 

carried out by WEPFER and, to a greater length afterwards, 

by A. STORCK: they performed numerous pharmacodynamical 

experiments with various medicinal substances* 

TJnder the influence of the discovery of the circulation of 

the blood, the first attempts were made to inject medicines 

into the veins as well as to replace great loss of blood by 

transfusion.t But the unfortunate results of these operations 

which depended partly upon the indifferent appliances 

and instruments used in performing them soon brought 

intravenous injections and transfusion into discredit and by 

degrees into oblivion, C. STALPERT VAN DER WiEL 

already made use'of a kind of oesophageal tube for artificial 

feeding.^ BENNET advanced special therapeutics by recommending 

inhalations in phthisis ;§ DOL/EUS by ordering 

milk diet in gout; and EDW. BAYNARD and J. FLOYER 

by causing patients suffering from high fever to be 

immersed in cold water. The two HAHNS, BRANDIS and 

CURR1E recommended that cold water should be poured 

over patients with typhus and thus gave a stimulus to the 

progress of hydro-therapeutics, while the curative employment 

of baths was placed on a firm basis by R. BOYLE and 

F. HOFFMANN. 

Surgery made less progress than the other branches 

of medicine during the 17th century. This was caused 

partly by the fact that the most gifted representatives of 

medical science turned their attention by preference to 

chemical and physical investigations which then promised 

great results, and also to physiology and microscopical 

anatomy ; partly by the continually increasing separation 

between internal medicine and surgery, in consequence of 

* PUSCHMANN op. cit. S. 35 et seq. 

f P. SCHEEL: Die Transfusion des Blutes und Einspritzung in die Adern, 

Kopenhagen 1802.—DIEFFEN BACH in RUST'S Handworterbuch, Berlin 1838. 

X STALP. v. D. WIEL : Observat. rar. cent, ii, 27 and KRUL in the Weekbl. v. 

h. Nederl. Tijdschr. v. Geneesk, 1883, No. 47. 

§ CUR. BENNET: Tabidorum theatrum, Lugd. Bat. 1714, Cap. 28.


which students of medicine held themselves aloof frc 

studying the art of treating wounds, while on the oth 

hand the practitioners who had received but. empiric 

training were fully occupied in learning to understand a 

to assimilate to themselves the teachings of the gre 

revolution in their art of which the preceding century h 

witnessed the commencement, in respect of the metho 

used in surgical operations. Certainly there were n 

wanting certain improvements in the technical procedur 

connected with operations : but no reforming genius lil 

AMBROISE PARE, embracing all branches of surgery ai 

guiding it into new paths, lived at this time. It was not un 

the second half of the 18th century that a new impetus w 

given to surgery though this did not show itself so much 

the development of the art of operating as in the foundatic 

of surgical pathology. 

Ligature was but seldom employed for the arrest 

haemorrhage, for this demanded more anatomical knoA 

ledge than the majority of surgeons possessed. Tl 

numerous unsuccessful results which followed the attemp 

made in this direction may be partly attributed to tl 

rough and incomplete methods employed. Compressic 

of the vessels was practised by preference and w; 

considerably facilitated by the invention by MOREL 

the fillet-and-stick tourniquet in the year 1674. PET 

replaced this by the screw-tourniquet in 1718. Digit 

compression also came once more into use at the instance 

SAVIARD and LOUIS. The Prussian surgeons THEDEN ai 

SCHMUCKER recommended the use of the tampon. Besid 

these means use was made of the hot iron, of cold, and 

various styptic applications. Ligature came to be mo 

generally recognized by surgeons only when it was unde 

stood what a mistake had been made in including in t 

ligature the nerves, veins, and surrounding cellular tisst 

and when the practice of ligaturing the isolated artery w 

commenced. Even ligature of great arterial trunks, su 

as the femoral and axillary was then ventured upon ; W A


NER and ELSE went so far as to perform ligature of the 

carotid in the year 1775. 

The amputations performed were chiefly those of the 

foot, leg, forearm, and hand ; above the elbow and knee 

they were practised less frequently. The methods of performing 

these operations were somewhat enriched by the 

introduction of the double and triple incision, of the 

flap-operation, and of the process of cutting the tissues 

in the form of a hollow cone, the object aimed at being 

the preservation of,enough of the soft parts to form a 

covering for the stump. Amputation was, however, performed 

more frequently than there was any occasion for. 

Thus SCHMUCKER states that in 1738 he saw in the Hotel 

Dieu at Paris a patient both of whose legs had been 

amputated on account of simple fractures. Conservative 

surgeons opposed this abuse which had arisen under 

the influence of the French school, and endeavoured to 

confine amputation within reasonable limits. The increase 

of anatomical knowledge and the improvement in the 

technical details of operations encouraged surgeons to perform 

exarticulations. A. PAR£ had already practised this 

method at the elbow-joint; at the knee it was first performed 

by FABRY VON HlLDEN and at the shoulder by 

MORAND and LE DRAN. The method of exarticulation in 

the tarsus named after CHOPART was made public in 1791. 

Exarticulation at the hip-joint was attempted but given up 

again on account of the unsatisfactory results attending it. 

Resections of certain bones or portions of bones were also 

performed ; for instance of the humerus by CH. WHITE, 

of the clavicle by CASSEBOHM, while the first successful 

excisions of joints were practised by FILKIN (1762) and 

PARK (1781) in the case of the knee joint; and by CH. 

WHITE (1768) and J. BENT (1771) in the case of the 

shoulder. 

Trephining was frequently performed for the most trivial 

causes ; it is inconceivable, how readily this measure was 

resorted to. It was performed 17 times, on PHILIP WILLIAM


Prince of ORANGE as we are told by C. SOLINGEN. On! 

here and there was a voice raised against this dangerot 

mania for operations. The first opening of the maxillai 

antrum for disease belongs also to this period. Catheterisi 

of the Eustachian tube owes its invention to the deaf pos 

master GUYOT of Versailles who practised it upon hin 

self.* Tracheotomy was recommended and performed nc 

•only for the removal of foreign bodies and the relief ( 

dyspnoea, but also in croup and diphtheria.f CEsophc 

gotomy was performed for the first time in the i'8t 

century, while gastrotomy was practised as early as th 

year 16354 GIOVANNI FANTONl reported the first sue 

•cessful extirpation of the spleen. In the subject of herni 

the influence of the study of anatomical relations, whic 

are of such fundamental importance, began to make itsel 

felt. Besides inguinal and umbilical hernia other form 

began to be distinguished and attention was drawn t< 

femoral hernia and to the pudendal, obturator and sciath 

varieties.§ Efforts were made to throw light upon th< 

origin of ruptures; HALLER considered congenital hernh 

to depend upon embryological conditions. In the treat 

ment, trusses were more generally employed especially 

after N. LEQUIN had in 1663 introduced the elastic spring 

The operation for radical cure was less frequently per 

formed and was gradually more and more confined to case: 

•of strangulated hernia. Special care was taken to pre 

serve the spermatic cord; many surgeons, like DlONIS 

held it to be justifiable only in the case of priests to com 

bine castration with this operation. 

The operation for rectal fistula was brought into con 

siderable repute by the fact that LOUIS XIV was oblige* 

to undergo it. The Royal illness even exerted a grea 

* Machines et inventions, appr. par l'academie royale, Paris 1724, iv, Nc 

253. 

t B. SCHUCHARDT in LANGENBECK'S Archiv 1887, Bd. 36, H. 3. 

1 HAGENS in the Berliner klinischen Wochenschr. 1883, No. 7. 

§ J. FANTONI: Opusc. med. Genev. 1738. 

'• r tl


influence on politics; MlCHELET has, as is well known, 

divided the reign of this Monarch into the periods avant et 

apres la fistule* The debates upon the performance of 

the operation led to the invention of several fistula-knives 

amongst which that of POTT with SAVIGNY'S improvements 

was most esteemed. Colotomy with the object of the formation 

of an artificial anus in congenital closure of the 

natural outlet was performed in 1783 for the first time. 

Among the methods of performing lithotomy the sectio 

lateralis was most extensively adopted. CHESELDEN 

modified the procedure in some measure and FRERE COME 

recommended the use of the lithotome cache. The high 

incision over the pubes was less frequently employed. 

Lithotrity was described by ClUCCl : he made use of a 

grooved instrument with toothed blades resembling 

ClVlALE's lithotrite and enclosed in a sheath. In the 

treatment of urethral stricture the elastic bougies recommended 

by DARAN which swelled in the urethra were in 

great favour. 

HENDRIK VAN DEVENTER, A. J. VENEL and others 

sketched out the principles of orthopaedics. About the 

same time HENDRIK VAN ROONHUYSE and afterwards 

TULP made the first attempts to cure caput obstipum by 

dividing the sterno-cleido-mastoid muscle. In 1784 M. G. 

THILENIUS performed the first division of the tendo Achillis 

for club-foot. 

Surgical pathology received valuable additions at the 

hands of PERCIVAL POTT who made chronic inflammation 

of the joints or tumor albus the object of careful observation, 

as he did also the subject of vertebral caries, the 

curvature resulting from which disease is named after him;. 

while J. L. PETIT drew attention to the suppurative osteomyelitis 

which supervenes upon wounds. PETIT and JOHN 

HUNTER also studied in greater detail the processes which 

occur in the tissues in thrombosis, suppuration, cicatriza 

tion and granulation. 

* HJ-ESER op. cit. ii, 432.


Ophthalmology made a great stride at this time, in laying 

aside the error, that cataract results from an extra-ocular 

humour which is deposited in the form of an opaque pellicle 

before the lens, and by adopting the correct view that it 

consists of a disease of the lens itself. This discovery 

received a splendid confirmation in the method of extraction 

by which DAVIEL in 1746 performed the first operation 

for removal of the lens. Extraction from this time 

forth maintained an established position in ophthalmic 

surgery along with the couching operation. The formation 

of an artificial pupil constituted a further step in advance; 

this was advocated by WOOLHOUSE and first performed in 

1728 by CHESELDEN. The procedure consisted of an 

incision made in the iris ; the elder WENTZEL modified 

this by excising a portion of the iris—performing an iridectomy 

in fact. 

To this period midwifery owes the beneficent discovery 

of the forceps. Long led up to by the instruments which 

obstetricians made use of for the extraction of dead 

foetuses, they appeared upon the scene finally in the 17th 

century and assumed a form calculated to adapt them to 

their peculiar ends. The CHAMBERLENS in difficult labours 

made use of appliances consisting of levers, or blades of 

steel covered with leather. This invention remained a 

business-secret until JEAN PALFYN made it public after 

introducing many improvements.* It was then further 

perfected by DUSE, who introduced the crossing of the two 

blades, by the younger GREGOIRE who had them fenestrated 

and united by a locking apparatus, and above all by 

LEVRET who changed the straight form of the blades into a 

curved one, arranged for the locking by means of a moveable 

peg, and laid down a statement of the indications 

which justified the use of the forceps. To avoid the 

dangers of Csesarean section—an operation but rarely performed—a 

division through the symphysis pubis was 

* J. H. AVELING: The Chamberlens and the midwifery forceps, London 

1882.—A. GOFFIN: Jean Palfyn, Bruxelles 1887.


recommended, by which it was hoped, erroneously however, 

to increase the width of the pelvis; the bad results of 

this operation were soon seen and led to its general condemnation. 

On the other hand the procedure first recommended 

by CAMERARIUS and SLEVOGT—that namely of 

inducing premature labour in the 7th or 8th month in a 

case where, in consequence of a narrow pelvis, a child could 

not be delivered by the natural passages,—was well received 

by obstetricians and maintained its place in gynaeco 

logical practice. 

To this period belongs also the first treatment of medical 

jurisprudence in a scientific spirit as we see for example in 

the application of the lung-test to forensic purposes:* the 

same may be said of the first beginnings of a system of 

medical statistics.! 

If we follow the course of the development of medicine 

during the 17th and 18th centuries, we recognize in it the 

same phases as those which characterize the general march 

of civilization during the same period. That spirit of active 

investigation, so rich in results, which was displayed in an 

indefatigable accumulation of empirical facts, gradually to 

a certain extent ceased to manifest itself: it became 

apparent that the results gained required to be sifted and 

to be looked at in their relations to one another and to the 

general intellectual life of man. Like the traveller, who 

after a fatiguing march has ciimbed a height, and who 

looks back with a proud contentment on the path he has 

traversed ; even so the genius of civilization after great 

victories won, now halted for a brief rest, before arming 

once more for new achievements. In the history of mankind 

such a moment had arrived in the 18th century and 

the efforts of the Encyclopaedists gave clear expression to 

the fact. In medicine too this tendency of men's minds 

was noticeable and manifested itself in a series of com- 

* BLUMENSTOCK in the Vierteljahrsschr. f. gerichtl. Medicin, 1884, Bd. 38 

S. 252-69. Bd. 39, S. 1-12. 

f J. GHAETZER : Daniel Gohl und Christ. Kundmann, Breslau 1884.

ART AND PHILOSOPHY 381 

positions which dealt chiefly with the history of medicine. 

The first prominent representatives of medical historical 

literature were DANIEL LECLERC, JOHN FREIND and 

JOHANN HEINRICH SCHULZE. It found influential friends 

and supporters in BOERHAAVE and especially in HALLER 

who rendered imperishable services to the history of medicine 

by editing the medical writings of antiquity and by 

his bibliographical works. PORTAL, also, who was the 

author of a History of Anatomy, WERTHOF, HENSLER and 

GRUNER, whose thorough investigations in the history 

of diseases have an enduring value, ASTRUC, BALDINGER, 

TRILLER, MOEHSEN, ACKERMANN, MESLER and others 

bear witness to the fact that the taste for historical 

inquiry among the doctors of the 18th century was widely 

spread and abundantly fruitful. 

THE CHARACTER OF THAT PERIOD IN REGARD 

TO ART AND PHILOSOPHY. 

THE intellectual life of the 18th, was of a different ch 

to that of the preceding, century. This change manifested 

itself either in the neglect of experimental inquiry, as was 

the case in the natural sciences, or else in an alteration of 

direction in work and aims, as was most clearly indicated 

by the productions of the painter's art. 

The 17th century produced GuiDO RENI, SALVATOR 

ROSA, the Spaniards VELASQUEZ and MURILLO, the French 

masters NICHOLAS PoussiN and CLAUDE LORRAIN and the 

great artists of the Netherlands, RUBENS and REMBRANDT. 

The 18th century could place by the side of these but few 

artists whose names would not pale in the presence of that 

dazzling company of masters. In the place of the classical 

beauty of those figures, which have become a pattern to all 

time by virtue of the noble simplicity of their design and 

the correct appreciation of the harmony of colours shown


in their composition, and which, even when, as in RUBENS' 

works, they exhibit a downright naturalism never merely 

captivate the eye but always speak to the heart as well,— \ 

in the place of such works as these appeared others, unwholesomely 

surcharged with quaint accessories, in consequence 

of the desire of the painters to appear original, the 

effect of which was to lead art astray from the true path. 

The philosophical ideas and systems which were put forward 

at this time afforded a life-like image of the intellectual 

struggles and changes of the period. The inductive 

philosophy of BACON, founded upon experience and experiment, 

which was justified beyond all expectations by the 

rapid strides made in the natural sciences and by a multitude 

of discoveries and inventions, developed under the influence 

of these results upon a basis of materialism to which the 

doctrine of pantheism imparted some bias towards idealism. 

That belief the unfortunate GIORDANO BRUNO had proclaimed 

as his sacred conviction and suffered death for in 

the flames. BARUCH SPINOZA also professed the same creed 

at a later period, and, expelled from the Jewish community 

on account of his freedom in religious thought, endeavoured 

to found it on scientific facts and to make it a method of 

general application in explaining the phenomena of the 

universe. He taught the conformability to law of every 

event in nature and the unity of substance which, as he 

explained in his appendix to Descartes, manifests itself 

outwardly in a twofold form—Spirit and Matter. 

JOHN LOCKE went a step further. Accustomed as a 

doctor to exclude metaphysics from the field of discussion, 

he took up a position on the ground of pure philosophic 

empiricism and declared that there are no such things as 

innate ideas but that all knowledge is founded on experience. 

The human soul, he says, resembles at birth a blank 

page on which the perceptions of the senses are impressed 

as experiences, until by reflection and by the understanding 

—which LOCKE calls the internal sense—they are arranged 

into pictures of ideas. He thus brought philosophy once

ART AND PHILOSOPHY. 383 

more back into the arms of naturalism inasmuch as he 

referred his theory of the acquirement of knowledge to the 

investigation of things by means of the bodily senses. 

LOCKE'S philosophical views found distinguished advocates 

in France in the persons of E. B. DE CONDILLAC and VOL 

TAIRE, and in England incited to a scepticism which DAVID 

HUME gave powerful expression to, while Germany produced 

a mighty opponent to them in LEIBNITZ. The lastmentioned 

combined the innate ideas of PLATO with the 

outlines of the atomic philosophy of DEMOKRITUS,—with 

which G. BRUNO and P GASSENDI had already established 

some connection,—and adapted these views to the Christian 

doctrines of the wisdom of the Creator and the suitability 

of nature to its ends. He assumed the existence of certain 

metaphysical points indivisible, without dimensions, and 

probably endowed with perception, which he called monads; 

he believed that he explained their mutual relations and 

their connection with the unity of consciousness by the 

fantastical hypothesis of a " pre-established" harmony 

settled before the beginning of time. 

LEIBNITZ exerted no promoting influence on the development 

of the natural sciences or of medicine in particular; 

for philosophy, for literature in general, he has perhaps been 

credited with greater importance than he deserves. His 

system was chiefly confined to Germany where CHRISTIAN 

WOLFF was his most zealous apostle. He arranged the 

ideas, which LEIBNITZ had jotted down in a loose disconnected 

form, into an orderly scheme with the pedantry 

of a schoolmaster, and wherever there were manifest gaps 

or whenever a too high-flying fancy prevailed he amended 

matters by the doctrines of other philosophers. 

More coherent and uniform in composition, but at the 

same time more daring and more terrifying in its conclusions 

was the materialism which made its appearance in France 

about the middle of the 18th century. The most radical representative 

of this, the French doctor LAMETTRIE, made 

an attempt in his " Histoire Naturelle de l'Ame" and his


"L'Homme Machine" to deduce from the material and 

corporeal organism even the processes of thought, the 

intellectual faculties, and the moral feelings. He disregarded 

the transcendental character of the human soul, 

appealing, amongst other things, to the fact of psychical 

disturbances which depend upon changes in the brain. 

Immortality he granted, but only in so far as he held that tj 

matter, from which the things of this world are made, does 

not perish, but only changes its form and participates afresh -j 

in the formation of other bodies. Unfortunately LAMETTRIE 

at the same time preached a philosophy of pleasure which 

amounted to a shameless glorification of self-indulgence,;!! 

and especially of venereal pleasures. The violent attacks^ 

which he had to sustain were provoked entirely by this circumstance 

and were by no means the result of his more 

serious philosophical theories. It may well be that during ' 

his life he did not practise the frivolous cynicism which he * 

made so conspicuous a feature of his writings : but even F/ ' 

A. LANGE who undertook the vindication of LAMETTRIE was * 

able to bring forward in his defence nothing more than the 1 , 

claims that he neither sent his children to the foundling 

hospital like ROUSSEAU, nor married two brides like SWIFT, 

that he had not like BACON been convicted of bribery, and 

had never been suspected of forging documents like VOL 

TAIRE.* In any case LAMETTRIE by his teachings exerted 

an injurious influence upon morals and poisoned many 

pure spirits, and he was chiefly to blame if materialistic 

philosophy was for a long time identified by ignorant. 

people with an unlimited indulgence in sensual gratifica 

tions. 

The other adherents of materialism, especially those 

who have become known under the name of the Encyclopaedists, 

sought not so much to secure a scientific founda-^ 

tion for their philosophical tenets as to wage war against 

ecclesiastical and political authorities. The author of the 

" Systeme de la Nature " developed the theory of the 

i f 

* F. A. LANGE : Geschichte des Materialism us, Iserlohn 1876, i, 349.

LEARNED SOCIETIES AND UNIVERSITIES. 385 

circular course of life and the intimate interdependence of 

the three kingdoms of nature; but he laid, at the same 

time, undue, stress upon such subjects as the rationalistic 

enlightenment of the people and their right to self-government 

These theories no doubt contributed largely to lead on 

the mighty revolutions which, at the end of the eighteenth 

; century, shook France to its foundations and affected the 

whole of Europe, and make it, to some degree, apparent 

why many looked upon materialism as the source of 

irreligion and the foe of monarchy. 

THE LEARNED SOCIETIES AND UNIVERSITIES 

IN THE SEVENTEENTH AND EIGHTEENTH 

CENTURIES. 

THE development of the scientific spirit was es 

advanced in the 17th century, as it had been in the 16th, 

by the foundation of learned societies and of universities. 

In Italy Prince FEDERIGO CESI established in 1603 the 

Accademia dei Lincei, so called because its members 

required for their investigations the eyes of lynxes and 

because the coat of arms of the society bore a lynx on it; 

while in 1657 under the patronage of the Medici princes 

there arose in Florence the Accademia del Cimento which 

gave forth that experiment should be its particular charge. 

.Learned societies were formed after this pattern in other 

countries also. In Germany, Schweinfurt was the centre of 

a society of doctors and natural philosophers which in 

1672 was raised to an academy by the Emperor LEOPOLD. 

In Paris the Academie des Sciences came into existence 

about the year 1666 and in 1793 was converted into the 

Ihstitut National. The Royal Society was also founded 

in London in the year 1666: its Transactions have 

appeared in almost unbroken succession up to the present 

day, and form for the history of science one of the most 

C C

386 

RECENT TIMES. 

important arid valuable series of publications extant* . 

Upon these followed the Academy of Berlin which was 

êstablished in 1700 through the efforts of LEIBNITZ ; the 

-PhilosophicaLSociety of Gottingen in 1733.; the Academy of 

St. Petersburg, which was built, certainly, on Russian soil, 

but the members of which were chiefly Germans, in 1725; 

the Academy of Mannheim in 1755; and that of Munich in 

1760. 

The scientific life of this period brought forth rich fruit 

in England and the Netherlands. Italy too saw the ripen-. 

ing of some late harvests, which called to mind the best I 

periods of that country's great past. The splendid Court j 

of LOUIS XIV. threw upon France broad beams of light \ 

which rendered conspicuous a surprising quantity of talent 

and energy combined with much inward unsoundness. 

During the 18th and far into the 19th century, the French •' 

people stood at the head of intellectual progress; the'0 

learned men and investigators of France not only worked | 

strictly as pioneers in the advance of science, but they also :j 

•widened its boundaries and increased its subject-matter in 

various ways. Germany was checked in political and intel- ,j 

lectual development by the miserable religious war, which 

laid the land waste during 30 years, and did not until two 

centuries later enjoy an assured peace for the full exercise 

of her power. 

; Ât the end of the 16th century, the academies and 

educational establishments in the different countries were 

sufficient in number, as a general rule, to satisfy existing 

requirements. In England the ancient universities of 

Oxford and Cambridge formed the most important centres • 

for the higher studies. France centralized scientific study 

more and more in Paris. Holland acquired new academies, 5 

at Groningen (1614), Utrecht (1634) and Harderwyk (1648). 

In Italy universities arose at Parma, Cagliari, Mantua, 

Urbino, Piacenza, Sassari, and Milan, some of which»c 

indeed, owed their origin merely to the petty jealousies of 

* CH. R. WELD: History of the Royal Society, London 1848, 2 Vols.'

LEARNED SOCIETIES AND UNIVERSITIES. 387" 

these towns and their rulers. In 1608 a university was 

founded at Pamplona, which, nevertheless, remained as 

unknown as-the other institutions of this kind in Spain. 

Establishments of a kindred nature, which were founded in 

Eastern Europe, like those at Tyrnau, in Hungary, after* 

wards removed to Pesth, at Klausenburg, in Transylvania, 

and. at Kiew and Moscow, did not acquire any particular 

notoriety. An academy for Finland was created in 1640, at 

Abo, which was moved to Helsingfors in 1828 ; and Sweden 

acquired a second university at Lund, in 1668. 

The number of academies which during this period arose 

in Germany was inordinately great. In part they were called 

into existence not by any want felt for an academical education, 

but merely through the vanity of the minor territorial 

lords, who in the foundation of an academy saw a not too 

costly method of advertising their sovereignty and of hearing 

themselves extolled in speeches and poems as patrons of 

the sciences. When the gymnasium at Herborn in Nassau 

was, in 1652, raised into a university it cost the territorial 

princes much trouble to find the fee of 4,ioofl. required to 

pay for the grant of the Imperial privileges. The town of 

Rinteln, when in 1621 it was made the seat of a university, 

possessed neither an apothecary's shop nor an inn* The 

partition of the Hessian countries among various branches 

of the dynasty led in 1607 to the foundation of the 

academy at Giessen ; but from 1625 to 1650 it was again 

united with the neighbouring sister institution of Marburg. 

The University of Strassburg arose out of the academical 

gymnasium there, at which, among other branches of 

scientific instruction, medicine found a place ; in 1566 and 

1621 this university received the Imperial sanction. In 

1602 there were at it 70 students of theology, 77 of law, 

11 of medicine, and 145 of philosophy, t Afterwards this 

seat of learning was less frequented, the number on a 

* A. THOLUCK: Das akademische Leben des 17. Jahrhurrderts, Halle 1854, 

Bd. i, Abth. 2, S. 96, 303. 

t Id. i, 2, 122. '• -'

388 

RECENT TIMES. 

yearly average amounting to little more than four students 

in all the faculties put together; not till 1718 did it once 

more raise itself from this depressed condition, when under 

the French rule political circumstances assumed a peaceful 

aspect* The University of Altdorf arose in a similar 

manner in 1622 in the district of the imperial free-town of 

Niirnberg.f The gymnasium at Bremen also resembled an 

academy; and a professorship of medicine was founded 

there in 1610. A similar character was borne by, the 

higher educational establishments at Steinfurt and at 

Neustadt on the Haardt, that at the former of these towns 

being intended for the Grafschaft of Bentheim-Tecklenburg, 

and that at the latter for the Palatinate. Those at Hanau 

and Lingen also resembled universities. At Duisberg a 

university arose in 1655 and one at Kiel in 1665. The 

academy at Dorpat owed its foundation in 1632 to King 

GUSTAVUS ADOLPHUS, of Sweden ; but it existed only a 

few decades and did not awake to renewed life until 1802. 

The system of higher education in the Catholic states of 

Germany came by degrees completely into the hands of 

the Jesuits. Several new institutions, founded at the 

instance of this Order, were, even if they received the 

rights of a university, essentially only spiritual seminaries. 

Thus there arose at Molsheim, in Elsass (Alsace), a 

Jesuitical gymnasium which, in 1617, was raised by the 

Pope into a university: this in 1702 was transferred to 

Strassburg and united with the high school at that place. 

At the same time the cathedral school at Paderborn acquired 

the character of a university ; the same happened to the 

cathedral school at Osnabriick. The academy founded in 

1647 at Bamberg gradually developed in like manner into a 

complete university. In 1734 the Jesuitical gymnasium at 

Fulda was also raised into a university, while the cathedral 

school at Miinster did not attain this dignity until 1780. 

* F. WIEGER : Geschichte der Medicin in Strassburg, 1885, S. 71. 

f G. A. WILLIS: Geschichte und Beschreibung der Universitat Altdorf, 

Altdorf 1795 J


To these were added numerous academies in the 

countries belonging to the reigning house of Hapsburg. 

At Salzburg, learned Benedictines founded an establishment 

for the higher teaching, which in 1623 was raised into a 

university by the Pope. A like honour was granted to 

the Jesuitical gymnasium at Innsbruck, in 1673. So too at 

Breslau the Jesuitical college developed, little by little, into 

a university and in 1702 was recognized as such. The 

establishment at Briinn acquired in 1779 for the first time 

the privileges of a university, the high school at Olmiitz 

being removed thither and united with it. But only a few 

years afterwards it lost this character again and was 

changed into a lyceum, which later on was associated with 

an establishment for teaching medicine and surgery and 

had its seat in Olmiitz.* 

The universities of Halle and Gottingen exerted an important 

influence on the development of the scientific spirit. 

The former was founded in 1694, after the Archbishopric 

of Magdeburg, with the lands belonging to it had come 

into the possession of Brandenburg. The Great Elector had 

already occupied himself with the formation of a kind of 

academy which should form a centre for all things worthy of 

study; he contemplated providing it with a chemical laboratory, 

a physical and technological establishment, a zoological 

and botanical garden, workshops, museums, etc., and decreed 

that it should be accessible to all desirous of learning, 

without distinction of nationality or religious belief.f But 

the time was not ripe, nor was money forthcoming for the 

completion of a plan of this magnitude and so much in 

advance of the rationalistic mode of thought of the 18th 

century. The financial means of the university of Halle 

were also somewhat limited: its yearly income up to 1786 

reached no more than 7,000 thalers, with which it was 

necessary to meet the salaries of all the teachers, and 

* F. J. RICHTER : Geschichte der Olmiitzer Universitat, Olmiitz 1841. 

f ERMAN and RECLAM : Mem. p. servir a l'histoire des refugies francois, T. 

iii, p. 293 et seq., Berlin.

39° 

RECENT TIMES. 

generally speaking, all the expenses of the academy. In 

vain did the professors request that the income Of the, 

estates formerly belonging to the cathedrals of Magdeburg., 

and Halberstadt should be assigned to them* It was? 

owing to the ability of its teachers, amongst whom were? 

the jurists STRYX and THOMASIUS, the theologian 

FRANCKE, the philologist CELLARIUS, and the doctors 

STAHL and F. HOFFMANN, that the university of Halle^ 

maintained for a long time the first position among the, 

German academies. It did not begin to recede fromthis 

position until the Hanoverian Government in 1734 

founded a university in Gottingen, for the maintenance of 

which a.yearly sum of 16,000 thalers was voted. In the, 

appointments to professorships and in the regulation of, 

studies there prevailed now a freer spirit which strove toaccommodate 

itself in every way to the demands of the 

time. More respect was paid to the natural sciences here 

than in other academies. WERLHOF, who was commissioned 

to furnish a preliminary report upon the pro-. 

posed foundation of the medical faculty, gave his judg-T 

ment upon the subject on the 16th December, 1733, and 

proposed that professorships in anatomy, botany, chemistry 

with materia medica, and the theory and practice of 

medicine, should be established, that a botanical garden 

should be laid out, a chemical laboratory constructed, andthat 

a hospital should be built and used for the purpose of 

teaching, students of medicincf Smaller universities 

arose in the 18th century at Erlangen (1743), at Biitzow in 

Idecklenburg (1760), at Stuttgart (1781) and at Bonn (1784), 

that at Stuttgart having grown out of the Karlsschule, and. 

that at Bonn having developed into an academy, from being, 

a Jesuitical gymnasium, but existing in its new form hardly- 

one year. -, : 

I . • - ••• 

' * J. C. FORSTER : Geschichte der Universitat Halle in ihrem ersten Jahfhunderj-., 

Halle 1799. 

' t E.. F. ROSSLER: Die Griii.idung der. Universitat Gottingen, Gottingten 

1855- - c '-FF -i ::i

LEARNED SOCIETIES AND UNIVERSITIES. 391" 

Germany, with a population which scarcely reached half 

that of the present day possessed about twice the number . 

of academies she does now. Even from this fact we, 

may see - that universities at that time differed in many 

respects from those of to-day. They did not subserved 

so exclusively the preparation for a particular calling in 

life as they do now, but often only offered a completion of 

the general education : and they were contented with a 

much smaller attendance of students, since the cost of 

maintenance was also much smaller than it is now. In 

Vienna there were only 25 medical students in the year 

1723, in Gottingen from 50 to 80 during the period 

between the years 1767-78. Jena, in 1768, numbered 17, 

and in 1773, 42 students of medicine. In Altdorf no more 

than 386 medical students graduated between 1623-1794. 

In Wiirzburg about the middle of last century medical 

studies were in an extremely depressed condition. The 

Russian Court Doctor, M. A. WEIKARD, says in his autobiography 

(Berlin and Stettin, 1784): •'When I began to 

study medicine in Wiirzburg with C. C. SlEBOLD and 

SENFFT in the year 1761, there had been no pupils for 

several years past and consequently no lectures had been 

given. A year before two had entered and afterwards the; 

number was increased to nine. The teachers, who received 

only 200-300 gulden, naturally treated their office as a 

secondary matter, and were, moreover, unaccustomed to 

scholastic affairs; indeed we had to complain several times 

to the Rector Magnificus before we could bring them all 

to deliver lectures again. They had to be forced thereto 

by admonitions and serious threats. In spite of this they 

showed the extremest thrift in their utterances : f requently: 

they remained silent for a whole quarter of a year; and yet 

for all that the loss was not great."* The attendance at 

some foreign academies was greater. ALEXANDER MUNRO, 

during the 50 years that he taught at Edinburgh, had 14,000 

pupils: the average number of medical students present 

* KOLLIKER Op. Clt.S. 21. . . i

39 2 RECENT TIMES. 

there during the second half of the 18th century was 400 

at a time. At Leyden in the year 1709 the number was 

about 300. In Padua, when in 1613 not more than 1,400 

students matriculated, it was considered a bad year. Pavia, 

in 1782, among 2,000 students numbered 200 medical* 

The arrangements of the German medical faculties were of 

a less complete and more meagre description than those of 

Holland, Italy, and France. On this account many students 

of medicine betook themselves to these countries from 

Germany, in order to complete their professional education- 

Especially the universities of Leyden, Padua, f Montpellier, 

and Paris acquired a great reputation in this respect and 

were much frequented. 

It came about by degrees that France developed into the 

chief centre of polite learning and education, such being 

unfortunately much neglected at the German universities. 

These, in the 16th century, had fulfilled their task and had 

afforded as much instruction as at that time was looked 

upon as indispensable for a general education of the 

higher class. When, however, among the upper classes a 

knowledge of the Latin and Greek tongues ceased to be 

the principal object, and the discoveries and progress in the 

natural sciences pressed other ideas into the foreground, 

the curriculum of the German universities no longer satisfied 

requirements and people sought in foreign lands what 

they could not get at home.J In this manner there arose 

differences between these two systems of education—that 

for the learned professions, and that in polite literature— 

which has, in some degree, endured up to our own time. 

The universities were on their guard against accepting 

new subjects of education, and, on the other hand, men of 

•, # G. FISCHER: Chirurgie vor 100 Jahren, Leipzig 1876, S. 77. 

f See the list of the names of the students who matriculated there in 

" Dell'.universita di Padova," Padua 1841. 

,*v X BIEDERMANN (Deutschland im 18 Jahrhundert, Leipzig 1858, ii, 1, S. 18) 

Says,: "Most (of the German universities) had degenerated into exercising 

grounds for the exponents of the narrow views of orthodoxy, pedantic booklearning, 

and scholastic subtlety."


mark in the political, military, artistic, manufacturing, and 

industrial walks of life, who by their residence abroad had 

acquired a wider outlook, laughed at the narrow views of 

the bookworms who sometimes cut a pitiful figure in con 

sequence of the awkwardness of their manners. 

A wild and a rough life prevailed at the German univer 

sities of that time. " At our German high schools," writes 

the doctor LOTICHIUS in 1631, "the attention of the 

students is devoted, not to books, but to quarrels ; not to 

literary compositions, but to daggers ; not to the pen, but 

to the sword and plume; to bloody feuds instead of to 

learned discussion; to drinking and riot instead of to 

assiduous work ; to the tavern and the brothel rather than 

to the study and library."* The fagging of freshmen, a 

custom which by usage came to be a regular practice, led 

to terrible excesses, to cruelty and even to crime. The 

students indulged also in many acts of insolence towards 

the townsmen, f The senate of the University of Leipzig 

found themselves compelled, in 1625, to forbid the students 

"" to disturb weddings, to strike strangers, to insult ladies 

and young women by obscene remarks, or to trip them 

up." J At Jena, in the year 1660, the students gave actual 

battle to the police, in which conflict many were killed. 

-Similar excesses also occurred at Ingolstadt. 

But it was not surprising if such things did occur among 

the students; for the tone which prevailed among the pro 

fessors was at times not much better. In 1663 a professor 

was punished by the Rector with imprisonment because he 

had cudgelled his father-in-law.§ The University of Helm- 

•stadt was admonished by the reigning prince not to bring 

forward as candidates, at the appointment of professors, 

any "who were given to drinking." || Of the University 

* Oratio de fatalibus academiarum in Germania periculis in acad. Rintel. 

xec. 1631, p. 67 according to MEINERS : Gesch. d. hohen Schulen. 

t THOLUCK op. cit. i, x, 264 et seq. 

X GEBHARDT in ZWIEDINECK-S*UDENHORST'S Zeitschr., 1887, iv, 955. 

§ PRANTL op. cit. i, 500, ;;o3. 

|| THOLUCK op. cit. i, 1, 142.

394". RECENT TIMES.' 

of Herborn STEUBING states: "Not only was the high; 

school completely split up into factions, but, besides this,? 

one professor was opposed to another. They not only-, 

taunted one another whenever they could in their lectures,; 

but even carried on their feuds in the presence of thegoverningbody."* 

Relations of this kind existed even a 

century later; when in 1760 a professor complained to the 

senate of the University of Ingolstadt that he had been. 

insulted by the medical faculty, the latter declared: 

" that they certainly did consider him—the plaintiff—a low 

fellow, on account of his mean practices, but that they had* 

no recollection whatever of having at any time called him/ , 

so, officially."t 

It was to be expected that a reaction would set in against; , 

this growing barbarism in manners and social intercourse^ 

The University of Gottingen took the initiative in recom-. 

mending its students to adopt polite behaviour. The- . 

manners of the French, which had everywhere been adopted. 

at the courts of princes, were taken as a pattern. That 

Which the students belonging to the higher circles learned 4 ;| 

to value soon found favour with the rest. And thus among 

a proportion of the students of Germany the praiseworthy 

endeavour was made to grace social life by pleasing 

formalities. Those possessing the rudeness of manners; 

which were displayed at many high schools, chiefly of the 

smaller class, regarded this innovation with scorn, characterizing 

it as foppery and an unpatriotic aping of foreign, 

usages. Even grave historians have shared this view, and 

have attached too little importance to the fact that a reform" 

in this direction was required. The German race, without? 

a doubt, owes very much to the circumstance that it haS. 

always been intent upon improving its deficiencies and, 

learning alike from friends and from foes. 

In the beginning of.the 17th century the general educa^ 

tion of students embraced the Latin, Greek,, and Hebrew 

languages, arithmetic with some mathematics, Church 

* THOLUCK op. cit. i, 1, 140. cf PRA"NTL op. cit,, i,.6p%

LEARNED SOCIETIES AND UNIVERSITIES. 39$ 

history, and the study of ancient authors, which afforded 

opportunity of giving some information upon subjects con-. 

nected with history, geography, and the natural sciences. 

Gradually, however, more scope was given to the lastmentioned 

subjects. As early as at the conclusion of that 

century we find appearing as regular subjects of instruction 

in the curriculum of the gymnasia intended for the sons 

of noblemen, the French and English languages, sometimes 

even Italian and Spanish, history, geography, physics, and 

the natural sciences, with dancing, fencing, and riding. 

These sciences and arts were designated by the epithet 

" gallant; " just as people were fond of employing the same 

expression in other connections as equivalent to " knightly " 

or " reserved for the upper classes." LEIBNITZ, SECKEN- 

DORFF, THOMASIUS, and other unprejudiced men energetically 

demanded that practical science should receive more 

attention. But the mother tongue was neglected even 

more than this in the German schools. In Pomerania the 

teachers at the Latin schools were enjoined in 1690 always 

to speak Latin to their pupils and never German, because 

the latter language was unstable, troublesome, and inconvenient* 

The schoolmaster FRANCKE of Halle complained, 

in 1709, that there was seldom to be found a student capable 

of writing a German letter without mistakes in spelling. 

Here too was a reform urgently demanded. 

The modernizing of the schools of learning began in the 

18th century, and was accomplished at the expense of the 

studies in the ancient languages, which were advantageously 

cut down in the curriculum. Some philologists, somewhat 

Crazed on the subject, lamented this course, it is true, and 

prophesied for Germany a return "to the barbarism of the 

middle ages; " a prophecy not fulfilled however unless, as 

PAULSEN wittily remarks, we look upon the appearance of 

LESSING and KLOPSTOCK as a retrogression in culture.f 

* THOLUCK op. cit. i, 1, 173. BIEDERMANN op. cit. ii, 1, 511. 

t PAULSEN .op. cit. Si 378.


MEDICAL TEACHING IN THE THEORETICAL 

DEPARTMENTS AND IN ANATOMY, BOTANY, 

CHEMISTRY, AND MATERIA MEDICA. 

THE universities changed but little during the 17th century 

in the organization and management of teaching. Even in 

the medical faculties theoretical lectures formed the principal , 

method pursued, although the importance of practical demonstrations 

was more recognized than before. In the list of 

lectures of the University of Wiirzburg for 1604 the following 

were announced in connection with the medical 

faculty :—1. HERM. BlRKMAN lectures on the three treatises '* 

of HIPPOKRATES upon Prognostics. 2. JOH. STENGEL 

treats of the diseases of the breast and certain other f 

organs. 3. GEORG LEYER deals with the diagnosis and 

causes of diseases and their symptoms according to GALEN.* 

The professors treated their subjects more after the literary 

and historical method of the schools than in the spirit of the 

inductive experimentalism of later times. 

It was only in the 18th century that there gradually 

came about a strict-division of professorships according to 

the different subjects taught. This became necessary in 

proportion as the development of practical teaching in 

medicine demanded an increased amount of special 

knowledge in the subjects dealt with. While, heretofore, J 

the professors had been able to exchange their chairs ~'\ 

among themselves without injury to their teaching, inasmuch 

as the condition of science permitted of a similar 

degree of training in all the subjects, from this time forth 

each confined himself to a special department, and was 

thus able to make himself a master of that particular 

branch. Nevertheless, the smallness of the number of 

regular professorships, rendered possible by the inferior j 

scientific requirements of the time and demanded by the > 

* F. v. WEGELE : Geschichte der Universitat Wiirzburg, Wiirzburg 1885, 

ii, 226.


poor financial condition of the universities, brought about 

the result that, nearly everywhere, several subjects were 

represented at the same time by one professor. Thus, at 

most academies, the teaching of botany and chemistry was 

united with that of materia medica; in the same way 

anatomy was joined to surgery, physiology to anatomy, or 

to general pathology. To such a length was this combining 

of subjects carried that professors of another faculty—that 

of philosophy for example—held lectures upon particular 

branches of medical science just as, on the other hand, it 

not unfrequently happened that doctors ventured to teach 

sciences far removed from their proper sphere. H. CONRING 

not only taught medicine in Helmstadt, but philosophy and 

politics as well, and was, as O. STOBBE says, " the founder of 

the history of German law." MEIBOM lectured upon history 

and the art of poetry, as well as upon medicine, and 

JOHANN HEINRICH SCHULTZE, besides being professor of 

medicine at Altdorf, held the chair of Greek also, and in 

Halle, to which town he afterwards removed, that of 

elocution and archaeology. 

The universities of that time resembled, in this respect, 

our gymnasia of to-day, at which, sometimes, a teacher of 

mathematics takes over a part of the lectures of the teacher 

of philosophy, and vice versa. It was at that time not 

required of an academical teacher that he should have 

advanced by any work of his own the science upon which 

he lectured. Patronage, relationship, personal preferences, 

and accidental circumstances of all kinds were often the 

causes which led to the conferring of a professorship. The 

stipends, for the rest, were sometimes so insignificant that 

there were hardly any candidates. At the small academies 

they had to be contented, if one of the doctors in the neigh 

bourhood declared himself willing to undertake a professor 

ship in the medical faculty, which, however, he perhaps 

relinquished as soon as the prospect of a lucrative practice 

in a larger town was opened to him. It was usual at the 

German universities for the teacher to make a treatise or

398 RECENT TIMES. LI 

text-book dealing with his subject the foundation of his 

lectures. He generally added remarks -of his own to 

supplement its contents. The Latin tongue, which the 

teacher was obliged to use, was not calculated to allow the 

"pupils to arrive at "a comprehensive and profound under^ 

standing of the subject; it led to misapprehensions, and td 

"the habitual use of meaningless phrases, behind which a 

pretentious superficiality sought to hide itself. 

- It may be easily conjectured that all this must have led 

to the worst results in the education of the doctor. | 

Lectures, without the help of a book, were seldom given; 

at least at the German universities, for such pre-supposed ; 

that the teacher was a thorough master of his subject, and J 

also that he possessed an extraordinary command of the :J 

Latin tongue. Not until the 19th century was the custom of 

using Latin, pressing heavily and uselessly as it did upon '>• 

teachers and taught alike, at length abolished. The injury | 

inflicted by it upon the students, the patients, medical science 

generally, and upon the development of German culture 

constitutes a crime which can never be expiated. 

Practical instruction in medical science lay, as has been | 

said, at first outside the University curriculum. It came, how-' | 

ever, to be by degrees included; this happened first with- j 

anatomy, last with clinical teaching. The progress made ' 

by anatomical teaching during this period consisted in the 

increase of material for study, and the more complete use 

made of the same, the foundation of anatomical collections;* I 

the establishment of separate professorships and schools •J 

for this speciality, and the participation of students in actual- 

dissection. The scarcity of human subjects, it is true, 

rendered it necessary that bodies of the lower animals, as * 

was usual at an earlier period, should frequently be made-*| 

use of for anatomical study: yet this circumstance was 

attended with many advantages to anatomical training, and ; s; 

led to the observation of numerous facts in zootomy, and L 

comparative anatomy. Although the number of human' 

subjects at the disposal of the schools of anatomy was*'


small, we must recollect that the number of students also 

was not large, so that the individual student could clearly 

see and note everything. Yet many difficulties were thrown 

in the way of anatomical teaching by the neglect of the 

authorities to supply the necessary bodies, by the tedious 

prolixities and time-killing scribblings of stupid officials, 

•which were connected with this matter,* and, above all, by 

the prejudices prevailing among the people. In the circles 

•of the well-to-do classes these prejudices were certainly less 

pronounced; but gave place to a scientific inquisitiveness 

with which a kind of cultivated sensuality was not unfrequently 

associated. The dissections were looked upon as 

racy exhibitions, and spectators crowded to see them ; the 

height of the dramatic situation was reached when the 

sexual organs were demonstrated, and for this part of the 

performance a higher entrance-fee was demanded. When 

the reigning Duke of Wiirtemburg received in 1604 the visit 

of three Saxon princes, to provide them with an entertainment 

he took them to Tubingen, where they assisted at the 

dissection of a human subject which lasted for eight days.f 

The anatomist WERNER ROLFINK of Jena was appointed to 

the Court at Weimar, where, in the presence of princes and 

distinguished personages, he had to perform a dissection ; 

this formed, as it were, one of the amusements with which 

the Duke provided his guests.J 

In France it was the fashion to take an interest in science ; 

even ladies of high position were not ashamed to divert 

themselves at anatomical dissections. 

The populace had a different view in this matter. 

Amongst them was still preserved that kindly pious super- 

.stition which regarded a dissection of the human body as a 

crime committed against it. To this was added the fable 

which took its origin from remote times, that anatomists, 

* PRANTL op. cit. i, 496. 

t J. SAXINGER : Uber die Entwickelung des medicin. Unterrichts an der 

Tiibinger Hochschule, 1883. 

| G. W. WEDEL : Oratio funebr. Rolfincio dicta, Jena 1675.


when they had no dead bodies, made use of living men in 

tfeeir investigations. The 'ill-feeling thus engendered was 

still more increased by the illegal way in which bodies often 

came into the possession of the schools of anatomy. In 

Jena criminals condemned to death used to entreat the 

favour, before they were^given over to the hangman, that 

•stheir bodies should not be delivered to Professor ROLFINK ; 

and the country-folk in the district around Jena had the 

graves of their friends watched in order to prevent their 

bodies being " rolfinked.'J. J. BECHER had to flee from 

Wiirzburg in 1661, because he had dissected the body of a 

woman who had,been executed.* In Berlin and Lyons the 

anatomical schools were stormed by the excited populace, 

and the anatomists were roughly handled.f Similar causes 

led to the destruction of the dissecting-room at Edinburgh 

by the mob in 17254 Even at the present day this prejudice 

has hardly disappeared. A few years ago the beneficed 

clergy of Vienna proffered a request to the magistrates^ 

that their corpses should not be dissected. 

Fortunately people were not everywhere so narrow^ 

minded. ' VlEUSSENS had the opportunity at Montpellier op 

dissecting over 500 bodies. LiEUTAUD could rely upoft^ 

1,200 reports of dissections. HALLER states that while " 

was teaching in Gottingen (1736-1753) he performed abdt 

350 dissections ; the dissecting-room there which was unc 

his charge received annually fromc3o to 40 subjects.§ Tê 

same favourable conditions obtained at Strassburg; in tha 

winter of 1725 thirty bodies, and in that of 1760 as many aj> 

sixty bodies were dissected at the anatomical department 

there. || v At Paris, Leyden, and some Italian academies the 

greatest possible desire was shown to provide the anatomical 

schools with the necessary material of study. ALBERTINI 

* K6LL1KER op. cit. S. II. 

f J. P. FRANK: System der medicinishen Polizei, Wien 1817, vi, 2, S. 60 

Anm. 

X A. GRANT : The Story of the University of Edinburgh, London 1884. 

§ A. VALENTIN in the Memoir on A. v. HALLER, Bern* J87*7, S. 72. 

|| WlEGER Op, tit. S. 82,


of Bologna stated that, even in families Of good position, 

permission was readily granted him to perform a dissection 

where it was a question of determining the cause of a 

disease. In other places the neglect of anatomical demonstration 

was caused not so much by a scarcity of bodies as 

by the idleness and ignorance of the professors. In Prague 

during a space of 22 years (1690-1712) only three dissections 

were performed.* In Vienna during the year 1741 

not one single actus anatomicus took place ; when the departmental 

professor was blamed by the Government for 

this, amongst other excuses he put forward that of not being 

supported by a prosector.f The medical faculty of Ingolstadt 

even proposed in 1753 to abolish the professorship 

of anatomy, considering that it would be best to begin to 

learn this science after the completion of medical study, 

while engaged in the practice of the profession.! But 

arrangements were made in most of the German states in 

the 18th century to remedy this constant lack of subjects 

which pressed heavily upon the schools of anatomy. In 

1716 the electoral government of Saxony decreed that the 

Corpses of all criminals condemned to death in the district 

of Leipzig should at the request of the medical faculty be 

handed over to the dissecting-room without delay. The 

jpquirements of the anatomical school at Wittenburg were 

Ca|.ed for in the same way. A regulation was made in 

1323 that the bodies also of persons who had been drowned 

or found dead from any cause—so long as it was not a 

question of the " honoratiores"—or of suicides or of 

criminals who died in prison should be made use of for the 

purposes of anatomy; it w r as further arranged that the 

poor people, who were cared for at the public expense in 

the infirmaries, should, in the event of their death in such 

institutions and of their friends not being able to afford the 

expense of burying them, be delivered over to the medical 

* HYRTL: Geschichte der Anatomie in Prag, 1841, S. 26. 

f ROSAS op. tit. ii, 256. 

X PRANTL op. cit. i, 607. 

D D


faculties, " but only to be opened for the demonstration of 

the viscera, not for complete dissection."* The Prussian 

Government also issued orders calculated to provide against 

a failure of the material needful for anatomical study. 

The dissecting-room at Gottingen received the bodies of 

prostitutes and of illegitimate children. In Vienna, after 

1749, the hospitals had to provide bodies for anatomical 

investigation and demonstration, when no executions took 

place.f M. STOLL thought that the material for study 

would be much increased if the corpses of bankrupts were 

also assigned to this use. The anatomical school at Abo, '! 

in Finland, was even allowed to claim the bodies of all ; 

those who had received support from the State. 

It was during this period that the first special buildings 

were erected for anatomical dissection. HAZON has left a 

•description of the anatomical theatre which was built in 

Paris in the year 1604. The construction of this was 

effected within a fortnight: it was very small and by .t 

no means solidly built. Only a short time afterwards 

another was erected in its place, of larger size and 

better suited to the purpose, but which, nevertheless, was^ 

also exceedingly inadequate. It had, for instance, mm 

window but only an air-hole, as HAZON, who attended 

lectures there as a student in 1730, informs us, and was 

consequently exposed to the cold and wind. At thej 

suggestion and under the direction of WlNSLOW, the \ 

Paris school of anatomy in 1744 became possessed of 

a building of free-stone provided with glass windows. | 

The institution for anatomical teaching at Leyden was 

provided with skeletons of men and of various kinds 

of beasts and was roomily arranged. % The guild of 

surgeons at Edinburgh founded an anatomical theatre in 

1697, in which demonstrations were given, and in 1705 \ 

i 

* J. P. FRANK op. cit. vi, 2, S. 73 et seq. 

t ,]. D. JOHN : Lexikon der k. k. Medicinalgesetze, Prag 1798, vi, 712 et seq. j, 

X ALB. KYPER : Medicinam rite discendi et exercendi methodus, Lugd. ' 

Batav. 1643, p. 112. >••


created a professorship of anatomy. At Wiirzburg an 

anatomical theatre was established in 1724 ; it was a domed 

building with sky-lights and had water laid on ; the cost of 

it was io,ooofl. In the Parnassus Boicus (Miinchen, 1725, 

p. 310) mention is made of it thus : " No expense is being 

spared in the. improvement of the studium anatomicum et 

chirurgicum, and a famous surgeon has been summoned 

thither from Paris—Monsieur SlVERT by name—at a high 

salary (namely 400 reichsthaler) ; his duties being to 

demonstrate the art of surgical manipulation in a skilful 

manner, and to teach anatomy or the dissection of the 

human body, for which purpose corpses are provided him 

out of the splendid hospital: thus he has not long ago completed 

an examination of a woman who died insane." In 

1788, the anatomical institute at Wiirzburg was enlarged, 

two rooms being built, adjoining the amphitheatre, to 

deposit the anatomical collection in; to these were added 

a hall used by the students in which to practise dissecting, 

a room in which the Professor worked, and a kitchen.* 

The University of Breslau was furnished with an anatomical 

j&gatre in 1745, and that of Konigsberg in 1738 ; in the latter 

,la'se thanks to the Professor of Anatomy of the day who 

had it built at his private expense.f The anatomical 

theatre at Pavia accommodated 400 spectators, was well 

lighted and adorned with the portraits of celebrated 

anatomists. In the hall adjoining it, which was paved 

with broad squares of stone, and was provided with a fireplace, 

large boilers, and a constant stream of pure water, 

the students practised dissecting.^: Establishments of this 

kind were also founded in towns which possessed no 

universities, such as Berlin, Bremen, Frankfort-on-the- 

Main, Niirnberg and others, and were given up to the use 

of the doctors and surgeons. At many places a shed or 

some other place of which no use was otherwise made, 

* KOLLIKER op. cit. S. 25, 75, 78. 

f D. H. ARNOLDT op. tit.—FRANK op. cit. vi, 2, S. 88. 

X J. P. FRANK op. cit. \i, 1, S. 327.

4°4 

RECENT TIMES. 

was assigned for anatomical dissections and demonstra 

tions. 

In addition to these schools of anatomy, there arose 

anatomical museums which were soon recognized as forming 

valuable aids to medical teaching. F RUYSCH made a 

collection of anatomical preparations which he sold in 1717 

to PETER THE GREAT at the enormous price of 30,000 

florins. Within ten years he succeeded in making a new 

collection the greater part of which became the property 

of King JOHN SOBIESKI who paid 20,000 florins for it. 

JOHN HUNTER'S famous museum consisted of 14,000 

anatomical preparations ; at his death it was bought by the 

English Government for £15,000 and was presented to the 

Royal College of Surgeons in whose possession it remains 

to this day. J. N. LlEBERKUHN'S injected preparations 

acquired a great reputation, as did J. G. WALTER'S anatomical 

collection, the fruit of 54 years' assiduous labour; 

the latter consisted of 2,868 numbered specimens, was 

acquired in the year 1803 by the Prussian Government for 

100,000 thalers, and formed the foundation of the museum 

of human and comparative anatomy at the Berlin University. 

Imitations of anatomical preparations were also 

executed in wax by skilled artists and served for medical 

teaching. Some Italians attained to astonishing ability in 

making models of this kind. The Emperor JOSEPH 11.^ 

bought up a celebrated collection of preparations in wax, j 

which had been made in Florence under FONTANA'S direction, 

for 30,000 fl.: he had them brought to Vienna and 

handed over, for purposes of teaching, to the Military 

Medical Academy. But P. FRANKS early drew attention^ 

to the fact that these wax-models are not so suitable for 

teaching anatomy to students of medicine as they are for 

giving a general superficial knowledge of the human body 

and its different parts to laymen, who always have an 

invincible horror Of corpses. 

Another important aid to instruction was found in the 

anatomical plates and drawings which were either separate,


or bound up with text-books of anatomy. J. REMMELIN 

resumed the method, which was formerly practised, of showing 

the muscular layers and the viscera by means of pictures 

pasted and superimposed on one another ;* a similar practice 

was adopted by CLOPTON HAVERS. We owe some excellent 

anatomical plates, especially on the distribution of the 

nerves, to the painter PiETRO DA CORTONA; the vignette 

on the title-page of the edition of 1741 represents the transfusion 

of blood. GERARD DE LAIRESSE made the drawings 

for the anatomical text-book of G. BiDLOO. The following 

were intended chiefly for artists;—the anatomical work of 

B. GENGA with the drawings of C. ERRARDS ; the Anatomia 

dei pittori of CARLO CESIO, which appeared also in a 

German translation; the representation of the muscles of 

the body, designed by MARTINEZ the Spanish anatomist 

and painter, and remarkable for its faultless proportions ; 

the plates of ERCOLE LELLI ; and others. The copper plates 

too, which adorned the anatomical writings of W CHESEL- 

DEN and D. SANTORINI were conspicuous for their high 

artistic value : the latter were held by MORGAGNI to be of 

supreme merit. The introduction of coloured drawings of 

anatomical subjects constituted a further advance; by this 

method the arteries, veins, nerves and different organs 

could be more sharply distinguished. This method was first 

employed in the wood-cuts with which C. ASELLI enriched 

his work upon the lacteal vessels. In the beginning of the 

18th century J. C. LE BLON, the miniature-painter, made the 

first attempt to produce coloured etchings; in 1721 he 

published the first sheet illustrative of anatomy which had 

been prepared by this method. But the new invention of 

tinted copper engraving became more widely known and 

was made use of for anatomical representation first by 

JAN LADMIRAL, who provided several treatises of the 

anatomists B. S. ALBINUS and F. RUYSCH with illustrations 

by this process, and by J. F. GAUTIER D'AGOTY who 

made use chiefly of the anatomical preparations of 

* CHOULANT : Geschichte der anat. Abbildung, Leipzig 1852, S. 39, 82 etseq.


DUVERNEY as copies. ALBINUS left a thorough descrip,tion 

of the way of producing anatomical pictures, giving 

valuable advice as to the mistakes to be avoided and 

the rules to be observed* He spent out of his own 

resources, as he tells us himself, the sum of 24,000 gulden 

in the preparation of anatomical plates.f JAN WANDELAER 

was associated with him as designer. HALLER also, who 

made a collection of anatomical drawings, and W. HUNTER, 

whom his contemporaries had to thank for the best representation 

of the gravid uterus, were supported by skilful 

artists. Finally PlETER CAMPER who understood how to 

handle his pencil as skilfully as his dissecting scalpel, 

supplied valuable information upon the dimensions of the 

cranium, and drew attention to the importance of the facial 

angle (named after him " CAMPER'S facial angle") in 

estimating the intellectual endowments of the races of | 

man. 

We possess clear evidence of the manner in which 

anatomical instruction was imparted in numerous pictures 

of the Dutch school, which represent distinguished doctors 

of that period in the act of holding discussions upon. 

anatomical or surgical questions surrounded by their. 

pupils or colleagues. REMBRANDT'S celebrated painting, 

" The Lesson in Anatomy," which forms one of the 

most important works of this great master, shows the \ 

Amsterdam anatomist NlCHOLAUS TuLP, who at that 

time filled the office of burgomaster, in the act of demonstrating 

a human subject to his medical colleagues; 

this picture is now in the Royal Gallery at the Hague 

and has become very well known by copper engravings. 

In another picture REMBRANDT has represented Dr. 

DEYMANN, TULP'S successor as teacher, preparing a brain 

after removal of the cranial vault. Similar pictures are 

preserved in Amsterdam and other places in Holland; 

* B. S. ALBINUS: Acad, annotat., Lugd. Bat. 1754, lib. i, Praef. p. 7 et seq.d 

lib. vui, p. 30, 50. 

t ALBINUS op. cit., lib. iii, p. 73.


among them are found works of AART PiETERSEN, T. DE 

KEYSER, MICHAEL VAN MIEREVELD, ADRIAN BACKER, C. 

TROOST and T. REGTERS. They were mostly intended 

for the Surgeon's Guild at Amsterdam.* To us they offer 

a series of important lessons upon the history of medical 

teaching and upon the social position which doctors, at 

that period, occupied in the Netherlands. 

Anatomical teaching was no longer limited as formerly 

to demonstrating the organs of the large cavities of the 

body, but a detailed examination was given as well to the 

muscles, vessels, and nerves. The students were also urged 

to participate in anatomical work themselves. HALLER 

when a student at Leyden had the opportunity of dissect 

ing three corpses under the guidance of his teacher 

ALBINUS.f Arrangements were made at the College of 

St. Come at Paris, in 1750, for the students to practise 

anatomical dissections.j: At Vienna, the talented JOSEF 

BARTH introduced the practice of the students performing 

their own dissections. STOLL and P. FRANK explained the 

necessity of future doctors themselves taking an active 

part in dissecting.§ At most universities the anatomists 

had also the additional duty of demonstrating and explain 

ing the pathological changes as seen in the dead body. 

WERLHOF expressly demanded that this should be done, in 

the opinion he gave concerning the arrangements of the 

medical faculty of Gottingen. This circumstance is more 

over rendered evident by the fact that the representative 

anatomists of that period, such as LANCISI, VALSALVA, 

MORGAGNI, LIEUTAND, PORTAL, SANDIFORT, J. HUNTER, 

HALLER and others, laid also the foundations of patho 

logical anatomy. Already collections of specimens illustra- 

* J. B. TILANUS: Beschrijving der Schilderijen afkomstig van het Chirurgijnsgild 

te Amsterdam, Amsterdam 1865.—P. TRIAIRE: Les lecons d'anatomie 

et les peintres Hollandais, Paris 1887. 

f VALENTIN op. cit. S. 68. 

X P. FRANK op. cit. vi, 2 Abth., S. 331, Anm. 

§ FRANK op. cit. vi, 2, S. 87.

RECENT TIMES. 

tive of pathological anatomy were in process of formation. ,| 

Even in the 17th century G. RlVA preserved at Rome a 

number of specimens which had come into his possession * 

while doctor at the hospital. And afterwards this was 

more generally done. S6MMERING possessed a rich 

pathological collection, which at the suggestion of BRAM- 

BILLA was secured for the Josefinum (Academy of Medicine) 

at Vienna at the price of 400 ducats* 

Botanical gardens in which medicinal plants were 

cultivated and the apothecaries' shops gave opportunities. 5 

for instruction in materia medica. The " Jardin des. 

Plantes" in Paris was laid out in 1626 at the instigation of 

the Royal physician-in-ordinary LABROSSE. A decree of 

King Louis XIII. set forth at the same time " that in view 

of the fact that pharmaceutical operations are not taught;! 

at the medical schools, three doctors be chosen from | 

the Faculty of Paris in order to demonstrate to the students Jj 

the intimate character of plants and of all drugs, and 

to show the mode of preparation of every kind of medicine 

according to the simple chemical method, and speci- ; 

mens of all the different medicines and of the rarer 

natural objects of all kinds be exhibited in a room."f 

A yearly sum of 21,000 livres was devoted to the maintenance 

of this institution. Investigators of nature, like 

TOURNEFORT, the two JUSSIEUS, DUFAY, DAUBENTON, '"' 

and above all BUFFON, who worked there, made the 

botanical garden of Paris famous throughout Europe. In 

the course of the 17th and 18th centuries most universities 

were provided with botanical gardens. That at Chelsea, " 

presented, in 1686, by Sir HANS SLOANE to the Society of 

Apothecaries of London, was especially remarkable for 

its rich collection of officinal plants. Botanical gardens^ 

arose also in the first half of the 17th century at Amsterdam, i 

Utrecht, Copenhagen, and Upsala; and at Oxford in 1632, 

* RUD. WAGNER : Soemmerings Leben, Leipzig 1844, ii, 89. 

t ESQUIROS und WUIL: Die wissenschaftlichen Institute zu Paris, Stuttgart,: 

1850, i, S. 28.


Edinburgh (1680), Cambridge (1702), Harderwyk (1709), 

St. Petersburg (1725). 

In Germany the following universities had botanical 

gardens attached to them at the dates indicated :—Giessen 

(1609), Altdorf (1626), Jena (1629), Helmstadt (1634), Kiel 

(1669), Halle, Tubingen (1675), Wiirzburg (1695), Wittenburg 

(1711), lngoldstadt (1723), Gottingen (1737), Frankfort-on-the-Oder 

(1744), Vienna (1749), Greifswald (1765), 

Prague(i776), and Salzburg, Marburg and Rostock. 

Collections of dried plants were also used to some extent 

for the purposes of instruction in botany, as were atlases of 

botanical paintings, many of which were surprisingly true to 

nature* With the same object in view the students with 

their teachers undertook excursions together, which were 

called " herbations." Just as in botanical, so also in 

chemical teaching, especial regard was had to pharmacy, 

theoretical and practical. There were already at that time, 

in several universities, professorships of chemistry, and 

chemical laboratories in which the art of compounding 

pharmaceutical preparations could be learnt. The attitude 

of the senate of Innsbruck University, which in 1740 

declined to form professorships for botany and chemistry, 

was certainly exceptional ; this demeanour the senate 

-assumed because they considered that a thorough botanical 

training required ten years, " for in this inquisitive age 

some new thing in vegetables is perpetually coming to 

light," while on the other hand a professorship of chemistry 

was too expensive.f 

The apothecaries' shops afforded the best opportunity 

for instruction in chemistry; the interior arrangements of 

these places have been made generally known by H. 

PETERS, who in his book has published pictures of the 

•apothecary's establishment attached to the Court at Rastadt 

in 1700, of that designated the "Star" at Niirnberg in 

* H. PETERS op. cit. S. 57. 

t J. PROBST : Geschichte der Universitat zu Innsbruck, Innsbruck 1869.

410 

RECENT TIMES. 

1710, and of that at Klattau in Bohemia in 1733.* The 

training of the apothecaries resembled that for a handicraft. 

The scientific knowledge required of them was 

insignificant.f Thus F HOFFMANN wrote: " An apothecary 

must be acquainted with the fact that an acid and an 

alkali (i.e., a carbonate) if mixed together effervesce, but it 

is quite sufficient if he knows the effect even though he has 

nothing to say as to the cause." Another duty fell upon 

the apothecaries in addition to making up medicines, that, 

namely, of preparing and administering clysters. This 

business was very profitable at one time, for LOUIS XIII. 

j,"in a single year had 212 clysters given him, in addition to 

' 215 purgings. A Canon of Troyes in the space of two 

years brought the record up to the inconceivable number of 

2,190, a fact which has been preserved for posterity because' 

c he refused to pay the fees demanded, and was consequently 

sued for them. Clysters were in fact the fashion, and 

thY ladies of Paris whispered in strict confidence to one 

another that the secret of NlNON DE L'ENCLOS, who preserved 

to advanced age her greatly-admired beauty, rested 

purely and simply upon the frequent use she made of them-t 

CLINICAL TEACHING IN THE SEVENTEENTH 

AND EIGHTEENTH CENTURIES. 

THE greatest acquisition gained by medical education 

this period consisted in the introduction of clinical instruction 

into most universities and the adoption of it by them as 

one of the subjects in their curriculum, The first attempts 

which were made in this direction, as has been mentioned, 

in the 16th century at Padua had no lasting effectând 

exerted no visible influence upon the other universities.» Tothe 

University of Leyden the credit is due, of having made 

* H. PETERS op. cit. S. 78 et seq. « 

f F. HOFFMANN : Medicus politicus, Lugd. Batav. 1746, ii, 2, c. 16. 

X PHILIPPE op. cit. S. 131 et seq. 

1

CLINICAL TEACHING. 411 

clinical teaching a permanent institution and of having 

transmitted by its students the custom to other places. 

The Professors OTTO VAN HEURNE and E. SCHREVELIUS 

inaugurated this system about the year 1630 in the In 

firmary at Leyden. The method adopted was for the 

students first of all to examine the patient on his complaint, 

then for each one to state his view upon the nature, causes, 

symptoms, prognosis and treatment of the disease, and 

last of all for the Professor to confirm the correct opinion, 

to confute erroneous ones, and to add any explanation 

required. But this procedure did not please the students, 

for they ran the risk of having their ignorance exposed by 

questions which they could not answer, and O. V HEURNE 

found himself obliged reluctantly to give it up and in its 

place to undertake the examination of the patients himself 

and to follow this up closely with directions for treatment. • 

The bodies of the patients who died in the hospital were 'A 

opened in order to arrive at certainty as to the cause 

and seat of their diseases. An apothecary's shop was also 

attached to this hospital where the students could see and 

learn how to prepare medicines* 

In 1648 ALBERT KYPER, to whom we owe this account, 

coming from Konigsberg in Prussia took over the direction 

of the clinic at Leyden. After a few years he was 

succeeded by F. DE LE BOE (SYLVIUS) who has been 

thus described, when engaged in clinical instruction, by his 

colleague LUCAS SCHACHT: f " when he came with his 

pupils to the patient and began to teach, he appeared com 

pletely in the dark as to the causes or the nature of the 

affection the patient was suffering from, and at first ex 

pressed no opinion upon the case; he then began by ques 

tions put to different members of his audience to fish out 

[pxtiiscabatur) everything and finally united the facts dis 

covered in this manner into a complete picture of the dis- 

* ALB. KYPER op. cit. p. 112 et seq., 256 et seq. 

f Oratio funebris in obitum F. DE LE BOE SYLVII in Sylvii opera medica, 

Amstelod. 1680, p. 931, and NEUBERT op. cit. 1836, ii, 162.

4I2 £** ,,„ RECENT TJMES. 

ease in such a way that the students received the impression 

that they had themselves made the diagnosis and not learnt 

it from him." Under his direction the Leyden clinic 

acquired such a reputation that students and doctors came 

thither, as SCHACHT says, from Hungary, Russia, Poland, 

Germany, Denmark and Sweden, from Switzerland, Italy, 

France and England, in fact from every country in Europe. 

The clinic of Leyden maintained for a long time the first 

rank among institutions of the kind. BOERHAAVE, who 

occupied the chief position there till 1738, was known all 

over the world and numbered among his pupils HALLER, 

G. VAN SWIETEN, A. DE HAEN, PRINGLE, H. D. GAUB, 

RIBEIRO SANCHEZ and others, who filled the 18th century • 

with their fame. Clinical instruction was given also in 

other universities of Holland the infirmaries of which 

country were highly praised* by eye-witnesses. At 

Utrecht, W VAN DER STRATEN held a clinic : his method 

of leading students on to a knowledge of diseases excited 

the highest approbation in the mind of KYPER.f An 

establishment for clinical teaching was founded in 1715 at 

the Hospital of S. Spirito in Rome at the suggestion of 

LANCISI. The university at Edinburgh got a hospital (the 

Edinburgh Royal Infirmary) in 1738: this since 1746 has 

been used for clinical instruction.^ 

The policlinical instruction in Paris—a system which 

had there been practised for centuries—was, in 1644, 

incorporated with the curriculum of the medical faculty. 

It appears that this measure was adopted at the instance 

of THEOPHRASTE RENAUDOT. This clever and enterprising 

man, who founded the first loan-office and the 

first bureau d'addresse in Paris and who also edited 

the first French newspaper—the " Gazette de France,"— 

organized in conjunction with some medical colleagues 

an institution of the nature of an ambulance for relieving 

poor patients gratis. This brought him many rm$£ 

* Cf. THOLOCK op. cit. i, 2, S. 205. t KYPER op. cit.-p. 2|*J. 

X A. GRANT op. cit.

jf r-i . ' 

1 t 


of ill-will from the medical faculty, with which he 

lived at continual feud, as he would not fall in with 

the exclusive party spirit which animated that body. 

To such a point did they carry their opposition that 

after the death of his patron the powerful Cardinal 

RICHELIEU, RENAUDOT'S policlinic, which had been a 

source of so much benefit to the poorer population, was 

closed.* This resulted in the medical faculty taking the 

duty upon itself of maintaining a similar institution. It was 

arranged that six doctors, three old and three young, should 

be commissioned to examine and supply with medicines 

twice every week in the Ecole de Medecine patients able 

to get about: the attendance was to be gratis. Surgical 

operations they were either to undertake themselves or else 

to get a skilful surgeon to perform. In difficult cases they 

were bound to hold consultations among themselves: the 

Dean of the Faculty was charged to be frequently present 

at these. Poor patients not in a condition to come to the 

consultation were visited and treated gratis in their dwell 

ings. The bachelors, in other words the senior students 

of medicine, were obliged to attend the policlinical consul 

tations : they were occupied there in writing down the 

prescriptions dictated by the doctors and in rendering 

other services. They also had to be present at the medical 

visits to the Hotel Dieu or some other hospital.t These 

policlinical studies lasted for two years. Stationary clinics 

were not instituted in Paris until the end of the 18th 

century. 

Even in Germany the first clinics did not come into 

existence before the middle of last century. It is true that, 

on the occasion of the foundation of the University of 

Gottingen, WERLHOF proposed that a clinic should be 

associated with it, but in vain. The circumstances were 

similar in the case of the medical faculty of Vienna in 

1718. F. HOFFMANN, of Halle, even pronounced a decided 

4* GILLES DE LA TOURETTE: Theophraste Renaudot, Paris 1884. 

f HAZON op. cit.—SABATIER op. cit.

414 

RECENT TIMES. 

opinion that no one is properly educated for a doctor by 

attendance on medical lectures alone, but that clinical 

instruction is a necessary adjunct* The conviction that 

the clinic is an indispensable feature of medical teaching 

was thus general: but the small amount of power possessed 

by the professor of medicine, the indifference of the anthorities 

and, above all, want of money resulted in a continual 

postponement until later times of the realization of any 

schemes there might have been for erecting the necessary 

;; establishments. 

Vienna was the first German university to institute a 

clinic. At the instance of GERHARD VAN SwiETEN in 1753 

a clinical department was founded in the so-called City 

Hospital; consisting of six beds for men and six for 

women ; to supply this with cases the right was reserved 

'" of ^removing thither from the other departments of the 

establishment, and from the Hospital of the Trinity, any 

{,_patients required for clinical instruction. The Dutchman 

'Â. DE HAEN was summoned to assume the direction oft the^, 

clinic and he organized it throughout after the model of 

that of Leyden. " Daily, at an early hour, he appeared at 

the hospital and examined the sick in order to inform himself 

of any changes which might have taken place in their 

condition. At eight o'clock began the clinic, the patients being 

examined and handled by the students under his guidance. 

In this he followed a plan of teaching much to be recommended 

; each of his pupils had to whisper to him the 

result arrived at after examination of the case and at the 

conclusion DE HAEN imparted the correct diagnosis to 

those present in a loud voice, so that those who had made 

mistakes could be assured of it without being made to look 

foolish. After the clinic, began the prescribing for those 

patients who were not being treated in the hospital. The 

students attended this function also. Here, as in the 

o i 

clinic, a register was kept of each patient and the history 

of his illness was entered together with the prescriptions 

* F. HOFFMANN : Medicus politicus, Halle 1746, i, 1, G.


which were employed. If patients died in the clinic the 

autopsy was performed by DE HAEN in the presence of the 

students, the results of it were compared with the diagnosis 

formed during the course of the disease and the value and 

utility of the treatment which had been adopted were dis 

cussed."* DE HAEN founded the fame of the Vienna 

•clinic. His successor MAXIMILIAN STOLL increased it by 

his great success in teaching and attracted to it students 

and doctors from every country. Under him it reached 

"a degree of perfection which justified it in standing forth.;' 

as the unique pattern of all clinical schools."f 

The Academy of Sciences at Paris proposed to King 

LOUIS XVI. of France a plan for founding a clinic there 

modelled on the school directed by STOLL.J The 

arrangements of the Vienna school were imitated by the 

clinics which arose in the provinces of Austria and in Ger 

many. Prague acquired a clinic in 1769 ; under PLENCICZ, 

in 1778, the beds were increased in number from 8 to> 50 

and an unqualified right was granted of claiming patients, *' 

required for teaching purposes, from the other departments "' 

of the infirmary.§ BORSIERI, in 1770, introduced clinical ',',;,, 

teaching into Pavia; in 1774 it was introduced at Modena. 

In Wiirzburg the students of medicine had, long since, been 

directed to attend the visits of the doctors to the Julius 

Hospital. As early as 1729 clinical teaching was practised 

there under BERINGER'S guidance; but it appears not to 

have been continued afterwards or only to have taken 

place intermittently,|| for, in the "Regulation of Studies" 

for 1749, attention had again to be drawn to the high 

* Freimiithige Briefe an den Herrn Grafeii von V., Frankfurt-a-M. und 

Leipzig 1774, S. 69, ei seq.—TH. PUSCHMANN : Die Medicin in Wien wahrend 

der letzten hundert Jahre, Wien 1884, S. 17. 

t J. F. C. HECKER: Geschichte der neueren Heilkunde, Berlin 1839, S. 506. 

X M. STOLL: Uber die Einrichtung der offentlichen Krankenhauser, Wien 

1788, S. 28. 

§ SEBALD: Geschichte der medicinisch-praktischen Schulezu Prag, Prag 1796. 

|| J. N. THOMANN: Annales instituti medico-clinici Wirceb., Vol. i, p. 24, 

Wiirzburg? 1799.


importance of the professors taking students and young 

doctors with them in visiting the hospitals and in their 

private practice and there making them acquainted with 

the treatment of the sick with a view to the perfecting of 

their medical education. Clinical teaching of a regular 

and systematic character was not introduced into Wiirz 

burg till 1769. 

In Strassburg, too, after 1738 clinical demonstrations were 

occasionally held. GOETHE, when studying there in 1770, 

was, as is well known, among those who attended them* 

But a right to make use of the clinical material in the City 

Hospital was not granted to the Strassburg clinic until long 

afterwards.t Gottingen was, in 1764, provided with a 

•collegium clinicum by R. A. VOGEL, which, in 1781, was 

replaced by a stationary clinic. In Halle, JOHANN JUNCKER 

was the first to practise clinical teaching: but a stationary • 

clinic set apart for university teaching was not founded there 

until18104 Clinics were established at the following places 

at the dates indicated : Erlangen (1779), Altdorf (1786), Kiel 

(1788), Jena (1791), Tubingen (1793), Leipzig (1798).§ _ 

At most of the other universities only policlinical institu-j 

tions were to be found. Efforts were made in some places; 

to induce students to visit the hospitals where they mighthave 

the opportunity of observing patients. So, too, in other 

countries these methods of teaching had to suffice, in the 

absence of clinical teaching proper, that is to say lectures at 

the bedside. Education in the practice of the healing art 

was materially benefited by the very widely-spread custom 

of allowing the older students and the young doctors to 

work as practitioners for a considerable time in a hospital, 

where they were, by the leading doctors, made familiar with 

the requirements of practice. In France and England, 

* Aus'meinem Leben in GOETHE'S Weaken, Leipzig 1870, iv, 167. 

t F. WIEGER,O£. cit. S. 113 et seq. «H 

X P. FRANK op. cit.'vi, 2, S. 221. ^ *^ 

§ G. W. A. FIKENTSCHER : Geschichte der Universitat Erlangen, N®rnber| 

1806, ii, 104. |


where this arrangement exists to the present day, members 

of the medical staff of hospitals often took pupils who paid 

stipulated fees for the practical instruction which they 

received. As J. HUNCZOVSKY states, such opportunities 

were afforded at St. Bartholomew's Hospital in London, 

in the Seaman's Hospital at Portsmouth, in the Hotel 

Dieu at Paris, and at Rouen* In Italy a similar custom 

appears to have prevailed. LANCISI, after completing his 

course of medical studies, entered the S. Spirito Hospital 

at Rome in order to prepare himself for medical practice by 

further practical work of several years' duration.-j- He re 

commended students of medicine to see numerous patients 

and to visit the hospitals, and he advised them to spend 

several years in this mode of study.J Again, at the Trinity 

Hospital in Vienna, a number of students of medicine were 

constantly admitted in the capacity of practitioners.§ In 

the town hospital at Bremen also the doctors in authority 

gave clinical instruction to the students who took part in 

the visits to the patients. || There is no doubt that arrange 

ments of this kind prevailed at many hospitals. 

The archives of many an institution must contain im 

portant information upon this subject; it would be a thank 

worthy task to collect and to complete the arrangement of 

such material, which, as yet, especially in the case of Ger 

many, has been but very imperfectly done. But the facts 

already adduced will be found sufficient to prove that the 

view reiterated in works on the History of Medicine even 

to weariness, that before the establishment of institutions 

for clinical teaching young doctors relied simply upon books 

* J. HUNCZOVSKY : Medicinisch-chirurgische Beobachtungen auf Reisen 

durch England und Frankreich, Wien 1783, S. 7, 62, 84, 162. 

f Eus. SGUARIUS: Vita LANCISI in the preface to Lancisii opera vera, Venet. 

1739- 

J LANCISI : De recta medicorum studiorum ratione instituenda, Rorriae 171s. 

§ Nachrichten von dem Krankeri-Spital zur allerheil. Dreifaltigkeit, Wien 

1932. 

||*KULEN*KAMPFF: Die Krankenanstalten der Stadt Bremen* ihre Geschichte 

tandinre jetziger Zustand, Bremen 1884. 

E E' ,


and theoretical lectures for their technical knowledge, is incorrect, 

at least as a rule of general application. The 

circumstance that practical instruction at the bedside 

generally lay outside the curriculum of university study, 

and was not generally sought for until after the conclusion 

of such study and after promotion to the degree of Doctor, 

must have contributed to this mistaken view. On the 

other hand it may frequently have happened that young 

Doctors of Medicine, possessed with a high sense of their 

new dignity, were unconscientious and daring enough to 

commence practice before they had acquired the practical 

skill which it demands ; but the majority recognized the 

necessity of practical training, and visited the hospitals J 

with this object in view, as is clearly shown in the numerous 

biographies and writings of the distinguished doctors of 

i 

that period. 

TEACHING IN SURGERY, OPHTHALMOLOGY, j 

AND OBSTETRICS. 

ONLY a small place was allotted to surgery in the scheme 

of studies at the universities. The students of medicinej 

were given a general view of the subject, and the most \ 

important operations were demonstrated to them upon < 

the dead body. HALLER, who, in addition to his other 

posts, held for a time the professorship of surgery at 

Gottingen, could never, as he says himself, make up his 

mind to operate upon a living man, although he had had 

considerable practice upon the dead body. Since the 

doctors of that time were not called upon to perform 

surgical operations, this theoretical teaching might perhaps 

suffice to give them a knowledge of the important bearing 

of surgery upon internal medicine ; but it was by no means 

sufficient to permit them to form a judgment upon surgical 

questions. When the doctors were conceded the right of 

controlling and advising the surgeons in their work, and

TEACHING IN SURGERY. 419 

the latter had the duty imposed on them of consulting the 

doctors upon the necessity and the nature of surgical inter 

ference, a state of things was created which necessarily led 

to quarrels. The doctor was exposed to the risk of making 

an exhibition of his ignorance, and the surgeon felt himself 

•subjected to a mortification which he did not deserve, in 

having to rank below a man who understood but little or 

nothing at all of the subject. 

F HOFFMANN in the " Medicus Politicus " gives 

doctors the reasonable advice that " they should place 

themselves on a satisfactory footing with the surgeons, 

.should not address them harshly in the presence of patients, 

but only admonish them with modesty; moreover they 

•should not dispute with them, especially upon surgical 

subjects, since the surgeons may be more experienced 

in these matters than themselves." But with most 

doctors, especially with those who lacked experience, 

pride prevailed over prudence, and they looked down upon 

surgeons and surgery with haughty disdain. The author 

of the book, " The Unworthy Doctor of the Trusty 

ECKHART" (Augsburg and Leipzig, 1698), describes these 

relations (p. 428 et seq.) : " Your young doctor is indeed a 

high-mettled animal, what time the brain is filled with all 

manner of vanities and fantasies and will submit to no 

manner of influence or control. His opinion is that every 

one must give way to him, and must see at once by his 

face that he is a physician." 

It is certain that the low social position of the surgeons 

was founded to a large extent upon the fact that their 

general education was very scanty, and the distinction 

between them and the bagnio-keepers and barbers was not 

strictly defined. In Paris an official union was even 

effected between these callings in 1655 ; fortunately this 

lasted only until 1699. Under these circumstances the 

College de St. Come suffered a loss in importance and 

respect. More favourable conditions began to prevail once 

more when in 1724 success crowned the efforts of the

420 

RECENT TIMES. 

Royal, body-surgeons, MARESCHAL and LA PEYRONIE, 

who possessed great influence at Court, to establish the 

"appointment of five teachers, for anatomy, theoretical and 

practical surgery, operative surgery, and midwifery. 

The foundation of the Academie de Chirurgie at Paris, 

which received the Royal sanction in 1743, contributed 

still more to raise the surgical profession. This formed 

from that time forth the centre for all the chief representatives 

of surgery ; and not only in France, for among its 

members it numbered many distinguished surgeons of 

other countries. By offering annually prizes for essays on 

surgical questions, by material support extended to investigators, 

and by editing its transactions, in which valuable 

matters of observation and experience were made public, 

this body advanced the development of surgery and established 

its scientific basis. The Academy was made to rank 

as equal with the Faculty of Medicine, was rendered independent 

of the latter, and received the right of granting the 

degree of Master of Surgery; but this might not be conferred 

on anyone who had not attained to the dignity of. 

Master of Philosophy. 

The Academie de Chirurgie was also in connection with 

the College de St. Come, inasmuch as numerous distin- i 

guished members of the former were teachers at the latter. 

In 1750 a regulation was made that the curriculum for 

surgeons who studied in the College de St. Come should be 

of three years' duration; practical exercises in anatomy 

and in operative surgery were also introduced* The 

medical faculty lost almost entirely its influence over the 

education of surgeons and was now only represented at the 

actual conferring of the degree of Magister. It is true, the 

medical faculty opposed by all means in its power this 

emancipation of the surgical profession, and sought to prove 

by references to history and by the opinions furnished 

by the medical faculties of Gottingen and Halle that the 

* P. FRANK op. cit. vi, 2, p. 331, note, ou les .eleves feront. eux-memes les dis* 

sections et les operations qui leur auront eti enseignees.


subordination of surgery to medicine had existed from all 

time and was necessary and natural: it even went so, far. 

as to make the absurd assertion that the possession of a 

higher general education is detrimental to surgeons ; but 

all in vain. The surgeons maintained the independence 

they had struggled after for centuries, and their deeds 

proved that they were worthy of it. Only the elite of the 

surgeons received their technical training at the Surgical 

Academy of Paris; the majority learned surgery like a 

handicraft with a master, getting the necessary practice 

and skill by frequenting, and acting as surgical practitioners 

in, the hospitals. A regulation was made that no 

master should have more than one pupil, so that he might be 

in a position to devote sufficient attention to his training. 

In towns where several surgeons were practising they 

formed societies, took duty in the hospitals by turns, and 

furthered the instruction of their pupils by means of lectures 

and practical demonstrations in anatomy and surgery. At 

the beginning of every year each surgical guild submitted 

a list of its masters to the Royal body-surgeon who stood 

at the head of the surgeons of France.* 

In England and Holland the system of higher surgical 

education lay entirely in the hands of the surgeons' guilds, 

which at a very early period in these countries appeared 

as exclusive corporations with defined privileges. Although 

CROMWELL in 1656 empowered the College of Physicians 

in Edinburgh to deal with surgery because it was simply a 

branch of medicine, this arrangement only lasted for a short 

time.t The societies of surgeons in London, Edinburgh, 

Dublin, Amsterdam, at the Hague and elsewhere, arranged 

courses of instruction for students of surgery and took care 

that they were able to get a practical education in anatomy 

and surgery. JOHN KAY was summoned to London in the 

time of HENRY VIII. to instruct surgeons in the performance 

* G. FISCHER : Chirurgie vor hundert Jahren, Leipzig 1876, S. 254 et seq. 

f Historical Sketch of the Royal College of Physicians of Edinburgh, Edin 

burgh 1882.


of operations.* What care the Dutch surgeons devoted to 

anatomical dissection is shown by the already mentioned 

pictures of the painters of the Netherlands. The students. 

had the opportunity of observing patients and seeing 

surgical operations in the private practice of their teachers. 

and in the service of the hospital. 

The German surgeons as a general rule occupied the 

position of barbers; only a few rose above this and, 

were capable of regarding the treatment of wounds in a 

scientific spirit. Whoso adopted this callingf learned in. 

the first place from a master of the art, how to shave and 

cut hair, to spread plasters, to cup and to bleed. After 

this he was shown how wounds and ulcers are treated,. 

dislocations reduced and fractures set and cured. Only 

such surgeons as had been matured in the school of experi- '| 

ence, or specialists who had attained conspicuous skill in 

very limited fields of work, ventured upon the higher _'_ 

surgical operations. The town-surgeon of Zurich was. 

ordered in 1716 to invite young surgeons to the operations | 

which he performed " that they might have the opportunity. | 

of gaining further knowledge in such methods of cure."t 

At Wiirzburg the chief surgeon at the Julius Hospital 

was commissioned, in 1725, to give instruction in his art at. 

the bedside. 

In the treatise entitled " The Bold Surgeon of the Trusty ' 

ECKHART" (Augsburg, 1698) the students of. surgery were \. 

advised to study anatomy thoroughly, and, should human subjects 

fail, on the bodies of the lower animals, for if learned. 

doctors were not ashamed to pursue this study " a saucy 

barber's or bathman-fellow's honour will be unscathed." 

Further, the advice was given them to visit hospitals and 

to attend operations which famous surgeons performed, \ 

even after their student-life was passed. The remaining 

* A. CORRADI op. cit. Ser. ii, Vol. vi, p. 638. 

t O. BUCHNER: Aus Giessens Vergangenheit, Giessen 1885, S. 27. 

X MEIER-AHRENS : Geschichte des Ziircherischen Medicinalwesens, Basel 

1840.


admonitions given them throw a strong light upon the 

social aspect of their condition. Thus: " he is not to brag 

about his cures over the tavern tables, or approach a patient 

as a pig would a beggar's bag, or treat him in a tyrannical 

or wrathful manner. He is not to demand twelve thalers 

when he only deserves two. He must not use the knife 

without due consideration; for it is a question of human 

flesh, not mere slaughtered beef or pork : a man sets a high 

value on his skin. When danger threatens he is to call 

in doctors and brother-surgeons to consult withal."* M. 

G. PURMANN even complained that surgeons, in order to 

win patients from one another "perpetrated tricks and 

treacherous artifices with the instruments."! The sur 

geons of Germany attained a higher position when schools 

began to be founded for their education. These were first 

intended to train up a body of medical officers for the 

military service ; but the want of practitioners soon led to 

pupils being taken from the civilian classes. In 1716 an 

institution of this kind was founded in Hanover. Berlin in 

1713 acquired a theatrum anato?nicum, forming the first 

completed portion of an establishment intended for the in 

struction of military doctors and " medico-surgeons," which 

was opened in 1724 and became associated with the Charite 

Hospital, the founding of which followed a few years later. 

Six professors and a demonstrator of surgical operations 

constituted the teaching staff; the instruction given em 

braced not only anatomy and surgery, but also pathology, 

.materia medica, botany, chemistry, and even mathematics. 

" Following the example of Paris, London, and Amsterdam, 

1 Medici and Chirurgi were, in the Charite, to be given 

ample opportunity of seeing and practising methods of 

treatment for both internal and external diseases."! A 

military medical school was founded in Dresden in 1748. 

* G. FISCHER op. cit. S. 33 et seq. 

t G. PURMANN: Lorbeerkrantz oder Wundartzney, Frankfurt u. Leipzig 1722. 

X A. GUTTSTADT : Die naturwissenschaftlichen und medicinischen Staats- 

anstalten Berlins, Berlin 1886, S. 344.


The students of these establishments were clever barbers, 

who had already served for a considerable time in the army, 

or had been busily occupied in the hospitals or in private 

practice, and thus were by no means beginners, but men 

who already possessed a certain amount of experience in 

the healing art. It was intended that in the surgical school 

they should receive a scientific professional education, and 

thus be able, in future, to take prominent positions as operators 

and teachers of surgery. 

An arrangement of this kind existed also at the military 

medical school of Vienna, which was opened in 1781. This 

school, named at a later period after its founder, the 

Emperor JOSEPH, was provided in 1785 with a new building 

for the purposes of teaching, which was raised at the cost of 

one million gulden ; it contained lecture rooms, a library, 

scientific collections, arid the residences of the teachers. 

The military hospital, which afforded accommodation for 

1,200 patients, and contained two wards for the wives of 

soldiers when lying-in—a small obstetric department in 

fact—was associated with this school* Moreover, in 

the vicinity of the establishment a botanical garden 

was laid out, and a small chemical laboratory fitted up. 

The course of instruction lasted for two years. Thirty of 

the ablest military doctors were ordered to attend this 

course, and at the end of their studies were promoted to be 

regimental surgeons. At the same time the school was the 

resort of students who were making their earliest studies 

for the surgical profession. 

The teaching staff at first consisted of five professors, of 

whom one had to teach anatomy and physiology, as well as 

that amount of elementary mathematics and physics necessary 

for a proper understanding of the former sciences; a 

second had to treat of general pathology and therapeutics, 

with hygiene ; a third lectured on instruments and bandaging, 

conducted the surgical clinic and the practice of 

* DE LUCA: Wiens gegenwartiger Zustand unter Josephs Regierung, Wien 

1787.


operations, and represented midwifery and forensic medicine 

; a fourth held lectures on internal medicine and conducted 

the clinic for internal diseases; while the duty of 

the remaining professor was to lecture on botany, chemistry, 

and materia medica, and to superintend the botanical! 

garden. A prosector was also appointed; he had to get 

ready the anatomical preparations required for teaching and 

to perform the autopsies on patients who died in the 

military hospital.* 

In teaching, the words of the Emperor were to serve as 

the guiding motto: ' My design is that not merely the outside 

of the various sciences dealt with should be taught to 

the surgeons who are to be trained here, and that they 

should be sent forth hence with nothing but a knowledge 

of technical terms and with an over-hurried and 

shallow training. I desire rather that they should get a 

firm hold of their subjects and, thus provided, return to the 

regiments."t An academy, organized after the pattern of 

the Academie de Chirurgie at Paris, was in connection with 

this establishment; it offered prizes for the solution of 

•questions of surgical interest and published the compositions 

sent in.J It received, moreover, the rights and dignity 

•of a university and could grant the degrees of Magister and 

Doctor in Surgery. In this way educated surgeons were 

placed in the same social position as representatives of 

internal medicine. 

Reasonable, unprejudiced doctors welcomed these arrangements 

with enthusiasm as being the first step towards 

the wished-for reunion of these two important branches of 

the healing art. 

Professor AUGUST RICHTER of Gottingen gave expression 

in the following words to the expectations formed generally 

* G. PIZZIGHELLI : Accademia medico-chirurgica Giuseppina, Vienna 1837. 

t Allerh. Entschliess. v. 3. April, 1781, im Archiv des k. k. Kriegsminis- 

teriums. 

X J. A. v. BRAMBILLA: Verfassung und Statuten der Jos. med.-chir. Akademie, 

Wien, 1786.—TH. PUSCHMANN op. cit., S. 96 et seq.


on this subject: "All Germany assuredly takes an interest 

in the honour of this academy, in the happy issue of its 

endeavours, and in the election of its members, for these are 

they from whom the surgery of Germany may now expect 

direction, guidance, and enlightenment; by the successful or 

unsuccessful results of their efforts will the foreigner hence-, 

forth appraise the value, positive or negative, of German 

surgery as a whole ; among the members of this academy 

will the most eminent surgeons of Germany be sought, and 

in their performances will every important achievement of 

German surgery be looked for."* These hopes were only 

fulfilled in a minor degree. The early death of the Emperor ,; 

JOSEPH II., by which the academy lost a devoted and 

generous patron, the political events and the continual wars 

which robbed military doctors of all leisure for scientificwork, 

and above all the feeble development and dependent 

position of German surgery were the baneful causes which 

prevented the attainment of these lofty aims. 

Modelled upon the • Josefinum of Vienna, schools -of 

medicine and surgery arose at St. Petersburg and Copenhagen 

in 1783 and 1785 respectively. In Spain a school* 

for the education of naval doctors was founded at Cadiz in 

1748, and was placed under the superintendence of a 

director and ten teachers.f 

Numerous other schools were founded in the 18th 

century, and in them barbers and bathmen were, by a 

course of instruction of from two to three years' duration, 

trained into district medical officers and surgeons. In 

Austria these schools were in some instances departments-; 

of medical faculties or lyceums, in others separate institutions 

in places where there was no university. In other - , 

German countries, establishments of this kind arose at 

Frankfort-on-the-Main, Hamburg, Regensburg, Brunswick, 

Bruchsal, Celle, Cassel, Gotha, Dillingen, Zurich, and other 

* A. G. RICHTER : Chirurgische Bibliothek, Gottingen 1788, Bd. ix, St. 2, S._ 

191. 

t MOREJON op. cit. T. vi, 341.


places. About the same time greater attention began to 

be bestowed upon practical teaching in surgery at the 

universities. The clinics, which arose at this time, at first, 

indeed, were limited to the treatment of internal diseases ; 

all surgical matters which required attention were as a rule 

put into the hands of a surgeon, who was subordinate to 

the chief of the clinic. 

In Holland alone had medical students the opportunity 

of assisting in surgical operations at the hospitals. J. J. 

RAU, at Leyden, instituted a course of surgical operations 

on the dead body, demanding a fee of 100 Dutch 

thalers for the same. Many German practitioners, anxious 

to acquire practical knowledge in surgery, betook themselves, 

therefore, to Holland, as FRIEDRICH HOFFMANN, in 

his " Medicus Politicus " (i, 1, 6), advised them to do. In 

the same way France and England were also visited with 

this object. In Germany the first surgical clinic arose in 

the year 1769 at Wiirzburg; CARL CASPAR SlEBOLD 

organized it in a highly satisfactory manner, illustrated 

the surgical lectures by the demonstration of anatomical 

preparations, and introduced the practice of surgical operations 

on the dead body.* At "Vienna a surgical clinic was 

opened in 1774. Gottingen acquired a similar institution 

in 1781 ; Germany's most celebrated teacher of surgery, A. 

G. RlCHTER, gave clinical instruction there. 

Ophthalmology, too, and midwifery, which, in BOER- 

HAAVE'S time, had been taught in association with other 

subjects, especially surgery, by degrees met with greater 

consideration in the plan of studies. France, England, and 

Italy produced some able ophthalmic surgeons ; it is not until 

the close of the 18th century that we find several Germans 

occupying a position of equal importance. Celebrated 

ophthalmic operators were then, like famous tenors at the 

present time, summoned from great distances to give illustrations 

in their art. N. J. PALUCCI was induced by G. VAN 

SwiETEN to come to Vienna, and he there performed the 

* F. v. WEGELE op. cit.


operation for cataract in the presence of the students of 

medicine and surgery at the Trinity Hospital. The elder 

WENTZEL came thither afterwards for a similar purpose, 

and it was under his guidance that JOSEPH BARTH was 

educated to become an ophthalmic surgeon. The success 

of the latter in this field of practice induced the Emperor 

JOSEPH to order him to train up two young doctors in 

ophthalmology. An extraordinary honorarium of 1,000 

gulden was promised him for this service, but he was not 

allowed to receive it until his pupils had furnished a 

proof of their skill by performing successfully six operations 

for cataract. His first pupils were his prosector 

EHRENRITTER, who died very young, and ADAM SCHMIDT, 

with whom G. J. BEER was afterwards associated, having 

been at first employed by BARTH as a designer. These 

were the founders of the ophthalmological school of Vienna, 

to which the world owes a succession of able ophthalmic 

surgeons. At the same time in Gottingen, Jena, Leipzig, 

and other places ophthalmology began to be drawn into 

the domain of clinical teaching. 

'In the 17th century midwifery was still almost exclusively 

practised by midwives. They acquired their knowledge 

of the subject by personal instruction from an 

elderly experienced practitioner of their own sex, and were 

examined therein by ladies of good position, or by doctors 

of the town where they desired to reside. In Leipzig the 

wife of the Burgomaster conducted the examinations of the 

midwives; but in most places the doctors and surgeons, 

and especially those who held public appointments, undertook 

this duty. This led to the latter commencing to teach 

the midwives as well,—a very necessary proceeding; for 

GERVAIS DE LA TOUCHE states that through the ignorance 

of the midwives a large number of women and children 

perished annually, and FABRICIUS VON HlLDEN declares 

that the midwives had no idea of the structure of the 

female sexual organs, or of the duties of the midwife* 

* C. J. v. SIEBOLD op. cit. ii, 132 et seq.


Certain highly-gifted women, like LOUISE BOURGOIS, who 

attended MARIA DE' MEDICI, consort of HENRI IV., and 

advanced the literature of obstetrics, must be looked upon 

as exceptions. In Paris the midwives received a systematic 

education. In the Hotel Dieu there was a lying-in institution 

in which the obstetric probationers were taught by 

the head-midwife. The well-known MARGUERITE DE LA 

MARCHE, whose handbook for midwives is among the best 

literary productions of that age, worked for some time in 

this position. 

The course of instruction lasted for three months. During 

the second half of this period the probationers had themselves 

to perform all the services required during labour. 

Only in extraordinary cases was the surgeon of the department—himself 

also an obstetrician—called into consultation. 

As a general rule women in labour refused to accept the 

assistance of a man. This unseasonable modesty derived 

support from the ignorance of most of the doctors and 

surgeons who had no opportunities of getting experience 

in midwifery. This state of affairs was not altered until 

such exaggerated prudery was given up* and the help of 

the male sex was claimed in cases of labour. The Duchesses 

DE LA VALLIERE and DE MONTESPAN, and other ladies of 

the French Court, made a beginning. " Their example was 

soon copied," writes P DlONlS, " and even women of the 

lower classes declared that they would rather have obstetricians 

of the male sex than midwives, were they not 

deterred by the high fees of the former."t A school of 

obstetrics was in 1720 founded at the Hotel Dieu in Paris. 

In 1743 a course of instruction in gynaecology was also 

started in the surgical school, and in 1754 the medical 

faculty even felt itself called upon to create a professorship 

of obstetrics. 

* On certain other occasions quite different conditions obtained. Fide Les 

consultations deMME. DE SEVIGNE, ed. p. P. MENIERE, Paris 1864, p. 21 etseq. 

t SIEBOLD op. cit. ii, 189.—SUE d. Jungere; Versuch einer Geschichte der 

Geburtshilfe, Deutsche Ubers, Altenburg 1786, S. 99.


Already in the 17th century Holland was in possession of 

a system for the regulation of midwives. The females 

who devoted themselves to this calling were taught and 

examined by surgeons practised and experienced in midwifery. 

Among their instructors were men like H. VAN 

ROONHUYSEN, F. RUYSCH, and others. 

A number of lying-in institutions arose in England 

during the 18th century. These were to some extent 

made available for the instruction of midwives and students 

in the obstetric art. The Westminster Lying-in Hospital, 

founded by private charity in 1765 through the exertions of 

J. LEAKE, gave young doctors and surgeons the opportunity 

-of getting a practical education in midwifery. Again., ' 

many doctors who conducted lying-in institutions took 

pupils, who were trained at these to become obstetricians.* 

A professorship of midwifery was founded at the University 

of Edinburgh in 1726. At Dublin, the College of Physicians, 

and afterwards the College of Surgeons, instituted courses 

of instruction in this branch; while the Lying-in Hospital . 

founded there in 1746 gained a high reputation. 

Germany in the 17th century did not produce one single 

male obstetrician of note ; on the other hand, certain midwives 

made themselves widely known. " The court midwife 

of the electorate of Brandenburg, JUSTINE SlEGE- 

MUNDIN, nee DlTTRiCHiN," " the Mother Grete," who also 

assisted DOROTHEA SIBYLLA, Duchess of Brieg, as a 

"trusty privy counselloress," as SlEBOLD (op. cit. ii, 

207) remarks, and had the duty of superintending the 

•" maids of honour," they, together with the town midwife of 

Brunswick, A. ELISABETH HORENBURG, won for their art a 

well-deserved respect by their services, and contributed by 

their writings to its extension and advancement. The 

obstetric physicians were seldom called into consultation. 

The conception which many of them had of their duties 

must have filled the breasts of women needing assistance 

with fear and dismay. LORENZ HEISTER narrates that 

* C. G. BALDINOER'S Medicin. Journal, Gottingen 1787, St; 15.


they "were sadly wanting in experience of the arts of 

turning and extracting the child. When they intended to 

perform any operation they came with a hooked instrument, 

and in a pitiful and horrible manner tore the child into 

many pieces in the mother's womb in cases where, had 

they possessed the befitting knowledge, they might easily 

have reached it with their bare hands, and thus have prevented 

the uterus being lacerated as well as the child and 

extracted with it, as it actually was frequently in the 

case of these unhappy women."* 

Dr. DEISCH was called by the populace " the butcher of 

children and women." Augsburg was his slaughter-house. 

" He perforated and dismembered without intermission, 

whether the children were alive or dead. He practised 

decapitation, too. If he had performed turning he wâs 

astounded if the child came into the w r orld alive." In 

1753 he used sharp instruments 29 times in 61 births, 

10 of the mothers perishing. His colleague MlTTEL- 

HAUSER, who resorted to similar practices as town 

physician of Wiessenfels in Saxony, considered he had 

been especially successful if out of ten women whom he 

attended only two died.f 

In other places matters do not seem to have been at 

times much more satisfactory; NICHOLS' choice satire 

" The petition of the unborn babies" (London, 1751) in 

which they complain of the rough handling they get from 

the obstetricians, and the figure of Dr. SLOP in STERNE'S 

"Tristram Shandy,"—the accoucheur with his instruments, 

all ready for action,—were certainly more than mere products 

of the writers' fancy. 

We can easily understand how a universal disgust at 

this kind of midwifery arose. The progress which this 

branch of knowledge made in the 18th century opened 

men's minds to a more correct recognition of the laws of 

* LOR. HEISTE.R : Medicinische, chirurgische undanatomische Wahrnehmun- 

*gen, Rostock 1753, Vorrede. 

t SIEBOLD op. cit. ii, 426 et seq.


nature in the act of birth, and to more humane views as to 

the part allotted to the accoucheurs' art. The introduction 

of regular teaching in obstetrics at the university, 

and the increase in the number of lying-in institutions 

were conspicuous among the causes which brought about' 

this beneficent reform. Besides the theoretical lectures 

upon midwifery which at most universities were held in 

connection with those on surgery a commencement .was 

made in the practical instruction of students. In this, 

Strassburg was in advance of all other German Universities: 

in 1728, a school for obstetricians was founded in the Lying- f 

in Institution there which had already for a considerable 

time been made use of for the instruction of midwives* 

It was under the direction of FRIED and, as OsiANDER says, >; 

was the parent of all other institutions of this kind in 

Germany. The pupils practised the manipulations of mid-.,, 5 

wifery in the first instance upon a model, then visited * 

women in pregnancy and superintended the labours. The 

fee which they had to pay their teacher for this course of instruction 

was somewhat high : it came to about 100 thalers.. 

Several of the best obstetric physicians of last century proceeded 

from this school; among these was J. G. ROEDERER 

who, in 1751, was summoned to Gottingen as Professor of 

Midwifery and Director of the recently founded Lying-in 

Institution. A school of midwifery was at the same time 

opened at the Berlin Charite. In 1786, there were in the 

Kingdom of Prussia, without the province of Silesia, as 

many as 14 teachers of this branch. So also in other 

German countries institutions of a similar kind arose and 

at them midwives and students received instruction in 

obstetrics, for example at Wiirzburg (1739), Copenhagen 

(1760), Cassel (1763), Brunswick (1768), Karlsruhe, Dresden 

(1774), Jena (1781), Marburg (1792), Detmold, Mann* 

heim, Weimar, Bern (1782), etc. 

At Vienna the instruction of midwives was introduced in 

1748, and in 1754 a professorship of midwifery was founded; 

* WIEGER op. cit. S. 100 et seq. j

THE EIGHTEENTH CENTURY 433 

at the university. A special clinic was arranged for this 

department in 1789, courses of instruction in obstetrics 

having already, since 1774, been held in a hospital, and 

cases of this nature having also been received into the 

surgical clinic. But at many institutions instruction in 

midwifery, like that in ophthalmology, remained until far 

into the 19th century associated with instruction in 

surgery.* 

MEDICAL TEACHING AT THE CLOSE OF THE 

EIGHTEENTH CENTURY AND THE POSITION 

OF THE MEDICAL PROFESSION. 

THE changes which medical teaching underwent in 

universities during the period between the beginning of 

the 17th and the end of the 18th century were very considerable. 

Instead of two or three professors whose teaching 

was limited to a few theoretical lectures and only occasionally 

concerned itself with practical training in anatomy, 

materia medica and the healing art proper, now, at least at 

the greater universities, boards of teachers were formed 

the members of which represented the various branches of 

medicine and had anatomical schools, laboratories, and 

clinical establishments at their disposal. 

According to the '"' scheme of studies " for the year 1749, 

there were then five ordinary professors in the medical 

faculty of Wiirzburg. Of these professors the first had 

to give the students a concise review of the history of 

medicine, to treat of the " Institutes of Medicine " (physiology) 

upon a scientific physical basis, to discuss the 

causes and effects of health and disease in relation to 

anatomy (general pathology) and in this way to smooth the 

path to medical practice; the second taught botany and 

was director of the botanical garden ; the duty of the third 

* A. GUSSEROW: Zur Geschichte und Methode des klinischen Unterrichtsc, 

Berlin 1879. 

F F

RECENT TIMES. 

was to give lectures on chemistry and to show the 

methods of compounding medicines in the dispensary 

attached to the Julius hospital; the fourth gave lectures on 

the special pathology and therapeutics of internal diseases, 

took the students to the hospitals and made them familiar ; 

with the treatment of the sick ; and the fifth.had to teach 

anatomy and surgery : the last-mentioned was assisted by 

a prosector, who acted also as chief surgeon and teacher ofi ( 

obstetrics* *• 

The medical staff at Heidelberg had in 1763 four ordinary ^ 

professors, that of Gottingen in 1784 six, and that of Pavia, ,4 

about the same time, eight.t The curriculum, which P 

FRANK drew out in 1785-86 for the medical faculty of Pavia, | 

shows what demands were made upon the head of a department 

at that time.J The natural sciences assumed a 

position of higher consideration than before; this is clearly 

indicated by a decree of the reigning Prince Bishop of 

Wiirzburg in 1782, in which he says: "If in former times 

men had reason to consider it a settled truth that physics 

formed a subject of study not only very useful but absolutely 

indispensable for those who had a mind to devote themselves 

to medicine, in our days when physics has assumed 

such a greatly improved form still less can we venture to 

doubt it; arid although physics may be of less use to theologians 

and jurists than to students of medicine, yet the 

advantages which future students of theology and law may 

expect from mathematics and the so-called practical philo 

sophy are at length beyond dispute."§ 

The medical faculty of Vienna possessed already in 1780 

nine regular professorships devoted to the following subjects;—anatomy, 

physiology, natural history, chemistry 

and botany, general pathology and therapeutics with 

materia medica, medicine and clinical teaching, theoretical 

* WEGELE op. cit.—KOLLIKER op. cit. S. 75. 

+ P. FRANK op. cit. vi, 2, S. 46. 

X Ibid. Suppl.—Band i, S. 176 et seq. 

§ WEGELE op. cit. ii, 428.

THE EIGHTEENTH CENTURY. 435 

surgery, clinical surgery, and midwifery; besides the 

professors numerous assistants and a prosector took part 

in the teaching, the duty devolving on the professor of 

.anatomy to train " a person competent to succeed him in 

•course of time, at his own expense." 

The Emperor JOSEPH II. took a lively interest in the 

system of medical teaching. In a rescript of the 27th 

April, 1786, he gave expression in the following words to 

his opinions about the curricula of the medical faculties 

which had been submitted to him: "That surgery, the 

whole of operative surgery and bandaging, can be properly 

taught in six months appears to me to be barely possible, 

and, in general, I distribute the subjects of medical study 

after the following fashion. In the first year, anatomy 

associated with physiology in such a way that on exposing, 

for instance, a lung in the course of dissection its use and 

function in the healthy body may be dwelt upon at the same 

time, and so for every muscle in the body it should be 

shown what its action is. Both medici and chirurgi must 

-complete this year of study. The necessary prosectors 

and all else he requires must be provided for the Professor 

of Anatomy and Physiology so as to maintain his department 

in a fitting state. Also let the medici in the first 

year be taught botany and chemistry, and the chirurgi 

operations, bandaging, and midwifery. In the second year 

the surgeons must learn surgical and medical practice, 

devote themselves to clinical work in the hospital, and also 

practise midwifery in the hospital, and then have finished. 

The physicians, however, must attend lectures on materia 

medica, pathology, and all that belongs to the learned profession 

of medicine, but in the third year they must give 

themselves up entirely to practice and clinical work, and to 

treating patients in the hospital. And in this way let able 

surgeons be trained for the country and doctors for the 

town. I await a further elaboration of the scheme in this 

sense.—JOSEPH."* 

* Archiv. des k. k. Unterrichtsministeriums zu Wien.


The curriculum which was published soon after this 

diverged from these principles mainly in the period of 

study for medical and surgical students being fixed at four 

years, and a course of studies being arranged applicable 

to both classes in most of the departments, the only difference 

being that the medici had to spend a longer time on 

materia medica, chemistry and internal medicine, while the 

chirurg had to enter more deeply into surgery and the 

subjects associated with it, and to give proof of this in 

examinations. 

So in this way at last in Austria and Germany, as was 

already the case in other states, surgery had assigned to it 

a more dignified position. Physicians and surgeons were ^ 

recognized as two classes of doctors enjoying an equal,| 

rank, in possession of an equally sound education, and f 

differing only in the kind of work assigned them. At 

the same time there arose an inferior class of practitioners 

whose acquirements were of a lower order, and who were 

intended chiefly for attendance upon the peasantry. They 

practised as doctors for both internal and external diseases. 

The opposition which had hitherto existed between 

physicians and surgeons was now transferred to the more 

highly-educated practitioners on the one hand and the less i 

thoroughly trained physician-surgeons on the other. Informing 

an opinion upon the state of affairs which was thus 1 

produced, we must not forget that a shifting of positionj 

had taken place among the factors in question which | 

justified many things which would before have been inde-| 

fensible and wrong. 

It is, then, certain that the surgeons of the 17th century , 

occupied a somewhat low position from an educational 

point of view; but have we any reason to suppose that it 

was otherwise with the physicians of that period ? In the 

eyes of many a clear image of fresh and living nature was 

perverted by the distorting atmosphere of a lifeless desert 

of unprofitable learning. "They understood their GALEN? 

but not their patients," as MONTAIGNE said. The figure of 

Dr. DiAFOlRUS, in " Le Malade Imaginaire" of M0LIERE>


must have been drawn from life.* The great majority of 

doctors sought to impose upon the public by the grandiloquence 

of a Graeco-Latin phraseology; their impression 

was that, as KANT says, in giving a name to their diseases 

they had rendered their patients a service.f They 

endeavoured to remove a disease by pills and plasters, 

medicines, clysters, and repeated blood-letting; so that at 

times it took a good constitution to resist these frequently 

inappropriate of preposterous measures. The title of 

Doctor of Medicine by no means afforded a guarantee that 

the bearer of it possessed medical knowledge. Outside 

the universities the right to confer this dignity was assumed 

by the EMPEROR, the POPE and his plenipotentiaries, and 

the Counts Palatine. At Naples, even during last century, 

the D'AVELLINO-CARRACIOLO family enjoyed the privilege 

of conferring the degrees of Doctor of Medicine and Doctor 

•of Law; they made extensive use of this privilege,—and 

.made it correspondingly profitable. 

But even at some universities a disgraceful misuse was 

made of the privilege of granting the degree of Doctor. 

Many professors found in the fees paid a desirable increase 

•of income, and sought to allure candidates by making the 

least possible demands upon their knowledge. Examinations 

were either omitted altogether or reduced to a 

mere formality. The theses for the doctorate might be 

bought at a fixed price from certain learned contractors 

who made a profitable business by the preparation of such 

essays.J At Greifswald acobbler in the year 1788 got the 

diploma of Doctor of Medicine; on the strength, too, of a 

dissertation upon the therapeutic effects of pitch. The 

University of Erfurt created 97 Doctors of Medicine in a 

•single year while not numbering more than 30 students in 

all the Faculties put together. At other universities the 

cost connected with the acquisition of the doctor's degree 

* M. RAYNAUD : Les medecins au temps de Moliere, Paris 1862. 

f IM. KANT : Versuch uber die Krankheiten des Kopfes in der Ausg. sammtl. 

Werke von Rosenkrantz u. Schubert, Leipzig 1838, vii, 16. 

X Kais. priv. Reich sanzeiger, Gotha 1802, No. 169-170.


was so great that candidates without means had to 

renounce it altogether. The consequence was that persons 

of this, kind either repaired to places where less money 

was demanded or remained content to engage in practice 

as licentiates of medicine. At Vienna the advancement to 

the doctor's degree cost up to the year 1749 about 1,000 

gulden, at Gottingen some 130 thaler in 1765, at Paris 7,000 

livres, and at Oxford one hundred pounds* And this degree 

did not by any means give special rights in all places. 

Besides numerous other practitioners entitled by law to 

practise medicine there was no special difficulty experienced 

at many places by wandering quacks, rupturecurers, 

cutters for stone, and cataract operators in getting 

permission to practise their art. 

In a showy cortege tricked out with all manner of parti- 1 

coloured finery and attended by a harlequin, like the Dr. 

ElSENBART immortalized in the popular ballad, these gentry | 

roamed about to the annual fairs and Church festivals and 

detailed to the public the remarkable cures which they professed 

to have performed. With shameless effrontery they 

extolled the healing virtues of their medicines against consumption, 

deafness, and all the incurable diseases imagin- ; j 

able. Many declared that they had the power of at once \ 

restoring the sight, even if it had been lost for many years ; 

others recommended pills to cure barrenness, which according 

to their account produced the desired effect even without \ 

coition. The executioners, who occupied a prominent 

position among the quacks, sold human blood which in a 

fresh and frothy state was regarded as a remedy for 

epilepsy; it was retailed according to a fixed tariffdepending 

on the kind of humanity it had flowed from: 

dearest was the blood of a virgin or youth ; cheapest, that 

of a Jewt However, the wandering operators wrought the 

* P. FRANK op. cit. vi, 3, S. 291. 

f G. FISCHER op. cit. S. 49 et seq.—Des getreuen Eckharts medicinischer 

Maulaffe oder der entlarvte Marktschreier, Frankfurt und Leipzig i?M).—Thi, 

Tattler, London 1723, iv, No. 243.—O. BUCHNER op. cit. S. 145 et seq.

• 


greatest mischief. When in the public squares they exhibited 

proofs of their skill to the astonished multitudes 

amid the blasts of trumpets and the beating of drums, 

which were intended to drown the cries of the unfortunate 

patients, none thought of the sad consequences entailed 

too often by these surgical manipulations. But does not 

the saying of BACON hold good to the present day that 

every charlatan and every old woman is regarded as a rival 

of the most skilful doctor, and does not scruple to contend 

with him for mastery at the bedside of the patient ? 

END OF PART III.

IV.—MEDICAL TEACHING IN MODERN TIMES. 

THE WIDE OUTLOOK OF THE NATURAL 

SCIENCES IN THE NINETEENTH CENTURY. 

THE history of modern times begins with the great events 

of the last decade of the eighteenth century. The political 

and social forms of the present day first took shape during 

the French Revolution and amid the intellectual movements 

of that time. 

The French Revolution was directed less against Monarchy 

than against Feudalism, the representatives of which 

had abused their high position in unheard-of ways. For 

the first time it was recognized to be a grievous injustice.f 

that one portion of the population should have to bear all 

the burdens of the State, while another enjoyed all the 

rights and privileges it had to confer; for the first time the 

principle was enunciated that those who maintain the State 

are also entitled to have an important influence upon its 

management. This thought was universally prevalent, 

forming, as it were, a constant residual product in the manifold 

political processes of decomposition and change which 

were taking place at that time. It led to the Parliamentary 

system, which became a legal institution in the nineteenth 

century in nearly every civilized country. With the removal 

of historical privileges and of the subordination of one class 

to another in the State, with the abolition of serfdom, with 

the introduction of civic independence, of the principle of 

the equality of every individual person before the law, and 

of the participation of the masses of the people in the 

government, a social revolution was effected of far-reaching, 

importance.

THE NATURAL SCIENCES. 441 

Contemporaneously with the political emancipation of the 

middle-classes began also the increasing activity of the 

daily press, the development of journalism, and the popularization 

of art and science. An interest in the efforts 

made in these directions penetrated into circles which before 

had been entirely uninfluenced by them. All nations of 

any moral elevation took part in the development of culture, 

but especially the French, the English, and the German. 

The German face, wdiich already in the eighteenth century 

had produced LESSING, HERDER, GOETHE, SCHILLER, 

MOZART, BEETHOVEN, KANT, and other enlightened spirits, 

•and in poetry and literature, in music and philosophy had 

attained a position which commanded respect, by degrees 

.assumed the lead in medicine and the natural sciences. 

While at first in the history of these branches of knowledge 

the names met with are those of Frenchmen and a few 

Englishmen, since the middle of the nineteenth century the 

men of learning and the investigators of German origin 

have acquired a preponderating influence. 

It was otherwise with philosophy, for this unfortunately 

•in Germany lost touch completely with practical life under 

the baneful influence of scholastic pedantry, and has only 

rediscovered the lost path in the most recent times. The 

.great thinker of Konigsberg had with critical acuteness 

indicated the sources, the extent, and the limits of human 

thought; but the philosophers following KANT were able to 

add but little to his theory of knowledge, and confined themselves 

to a further development of his system in this or that 

direction. Inasmuch as they attacked directly the question 

of the essential nature and ultimate foundation of things—a 

•question KANT himself had declared to be superfluous and 

unanswerable, limiting inquiry, as he did, to the world of 

phenomena—they displaced once more the problems of 

philosophy into the mystico-transcendental realms of speculation. 

The subtle hypotheses of a FlCHTE who sought an 

answer to the enigma of existence in the conception of an 

Ego, thus arriving at an unlimited idealism, of a ScHELLING

442 MODERN TIMES. 

who preached the identity of nature and spirit, and so 

founded " the philosophy of nature," of a HEGEL who saw 

complete salvation in the idea of the Absolute, and of a 

SCHOPENHAUER who declared the world to be will and subjective 

representation, might for a time captivate but could 

not permanently convince. 

None of these systems have influenced the natural 

sciences more than that of "the philosophy of nature." 

Distinguished doctors and natural philosophers like BLU- 

MENBACH, OKEN, KIELMEYER, I. DOLLINGER, OERSTED, 

BURDACH, NEES V. ESENBECK, KIESER, K. G. CARUS, and 

others attached themselves to it, finding in it a definite 

standpoint from which to view, and form a just estimate of, 

the collections of empirical facts which surrounded them. 

Like the Romanticism which at that time dominated art and 

literature—the true child of an age which was struggling 

towards some satisfying conclusion to its efforts, selfcontradictory 

and incomplete as they were—so too did the 

philosophy of nature pursue throughout noble ends, for 

it penetrated into the depths of men's hearts, reminded 

medicine of her high ethical functions and gave expression 

to the doctrine of the unity of the various natural 

\ sciences. 

The philosophy of nature, having been injuriously 

affected by contact with religious mysticism, at first assumed 

a hostile attitude towards experimental inquiry and 

chose metaphysics for its arena: in the words of HAMANN 

" from a general knowledge of the possible it arrived at 

a thorough ignorance of the actual." When natural 

philosophy, in a spirit of senile self-glorification, applied its 

vague and often antiquated definitions to natural science in 

its state of daily progress, the only result was that the 

latter became entirely alienated from the former. That 

clumsy form of stating a proposition, introduced into- 

philosophy chiefly by HEGEL, which, with great labour, in a 

newly-made dialect, succeeded in rendering the simplest 

things incomprehensible, contributed not a little to the


estrangement which grew up gradually in Germany between 

natural science and philosophy. 

In other countries better conditions prevailed in this 

respect. In these philosophy was in close touch with the 

sciences and arts of real life and placed her powers at their 

disposal with a view to their methodical improvement. In 

France Positivism was founded by AUGUSTE COMTE. Like 

KANT, to whom in genius he was allied, COMTE had 

received a school-training in mathematics and the natural 

sciences. Positivism, in harmony with the sudden great 

increase of activity which experimental inquiry manifested 

at that time in France, excluded metaphysical and 

teleological explanations and demanded that every philosophical 

speculation and every science should appeal to 

our understanding in virtue of support received from facts 

corroborated by experience or experiment. Such a 

doctrine was bound to be found agreeable by investigators 

of nature, and it found among them numerous disciples 

and advocates. It was promulgated in Germany by 

FECHNER, H. LOTZE, H. CZOLBE and other distinguished 

men of science, and material necessary to its secure 

foundation was contributed by them. The exact school of 

the present day began once more to take account of 

philosophy, and one of the greatest investigators of nature', 

KARL ROKITANSKY, drew attention to its uses and, 

significance in reference to the natural sciences and 

medicine. But the philosophers also were well aware that 

the positive knowledge of scientific facts must be presupposed 

as a self-evident requisite for any intellectual 

activity on their part which was to prove fruitful or could 

hope to win any serious regard. 

At certain universities the chairs of philosophy were 

handed over to experts in natural science, such as had 

tested the value of observation and experiment, and thus 

a clear expression was given to the importance which a 

scientific view of nature had acquired in reference to the 

development of modern civilization. The civilization of

444 

MODERN TIMES. 

the present day has been established on the abundance of 

newly-discovered facts which have enriched the natural 

sciences during the nineteenth century, and in the knowledge 

of their mutual relationships and common laws, 

which has rendered possible a simplified view of the life of 

nature. 

In bringing forward certain facts from the history of the 

various natural sciences I desire only to indicate the course 

of their development in a few words. 

Already in the eighteenth century attempts had been 

made to classify minerals on a rational basis. Their external 

characteristics and resemblances formed the foundation of 

the arrangements of LlNNÛS and WALLERIUS. On the 

other hand AXEL F. CRONSTEDT, the Swede, regarded their 

chemical constitution as all-important; ABRAHAM GOTTLOB 

WERNER, the Saxon counsellor of mines, then made a 

classification of them, founded both upon their chemical 

and physical peculiarities, and upon their external form. 

To him is due the credit of having defined the limits of 

oryktology and geognosy and of having founded the latter 

science. 

The improvement of the science of crystallography* was 

commenced by ROME DE L'ISLE and HAUY and was successfully 

carried on by WEISS and MOHS. Others studied 

the chemical, optical, and electrical properties of certain 

minerals, and also the phosphorescence and phenomena of 

polarization observed in them. The appreciation of the 

value of chemistry as an aid to mineralogy led to the 

intimate association of these two sciences, which proved to 

be suggestive and advantageous in many ways. 

LEOPOLD VON BUCH did the work of a pioneer in the 

subjects of geognosy and geology. At the same time, too, 

the subject of the formation of fossils, to which 

SCHEUCHZER was the first to direct attention, was 

* CUVIER: Geschichte der Fortschritte in den Naturwissenschaften seit 1789, 

Deutsche Ubers, Leipzig, 1828, 4 Bde. ;f


diligently worked at, and afforded material for the solution 

of many questions of geology and anthropology. 

In botany various attempts were made to discover a 

natural system of plants. ADANSON declared that " nature 

everywhere exhibits to us natural groupings," and was of 

opinion that classification should not certainly be based 

upon the similarities and differences of one particular 

organ, but only upon the collective phenomena and 

characteristics of the organism. In order to reveal this 

system he compared individual plants in respect of their 

various organs and arranged them into classes of varying 

degrees of affinity according to the greater or less correspondence 

between them. His method of classification was, 

above all things, wanting in lucidity, and could not, therefore, 

gain for itself any approval. 

A more correct method was introduced by A. L. DE 

JUSSIEU, A. PYRAMUS DE CANDOLLE, ROBERT BROWN and 

others: they insisted first of all upon an accurate definition 

and delimitation of the families of plants, and did a quantity 

of valuable preparatory work in this direction. A. P DE 

CANDOLLE, who himself described with great care more than 

one hundred families, founded the doctrine of the symmetry 

of the plant-form. The investigations of J. GAERTNER 

upon the fruits and seeds of plants and R. BROWN'S monographs 

were of fundamental importance for morphology. 

GOETHE'S doctrine of metamorphosis excited the attention 

of philosophers of nature rather than that of men of 

science. It was of a confused and indefinite character, and 

was first explained scientifically by ALEXANDER BRAUN 

who brought forward valuable information upon the form 

of the leaf and the development of the plant.* The 

anatomy of plants was diligently worked at by BRISSEAU- 

MIRBEL, the younger MOLDENHAWER, LINK, MEYEN, HUGO 

MOHL and others, who succeeded in giving definiteness to 

men's views upon the structure of plants. Their micro- 

* WIGAND: Geschichte und Kritik der Lehre von der Metamorphose der 

Pflanzen, Leipzig 1846.


scopical formation was also closely examined, and the 

discovery that the cell is the unique ultimate element of 

their structure gave a new direction to morphological 

investigation : it demanded that a greater attention should 

be given to histogenesis. This was studied first upon the 

lower cryptogams, since the facts to be dealt with in them 

were simpler and less difficult to examine; then gradually 

the more highly organized plants were taken in hand. The 

results thus arrived at cast a remarkable light upon the 

origin and growth of organs. MOHL observed various 

modes of spore-formation, and in 1835 described an instance 

of vegetable cell-partition. SCHLEIDEN in 1838 brought. 

forward a theory of cell-formation, which however was disfigured 

by so many mistakes that it was soon afterwards 

abandoned. Its place was taken by the theory of NAEGELI 

which was of a more comprehensive character, gave a 

defined image of the different kinds of occurrences and 

determined the law which controlled them. In 1839 

SCHWANN enunciated the proposition that the animal cell 

is analogous to the vegetable cell, and in 1855 UNGER 

drew attention to the similarity between the protoplasm of 

the vegetable cell and the sarcode of the most lowly 

organized animals: this observation received increased 

support by investigations made upon the myxomycetes. 

These things led to a more correct appreciation of the 

puzzling relations between the vegetable and animal king^ 

doms and also helped to remove the doctrine of the fixity 

of species which had for long prevailed as an incontrovertible 

dogma. The fecundation of plants was studied by 

Du HAMEL who described the way pollination is effected, 

and the part which is here played by many insects. This 

subject was thoroughly worked at from 1830 onwards, the 

processes which take place in the interior of the ovules 

being made the subject of careful examination, and sexuality 

being proved to exist even in cryptogams. 

So, too, the processes of nutrition, of absorption, and 

excretion, and of growth were fully described. The move-


ments of the sap, on which STEPHEN HALES had already 

made some interesting experiments were elucidated chiefly 

by DuTROCHET who asserted their connection with the 

phenomena of osmosis. 

INGENHOUSZ found out that the green parts of plants 

under the influence of light absorb carbonic acid gas, 

separating and giving out the oxygen and retaining the 

carbon which in the form of organic combinations is stored 

up in the plants : he thus was the founder of the doctrine 

of the respiration and nutrition of plants. SENEBIER 

added some investigations upon the influence of light upon 

the life of the plant. Numerous works at this time dealt 

with the chemistry of the nutrition of plants and with the 

movements exhibited by them.* 

Their pathology, too, was not overlooked and especially 

of recent years has been advanced in an extraordinary 

degree. Finally the subject of the geographical distribu 

tion of plants assumed a definite shape : this, inasmuch as 

it indicated and explained the dependence of the vegetable 

world upon climate and soil, acquired high importance for 

medical science and especially for the subject of the 

geographical distribution of disease. 

By the discovery of new species of animals and by the 

careful investigation of their anatomical structure zoology 

gained not only a great increase of its subject-matter and 

improvement in its system of classification but was enabled 

with the help of the history of development, of comparative 

anatomy and of palaeontology to arrive at broad views of 

natural history apparently capable of embracing the whole 

range of living and extinct forms of life. BUFFON't already 

approached this point of view when he declared that there 

is no essential difference between animals and plants, and 

that the series of organic life shows one uniform plan. 

His popular and clever way of representing the subject, of 

interweaving bold hypotheses with abundant facts, stimu 

lated men of science to new investigations and aroused far 

* SACHS op. til. S. 27G et. seq. -f V. CARUS op. cit. 522 et seq.

MODERN TIMfiS^S- 

and wide an interest in matters connected with natural 

science among large classes of the educated public. 

BUFFON entered also upon the subject of the geographical 

distribution of the animal kingdom, and, like LlNN-ÛS , 

before him, drew attention to the difference between the 

species inhabiting the different continents. He concluded v 

from the fact that the forms of animal life belonging to-the 

Arctic regions of America and Europe are identical, that * 

there once existed a connection between the two continents, 

or at least that migrations of animals from one to 

the other were possible. An acquaintance with the trans- . 

oceanic fauna was brought about chiefly by scientific expeditions 

to which naturalists were appointed, Thus 

SONNERAT described numerous animals inhabiting islands 

off the southern shores of Asia ; but the greatest services 

in this respect were rendered by the elder FORSTER, j 

ALEXANDER VON HUMBOLDT, and LICHTENSTEIN. So. 

also a closer study was made of the distribution of animals '% 

in the different countries of Europe. PALLAS described , : 

several new forms. 

In the meanwhile men's knowledge of the species already ^ 

recognized was enriched by important observations. BONNET ; 

was the first to notice the asexual propagation of .aphidesy 

or plant-lice. P. CAMPER and J. HUNTER discovered 

simultaneously and independently of one another the aircavities 

of the bones of birds and the connection of these * 

with the lungs. FABRICIUS and afterwards LATR-EILLE" 

turned their attention chiefly* to entomology, RUDOLPHI 

worked at helminthology, and LAMARCK, O..F. MULLER,* 

and EHRENBERG applied themselves to the vast subject of 

the infusoria. 

Zootomy afforded important information upon the structure 

of the various animals, and a comparison of their'* 

organization opened up a view which rendered it pos-s 

sible to form a comprehensive judgment on this subject. 

Comparative anatomy and physiology gained rich accessions 

of scientific material through the labours of J. HUNTER,, 

F. VlCQ D'AZYR, BLUMENBACH, KlELMEYER, GEOFFROY,


ST. HILAIRE, CUYIER, TIEDEMANN, C. G. CARUS, J. F 

MECKEL, and J. MULLER, and the advancement of these 

sciences was looked upon as the proper object of zootomy. 

IGNAZ D6LLINGER wrote in 1814 : "The task of zootomy 

is to unfold the structure of animals, and in it to show the 

nature of life. The parallels drawn by the zootomist will 

be in this wise : he must collect facts and examine as to 

« how far they tally with one another or how far they are 

opposed; he must compare them with the theory of life 

and investigate how one individual Object has been formed 

through a series of metamorphoses."* GEOFFROY ST. 

HILAIRE laid down leading principles which might serve for 

the guidance of investigators. 

CUVIER discovered the law of the correlation of parts— 

a haw which J. HERMANN had already had a presentiment 

of—^-according to which every organic being forms a com 

plete whole, particular parts or organs of which cannot be 

modified without modifications also occurring in the other 

parts or organs. 

On the strength of these newly-disclosed facts classifica 

tion was ventured upon. BATSCH attempted in the first 

place to separate the bony animals from the others ; but 

LAMARCK was the first to bring the division into verte- 

brata and invertebrata clearly before the world ; this dis 

tinction was universally accepted. 

The greatest advance made in classification was owing to 

CuviER, who founded the doctrine of types. His explana- 

: - tion was that in the animal kingdom there are four principal 

branches simultaneously existing, or "general plans on 

which the animals belonging to them appear to be modelled, 

and the subdivisions of which are characterized only by 

slight modifications founded upon the development or sup 

pression ;of particular parts, no change, however, being 

made in the essential nature of the plan." K. E. V. BAER 

gave more definiteness to the conception of the type and 

.* J. DOLLINGER: Uber den Werth und die Bedeutung der vergleichenden 

Anatomie, Wiirzburg 1814, S. 17. 

G G


rendered the theory more correct, especially in regard to 

the history of development which CuviER had completely 

disregarded. 

The scientific treatment of development began at this 

time to assume a more conspicuous place than heretofore, 

and to exert an influence upon the branches of knowledge 

allied to it. PANDER published his original and helpful 

investigations upon the development of the chick, proving 

that the avian body is formed out of three embryonic layers. 

K. E. V. BAER made observations upon the other classes of 

the vertebrata, and referred to the different processes of 

cleavage in the ovum. The changes of the ovum after impregnation 

were observed, and its segmentation described 

by others also. Moreover, the development of particular 

organs, of the brain, for instance, the eye, the Wolffian 

bodies, etc., was made the subject of special study. In this 

way attention was drawn to the similarity of embryonic 

development in the various kinds of animals. JOHN 

HUNTER, KIELMEYER, and afterwards OKEN founded the 

theory that the embryos of the more highly-organized,. 

animals pass through the stages of development of the 

lower classes of animals. 

The facts in the history of development associated with 

palaôntological discoveries, which rendered it possible 

to recognize the differences existing between fossil plants 

and animals and the representatives of their species at 

the present day, shook men's faith in the immutability of 

form in zoology, and prepared the way for the theory of 

descent from. other forms. As early as in the year 1804 

LAMARCK declared, in referring to hybridization and the 

formation of varieties, that it is only because the judgment 

of man is accustomed to deal with small periods of time 

that a species is conceived by him to be unchangeable, but 

that in reality it does change and adapts itself to external 

conditions. 

In 1830, LYELL published his Principles of Geology in; 

which he contended that to explain the changes in the


earth's crust it is by no means necessary to assume that 

great and stupendous catastrophes have occurred, but that 

the forces of nature, slowly but continuously at work 

around us, are a sufficient explanation. He referred to the 

action of rivers and seas, of springs and glaciers, and compared 

the changes of the inorganic world to the minutehand 

of a clock, " the advance of which one can see and 

hear, while the fluctuations of living creation are hardly to 

be seen and resemble the movement of the hour-hand." * 

The dogma of fixity of species was gradually abandoned 

by most investigators of nature. Men saw that species 

do change within certain morphological limits and they 

were constrained to adopt the opinion that species had 

developed in a similar way into their present forms. 

To CHARLES DARWIN belongs the never-to-be-forgotten 

merit of having raised the hypothesis into a scientific fact. 

Supported by a rich collection of observations he undertook 

to fathom the causes which lie at the root of an 

explanation of the origin of species, and he came to the 

•conclusion that the struggle for existence and natural 

selection lead to a survival of the better and fitter 

•organisms, followed by a suppression of the conquered and 

the gradual perfecting of the conquerors. This theory, 

corrected and enlarged at certain points by WALLACE, 

NAEGELI and others, formed the foundation of a new 

method of contemplating the world of organic nature. 

When, soon after, the attempt was made to construct a 

history of creation in accordance with the ordinary course 

of nature, and when the place of man in relation to the 

other inhabitants of the earth was introduced into the 

sphere of discussion, the new doctrine excited the vehement 

animosity of those who discerned in it an assault upon 

religion and upon the dignity of the human race. The 

incompleteness of the facts, especially in palaeontology, 

and the meagre knowledge which we possess of many processes 

in physiology and the history of development did 

* O. SCHMIDT: Descendenzlehre und Darwinismus, Leipzig 1873, S. 117.

45 2 MODERN TIMES. 

not certainly justify deductions of such magnitude as those 

which were sometimes advanced; but these clothed themselves 

in the unassuming garb of hypothesis and did not 

ask that people should accept them unconditionally, but 

rather that they should criticize them freely. 

Religion will never have anything to fear at the hands of 

science if she ceases to be hostile to freedom of inquiry 

and recognizes her true calling to lie in the ethical education 

of the human race and in the perfecting of the 

spiritual life. 

PHYSICS AND CHEMISTRY IN THE LAST 

HUNDRED YEARS. 

WHILE mineralogy, botany, and zoology were changing 

from sciences merely descriptive of objects to sciences 

involving explanations of processes, physics and chemistry 

also were assuming a new form in consequence of improvement 

in the methods of investigation and the number 

of new discoveries. 

This period in chemistry was inaugurated by the discovery 

of oxygen and the abolition of the theory of 

phlogiston, and was characterized by the introduction of 

the method of quantitative analysis. 

In 1774, JOSEPH PRIESTLEY discovered oxygen by heating 

red oxide of mercury. At the same time he observed 

that the gas so obtained supported breathing and combustion 

better than ordinary air; but he was unable to draw 

the conclusions which the facts offered. He was a highlygifted 

amateur who prosecuted science extensively rather 

than deeply. He enriched chemistry with a multitude of 

discoveries, and, as KOPP says, did more than professional 

men of science to improve our knowledge of the gases* 

LAVOISIER was the first to recognize the full significance 

of the discovery of oxygen. Two years anterior to it he 

* KOPP op. cit. i, 239.

PHYSICS AND CHEMISTRY. 453 

furnished an experimental proof that both in the combustion 

of metals and in the ignition of phosphorus and sulphur an 

increase of weight occurred (contrary to what was postulated 

by the phlogiston theory), and that such increase of weight 

was due to absorption of air; he was unable to say, however, 

whether this absorption was of the air as a whole or of only 

a part of it. When, thanks to PRIESTLEY, he became ac 

quainted with oxygen, it occurred to him to seek in it the 

cause of this phenomenon. After numerous experiments 

he came to the conclusion that only one-fifth part of the 

atmosphere takes part in combustion and that the air con 

sists of one part of oxygen and four parts of a gas which 

subserves neither combustion nor respiration. His state 

ments upon the composition of air, water, and various acids 

were confirmed and rendered more complete on some 

points by CAVENDISH * The theory of phlogiston being 

thus refuted, several questions asserted themselves which 

had hitherto been explained by means of it or by analogous 

reasoning. 

LAVOISIER, finding oxygen to exist in all the acids which 

he examined, pronounced it to be a necessary constituent 

part of all these bodies—to be that, in fact, which bad pre 

viously been designated " primitive acid ; " he also alluded 

to the part which the element plays in the oxidation or so- 

called "calcination" of metals. BLACK had already cor 

rectly described the nature of caustic alkalies. LAVOISIER 

disclosed more thoroughly the importance of oxygen in 

respiration and its effect upon the blood, and thus led the 

way to a fundamental change in the physiological explana 

tion of these processes. 

The discovery of oxygen also exerted a great influence 

upon pathology and therapeutics. Some doctors discerned 

in it the " air of life " upon which health depends. They 

thought that certain diseases depended upon the excess or 

deficiency of oxygen and they employed it in therapeutics. 

* KOPP: Beitrage zur Geschichte der Chemie, Braunschweig 1875, iii, 254 

et seq.


LAVOISIER'S doctrines found acceptance first in France, 

the country of his birth. Among his disciples were GUYTON 

DE MORVEAU wdio rendered a service by introducing a 

rational chemical nomenclature, FOURCROY who gave his 

attention to medical chemistry, and BERTHOLLET who 

found out the composition of ammonia, was the first to 

observe the bleaching property of chlorine and recognized 

its importance in daily life, discovered chlorate of potash 

and fulminate of silver, carefully analyzed hydrocyanic acid 

and determined its composition, corrected LAVOISIER'S 

mistake in asserting that all acids contain oxygen, founded 

the doctrine of chemical affinity referring to the im^- 

portance of the quantitative relations which here assert 

themselves, and advanced industrial chemistry, especially in 

the departments of the manufacture of steel and saltpetre. 

KLAPROTH was the first in Germany to support the anti- 

phlogistic theory. Chemistry owes to him the discovery of 

several elements and the correction of various erroneous 

statements which had been made by other investigators.. 

His analytical labours were characterized by their accuracy, 

surpassing in this respect even those of VAUQUELIN, who 

about the same time was elaborating mineralogical 

chemistry and discovered chromium and glucinum. He 

directed his attention also to organic chemistry, and dis 

covered, amongst other things, quinic acid. 

In the beginning of our own century J. L. PROUST 

enunciated the law that chemical combinations always 

manifest a definite composition. He also made important 

contributions to the chemistry of certain metals and dis 

covered grape-sugar. 

The Englishman DALTON attempted to explain the 

definiteness of chemical combinations by the atomic theory, 

in which he assumed that the atoms of the various elements 

unite with one another in definite proportions depending 

upon their weight; he discovered also the law of multiple 

proportions.* The stoichiometrical investigations of 

* A. WBRTZ : Geschichte der chemischen Theorien,\Deutsche Ubersetzung* 

Berlin 1879, S. 29 et seq.

PHYSICS AND CHEMISTRY. 455 

DALTON were confirmed and extended by BERZELIUS, and 

also by WOLLASTON, who introduced a classification by 

equivalencies instead of that by atomic weights. 

This subject received enlargement at the hands of GAY- 

LuSSAC who recommended that in analyzing chemical 

combinations attention should also be paid to the volumetric 

relation of bodies when in the gaseous state. In 1805, he, 

in conjunction with ALEXANDER VON HUMBOLDT, discovered 

that water is composed of one volume of oxygen 

and two volumes of hydrogen. Afterwards he examined 

other combinations in the same way and established the 

fact that their constituents in the gaseous state stand in 

definite relations of volume to one another; he thus laid 

the foundation of the theory of volumes. GAY-LUSSAC 

published the valuable results of his labours upon the expansion 

of gases by heat; upon the density of vapours, for 

the determination of which he contrived peculiar methods 

of investigation ; upon iodine (which had been discovered 

shortly before) and its combinations, and also upon several 

combinations of chlorine. He gave the first correct description 

of the composition of hydrocyanic acid, explained 

the nature of cyanogen, discovered hydriodic acid and 

hyposulphuric acid and simplified the examination of many 

bodies made use of in daily life 

The quantitative analysis of chemical combinations 

entered upon a new stage when it became known that 

the electrical current decomposes them. NICHOLSON, 

CARLISLE, CRUIKSHANK, BERZELIUS and HISINGER made 

several interesting observations on this subject, and 

HUMPHREY DAVY gave them a theoretical basis. He 

pointed out that water is decomposed by means of the 

electric current into oxygen and hydrogen, and salts into 

acids and bases of which the former bodies in each case 

are discharged at the positive, the latter at the negative 

pole of the Voltaic battery ; he proved the decomposability 

of several compounds, as for instance the fixed alkalies, the 

alkaline earths, baryta, strontia, magnesia, lime, etc., and 

gave it as his opinion that chemical and electrical effects


are manifestations of the same force; he thought that these 

manifestations took the -form of electricity when larger 

masses come into contact, that of chemical affinity when 

smaller particles met. DAVY'S labours gave the impulse 

to a series of electro-chemical investigations which were 

instituted by THENARD, the discoverer of peroxide of hydro 

gen, and GAY-LUSSAC ; they greatly increased our know 

ledge of certain elements, especially potassium and sodium, 

and improved the technical methods of research. 

At the same time SCHWEIGGER and BERZELIUS elaborated 

the theory of electro-chemistry ; the latter proceeded upon 

the assumption of the electrical polarity of the atoms of 

bodies, and, in conformity with it, asserted that chemical 

combinations arise from the juxtaposition of the opposite 

poles of the atoms of different bodies. 

In 1834 FARADAY discovered the important fact that the 

chemical effect varies in quantity directly as the amount of 

current electricity producing it. By this he succeeded in 

establishing a measure for determining the quantity of 

electrical action present in any case. By studying the 

effect of electrical action upon, different combinations he 

found that the weights of the bodies decomposed by the 

electric current correspond with their chemical equivalents.- -} 

The whole subject of electro-chemistry thus served to 

illustrate the doctrine of chemical affinities. 

Much successful work was done in other parts of 

chemistry. DAVY corrected the erroneous views about 

chlorine, and introduced the conception of hydrogen-acids; 

he was moreover the first to draw attention to the intoxi 

cating effect of nitrous oxide, a gas discovered by 

PRIESTLEY. His investigations upon the pigments of 

ancient works of art and upon the means of rendering 

legible the manuscripts found at Pompeii also deserve 

mention. BERZELIUS did suggestive and original work in 

all departments of chemistry and created a school which ' 

produced a succession of distinguished chemists during the 

nineteenth century such as C. GMELIN, MiTSCHERLlCH,

PHYSICS AND CHEMISTRY 457 

GUSTAV and HEINRICH ROSE, WOHLER, MAGNUS, 

ARFV*EDSON and others. He facilitated quantitative 

analysis by bringing the blowpipe into more general use, 

discovered and described several elements not kriown before 

.and made valuable contributions to animal chemistry. 

FARADAY worked at the liquefaction of gases and at the 

improvement of the steel and glass manufactures, while 

DUMAS instituted experiments upon the specific weights of 

various gases. MlTSCHERLlCH formed inorganic substances 

synthetically and showed that they were identical with the 

minerals occurring native; published the results of impor 

tant work upon the combinations of sodium with iodine 

and upon the degrees of oxidation of manganese, and, by 

his discovery of isomorphism and dimorphism in chemistry, 

opened up a branch of the subject having a direct physical 

bearing and full of importance for mineralogy. The dis 

covery of the fact that bodies differing'in chemical com 

position may possess the same crystalline form and may 

have their constituent elements replaced by others without 

•changing such form, whereas other bodies like sulphur may 

exhibit different forms while retaining the same chemical 

•composition exerted a great influence upon the further 

development of chemistry. 

With LlEBlG and W6HLER organic chemistry came into 

prominence. A field of work was here opened to scientific 

research hitherto scarcely, if at all, cultivated. The study 

•of organic combinations, their composition and properties, 

and the attempt to produce them artificially, constituted a 

series of problems, the solution of which has fully occupied 

the chemists of the nineteenth century* Then it came to 

be recognized how manifold and far-reaching are the rela 

tions between chemistry and practical life, and of what 

value that science is in agriculture, in the various handi- 

* A. LADENBURG : Vortriige uber die Entwickelungsgeschichte der Chemie 

in den letzen hundert Jahren, Braunschweig 1887, S. xijetseq.—H.KOPP: 

Die Entwickelung der Chemie in der neueren Zeit, Miinchen 1873, S. 518 

•el seq.


crafts and industries, in painting, in war, in dietetics, 

physiology, pharmacology, and in the work of the dis 

penser. Agricultural chemistry, technological, physiological 

and pharmaceutical chemistry have gradually developed 

into independent branches, and chemistry in a broad sense 

has become the science of everyday life which regulates 

and satisfies the wants of man.* 

In physics this period was inaugurated by the discovery 

of the remarkable electrical phenomena which were rightly 

interpreted by VOLTA. This aroused extraordinary interest 

and furnished the occasion for a series of labours which 

resulted in the improvement of the Voltaic pile, the recog 

nition of the effects produced by it and of the conditions 

required to produce them, and the discovery of other impor 

tant things. The identity of galvanism and electricity was 

recognized, and the relative value of the different metals 

in giving rise to electrical currents was established. The 

observation of OERSTED that the magnetic needle is de 

flected by the current was one of fundamental importance; 

for the connection between electricity and magnetism was 

thus shown. ARAGO and GAY-LUSSAC soon pointed out in 

addition that the current not only deflects but magnetizes. 

SCHWEIGGER constructed the first galvanometer and 

AMPERE discovered the influence exerted by electrical 

currents upon one another, tried to give an explanation of 

the real nature of magnetism, and was the first to evolve 

the idea of the electro-magnetic telegraph. At the same 

time the relations between heat and electricity became the 

subject of observation and SEEBECK discerned a new source 

of electricity in the so-called thermo-electricity. OHM. 

discovered the laws which hold good for the conductivity 

of wires and for the relation existing between intensity 

of current, electromotive force, and resistance, and 

reduced them to a mathematical formula which can .be- 

easily grasped. 

FARADAY was the first to detect induction currents, and 

* KOPP : Geschichte der Chemie, i, 27c et seq.

PHYSICS AND CHEMISTRY 459 

studied the relations existing between electricity and light. 

The improvements in the technical methods of investiga 

tion, the invention of suitable instruments and apparatus, 

and the scientific data afforded by their help, constituted a 

further extension of our knowledge in this direction. 

For physiology two discoveries in physics were of the 

highest significance, namely, the establishment of the fact 

that electrical currents exist in the animal body, and the 

discovery of the law of conservation and transformation of 

energy. It was proved by the latter that electricity, heat, 

and mechanical work can be transformed or resolved into> 

one another, and are correlated manifestations of the same 

energy. In this way was discovered that bond which unites 

in common the most important functions of organic life. 

The application of electricity to technical purposes, for 

instance, to telegraphy, to lighting, to driving machines, 

etc., belongs also to the most recent times.* 

The close connection which united physics to mathe 

matics, and which enabled the latter to be used as a pioneer 

for advance as well as a check on the progress already 

made, and the conscientious and firmly-grounded method 

of experiment secured important results for research in the 

other branches of the former science. These were destined 

to stand out most conspicuously in the domain of mechanics. 

LAPLACE, YOUNG, GAUSS and others undertook the task of 

establishing a clear conception of the laws which lie at the 

root of various phenomena, such, for example, as capillarity. 

Astronomy, meteorology and climatology also owed to these 

labours many a suggestion and great extension of their 

scientific boundaries. 

The development of the theory of heat was affected by 

the same influence. Count RUMFORD observed that heat is 

produced by friction, and thence laid the foundation of the 

mechanical theory of heat.f Observations upon the specific 

* E. HOPPE : Geschichte der Elektricitat, Leipzig 1884, S. 118 etseq. 

f G. BERTHOLD : Rumford und die mechanische "Warmetheorie, Heidelberg 

i87S-


heat of bodies, investigations upon the degree, of expansion 

which they undergo through the influence of heat, upon the, 

elasticity of steam, and especially the experiments in respect 

of the heating-power of fuels claimed the attention of 

physicists more and more in proportion as they subserved 

the requirements of daily life. The law of the mechanical 

equivalent, of heat* cast a strong light upon many of these 

questions, and pointed out the way in which a solution 

might be found. 

Optical science was advanced by the victory of the 

undulatory theory of light, and by numerous experiments. 

YOUNG made use of the principle of the interference of 

light to explain many phenomena, and FRESNEL studied the 

diffraction of light. In 1809 MALUS discovered polarization 

by reflection, and not long after BREWSTERt drew attention 

to biaxial crystals and to the intimate relation between' 

optical properties and crystalline structure. He afterwardsc 

constructed also the first stereoscope. The chemical effects 

of light were, moreover, subjected to a careful examination^ 

This led to the discovery of photography, with which are 

associated the names of DAGUERRE, NIEPCE, and TALBOT. 

FRAUNHOFER, like WOLLASTON before him, observed the 

dark lines in the solar spectrum ; but KlRCHHOFF was the 

first to give an explanation of them. 

The discovery of spectrum analysis afforded information 

upon the physical nature and chemical composition of the 

heavenly bodies, and threw open a new field of research; 

The improvements in optical apparatus, especially the invention 

of achromatic telescopes [by DOLLOND], as well as 

that of achromatic microscopes, which were first constructed 

by HERMANN VAN DEYL and FRAUNHOFER between 1807 

and 1811, and were afterwards rendered still more complete 

through the labours of PLOSSL, SELLIGUE, CHEVALIER 

AMICI, OBERHAUSER, HARTNACK, and others, had the 

* Determined by JAMES PRESCOTT JOULE.—E. H. H. 

t D. BREWSTER : Philos. Transactions, Lond. 1818, p. 199 et seq.

ANATOMY AND PHYSIOLOGY. 461 

highest significance for all departments of natural investi 

gation. 

The science of acoustics was enriched by some valuable 

work at the hands of CHLADNI, OHM, and others; but the 

scientific foundation of this branch of physics was first 

laid in the most recent times, and is chiefly due to the 

labours of HELMHOLTZ. 

Physics and chemistry have become the sciences pre 

eminently ancillary to medicine, and are called to its aid in 

physiology as in pathology, in surgery no less than in the 

treatment of internal diseases. 

MEDICAL SYSTEMS AND THE PROGRESS IN 

ANATOMY AND PHYSIOLOGY. 

THE doctrine, which gained general acceptance throug 

the teaching of HALLER, that sensibility and irritability 

form the distinguishing peculiarities of the animal organism, 

the new discoveries in chemistry, and above all the 

phenomena of galvanism called into existence a number 

of medical systems in which the attempt was made by the 

aid of these facts to explain the processes undergone by 

the human body in health and disease, and to gain a firm 

basis for the science of therapeutics. 

A certain proportion of doctors discerned, like-the 

Methodists of antiquity, in every physiological and patho 

logical manifestation a stimulation or a relaxation, the 

cause of which was at one time assigned to the action of 

the nervous system, as by CuLLEN, at another sought for in 

greater or lesser irritability, as by JOHN BROWN and his 

adherents. The theory of irritation was extended and 

elaborated by C. GlRTANNER, who alleged oxygen to be 

the actual principle of irritability, by R6SCHLAUB, who 

referred to the influence of the natural disposition or 

organization, by BROUSSAIS who substituted "inflammation" 

for " stimulation " and tried to support the theory by patho-


logical anatomy, and by RASORI who adapted the theory of 

BROWN, intended for the cold torpid natures of the north, 

to the conditions of his own southern home. This theory * 

became very widely spread, but was as quickly given up * 

again as soon as its untenability became manifest. Its position 

in reference to scientific research was one of coldness 

and indifference and it encumbered practical medicine with 

a troublesome polypharmacy which often did more harm 

than good. 

The vitalistic theory was of more solid worth; it contended 

with the irritation theory for dominion in medicine > 

and finally wrested victory from it. It took its origin from. 

Montpellier, and in many respects recalled the animism 

of STAHL; but it differed advantageously from the latter 

in the fact that in considering the general principle of life's 

which gives rise to order and harmony in the organism, it 

by no means neglected the study of the special functions 

and component parts of the body, and did not, like it, make"'? 

use of the soul to explain all, even the simplest, processes 

of life, but only had recourse to it to elucidate the ultimate 

active causes at work in the animal organism. It never 

succeeded in becoming the chief figure in the picture of 

contemporary medicine, but had to be satisfied with 

imparting to it its characteristic and predominant colour. 

Among its representatives were investigators like 

BORDEU, BA.RTHEZ, GRIMAUD, PlNEL, BlCHAT, CHAUSSIER,'| 

and others in France, ERASMUS DARWIN in England, ;*• 

BLUMENBACH, J. C. REIL, and others in Germany; men 

who stood at the head of scientific advance and afforded by 

their works the proof that the vitalistic theory w T as not a 

barrier to progress. This is, to a large extent, the reason , 

why it still endured when natural philosophy was the prevailing 

influence in Germany and the physiological'schoolj 

of medicine in France. * 

But it led to certain errors, especially in the field of 

therapeutics. Those who practised mesmerism and : 

homoeopathy maintained that their method of treatment


acted directly upon the vital powers. If a cure resulted it 

was, in the case of the first, chiefly dependent upon the 

phenomena of hypnotism, metallo-therapeutics or other 

agencies which only in the most recent times have been 

subjected to careful observation ; in the case of the second, 

to the effects of mechanisms and forces already present in 

the body and which exercise a controlling and curative 

power. Vitalism got beyond its depth when it strove to 

analyze the complicated processes of life into their several 

factors and to explain them in accordance with the general 

laws of nature. 

Experimental research, which all enlightened spirits 

since the time of ARISTOTLE had cherished as the unique 

source of knowledge, became gradually the order of the 

day and men looked askance at the invention of medical 

systems in which facts had the smallest, hypotheses and 

speculations the largest, share. Whenever, in the medical « 

history of the 19th century, research took any special 

direction, as for instance towards questions of physiology, 

of pathological anatomy, or (in the most recent times) of 

hygiene, and in this way influenced the development of the 

whole science, it was not owing to an arbitrary love of 

systematizing, but rather to the experience which had 

been gained that the elaboration of particular branches is 

the course most calculated to enrich the science as a 

whole. 

It is not my purpose here to enumerate all the discoveries 

and advances made during our century in the various 

branches of medical science. I must confine myself to 

citing the great achievements of medicine and not allow 

myself to describe the individual stones which enter into 

the composite mosaic structure of the science of to-day. 

The anatomical formation of the human body was already 

fairly well known to science at the beginning of this 

period; it was merely a question of filling up some gaps 

in the knowledge of special parts, notably in the case of the 

vascular and nervous systems and of the sense organs.


So too it was incumbent, upon investigators to get a clear 

insight into the minuter structure of the organs now that,,,;; 

with the improvement of the microscope' and the introduc-*'| 

tion of new technical, aids, this could be attempted with»,| 

better prospects of,success. 

An endeavour was also made, to regard anatomy.from . 

other than the purely descriptive standpoint. The various 

parts and organs of the body were considered in order 

according to their positions'and.: were studied in their ;* 

relations to the structures adjoining them, and the importance 

of these relations in regard* to surgery was discussed. ., 

While detailed study was thus being given to topographical:| 

and surgical anatomy, the influence of development upon 

the build and formation of the parts, of the body was the 

subject of research ; and in this manner an, opportunity was ;, 

given of viewing anatomy from a purely morphological 

point of view.. A rich store of material, still continually 

increasing, lay already at hand for the study of company 

tive anatomy, and now attention began to be turned to 

the peculiarities of, and the differences between, the races 

of mankind and in this way the ground' began to be pre^ 

pared for a scientific treatment of. anthropology. 3 

Among the most distinguished doctors who lived at the 1 

end of last century was T. SOEMMERING. His scientific' • 

work extended over all the paths in which contemporary 

anatomical research was moving. Even his inauguraldissertation 

upon the base of the brain was .a work of 

enduring value. He abundantly fulfilled the expectations 

which he then aroused. His excellent illustrations of the 

eye and the Other sense organs, his luminous description 

of the anatomical structure of the human body, his 

researches into the corporeal differences between Negroes 

and Europeans and his embryplogical writings, have'ad 

vanced science in many ways. He even attempted to 

explain the origin of malformations by means of the •.history 

of development. 

Descriptive anatomy has in the course of the last hundred


years received valuable contributions to its subject matter 

and by its connection with the history of development and 

with comparative anatomy has become of much deeper 

scientific import. 

Osteology was in its macroscopical aspect brought to a 

state of comparative completeness. SOEMMERING sought 

to lay down the lines of an ideal female skeleton just as 

S. ALBINUS had done in the case of the male skeleton; he 

employed for this purpose the corpse of a wonderfully 

beautiful maiden of twenty years of age who had lived at 

Mainz, .and which had been handed over to the anatomical 

institution ; he compared this body with the consummate 

proportions of antique statuary just as ALBINUS had 

based his portraiture on the form of the Belvedere 

APOLLO* 

In myology care was taken to observe the origin and 

insertion of muscles, their relative positions and their 

participation in the structure of particular parts of the 

' body, and the occurrence of any varieties. 

(, The subject of the vessels and nerves was most in need 

of improved teaching. The former were successfully 

•* worked at by MASCAGNI, G. BRESCHET, J. and C. BELL, 

TlEDEMANN, BERRES, V- FOHMANN and others : the most 

important progress made in the knowledge of the latter 

was due to ANTONIO SCARPA who was the first to describe 

• the naso-palatine nerve and who gave fresh information 

on the course of the cranial nerves and on the structure of 

nerves and of the sense organs; to CHARLES BELL who 

published a comprehensive description of the brain and 

the nervous system ; to EMIL HUSCHKE and BENEDICT 

STILLING whose wonderful labours upon the fasciculation 

of the brain and spinal cord formed the starting point for 

the more recent investigations on these parts. 

The researches into the minuter structure of different 

parts of the body led to the foundation by BlCHAT of a new 

* RUD. WAGNER : Soemmerings Leben und Verkehr mit seinen Zeitgenossen, 

.Leipzig 1844, ii/ 59. 

H H


branch of learning, that namely which treats of the tissues. ) 

Even in his dissertation upon the membranes which corre- ; 

sponds somewhat closely with A. BONN'S treatise, on the '"* 

same subject, but chiefly in his General Anatomy he argued i 

that the body is made up of different kinds of tissues, and ,_ 

he illustrated their peculiarities and distribution. These .-! 

observations were of great importance not only for 

anatomy but also for pathology ; for they threw light upon , 

the origin and extension of diseases from a point of view 

which had till then not been thought of. 

The improvement of optical aids and especially the | 

construction of achromatic microscopes rendered possible 

a thorough investigation of the minute structure of the < 

tissues. The results of these researches to which 

SCHWANN'S discovery of the animal cell imparted.a 

histogenetic interest affected our knowledge of every 

organ of the body and laid the foundation of a storehouse 

of learning on the subject of microscopical anatomy, to the 

building and extension of which JOHANNES MULLER, 

EHRENBERG, PURKINJE, HENLE, R. WAGNER, VALENTIN, 

MAX SCHULTZE and nearly all the distinguished anatomists : 

of this century have contributed. 

For mastering the subject of the origin and development 

of the human embryo a valuable store of scientific material 

was afforded by the facts known of the general history of 

development, of comparative anatomy, and of the generation 

of animals. The discovery of the germinal vesicle by 

PURKINJE, and of the germinal spot by R. WAGNER, 

followed close upon the labours of PANDER and of BAER, 

which are spoken of by KOLLIKER as "the best work 

that embryological literature of any age or country has to 

show."* 

Numerous observations were made by celebrated investigators,—among 

whom only HEINRICH RATHKE, REICHERT, 

T. BlSCHOFF, and R. REMAK can be mentioned here,— 

upon the phenomena of generation and upon the gradual 

* A. KOLLIKER: Grundriss der Entwickelungsgeschichte, Leipzig 1884, p. 3-


formation of the human embryo, and satisfactory answers 

were given to most of these uncommonly difficult questions. 

Comparative anatomy was worked at with diligence and 

with success. J. F. BLUMENBACH collected all the facts 

touching on comparative anatomy which had been stored up 

in literature by earlier observers, and added to them a 

number of observations of his own. It was he who first 

undertook the task of determining the anatomical differ 

ences between the various races of man,—especially 

Europeans, Negroes, and Indians,—and the anthropoid apes, 

having regard in this to the conclusions suggested by the 

contemplation of the sculpture of ancient times, and by 

the dissection of several Egyptian mummies. Amongst his 

discoveries was that made during the dissection of the eye 

of a seal, namely that the axis of that organ admits of 

being readily lengthened or shortened so as to permit the 

animal to see clearly in media of such different densities as 

air and water.* His far-famed collection of skulls of 

various nationalities had a stimulating influence upon the 

.study of this important part of ethnology. A series of 

important achievements was now effected in the subject of 

•comparative anatomy, and this science formed even up 

to modern times an inexhaustible field for investigators. 

The discoveries, following so quickly on one another, gave 

life to zoology, anatomy, and the history of development, 

and contributed chiefly to give a firm footing to that 

thorough morphological conception of organic life which at 

the present day characterizes these branches of knowledge. 

The application of anatomy as an aid to the statuary's art, 

and its cultivation for surgical purposes at the hands of 

MALACARNE, FRORIEP, VELPEAU, ROSENMULLER, T. 

BOYER, and others were measures followed bv considerable 

results. 

Much more conspicuous, however, has been the progress 

made by physiology during our century. From being a 

* K. F. H. MARX in den Sitzungsber. d. Gdttinger Soc. d. Wissensch. vom 8 

Februar 1840, S. 22.


subject still for the most part founded upon speculation 

and hypothesis and dominated by mystical, teleological, and , 

vitalistic ideas, it has now become one of the real natural 

sciences, the facts of which are supported by mathematical 

and physical laws, by chemical processes, and by anatomical 

observations, and are susceptible of experimental proof. 

The special physiological functions of the human body 

have stepped into the place of an ambiguous " vital power," 

an expression once used to cover up great gaps in men's 

knowledge of organic life. These physiological functions 

have had their significance in relation to the process of life 

determined and tested by observation and experiment. 

This has been achieved by the help of an improvement m 

the details of the methods of research which has been, 

rendered possible by the invention and employment of 

suitable apparatus, and favoured by the use of greater precision 

in the questions put and the answers given, and in 

the way seemingly secondary matters have been taken into, 

account Experiment came to be appreciated at its fullvalue, 

and MAGENDIE, FLOURENS, CLAUDE BERNARD, and; 

numerous German investigators prized most highly this. 

powerful aid to inquiry. 

Chemistry yielded some conclusions upon the composition ^ 

of the body and its constituent parts. The analysis of the j 

various tissues and fluids of the body, especially of the ; 

blood and urine, led to a new conception of the human 

organism and its functions. . 

Some insight was thus gained into the chemistry of ; 

nutrition, and into the part played by the albumenoids, 

carbohydrates, and fats in the economy of the human body.^ 

The relations between the income and output of the body, 

the metabolic processes, the renewal of the blood, the, 

formation of the secretions and excretions, the source of 

animal heat, and other matters were specially illustrated by 1 

the labours of LlEBiG, W6HLER, DUMAS, GMELIN, and their 

pupils and successors. 

The subject of digestion was studied more particularly


by MAGENDIE, GMELIN, J. N. EBERLE, HELM, BEAUMONT, 

and BLONDLOT,.whose experiments with gastric juice led to 

important results, by CLAUDE BERNARD, who investigated 

the action of the pancreatic juice upon fats, and discovered 

the glycogenic function of the liver, and by many other 

distinguished investigators. DUTROCHET explained the 

processes of absorption and elimination by the phenomena 

of osmosis discovered by the Abbe NOLLET, and studied the 

degrees in which various animal membranes permit diffusion 

to take place through them. ANDRAL and GAVARRET, 

BECQUEREL, SCHERER, NASSE, LEHMANN, and others 

worked at the physiology of the blood. 

The chemical composition of the blood, its colouring 

matters, its corpuscles, its coagulability, etc., were investigated, 

and the physical conditions of its movement in the 

vessels, the blood-pressure, the mechanism of the heart 

considered as a pump, the phenomena presented by the 

heart in all other respects and by the pulse, were, with the 

help of suitably constructed apparatus, rendered subjects 

of more exact knowledge. 

In addition to the labours of E. H. WEBER, VOLKMANN, 

FLOURENS, and others, who in this department rendered 

distinguished services, mention must also be made here of 

the important researches upon the influence of the nervous 

system on the movements of the heart and on the vascular 

system. EDUARD WEBER referred to the part played by 

the vagus in regulating the action of the heart; it was 

recognized afterwards that it is here really a question of 

the fibres of the accessorius. CLAUDE BERNARD discovered 

the vaso-motor functions of the cervical 

sympathetic, and probably by this suggested those 

researches which led to the discovery of the vaso-motor 

centre in the medulla oblongata. The centre for the 

respiratory movements, the point vital, was discovered in 

1837 by FLOURENS after LEGALLOIS had already drawn 

attention to the importance of the medulla oblongata in 

regard to the respiratory act.

47° MODERN TIMES. 

Other investigators threw light upon the mechanism of 

respiration, the functions of the muscles which take partin 

it, the interchange of gases in the lungs and the relation 

this bears to the colour of the blood; they attempted alsoto 

measure the force exerted by the lungs in inspiration 

and expiration, as well as the volume of air employed in 

these acts. The foundation of spirometric and manometric 

measurements of lung capacity, by which some help, 

is given in diagnosing pulmonary diseases, was the work 

of JOHN HUTCHINSON and WALDENBURG. 

The phenomena of motion also aroused earnest attention. 

Ciliary movement, which had before been thought to be 

limited to the lower animals, was observed by PURKINJE in 

the human body also ; molecular movement only came, 

under observation in quite recent times. The mechanism. 

of human locomotion was well-nigh exhaustively treated by 

the brothers EDUARD and WILHELM WEBER. 

The discovery of electric currents in muscles directed; 

attention to the chemical and physical processes which 

take place in the interior of muscles. In the same way, 

the electricity of the nerves suggested a multitude of 

problems, the solution of which still occupies the minds of 

philosophers and investigators* I have already pointed 

out how important for forming a judgment upon the acts 

performed by the organism is the law of the conservation 

and metamorphosis of energy discovered by J. R. MAYER. 

In 1811, CHARLES BELL raised into the position of a 

scientific fact the anatomical distinction, already suspected 

by GALEN, between the motor and sensory nerves, by 

bringing forward the proof that the former arise from the 

anterior, the latter from the posterior roots on the spinal 

cord. He hit upon a discovery of such extraordinary 

importance for the physiology of the nerves by a comparative 

study of the anatomical and physiological relations 

of the cranial nerves and especially of the two roots of the 

* E. DU BOIS-REYMONO : Untersuchungen iiber thierische Elektricitat, Berlin 

1848, Bd. i, S. 29 et seq.

ANATOMY AND PHYSIOLOGY 471 

trigeminus, the analogy of which with the spinal nerves 

had already been noticed by SOEMMERING and PROCHASKA. 

MAGENDIE, and JOHANNES MULLER in a greater degree 

still, confirmed BELL'S discovery by convincing experiments. 

The doctrine of reflex movement already advanced by 

DESCARTES, and plainly enunciated by PROCHASKA, to 

which MARSHALL HALL, in 1833, gave a scientific founda 

tion by his observations, and which JOHANNES MULLER 

corrected in certain points and demonstrated in a clear, 

intelligible manner, now constituted a recognized addition 

to science. The functions of the several nerves and the 

significance of the different nervous formations, as of 

ganglia, for instance, were determined by experiment. Even 

a solution of the difficult problems offered in the physiology 

of the central nervous system was attempted. 

F J. GALL thought that in examining and comparing the 

skulls of persons, possessed of definite peculiarities of 

intellect or character, he had observed that certain localities 

were more prominent than others. Adhering to the old 

theory that the faculties of the mind are definitely localized 

he inferred that intellectual centres are accurately mapped 

out in the brain and can be recognized by the increased 

vaulting of the cranial surface at particular spots. 

Although he was anxious to support this hypothesis by 

anatomical investigations, speculation really had a pre 

ponderating influence. His method of localizing and dis 

tributing the faculties of the mind was an arbitrary one, 

and his assumption that such give any characteristic 

indications upon the surface of the skull was an entirely 

erroneous one. For all this, he must be credited with 

having rendered the service of advancing the anatomical 

investigation of the brain and of stimulating men to a 

scientific study of the skull, a subject undertaken with 

great success by C G. CARUS, HUSCHKE, and others. 

It was reserved for the improved methods of research of 

modern times to throw some light into the dark places of 

cerebral physiology. By the help of these it became


possible to trace out carefully the course of the nerve-fibres 

in the brain and spinal cord, to determine their distribution 

in these organs, and to observe the minuter structure of the 

grey substance and the different forms of its cells; while at 

the same time by experiments on living animals, which 

consisted of effecting a local destruction of, and consequentabolition 

of vital functions in, certain parts of the central 

nervous system, men sought to determine the normal functions 

of such parts. A comparison was made between the 

results thus obtained and observations made at the bedside 

or in the post-mortem room. 

The physiology of the sense organs was also the subject 

of assiduous study. The origin of the visual act, the perception 

of colours, the importance of that part of the eye 

which is sensitive to light, the mechanism of accommodation, 

the action of the refractive media, intraocular appearances, 

binocular vision, the subject of the horopter, etc., were all. 

submitted to thorough examination and rendered intelligible 

by the accumulation of numerous facts. In the same 

way the senses of hearing, smell, and taste, and tactual 

and general sensation were studied individually and made 

subjects of scientific knowledge. 

Physiological research however has not only succeeded 

in rendering an almost complete account of the problem of 

the functions and laws of the human organism in health: 

it has, in addition, brought forward a number of observations 

which have prepared and smoothed the way for an 

explanation of phenomena manifested by the body in 

disease. 

DIAGNOSIS, PATHOLOGICAL ANATOMY AND 

EXPERIMENTAL PATHOLOGY, NOSOLOGY 

AND MATERIA MEDICA. 

PATHOLOGY, the science which deals with disease, has 

been marked throughout by stages of development similar; 

to those which have characterized physiology. After men

DIAGNOSIS AND PATHOLOGICAL ANATOMY. 473 

had come to recognize the hopelessness of attempts to 

fathom the essential nature of disease by bold but ill-founded 

hypotheses and philosophical speculations, they applied the 

analytical method to this subject also and began by making 

sure of and examining those concrete facts of which the 

whole picture of disease is made up. 

The perfecting of the appliances used in diagnosis gave 

rise to a deeper and more thorough study of the symptoms 

•of disease and the startling advance made in pathological 

anatomy held out a promise that valuable conclusions would 

be arrived at concerning the changes lying at the root of 

such symptoms. By a comparison between clinical obser 

vations and notes taken in the post-mortem room, the 

development and essential nature of most diseases became, 

by degrees, more intelligible. 

To physics and chemistry for the most part we owe the 

advances made in the art of diagnosis. During last century 

percussion was practised only by a few as, for example, by 

M. STOLL; it fell almost completely into oblivion and first 

under the influence of CORVISART assumed the place which 

it deserves among the means of diagnosis used at the bed- 

cside. Having had his attention drawn to it by AuEN- 

BRUGGER'S almost forgotten treatise, CORVISART tested the 

-observations there laid down during a period of twenty 

years, corrected and extended them by his own private 

-experience and then published his famous work on percus 

sion, in which he did full justice to the services rendered 

h>y the discoverer. Percussion was rendered more perfect 

in many ways by PiORRY, who introduced the plessimeter, 

by WlNTRiCH who recommended the employment of a 

hammer, by SKODA especially who furnished a correct 

-explanation of the various sounds heard on percussion and 

show 7 ed a reforming and inventive genius in all directions, 

by TRAUBE and others. 

Auscultation also at the same time underwent reforma 

tion and scientific improvement. Whereas before it had 

been only occasionally practised and then by the direct


application of the ear to the body of the patient, since the 

time of LAENNEC, who introduced the use of Ihe stethoscope 

or mediate auscultation, it became a method systematically 

and constantly used as an aid to diagnosis. It became 

well-nigh indispensable for examining cases of pulmonary 

or cardiac disease being here the most important, at times 

the only available, aid to diagnosis. 

But other departments of medicine also owed it much; 

thus LEJUMEAU DE KERGARADEC and soon after him 

MAYOR discovered the sounds of the foetal heart while 

auscultating the abdomen of a pregnant woman, and in this 

way furnished us with a way of recognizing the presence of 

life in the foetus. 

Besides these physical means of research to which 

must be added mensuration and the use of the clinical 

thermometer—a method elaborated in modern times chiefly 

by WUNDERLICH—the advance of the art of diagnosis waslargely 

contributed to by chemistry and microscopy. 

The existence and the severity of many diseases as well 

as their aggravation or abatement can be certainly affirmed 

only by the chemical proof that definite substances found 

in certain excretions—such as albumen or sugar in the 

urine—are either contained in a certain proportion or show 

a tendency to increase or to diminish in quantity as the 

case may be. The chemical analysis of pathological products 

acquired high importance in the study of diseases; 

particularly in reference to the theory of toxic agencies. 

And in no less degree was 'microscopical research in 

many cases entitled to respect, since it gave information of 

the presence of histological elements of a certain kind, 

which justified certain conclusions concerning the nature 

of the disease under investigation. A careful observation 

of all the symptoms and a scrupulous consideration of all 

the conditions bearing on the case constituted the necessary 

and proper preliminary to every diagnosis. 

The post-mortem appearances and their bearings upon 

the symptoms during life were, with a similar object, sub-


jected to careful study. Pathological anatomy acquired an 

unexpected importance in relation to the subject of disease 

; it assumed, as it were, the control of, or became a 

check upon, diagnosis. It developed first under the influence 

of BlCHAT's labours in France: numerous works 

dealt with general and special pathology, for illustrating 

which a considerable mass of facts had been discovered. 

In England, too, under the influence of J. HUNTER'S work, 

and in Germany, distinguished anatomists and clinical 

observers like P. FRANK, A. R. VETTER, J. F MECKEL, 

LOBSTEIN, JOHANNES MOLLER and others directed their 

attention to pathological anatomy. 

The period of this science's prime however began with 

ROKITANSKY who laid under contribution the rich pathological 

material of the General Hospital at Vienna. 

Possessed of opportunities enjoyed by none of his contemporaries 

he was enabled to collect a series of specimens 

illustrating natural and obvious types of pathological changes 

which included nearly all important diseases. While 

ROKITANSKY facilitated the understanding of the subject of 

pathological anatomy he at the same time enlarged its 

boundaries by a number of discoveries and went deeply into 

the investigation of pathogenetic influences. He was not 

contented with asking what pathological processes were, but 

sought also to discover how and why they arose, and to get 

an insight into their cause and development; as WuNDER- 

LICH says, he tried to turn pathological anatomy into 

anatomical pathology. 

Cellular pathology, a system constructed by ViRCHOW 

upon the basis of the cellular theory, impelled men more 

and more to examine minute pathological changes,— 

microscopical elementary forms—and led to the foundation 

of pathological histology. It is true that afterwards by the 

discovery of many new facts some rotten supports of the 

cellular pathology were removed; but the foundations 

remained firm and to this day bear the edifice of pathological 

teaching.


The stability and precision of the science were extraordinarily 

increased by the introduction of experimental 

tests into pathological investigations. CLAUDE BERNARD 

by injuring a particular part of the medulla oblongata produced 

glycosuria. By the administration of phosphorus its 

remarkable effect upon bony tissue was recognized and its 

connection with what is now known as phosphorus-necrosis 

was inferred. 

The methodical employment of experiment constituted a 

great advance in pathology; it decided many weighty 

questions in that science and created " a physiology of man 

in sickness," which in conjunction with pathological 

anatomy laid the foundations of a "biology of disease" 

and proved that the same natural laws prevail both in 

pathology and in the physiology of the healthy organism. 

Pathology has in this way become one of the true natural 

sciences. 

The general processes of disease as well as the conditions, 

present in the special affections of particular organs ; 

were carefully investigated and brought within range of 

scientific observation. CORVISART studied the pathological 

alterations of the heart and great vessels, a subject workedf 

at also by HODGSON, LATHAM, HOPE, STOKES, BOUILLAUD, 

SKODA, TRAUBE and others. Later on, the changes in the* 

blood were brought within the sphere of observation and 

•chlorosis and leukaemia recognized as individual diseases. 

G. L. BAYLE published investigations, which attracted 

attention, upon pulmonary consumption and its relation to 

the appearance of tubercle, and remarked on the similarity 

of this deposit in the different organs. ANDRAL, SCHON- 

LEIN, TROUSSEAU, who published a treatise on laryngeal 

phthisis, and others also studied the same subject, on 

which however no certain conclusion was arrived at until 

the most recent times, when the discovery was made that 

tuberculosis is an infective disease. By his work on the 

inflammations of the mucous membranes BRETONNEAU 

founded the teachings upon diphtheria, the relations of


which to catarrh and to croup were explained by later 

observers. 

The invention of the laryngoscope and its adaptation to 

medical practice brought about a complete revolution in 

laryngological inquiry, and rendered possible greater precision 

in the observation and treatment of diseases of the 

larynx. 

At the same time endoscopy, a method of observation 

previously attempted, led to remarkable results in other 

directions. CRUVEILHIER and ROKITANSKY explained the 

origin and nature of "simple ulcer" of the stomach; 

PETIT, SERRES, P. A. LOUIS, and others established the 

diagnosis of the so-called abdominal typhus or enteric 

fever, and J. R. BlSCHOF observed the intestinal ulcers 

characteristic of that disease. 

The pathology of the liver was advanced chiefly by G. 

BUDD, ANNESLEY, FRERICHS, and others, and that of the 

kidneys by P. RAYER, BRIGHT, and TRAUBE, the last of 

whom drew attention to the interdependence of affections 

of the kidneys and of the heart. ADDISON first described 

the degeneration of the adrenals, and BASEDOW drew a 

picture of the group of symptoms constituting the disease 

named after him. 

Dermatology was scientifically treated by ALIBERT, 

BlETT, WlLLAN, BATEMAN, C. H. FUCHS, ERASMUS 

WILSON, and F HEBRA, and the subject of venereal 

diseases by BAERENSPRUNG, K. W BOECK, RICORD, and 

others, while a scientific foundation was given to the study 

of nervous affections by VALLEIX, DUCHENNE, ABER- 

CROMBIE, ROMBERG, REMAK, and others. 

The treatment of the insane, a subject already for some 

time regarded as a special branch of medicine, was by 

degrees extricated from the chaos of mystical fancies 

which surrounded it, and which led people to regard mental 

diseases as the consequences of sin, or as the punishments 

of God, or, at all events, as purely psychical defects. The 

causes of mental aberration were at last sought for in


corporeal lesions. This path, already trodden by PlNEL, 

ESQUIROL, and CHIARUGI, was afterwards pursued further, 

especially by SPURZHEIM, the disciple of GALL, by REIL, 

FOVILLE, and CALMEIL, who by his work on general 

paralysis initiated observations upon this disease, by the 

two FALRETS, by MOREL, who turned his attention to the 

aetiology of derangements of the intellect, by SCHROEDER 

VAN DER KOLK, GUISLAIN, JACOBI, C. F. NASSE, and 

GRIESINGER. The results of autopsies were next called in 

evidence to establish and furnish strict proof of these 

views. Nevertheless, success was not met with in making 

diagnoses founded upon symptoms tally with the anatomical 

facts observed. Such an attempt could not be expected 

to succeed until the anatomy and physiology of the central 

nervous system had been placed in a clearer light. 

More remarkable than the progress in mental pathology 

was the improvement in the treatment of the insane. What 

a beneficent change has taken place in this since the time 

when, at the command of the philanthropic Emperor JOSEPH 

II., the " mad house" was built in Vienna, and the patients 

there, as at St. Luke's, in London, were exhibited to a 

spectacle-loving populace, were caged up in prison with 

criminals, and punished for their "mad tricks" by 

depriving them of food or by giving them the whip ! It 

was one of the greatest achievements of humanity when 

PlNEL gained his point with those in power during the 

French revolution, and released the insane—those most 

unhappy of men—from chains which had been forged by 

religious prejudice, and secured by the ignorance of the 

doctors. Tender nursing and appropriate medical treatment 

were now extended to those afflicted with insanity ; 

institutions were founded in which they were protected and 

kept under observation. JOHN CONOLLY promulgated the 

system of " no restraint," by which mechanical coercive 

measures were as far as possible banished from the treatment 

of the mentally afflicted, and still further progress 

was made in this direction by the foundation of colonies of


lunatics where, as at Gheel, the patients enjoyed a certain 

amount of freedom combined with careful supervision and 

nursing, and were provided with work suited to their con 

ditions. 

In no department of pathology, however, were the 

changes greater than in that of infectious diseases. New 

forms of disease were now recognized which had previously 

escaped observation, and those affections already on the 

nosological list were more correctly and accurately dis 

tinguished from one another, especially in respect of their 

aetiology. The nature of the infective material of disease, 

its origin within or without the human body, its develop 

ment in different media, its relation to climate, soil, etc., 

the duration of its virulence, and the possibility of its being 

transported from place to place were all subjects carefully 

investigated. 

Asiatic cholera in the 19th century outstepped the limits 

of its native land, and spread itself over the globe. The 

grievous loss of human life which its presence entailed 

rendered it incumbent upon the doctors to examine into 

the causes and real nature of this disease. The remarkable 

relations existing between its origin and extension on the 

one hand, and conditions of the soil on the other, were 

the subject of observation. With the discovery of the 

comma-bacillus, made not long since, it would seem that the 

real and essential cause of the disease has at last been 

found. 

Yellow fever, which had often been brought to Europe, 

was carefully studied, as also were other exotic diseases, 

such as beriberi. 

The appearance of cerebro-spinal meningitis in an 

epidemic form directed public attention to this previously 

unknown disease. 

At the same time enlightened views began to prevail on 

many other diseases. The conception of typhus, a term 

at first chiefly of symptomatological significance and lend 

ing itself to qualification according to the prevailing


phenomena of the disease, under such forms as abdominal 

typhus, brain typhus, pulmonary typhus, and spotted 

typhus, underwent a complete revolution as astiological 

considerations advanced into the foreground. It was 

recognized that three diseases which hitherto had been 

comprised under the name of typhus, namely, exanthematic * 

typhus, abdominal typhus, and recurrent typhus (or 

relapsing fever) are distinct in their origin, in their Jj 

extension, and in their essential nature, so that one never 

arises out of another. 

The exanthematic fevers came also to be more clearly 

understood. The relation of measles, German measles, 

small-pox, and scarlet fever to one another and to other 

affections was closely studied. 

The discovery that cow-pox protects, at least for a considerable 

time, from small-pox led to one of the most 

beneficent discoveries mankind has ever been blessed with. • 

The imperishable merit of this discovery belongs to 

EDWARD JENNER ; its utility can only be doubted by those 

who are ignorant of the history of small-pox. 

The pathology of infectious diseases entered upon a new 

phase when the parasitic character of a number of these 

was recognized. Observations upon certain diseases of 

plants, and upon muscardine, a disease of the silkworm 

caused by a fungus, examination of the itch-mite, of the . 

fungi causing favus, pityriasis versicolor, herpes tonsurans 

and other skin diseases, of the different entozoa of the . 

human body, the discovery of the trichina spiralis and of 

the symptoms produced by it, all led to more attention 

being paid to parasites and lowly organized forms of life 

and to their pathogenic significance being made the subject 

of inquiry. *% 

The experience acquired of pellagra and diseases of that 

kind arising from the consumption of tainted food, as too, 

observations made upon those diseases which are capable 

of being transferred from animals to men had a similar 

effect. When, in the splenic fever of cattle, in relapsing


fever, in pyaemia, puerperal fever, erysipelas, osteomyelitis, 

and many other diseases, microscopical organisms resem 

bling fungi of different kinds were found in the blood and 

in certain secretions or tissues, the idea inevitably suggested 

itself of ascribing the origin and cause of such diseases to 

these bodies. 

The scientific proof that these lowly organized forms do 

actually stand in a causal relation to particular diseases 

was only possible after these organisms had been success- 

fe :. fully isolated by special methods of research, inoculated on 

healthy animals and found to produce the diseases in 

question. These demands have, up to the present, only 

•*• been satisfied in splenic fever, relapsing fever, malignant 

erysipelas, diphtheria, and Asiatic cholera. But a multitude 

of facts and probabilities point to pathogenic bacteria 

being the active cause of the origin and spread of tuber 

culosis, leprosy, typhus and enteric fevers, scarlet fever, 

septicaemia, malarious and many other forms of disease. 

The difficulties encountered in carrying on these 

inquiries experimentally, especially in the choice of an 

animal suitable for inoculation and susceptible to the 

diseases, render it evident that results can only be arrived 

at slowly. The facts hitherto established have given a 

firmer basis to setiology, inasmuch as they have rendered 

manifest the really active causes of the diseases and have 

consequently indicated both to pathology and to thera 

peutics the paths upon which, for the future, they must 

travel. 

Materia medica has during the latter decades changed 

from a study of pharmaceutical wares into a science of 

pharmacodynamics which, being in close association with 

physiology and experimental pathology, is supported by 

clinical experience and experiments on living animals. By 

means of it a bridge may here and there be thrown across 

the deep chasm which divides the theory and the practice 

of medicine. 

During the same period the pharmacopoeia has been 

I I


enriched by the addition of a great number of remedies. 

Chemistry has shown us the way to extract the active 

principles of many vegetable and animal substances so that 

they may be used in therapeutics, while avoiding undesirable 

effects due to the admixture of other bodies with such active 

'principles. A number of alkaloids, especially of narcotic 

drugs, were thus discovered and introduced into medicine, 

for example morphia, in 1804, simultaneously by SERTUR- 

NER and SEGUIN; cantharidine, in 1812, by ROBIQUET; 

strychnine in 1818 and quinine in 1820, by PELLETIER and 

CAVENTON; veratrine, in 1818, by MEISSNER; caffeine, 

in 1820, by RuNGE; solanine, in 1821, by DESFOSSES; 

conine, in 1830, by GEIGER ; atropine, in 1831, by MEIN ; 

'r'aconitia, in 1833, by HESSE; colchicine by GEIGER and 

" : F HESSE; cocaine, in 1859, cumarine, curarine, saponine, 

'.. pantonine, pilocarpine, pepsine, pancreatine, etc. For 

"*" many other remedies such as iodine, discovered, in 1811, by 

• COURTOIS in the waste liquors produced in the manufacture 

of carbonate of soda; bromine discovered by BALARD, in 

^ 1826; iodide of potassium, bromide of potassium, chloro- 

C': form, iodoform, chloral hydrate, salicylic acid, and carbolic 

acid we have to thank the progress made in chemistry, 

whereas others again like kamala, kusso, condurango, etc., 

have been brought to Europe from distant parts of the 

world. Their effects upon the healthy and diseased 

oro-anism have been studied as well as the most suitable 

way of using them. 

In regard to the application of remedies the healing art 

in the nineteenth century has made important progress; 

the introduction of subcutaneous injections by PRAVAZ and 

A. WOOD, of treatment by inhalation, and of pulmonary 

therapeutics with the excellently adapted apparatus which 

supplies the diseased respiratory organs with vapour in 

a more or less concentrated state as required, are real 

advances in the method of exhibiting curative agents. 

The foundation on a scientific basis of balneology, climatology 

in relation to disease and its cure, hydrotherapeutics,

SURGERY AND OPHTHALMOLOGY 483 

electrotherapeutics and the Swedish gymnastic exercises 

are also achievements of our own time. 

SURGERY, OPHTHALMOLOGY, OBSTETRICS AND 

STATE MEDICINE. 

THE startling advance made in pathological anatomy 

the light thrown upon pathological theories, in conjunction 

with the progress made in physics and chemistry exercised: 

a powerful influence upon surgery. The processes of suppuration, 

ulceration, cicatrization and regeneration of tissues 

and other questions of surgical pathology were made subjects 

of precise knowledge by observation and experiment. 

The development and diagnosis of pathological new 

growths occupied in an equal degree the attention of surgeons 

and of pathological anatomists. 

Operative surgery also made important advances. This 

however did not consist so much in the improvement of 

methods of operating or in the invention of new operations 

as in the fact that it came to be understood that the task of 

surgeons is not to remove diseased parts so much as when 

possible and safe to retain them. This idea introduced 

the " conservative" surgery of our day. It could only 

become realized with the help of anaesthetic inhalations, to 

free the patient from pain during the operations and to 

prevent the reaction entailed by it upon the organism 

and by the invention and introduction of the antiseptic 

treatment of wounds by means of which the morbid 

•conditions apt to follow operations were avoided and a 

successful result insured. These two great achievements 

of the healing art of the nineteenth century have completely 

transformed the character of surgery. They have endowed 

the surgeon with.courage and self-confidence ; for he knows 

that the success of his art will no longer be imperilled by 

accidents it is impossible to foresee; and the breast of the 

patient is filled with hope so that he no longer looks upon

484 

' 

••-?c. 

MODERN TIMES. 

the surgeon with fear and horror but regards him rather as 

the dispenser of healing and health. 

Far back in ancient times and in the middle ages, as I 

have mentioned already, narcotic potions, and inhalations 

were employed for the alleviation of pain. The imperfect 

success of this practice and above all the disastrous results 

which ensued make it very probable that but little use was- 

made of such methods. After HUMPHREY DAVY had dis 

covered the stupifying effect of nitrous oxide gas, experi 

ments were made with it which led to its being used during 

operations, especially in the field of dentistry. About the 

same time the-narcotic properties of ether were discovered, 

a substance which was especially submitted to investigation 

and recommended by JACKSON. In 1847 FLOURENS by 

experiments on animals established the fact that chloroform, 

which had been simultaneously discovered by SOUBEIRAN 

and J. LlEBIG, is a more desirable narcotic. SlMPSON, the , 

obstetric physician, soon after introduced it into medical i 

practice. The advantages possessed by this over other 

kindred substances are sufficient to explain the fact of its 

having by degrees superseded them* 

Many other substances have been used for producing 

anaesthesia by inhalation ; chloroform has been associated^ 

with ether or with injections of morphia in order to increase 

or to prolong the narcotic effect, and the production of 

local anaesthesia in those parts of the body about to be 

operated on by means of cold produced by the ether-spray, 

etc., has been recommended. J. CLOCQUET, J. BRAID and,; 

others have attempted to perform surgical operations 

during hypnotic insensibility. The use of anaesthetic 

inhalations rendered the operator free to perform his task 

thoroughly and without hindrance. Difficult, prolonged 

and very painful operations might now be ventured upon 

which before did not admit of being performed. 

To obviate dangerous bleeding at or after operations, 

* O. KAPPELEU in "Deutsche Chirurgie," her. v. BILLROTH U. LUECKK„ 

Stuttgart 1880.—MARION SIMS : The discovery of anaesthesia, Richmond 1877.

SURGERY AND OPHTHALMOLOGY. 485 

besides ligature and other methods previously used, torsion 

again came into vogue. SlMPSON recommended acupres 

sure while other surgeons preferred forcible flexion of the 

limbs, styptics like liquor fern perchloridi, or else cold or 

the cautery in various forms. BRUNNINGHAUSEN sug 

gested the idea of previously rendering the part of the 

body about to be operated on bloodless by means of a 

tightly applied bandage, but it was reserved for a talented 

surgeon of the present day to discover a method of accom 

plishing this end. The galvano-cautery, the credit of the 

introduction of which rests chiefly with MlDDELDORPF,* 

and the method of operating invented by CHASSAIGNAC 

called ecrasement lineaire, both aimed at effecting the 

removal of diseased parts without loss of blood. By the 

first method the layer of charred tissue served at the same 

time as a covering under which the wound produced by 

the operation could cicatrize ; another advantage afforded 

: by it was that it was applicable in very vascular tissues 

and in parts of the body which are not easily accessible 

to the knife or actual cautery. The difficulties which 

present themselves in the removal of extensive morbid 

growths were by this method materially lessened. 

The methods of amputation were but little improved 

except for the introduction of the oval amputation by 

SCOUTETTEN, of the oblique incision by BLASIUS, of the 

elliptical (resembling the last mentioned) by SOUPART, 

and of improvements in the flap operation. But greater 

care was devoted to the after-treatment than formerly. In 

many cases exarticulation was preferred to amputation 

through the bone. The removal of the limb at the hip 

joint was first performed by LARREY. Exarticulation at 

the knee-joint was given a further development by sawing 

off the condyles as recommended by SYME and by the 

attempt to secure a union between the patella, after sawing 

off its articular surface, and the end of the femur. Special 

pains were taken to perfect the exarticulations in the 

* A. TH. MIDDELDORPF : Die Galvanokaustik, Breslau 1854.


tarsus and at the ankle. Besides CHOPART'S method in 

the mid-tarsal joint, the operation at the tarso-metatarsal 

articulation was recommended by LlSFRANC, that immediately 

below the astragalus by TEXTOR, and that at the 

ankle-joint by SYME and PlROGOFF. The conservative 

character of surgery at this period and the anxiety felt 

to retain as much of the body as possible were manifested 

by the increased favour in which resections were held.. 

These operations aimed at a total or partial removal of 

bones and were practised both in the extremities, on the 

spinal column by the removal of a spinous process or a 

transverse process, or of the posterior part of a vertebral 

arch, on the ribs as in empyema, on the pelvis and 

shoulder (especially on the scapula and clavicle) and on 

the upper and lower jaw-bones. 

The operation of resection of the joints reached a high 

degree of perfection. After the first successful attempts 

which had been made in the 18th century upon the 

shoulder and knee they were performed at other joints, for 

instance at the elbow and in the foot first by the elder 

MOREAU, and at the hip by A. WHITE. The numerous 

wars of these latter decades have afforded abundant 

opportunities to practise and improve this method. The 

indications for resection were accurately laid down and 

extended in some directions, for instance in relation to 

orthopaedic requirements. Special modifications of this 

procedure were suited to certain cases as the resection of 

a wedge of bone in club foot, the so-called temporary 

resections in which no permanent removal of bone was contemplated, 

subperiosteal resections, and osteotomies of 

different kinds. 

The treatment of fractures and dislocations was greatly 

improved by the introduction of stiffening bandages which 

keep the limb motionless while the cure is proceeding. 

LARREY for this purpose employed a mixture composed of 

albumen, white lead and spirits of camphor; SEUTIN invented 

the starch bandage in 1834, and VEIEL recom-


mended the glue-bandage. The plaster of Paris bandage 

became the most widely recognized and popular: it had 

been already known for a long time in the East, and at the 

beginning of the 19th century was introduced into Europe 

but did not acquire any great reputation until the plaster- 

bandages invented by MATHYSEN came into use. Besides 

these Tripoli powder, guttapercha, plastic felt and paste 

board, silicate of soda, paraffin and stearin were made use 

of for splints of this kind. The art of constructing suitable 

suspension and extension apparatus and couches for the 

sick was learnt with results favourable to the process of 

recovery. 

When fractures had united in a faulty position the callus 

was divided by breaking or cutting so that union might 

take place afresh. In ununited fracture endeavours were 

made to unite the bones by suturing them or by artificially 

inducing inflammation of the fractured ends and by other 

means. Myotomy and tenotomy for the relief of deformities, 

as for instance in caput obstipum and club foot, were as has 

been mentioned performed in earlier times : but the sub 

cutaneous operation is an invention of the 19th century. 

DELPECH introduced this operation into surgical practice 

and the success obtained in it by DUPUYTREN, DlEFFEN- 

BACH, STROMEYER and others in different affections secured 

for it a permanent place in operative surgery. The cure of 

aneurism was attempted by compression, ligature, galvano- 

puncture and prolonged flexion. 

The subject of hernia was advanced by valuable works 

upon its anatomical relations, upon the causes of strangula 

tion and other matters. In its treatment, after taxis, atten 

tion was directed chiefly to the trusses which were brought 

to great perfection : in the radical cure attempts were made 

to close the outlet by plastic operations—by drawing in 

the scrotal integument or by inducing hypertrophy of the 

tissues artificially. To the methods of lithotomy were 

added the recto-vesical operation designed by L. J. SANSON 

and the sectio vagino-vesicalis recommended by J. CLEMOT.


Great services were rendered to lithotrity by GRU1THUISEN, 

CIVIALE, LEROY D'ETIOLLES, N. HEURTELOUP and others 

by the invention and improvement of instruments. The 

cure of stricture of the urethra was attempted by caustic 

bougies, by gradual or forcible dilatation, or by urethrotomy. 

The removal of a kidney by operation was first accomplished 

by O. SlMON while splenectomy—an operation 

undertaken as early as in the 16th century,—since the time 

of QuiTTENBAUM has been performed in a methodical 

manner, all the.rules of surgical art being observed* The 

long-known operation of gastrotomy led to gastrostomy,— 

to the establishment of an artificial gastric fistula—a 

measure introduced by EGEBERG and SEDILLOT into 

surgical therapeutics. Resection of the stomach or 

oesophagus, and extirpation of the larynx have only been 

ventured upon in our own time. 

Rhinoplastic operations in the 17th and 18th centuries 

had become entirely forgotten. In 1742 the medical 

faculty of Paris declared the accounts left by TAGLIACOZZI 

upon the subject to be purely imaginary, and the operative 

procedure said to have been adopted by him to be impossible. 

Then English journals in 1794 brought the news 

that the art of replacing the loss of a nose by means of a 

plastic operation was practised in India by the natives.f 

European doctors studied the methods of operating in 

use, imitated them, and then tried the old Italian procedure : 

finally they generalized the operation by directing their 

attention to the replacement of the lips and eyelids, to the 

closure of abnormal openings, etc. Through the labours of 

C. F. GRAEFE, DELPECH, DIEFFENBACH, B. LANGENBECK 

and others, plastic operations reached a high degree of perfection. 

The transplantation of pieces of skin to replace a 

loss of substance as after burns, or of periosteum and bone 

for the purpose of making a firm support, and the attempts 

* ADELMANN in the Archiv f. Id in. Chirurgie 1887, Bd. 36, H. 2. 

f E. ZEIS op. cit. S. 208 el seq.


to enclose in a healing wound foreign tissues or substances 

are procedures belonging to the most recent times. 

Transfusion of blood after great haemorrhage was again 

looked upon with favour at the end of the 18th century and 

was made the subject of careful investigation by J. 

BLUNDELL. PREVOST, DUMAS and other physiologists 

who studied the question recommended the transfusion of 

defibrinated blood; PANUM advised that human blood 

alone should be used. The subject of transfusion came to 

be regarded in another light when it was recognized that 

the beneficial effect of the operation does not depend upon 

the increase of blood but to the heightened intravascular 

pressure consequent upon the addition made to the con 

tents of the vessels.* 

The satisfactory results achieved by operative surgery at 

the present day are very largely due to the strictly methodical 

employment of antiseptic measures which in the two last 

decades have received universal recognition.f With this a 

new period began in the history of surgery : how far and 

how deeply to influence that science can scarcely be cal 

culated precisely. 

Special branches of surgery have for the first time met \ 

with a scientific treatment in the 19th century and have 

become separately-taught subjects. 

Thus dentistry was by degrees withdrawn from the 

hands of ignorant barbers and quacks and placed in those 

of doctors who investigated the relation of diseases of the 

teeth to the other diseases of the body and established a 

scientific treatment of the former. 

The diagnosis and treatment of diseases of the ear were 

materially advanced by the improvements in the cathateri- 

zation of the Eustachian tube introduced by A. CLELAND. 

The artificial illumination of the tympanic membrane, the 

* E. v. BERGMANN: Die Schicksale der Transfusion im letzten Decennium 

Berlin 1883. 

f And for which the thanks of mankind at large as well as of the profession 

are due to Sir JOSEPH LISTER, Bart.—E. H. H.


auscultation of the middle ear, and the air-douche constituted 

further steps of progress in this department in the 

establishment of which ITARD, LEON DELEAU, W. R. 

WILDE, J. TOYNBEE, as well as W KRAMER and 

several other German aurists have rendered distinguished 

services. 

Ophthalmology has celebrated great triumphs. A clear 

insight has been gained into the causes and anatomical 

changes of most diseases of the eye, the ophthalmoscope 

has become an aid to diagnosis capable of solving the most 

difficult questions of pathology, and many new methods of 

treatment and operative measures have been added to our 

resources. ADAM SCHMIDT was among the first to draw 

attention to the relations existing between many diseases 

of the eye and diseased conditions of other parts of the 

body: he called eye-disease " the elegant diminishing 

mirror of diseases of the body." The different forms of 

conjunctivitis were accurately defined, and thus the real. 

characteristics of the Ophthalmia AUgyptiaca s. militaris— 

a disease terrifying to the people by its rapid spread and 

malignity—were recognized, iritis and choroiditis were 

studied, and attention was drawn to the increase of intraocular 

pressure which is the real cause of glaucoma and 

for which A. V. GRAEFE recommended iridectomy. In 

opacities of the cornea attempts i were made to graft on. to 

the place from which the cicatricial tissue had been excised 

a piece of glass or part of the cornea of an animal in order 

that thus the rays of light might be able to pass : or else an. 

artificial pupil was formed. BEER successfully avoided the 

evil results of the method of iridectomy introduced by 

WENTZEL, by which affections of the lens or its capsule 

were frequently induced ; this he achieved by ceasing to 

detach the flap of iris -within the anterior chamber (as had 

previously been done) and by introducing the procedure of 

drawing it out of the corneal wound and cutting it off outside 

the eye. This method was afterwards improved and 

is practised to this day, whereas other methods of opera-


tion conceived with the same object in view such as 

iridodialysis have long since vanished from practice. 

In the removal of cataract, the aetiology and anatomical 

seat of which disease were more closely investigated, 

extraction was the method chiefly employed as it appeared 

in most cases to be the best and safest operation : another 

method in use was couching of the affected lens which 

SCARPA combined with discission and which BUCHHORN 

advised should be performed through the cornea. The 

operation of extraction was materially improved by making 

the incision towards the upper part of the cornea, a method 

recommended by F JAGER though perhaps practised pre 

viously by other ophthalmic surgeons and which eventually 

led to linear extraction. The latter operation which had 

been previously practised in certain cases, for instance in 

shrivelled and soft cataracts, was improved and made 

the common property of the profession by A. V. GRAEFE 

who made his incision in the upper part of the cornea 

and performed an iridectomy as part of the same operation. 

Operations on the eye were remarkably facilitated when 

mydriatics came into use. HlMLY drew attention to the 

dilating effect upon the pupil of hyoscyamus and bella 

donna. Other drugs with similar properties were after 

wards discovered ; but the alkaloids and especially atropine 

were chiefly used. 

But there is no doubt that the greatest achievement of 

ophthalmology in the 19th century was the discovery of 

the ophthalmoscope. This instrument assumed a definite 

shape in 1851 though the invention had been led up to by 

researches upon the luminous fundus of the eyes of certain 

animals which were in possession of a tapetum lucidum, by 

observations upon the human retina in cases of absence of the 

iris, and by PURKINJE'S experiments. While HELMHOLTZ, 

the discoverer of the ophthalmoscope, elaborated nay almost 

completely perfected its theory, it was chiefly A. VON 

GRAEFE who recognized and demonstrated its importance

492 

MODERN TIMES. 

for ophthalmic practice. With the help of the ophthalmoscope 

it became possible to examine the state of the refractive 

media and of the fundus oculi. The meaning of 

-amaurosis—which had previously been defined in a jocular 

way as a disease " where the patient cannot see anything 

at all—nor the doctor either" was now rendered more 

intelligible * and the various diseases of the retina could be 

differentiated. When the relation of these to certain 

general diseases, such as BRIGHT'S disease, diabetes mellitus, 

etc., was established, the ophthalmoscope acquired 

importance as an aid to diagnosis in general medicine. 

Midwifery proceeded on its natural course of development, 

and by taking into consideration all the physiological and 

pathological processes which occur in women, became enlarged 

into gynaecology. The opinion came at last to be held 

that pregnancy, parturition, and childbed are physiological 

conditions, the course of which should be left to the management 

of nature, so long as abnormal circumstances do not 

•call for the interference of the doctor. LUKAS BOER, who 

defended these principles, rejected the so-called preliminary 

treatment, which in most cases acted injuriously, and proved 

that presentations of the face, breach, knee, and foot do not 

always require the art of the doctor, but that spontaneous 

birth frequently occurs through the regulative powers of 

nature. 

The clumsy and complicated instruments of an earlier 

day were simplified, and operative midwifery was confined 

to those cases in which it was indispensable. It was discovered 

how to diagnose a contracted pelvis by methodical 

measurements, and how to estimate the influence of changes 

of position and diseases of the uterus upon pregnancy and 

parturition. 

The pathology of the lying-in period was carefully investigated, 

especially in regard to puerperal fever, a disease 

-upon the pathogenesis of which a startling light was thrown 

by the observations of the unfortunate SEMMELWEISS. 

* A. HIRSCH : Geschichte der Augenheilkunde op. cit., S. 474.

SURGERY AND OPHTHALMOLOGY 493 

The diseases of the uterus, the ovaries, and the neighbouring 

parts gave opportunities for operative interference, the 

methods of which were now for the first time to be discovered. 

Extirpation of the uterus in malignant affectionsof 

that organ was already practised by MONTEGGIA, 

OSIANDER, and others, and in modern times the operation, 

has been perfected in points of technical detail. 

The same is true of ovariotomy, which was for the first 

time performed by MACDOWELL in 1809, and since then. 

has been much improved as an operation. The operativetreatment 

of prolapse of the uterus and vagina, as also the 

operation for vesico-vaginal fistula—a condition formerlyconsidered 

incurable—are also achievements of modern 

times, and are chiefly due to the labours of JOBERT DE 

LAMBALLE, MARION SIMS, G. SIMON, and other distin 

guished gynaecologists of our time. 

3 The progress of medicine in the 19th century was not, 

however, confined merely to improved methods of treating 

the individual sufferer, but it brought home to the conscience 

of the public the important relation borne bysanitation 

to the State itself. No doubt this was associated 

with political development, under the influence of which 

the government of the State was reminded of its duty toprotect 

society, and in every citizen s breast the sentiment 

was aroused that he, as a member of the commonwealth, 

had a duty to fulfil towards it, and was interested in its 

welfare. 

And thus forensic medicine, which was established and 

advanced by A. HENKE, MENDE, CHRISTISON, CASPER,. 

ORFILA, TARDIEU, and others, and State medicine, the 

foundation of which was the work of PETER FRANK, were 

added to the list of medical subjects in which instructionwas 

given. What the former became for the Law Courts 

the latter was intended to be for the Government—the 

compendium of all the knowledge required by the medical 

specialist when consulted by the authorities. Sanitary 

control became expanded into hygiene, or care of the public


health, as the opinion gained ground that not the State 

alone, but every individual member of it, is called upon to 

avoid diseases and to assist in the increase and maintenance 

•of sanitation. 

The identity of interests which unites the people and the 

government in questions of hygiene, certainly in a great 

measure affords an explanation of the fact that during the 

last few decades the scientific solution of such problems has 

been prosecuted with extraordinary zeal. The influence of 

nourishment, clothing, dwellings, soil, climate, temperature, 

air, occupation, age, and sex have been carefully investi 

gated.. Researches into the causes of the rise and spread 

of epidemics, studies upon the ways most conducive to 

„ health of laying out graveyards and constructing hospitals,- 

.factories, and buildings of all kinds, the supervision of 

prostitution, etc., formed other subjects for the public 

hygienist to consider. 

Much assistance in answering these questions was 

afforded, firstly by the history of medicine, which reported 

upon the course taken by the great pestilences which swept 

through countries in times past and upon the result of 

measures adopted to control them ; secondly, by medical 

geography, which showed that many diseases occur only, or 

•at least chiefly, in certain localities, and which essayed to 

explain this fact : and thirdly, by medical statistics which 

attempted to sift the accumulated material by the help of 

numerical methods, and to draw conclusions from the results 

obtained. Chemistry, the use of the microscope, and'the 

practice of experiment were all resorted to in research, and 

valuable information was certainly gained. Meanwhile 

bacteriology directed attention to the material causes of 

disease. 

The • results achieved by hygiene through these means 

during the last few years and the expectations which are 

fostered of further manifestations of its power in the future 

have created for it in a short time a prominent position 

among the various branches of medical science. The task 

of warding off diseases appears as great and as beneficent

MEDICAL TEACHING AT THE PRESENT TIME. 495 

as that of curing them, and public medicine and private 

medicine occupy equally honourable positions. The governments, 

in organizing sanitary administration, in appointing 

boards of health, and in providing for medical supervision 

in certain cases, bear testimony to their recognition of 

the truth of this fact and of its continually increasing 

significance, and the prophecy of Mr. GLADSTONE that the 

doctors are to be the leaders of the people is approaching 

its fulfilment.* 

MEDICAL TEACHING AT THE PRESENT TIME. 

THE changes and improvements in medical teaching during 

the last hundred years are not less important than the ,. 

results which have been achieved in the prosecution of' the " 

study of medical science. When we contemplate the institutions 

and medical schools of our own time richly provided 

as they are with every kind of appliance to facilitate 

teaching, with departments excellently arranged for the 

study of normal and pathological anatomy and physiology, 

and provided with the necessary apparatus and instruments ; 

their laboratories for physics, chemistry and hygiene ; their 

well stocked museums and numerous departments for 

clinical teaching ; when we look at all these and draw a 

comparison with the inadequate beginnings which were 

made in.; such things in the last century we recognize at 

once,how much has been done since then. 

At* the present time the above arrangements are 

* Wishing to get a corroboration of this rather sweeping prediction at first 

hand, I ventured to trouble Mr. GLADSTONE with a letter asking him if he could 

confirm it. I quoted to him the above passage as it stands in the German text. 

Mr. GLADSTONE honoured me with a reply as follows :—" So far as regards the " 

" exact words cited in your letter I cannot positively say Aye or No, and I" 

'rather think that I should in using them have added some qualifying or " 

" limiting expressions. But it is certainly the fact that, for a very long time " 

:

"advance from the progress of its science—this it may be said is,mere" 

;< commonplace—and of relative advance from the particular features attaching " 

'to our civilization in its onward movement."—E. H. H.


1 **&%, 

considered indispensable for teaching medical students, 

whereas then at most academies they were entirely absent . 

or at least but ve.ry poorly represented, and scarcely ever 

to be found in anything like the completeness of to-day,. 

The method of teaching has consequently assumed another 

form: practical demonstrations became by degrees of 

supreme importance in medical teaching, indeed together 

with the necessary explanations, constituted the whole of 

it/while theoretical lectures were pressed into the back- , 

ground and by degrees nearly abandoned. The comprehen- , 

siOn of scientific facts and theories is thus extraordinarily 

facilitated: for what the senses*take in is impressed not ,. 

merely upon the memory but also on the understanding. 

It now came about that a division of labour wal intro- \ 

duced throughout the teaching Of medicine and assumed a 

definite form. It was arranged' that the-lecturer should 

which he 

concern himself exclusively^tirthe ^"MgSL' 

represented "and might thns^be^ able to attain to the ability 

and- certainty, of jLjeuûasaJau it. The perfecting of 

medical teaching by the establishment of new professorships 

demanded by the development of medical science, 

its advance in the direction of specialization, and the introduction 

and improvement of examinations intended to afford. 

aguarantee that young medical men had acquired the knowledge 

necessary for their calling, constituted further additions 

made to medical education during this period. 

It is true that the progress on this path differed widely 

in different countries. The condition of general culture,. 

the state of medical science in particular, the social stand- 

, ing of doctors, historical traditions, and above- all the^ 

attitude of the State towards the subject of public instruction, 

exerted an influence quite opposed to uniformity in 

this matter., ?*5| 

Amongst rude savages, Caffres, Red Indians, native/" 

Brazilians,.etc, medicine-men and magicians are labouring* 

to this day to drive away, diseases by means of prayers and* 

incantations, and medical knowledge but seldom gets.

% 

MEDICAL TEACHING AT THE, PRESENT TIME. 497 

beyond the recognition of the ..healing 4 powers of certain 

herbs and roots.* 

Even amongst civilized people very different conditions 

prevail in regard to medical science. The native doctors 

in the "countries of Islam practise still for the most part 

upon the same principles which were propounded by the 

representatives of Arabian medicine in the middle ages 

and the Chinese doctors still believe in the untenable 

speculations which have received acceptance in their 

( country, for thousands of years.t Yet contact with 

European medicine and the recognition of its advantages 

have led to attempts being made to introduce it into these 

lands. At. Constantinople and Cairo medical schools have 

been- founded in which European and, by preference, 

- French and German- doctors have been installed as 

teachers. Th> reform was set in progress in Japan in a 

much more thorough way and as it appears with greater 

results, there, during the last few years numerous schools of 

medicine have arisen, organized entirely after the European 

2 " d p ;°;t 

d for the n,ost part with a 

5 1 " CUltUre gives W *y before the higher 

which everywhere presses forward victoriously and makes 

mankind happy with the blessings* it brings 

In civilized countries the general and special education 

or the various callings has come to. acquire a certain 

similarity, a fact explained by the easy and rapid way in 

which literature serves to transmit advances and achievements 

made in the domain of the intellect. Medical ) 

science exhibits the same phenomenon and the educated [ 

0, 4 9- iv, 473.. Vj 2, I49J et 

BAT,,,: Der Mensch in der Geschichte, Uip2is ,„& {],6 „*£ »"-*• 

T r. UABRY: La medecine chez les Chinois Paris i8fi3 n 1 M 

m the Med. Rep. Shanghai ,882, No. M. ' 63 '~ D ' J " M A C < % 

• S. 64 rt 4. N °'= r -- H - G ^«KH in the Breslauer arztl. Zeitschr. iv, 

K K

49§ 

MODERN TIMES. 

doctor in France professes the .same doctrines as his 

colleague in Germany, Austria, Italy and other couri nes. 

The science of medicine is the same in all civiiizea 

coLtries C but the amount of knowledge>*£^J£ 

representatives in particular states is *ff££ju£ the 

external forms which are associated with the teaching ot 

external iui rprtain places, for instance in 

students are manifold. In certain piac , 

America and England, the arrangement still ex.ts o 

doctors taking pupils and framing them up Ike handi 

craftsmen to become masters in their art;* but as a general 

r f medical knowledge is acquired at s c ^ ^ 

attainment is made the exclusive task * £ ^ j g * 

as medical faculties, joined with schools of other subjects 

and made universities or else lead an » ^ » ^ r ^ * 

These schools are in many countries conducted or at 

these sc Qthers th take up 

least supervised by the State w self_admimstered 

IffeXeTt tL organization of medical teachm ave 

been of great importance in its development as a review 

of the exiting conditions in the different countries shows us 

The tat of Lirs which has, in this respect, come to exist 

among the English, French and Germans will deservedly 

cairn our most careful attention, for it shows us ypes of 

the various forms exhibited by systems of medical edu a 

tion while the medical teaching of other nations cannot fail 

to have been powerfully influenced thereby. 

ENGLAND.-NORTH AMERICA. 

THE customs of the middle ages in regard to medical 

teaching have been preserved longest in England.t Here. 

* This, however, may be said to be exceptional at the present day in England,, 

_ t"",; "PUSCIMA.N : Das medicinische Unterrichtswesen in England in th. 

Be J d All* Zeitung, Miinchen ,886, No. 7-9.. This essay which I wr e 

!ntr the" fresh impression of personal observation formed a preparation for 

the present work.

ENGLAND.—NORTH AMERICA. 499 

At rt.ll happens, though far less frequently than it did 

formerly, that students of medicine begin their studies by 

wth himf PUP ' d0Ct ° r ^ PraCtice * th V "main 

of whir n " year '; n ° rder '° get Some " ' Wea 

of what mil some day be required of them* In a 

method such as this much naturally depends upon the 

.nd.v.duahty of the pupil and nearly everything upon he 

personal quaht.es of the teacher. If tL pupif is in 

dustnous and intelligent and if the teacher has patience 

knowledge, and a pleasure in his work, then this y'ea i to 

the former one of incalculable advantage for his later 

*.ud,es ; otherwise it is lost time and serves at mo to 

prov.de h.m with mechanical habits which sometL s 

approach charlatanism. "crimes 

the same occurs when the first year is nassed in =. 

osp.ta as is often the case. The "stude ts" th k "ha 

there at least they will have opportunities of observing 

, man ^ ^ hope fo ^ . ^ sen, „g 

r .dent doctors upon the most important cases. If they 

-e not d.sappo.nted in their expectations they n.ay indeed 

«,«.«. certa.n dexterity in their intercourse with pat e„,T 

wh.ch ,s very useful^ to them in their later clinica and 

profess.onal work. But for many other reasons th 

-nner of being i„troduced to Jedicalstu" on 

wh,ch must raise grave doubts as to its prop iety It 

tends to make the student a superficial observe for 

h^r^\FF:tFFFF 

'ess can they justify the inconveniences to which 11 ' 

pafents who are under treatment are subjectedI In 

iTîztr-^ in a raedi - ^ 

preferred to tins grop.ng ,„ the dark. On this account

MODERN TIMES. 

it has become more and more usual for students to betake 

LteLs at once to a medica, school o.- » ^ * - 

0j h 0I rtt ?X^ **« T; 

mediZ As the demands made >^« J 

raffia Sft^ h r- 

hat men of the required ability were appointed to teach. 

TLtT entered the" universities, for these up to quite* 

^tl^Twere destitute of the arrangements required 

for the prosecution of medica, s ud, , The ^ Engl^ 

universities were r % ^hmg more t^ ^ ^ ^ 

on an extendedI scale as d ^ M tQ ^ 

taction was not to educate OB ^ ^ . ^ . 

nnt rlnrtors or men ot science, uuu ^ 

W mathematical studies together with logic and moral, 

and mathemat ^ t

ENGLAND.—NORTH AMERICA. 

501 

where such was obtained : it permitted everyone to practise 

medicine and left it to the public to distinguish the good 

practitioners from the bad. Under these circumstances 

success naturally became the final court of appeal. The 

•quacks mistrusting a judgment which offered them so little 

security, endeavoured by means of testimonials, in which 

•their medical studies and their professional ability were set 

forth, to court the popular favour. Various doctors' guilds 

and medical schools were prepared to give such testimonials 

upon payment of fees, and held examinations, which, 

however, were neither arranged on any uniform plan nor 

supervised by any central authority, and consequently 

gave no guarantee .whatever of the training of the medical 

practitioner. Many got diplomas in foreign countries or 

endeavoured to procure them by illegal methods; the Arch 

bishop of Canterbury had * also the right of conferring the 

degree of Doctor of Medicine. It went so far at last that 

it was sufficient for anyone to.be recognized as a doctor 

if he were presented as such to the authorities bv two 

members of a medical guild. 

Such a state of things must have resulted in serious dis 

advantages to the patients upon whom these practitioners 

were "let loose." The imperturbable equanimity of the 

English people was at length shaken, and Parliament was 

induced to find a remedy. The result of its deliberations 

was the Medical Act of 1858, in which it was accurately 

defined what Corporations should thenceforth have the 

right to hold examinations and grant certificates which 

should be recognized as valid. These examinations were 

rendered subject to the supervision of the General Council 

of Medical Education and Registration of the United King 

dom, which body has to take care that the examinations 

are conformable to the end in view. Should this not be 

the case in any particular instance the General Council 

has authority to order a change of examiners, or, if the 

cause of complaint is not removed, to take away the 

: this is still a prerogative of the See of Canterbury.—E. H. H.

502 

MODERN TIMES. 

privilege of.'holding examinations from the Corporation in *. 

question. , , • • * . 

The names of persons who have proved their capacity 

for medical practice before a corporate body entitled to j>. 

hold examinations are entered in a Register kept by the 

General Council and published for general informationonly 

legally qualified and registered medical practitioners • 

are entitled to sue for fees in a court of justice or to hold 

official appointments. The General Council, upon which 

other duties connected with the polity of the medical profession 

also devolve, consists now of* 30 members 20 

elected by the various examining bodies, 5 nominated by 

the Crown, and 5 direct representatives of the profession. 

The President is chosen by the Council. 

By the Medical Act of 1858 a secure foundation was 

laid for the further development of systematic medical 

education in England and at least the grossest abuses were 

abolished. Proposals for reform were evoked by the 

defects in the system thus shown to exist; proposals, however, 

which were either not at all or but partially carried 

out In 1881 a commission of experts was appointed to 

consider the question of medical education. On this 

occasion distinct expression was given to the need oU 

general scientific preliminary training for medical students 

the introduction of State examinations was mooted and it 

was demanded that only diplomas testifying to the ability 

of the holders to practise all branches of medicine, and 

not merely special branches, should be granted. But the 

majority opposed these suggestions and rejected most 

resolutely the idea of absolute uniformity in medical education, 

considering it to be an especial advantage of the 

English system that within certain limits it allowed freedom 

of movement and by the number of the schools produced 

a natural diversity of training.f 

* By the Medical Act, 1886.—E. H. H. 

f Report of the Royal Commissioners appointed to inquire into the Medical 

Acts, presented to both Houses of Parliament (Parliamentary Papers for 1882,

ENGLAND,—NORTH AMERICA. !•» c0 

At the present time, students of medicine, get their 

technical education chiefly at the medical schools, and 

universities. Of the former there is no scarcity : twelve 

exist in London alone. They are connected with hospitals 

and are commonly named after them. 

The oldest school is that of St. Bartholomew's Hospital, 

the eventful history of which is closely bound up with the 

development of medicine in England. The existence of 

this institution for the sick dates from 1164 and the 

earliest records of medical teaching held there, from 1662. 

To its staff belonged WILLIAM HARVEY, the discoverer of 

the circulation of the blood, and at a later period the surgeons 

PERCIVAL POTT and ABERNETHY* 

St. Thomas' Hospital was founded in the 13th century; 

with it too a school is connected : in the records of this 

institution an apprentice is mentioned as early as in the 

year 1551. The present buildings were opened for use in 

1871 and by their very convenient arrangements excited 

the admiration of experts. 

So too St. George's, the Middlesex, the London, Charing 

Cross, Westminster, St. Mary's, and Guy's are hospitals 

used for medical teaching and have medical schools 

attached.f 

King's College and University College (not identical 

with London University) are also connected with hospitals; 

but they differ from the other medical schools in not being 

isolated from, but in organic connection with, faculties of 

vi '$ 

Vol. 29). « It would be a mistake to introduce absolute uniformity into medical 

education. One great merit of the present system, so far as teaching is concerned, 

lies in the elasticity which is produced by the variety and the numbers of 

educating bodies." 

* N MOORE in St. Bartholomew's Hospital Rep., Lond. 1882, xviii, p. 333. 

1846 DELAM0TTE: The R ^ al Hos P ltal °f St- Bartholomew, London 

t Bi». GOLDING: Historical account of St. Thomas' Hospital, London 

S^wT. 5 S ° N: The HiSt ° ry ° f thC MiddleseX Hos P ital > London 

»4?.-W. E. PAGE: St. George's Hospital, London 1866.-B. GOLDING • The 

°ng.n, plan and operations of the Charing Cross Hospital, London ,867.

5°4 

MODERN TIMES. 

law, arts and science, with technical institutions and other 

establishments. 

There exists also in London a medical school for women 

who intend devoting themselves to the profession 

In other towns of the United Kingdom medical schools 

are to be found, as at Birmingham, Bristol, Leeds, Liver 

pool, Sheffield; Dublin, Belfast, Cork, Gal way .Edinburgh, 

Glasgow, etc. ; there are also schools which offer instruc 

tion in certain departments but not a complete medical, 

education ; such are the West London Hospital Preparatory 

School and COOKE'S School of Anatomy. 

In the British colonies, Canada, and . British India a 

number of medical schools are also to be found arranged 

after the English pattern : there is a similar establishment 

at Valetta in the island of Malta.* 

The medical schools of England, like the hospitals to 

which they are attached, are as a rule private undertakings. 

The State neither pays for their maintenance nor gives any 

contribution towards it; as little does it exert any influence 

on their organization and administration or upon the educa- ( 

tion given at them. Consequently attendance at these schools 

by no means confers the right to practise. Their teaching 

staffs have no authority to hold examinations the passing 

of which confers any public rights, but are compelled to 

refer their pupils to the medical corporations and examining 

bodies for this purpose, the certificates and diplomas of 

which constitute the license to practise. The private 

character of the medical schools is manifested in their 

arrangements, in the way in which they are equipped with, 

appliances for teaching according to the taste and choice - 

of the teachers, and in other ways. The decision in these 

matters rests with the Governors who exercise a super 

vision over the affairs of the hospital. With them lies the 

duty of appointing the medical and teaching staff. As 

these Governors consist chiefly of laymen and have among 

* H. B. HARDWICKE: Medical education and practice in all parts of the 

world, London 1880.


505 

them no experts or next to none, there is imminent danger 

Qf patronage and favouritism being shown in filling up 

appointments, the more so that this is not, as in Germany 

and Austria, based upon distinguished scientific services 

rendered by the candidates or, as in other lands, the result 

of competition. 

The salaries of the teachers are derived from revenue 

brought in by the fees charged at the medical school: only 

in special cases, where this, on account of the small number 

•of students, is too little, or when it is considered worth 

while to secure a celebrated teacher, do the Governors 

make an extraordinary vote for this purpose. The tuition 

fees are consequently pretty high. Thus at St. Bartho 

lomew's 9 guineas are demanded for a course of physio- 

^°gy>Pj guineas for materia medica, 4 guineas for botany 

or forensic medicine; at St. Thomas' Hospital 4 guineas 

are paid for a three months' course of dissecting: but it is 

exceptional for a student to take out a card in only one 

subject. As a rule he joins all the lectures and demonstra 

tions in the order laid down in the curriculum of the school 

he is attending and pays a composition-fee smaller or 

greater according to whether it is paid at once or by 

instalments, but which is approximately within the limits of 

£95 and £13° for the whole period of studentship. Special 

charges are often made in addition for the use of instruments, 

for "parts ; ' for dissection, etc. 

The extent to which the different schools are provided with 

conveniences for teaching is by no means uniform. Many 

have lofty and well-ventilated lecture-theatres, convenient 

dissecting-rooms, well-arranged physiological and chemical 

laboratories, natural history collections, anatomical and 

pathological museums, libraries, and all kinds of con 

veniences for clinical teaching. Others are but poorly 

provided, and have less to offer in this respect than the 

smallest medical faculty in Germany. As a general rule, 

the departments for preparatory and preliminary studies 

are less complete than those which are more immediately

5° 6 MODERN TIMES. 

connected with medical and surgical practice. The utilitarian 

spirit which animates the English people is, perhaps, 

nowhere so plainly expressed as in those establishments 

which aim purely and simply at preparing men for medical 

examinations. They resemble the institutions in Germany 

which make it their business to provide the general education 

demanded of candidates for commissions in the shortest 

possible time, and which are known under the name of 

Fahnrichspressen (cramming-places for ensigns). 

On the other hand, the English universities look upon it 

as their highest task to call into existence and to nurture 

the taste for scientific pursuits. Whoever studies medicine 

in one of them has in view a thorough and profound education 

in the preliminary subjects of the natural sciences, and contemplates 

taking academical degrees. But it costs a man 

much more to maintain himself at the university than it 

does at a medical school, and by studying at the university 

the total period of student-life is prolonged, and much 

expense is incurred in consequence of associating with 

rich young men and participating in the amusements in 

vogue. The doctors who have resided at the university 

and have proceeded to degrees belong by their learning 

and their social position to the elite of the profession. 

The English universities are no more State institutions 

than are the medical schools. Their expenses are met by 

the academical fees paid by the students, and by the income 

derived from their rich estates. They are administered 

and governed by senates composed of public men in a 

distinguished position of life, and of academical professors. 

Unlike those of the rest of Europe, the English Universities 

are institutions not devoted merely to teaching, but 

to general training also. Affiliated to them are numerous 

colleges and halls—establishments suggestive of monasteries 

—where the students live together and are boarded and 

assisted in their studies. Oxford possesses 25, Cambridge 

20 of these institutions. Some of them in their origin, 

reach back into the middle ages. They owe their founda-

ENGLAND,—NORTH AMERICA. 5°7 

tion to pious bequests and donations, and are richly pro 

vided with pecuniary means. Unfortunately these are not 

always expended in a suitable or proper* way. Instead of 

serving to advance science and to support poor students, 

their chief function is to provide profitable sinecures for the 

Master and Fellows—that is to say, the head and officials of 

the colleges. If these positions were granted exclusively to 

persons who devoted their lives to scientific research, and 

whose efforts in this direction were rich in results, large 

salaries might, perhaps, be justifiable; but all that is 

demanded of the candidates for a fellowship is that they 

must possess an academical degree. Favouritism gives the 

casting vote in the election to these appointments; that 

the clergy should get the lion's share is consonant with the 

conditions of English life, which bestow upon the cleric of 

the State Church a social power like that which the 

Catholic priesthood in the Tyrol is vainly attempting to 

usurp. A member of the Senate of the University of 

Cambridge complained publicly that the places of authority 

in the colleges there were held by clergymen, and that the 

fellowships were given away to people who achieve nothing 

whatever for science, the university, or their colleges* E. 

RENAN says that a small German university, with its 

awkward professors and its starving private teachers, does 

more for science than all the pomp and wealth of Oxford. 

Most of the colleges at Oxford and Cambridge are 

ancient buildings and well worth seeing on account of 

their architecture and their artistic monuments. With 

their towers and archways, their chapels, colonnades and 

butteries they call back times long passed away; but the 

spirit which animates these establishments is that of 

scholasticism. Although it was a British monk who in the 

13th century directed the first powerful assault upon this 

system it is nevertheless precisely in his native land that 

the method of contemplating nature characteristic of the 

middle ages has been preserved to this day. Theological 

* A few brief remarks on Cambridge University, London 1870.

^08 MODERN TIMES. 

dogma dominates the educational system and the whole 

intellectual life of the English people and has impressed 

upon them a stamp of piety which suits but badly their 

freethought in politics and their restless grasping at earthly 

possessions. The theological character is impressed even 

upon the external appearance, of the professors and 

students : seeing them as they pass by in their long 

black gowns and biretta-like caps one would almost 

imagine oneself transported back to the days when monks 

conducted the education of youths. 

The students are kept subject to strict discipline. They 

are not treated like young men ripe for a certain amount 

of freedom and independence but like pupils in need of 

continual supervision. Among the students are to be 

found persons of various ages but as a general rule the 

16th year constitutes the minimum limit* They differ no 

less in respect of their knowledge ; while many have hardly 

surmounted the. elementary stages of a general education, 

others have by their scientific work already attracted the 

attention of specialists. 

The number of professors is proportionately small, reaching 

at Oxford 55, at Cambridge only 40 in all the faculties 

together. But there are in addition numerous readers or 

lecturers and tutors who work in the university or in the 

separate colleges, give lectures, hold classes, or impart 

private instruction. At some universities, as members of 

them assert, teaching lies chiefly in the hands of these 

persons : probably however only in the departments belonging 

to general education ; in medicine and the natural 

sciences this can hardly be the case. Medical science 

however is but partially represented at the English universities, 

f But a short while ago there were in hardly any, 

more than one or two medical professors ; only in the most 

recent times have they been increased in number. And 

* The 18th and 19th are the usual years for matriculation.—E. H. H. 

+ There is no doubt that the Medical School of Cambridge is now a great 

institution and one of which any country might be proud.—E. H. H.

'ENGLAND.—NORTH AMERICA. 509 

even by these theoretical teaching, especially of anatomy 

and physiology, was attended to more than anything else. 

The completion of professional training is effected by 

practical instruction in the healing art given in the medical 

schools situated at the same place or in the near neighbourhood, 

and either incorporated with the university or 

at least in relation to it. An opportunity for this 

practical training is afforded at Cambridge by Addenbroke's 

Hospital, in Oxford by the Radcliffe Infirmary,* at 

Durham by the Medical School of Newcastle-upon-Tyne, 

while at Manchester Owen's College forms a part of the 

university founded there in 1880. The University of 

Dublin (Trinity College) which has existed since 1591, 

and the Royal University of Ireland, which since 1880 has 

taken the place of the Queen's University, are associated 

in a similar way with the medical schools and hospitals in 

their vicinity. 

The connection between the medical faculties and the 

universities in Scotland is of a closer nature. The oldest 

universities of that country at St. Andrew's, Glasgow and 

Aberdeen arose under the influence of the Catholic clergy, 

and were governed by them : at St. Andrew's alone there 

existed a medical school. 

The University of Edinburgh began as a college and, as 

the educational establishment of the city, grew in importance 

and developed after the pattern of the Academy of 

Geneva.f When the medical corporation of the town laid 

out a botanical garden and gave instruction in medicine 

the obvious course was to associate such teaching with the 

college itself. Subsequently the town council of Edinburgh 

in 1685 appointed three professors of medicine:. 

they were doctors of the city, and lecture rooms were 

placed at their disposal but no salaries were given them. 

Amongst the first who taught there was ARCHIBALD PlT- 

* Oxford and Cambridge men generally attach themselves to London 

Hospitals for practical work.—E. H. H. 

t A. GRANT : The story of the University of Edinburgh, London 1884.


CAIRN. In 1770 there existed already in the medical 

faculty chairs of anatomy, the " institutes of medicine," 

the practice of medicine, midwifery, chemistry, 

botany, materia medica and natural history, as also a 

department for teaching anatomy, a botanical garden, a 

chemical laboratory and a clinic. In 1802 a surgical, 

and in 1825 an obstetric clinic were opened. In 1816 a 

proposal was made by the town council to appoint a 

professor of comparative anatomy and veterinary surgery ; 

but this was opposed by the academical senate. In the 

course of the 19th century the establishments required to 

satisfy the needs of medical teaching have been provided, 

as they have also at Glasgow and the other two universities. 

Besides the medical faculties there are in Edinburgh and 

Glasgow other special schools of medicine independent of 

the university. 

The University of London is no university at all, but an 

institution at which examinations are held and academical 

degrees obtained. 

The schools in the trans-oceanic countries under British 

rule are organized after the English model. 

Whoever devotes himself to the study of medicine has to 

give a proof that he has received a general education of 

a certain kind. If he is a university man the matriculation 

examination* suffices for this; if he first attends a ' 

medical school he has to pass the examination of one of 

the numerous bodies commissioned for this purpose, and 

which are competent to give certificates recognized as 

sufficient. These do not by any means require an equal 

degree of knowledge, but a general scheme of subjects 

lies at the root of all, though the severity of the test varies 

in degree at different places. 

The programme of the London University permits us to 

form an opinion of the amount of knowledge required, and 

* i.e., at the University of London. Oxford and Cambridge men generally 

take the B.A. degree before attaching themselves to London medical schools.— 

E. H. H.


this may be taken as the maximum of knowledge demanded 

from the examinees* The subjects taken up are as follows 

:—i. Latin. 2. One of the following languages at the 

candidate's choice: Greek, French, German, Arabic, or 

Sanscrit. 3. The English language, history, and modern 

geography. 4. Mathematics. 5. Natural philosophy 

(physics). 6. Chemistry of the non-metals and botany. In 

the Latin examination passages of C^SAR de bello Gallico, 

of SALLUST, of CICERO'S easier orations, of LIVY, OVID, 

VIRGIL, and HORACE have to be translated into English ; 

in Greek, XENOPHON, HOMER, and EURIPIDES are the 

authors set, and questions are added upon the grammar and 

upon ancient history. The authors and the particular parts 

of their writings destined to form the subjects of each 

examination are, however, published a year and a half in 

advance, so that the candidates may be in a better position 

to get "coached" in them. Similar arrangements are 

made with regard to examinations in other languages. 

The mathematical examination includes decimal fractions, 

extraction of square roots, and simple equations, and in 

geometry the earlier books of EUCLID. The knowledge of 

physics required is of an altogether elementary character, 

being confined to the simple laws and facts of mechanics,' 

hydrostatics, pneumatics, heat, and optics, with the apparatus 

and instruments necessary to display them. In the 

chemical examination it is required that the candidate shall 

be acquainted with the most important elements and their 

properties, the commoner chemical processes, and the composition 

of water, air, and of certain bodies of frequent 

occurrence. 

This is essentially the amount of knowledge which in 

England forms the foundation of professional study. Even 

this is, however, encroached upon in many places by the 

examination in some subjects—languages, for instance (excepting 

Latin and English), and also physics and chemistry 

—not being compulsory, but at the will and pleasure of the 

* Calendar of the University of London 188.-5, P- 53 et seq.

CI 2 MODERN TIMES. .« ' 

.** •* i' 

^candidates, and consequently for the most part falling ;< 

through altogether. 

If the general education of the English students is" 

-•inferior to that of the German, the English training has in * ; 

.another respect a great advantage over theirs, inasmuch as , 

the development of the body has its, full importance 

assigned to it in England. The English schools are not ; 

only careful for the education of the intellectual powers of m 

their students, but attend also to the deve^pment of their 

bodies in health and strength. The yOung men spend, a 

large portion of-every day in the parks and gardens sur- i 

rounding many of the colleges. Bodily exercises of all 

kinds, cricket and football, wrestling, gymnastics, riding,' 

swimming, rowing, etc., preserve their health and strengthen 

.their bodily powers. As a result of this the English students 

'appear, as a general rule, fresher, healthier, and stronger 

than their German brethren, who, after having been obliged 

to sit on school forms at the gymnasium for 32 hours in the 

week, and having been plagued for the rest of their time 

with school tasks and private lessons,, come to the unfver- i 

sity tired and weary, and suffering frequently from short 

sightedness, weakness of the chest, and other affections. , 

The curriculum of medical studies upon which the pro 

fessional education of most English doctors proceeds, 

exhibits many differences at the different seats of training, 

but shows in every case a marked preference for the so- 

called practical subjects. ( Leaving certain universities 

out of the question, a relatively small amount of time 

and labour is given to the, preliminary and* theoretical 

sciences ancillary to medicine. The extensive subject 

of physiology -which at" the_ German universities oc 

cupies six hours a week throughout a whole year is 

got through in 3-4 lectures a week during six months 

by, the medical schools, of England.* Practical work in 

* But in addition to the lectures on physiology which * the student has to 

attend during two winter sessions there are also physiological- demonstrations, 

and a course of practical physiology in the summer session : so the subject is 

really dealt-with in a satisfactory manner..—E. H. H.


anatomy or dissection is carried on only to a limited 

extent, as subjects can only be bought at a high price.* 

The_ dealers who used to undertake to supply them 

had in former times recourse occasionally to the practice •*• 

common' in the middle ages of stealing corpses from the 

'churchyard : some of these resurrection-men even perpetrated 

crimes, when there was a scarcity of subjects, by 

compassing the death of people and selling their bodies to 

the dissecting-room. The trial of the murderers BURKE 

and HARE at Edinburgh, in which the anatomist ROBERT 

•KNOX was involved, brought some horrible details to 

light, f It was not till 1832 that the practice of anatomical 

dissection in England was made subject to legal rules 

and the conditions defined under which it was to be 

carried on. 

The study of preparations in spirit and of wax models supplements 

actual dissection. Instruction in the theoretical 

sciences is limited to the elementary principles and most 

important' facts, especially in respect of their significance 

and use in professional practice. This keen sense of the 

practical applicability of acquired knowledge pervades the 

entire system of teaching at the medical schools. The 

teachers become reconciled to this demand for utilitarian 

science and in their lectures always give a prominent place 

to the relations borne bythe subject to points of practice ; 

by this they succeed in arousing and keeping engaged the 

attention of the students. In England the medical student 

.from the first day of his studentship is accustomed to 

regard medical practice as the goal which is set before 

him. Frequently during his first session he attends the 

visits to the wards made by the doctors in the hospital. 

The latter sessions are entirely devoted to clinical studies, 

the students serving in the wards and the different depart- 

* The supply, though not so abundant as on the Continent, is adequate.— 

E. H.H. 

t H. LONSDALE:, A Sketch of the Life and Writings of ROBERT KNOX, the 

anatomist,, London 1870. i{~ 

*®***?L%L


ments of the hospital or attending cases in the neighbourhood, 

writing diet-sheets and pr-es-criptions, keeping casebooks, 

performing surgical dressings, helping at operations, 

etc. When they are engaged on the surgical side of the 

hospital they are called " dressers," when on the medical, 

'•' clinical clerks." Whoever is unable to get an appointment 

of this kind at the hospital adjoining his medical 

school, has an opportunity of finding what he wants at 

one of the numerous large country hospitals. Students 

are only compelled to remain for 2\ years at the medical 

school; during the rest of the period of studentship they 

are at liberty to work at a hospital in the way mentioned. 

According to the Medical Act of 1858, 19 corporations 

and societies had the right to hold examinations and to 

grant permission to practise. These were the Societies 

of Physicians, Surgeons, and Apothecaries in London, 

Edinburgh, Glasgow and Dublin, and the medical faculties 

of the universities. The scientific and financial demands 

imposed upon candidates by these bodies differ as much as 

do the titles and degrees conferred. How this comes 

about may be rendered clear by the following examples. 

The two highest professional Societies of London, the 

Royal College of Physicians and the Royal College of 

Surgeons have agreed to hold conjoint examinations, after 

the satisfactory passing of which the diplomas of the two 

Corporations are granted* To be admitted to this examination 

the candidate must submit proofs that he has 

received instruction in botany, chemistry, materia medica, 

and pharmacy, has worked in a chemical laboratory, has 

dissected for twelve months, has attended a six-months' 

course of lectures on normal human anatomy, another of 

the same duration on physiology and histology, and a 

three-months' practical course on the two last subjects; 

further, that during six months he has attended lectures on 

internal medicine and surgery, and, for three months, 

lectures on midwifery and gynaecology, that he has 

J*^!'* This came into force on Oct. 1st, 1884.—E. H. H.


attended at least 20 labours and has received a systematic 

introduction to practical medicine in regard to such matters 

as the various methods of diagnosis, the examination of 

diseased tissues and of excreta, and the use of apparatus 

and instruments employed in these investigations; again, 

that he has attended a three months' course of pathological 

anatomy, has assisted at post-mortem examinations while 

engaged in clinical work, has attended lectures on forensic 

medicine for three months, and that, for nine months, he 

has been in attendance at the medical and surgical clinics 

and altogether has spent two years and a half at a hospital: 

he must have been clinical clerk and dresser each for six 

months and have acquired practical skill in the perform 

ance of vaccination. The candidate's knowledge is tested 

by many examinations, some of which are passed during 

the period of studentship. The first examination deals 

on the one hand with chemistry, physics, materia medica, 

pharmacy and medical botany, on the other with elemen 

tary anatomy and physiology. For the convenience of 

•candidates it may be divided in two portions which are 

held at different times : but the whole must, if possible, be 

passed during the first year. Six months later the candi 

date has to present himself for the second examination, 

which includes anatomy and physiology, but a more 

advanced knowledge of these sciences is required than in 

the first examination. In the third and last examination 

the subjects are internal medicine, therapeutics, patho 

logical anatomy and general pathology, surgery, surgical 

anatomy and pathology, midwifery and gynaecology : some 

questions on the subjects of forensic medicine and public 

health may be added. This examination, like the first, 

may be divided and passed at different times. It must 

however not be entered upon earlier than two years after 

the second examination. The candidate must be at least 

21 years of age. The examinations are partly oral, partly 

on paper, and partly again of a practical nature, such as 

involves the demonstration of anatomical preparations, the


examination of patients, the performance of operations on 

the dead body, etc. 

The candidate who passes these three examinations 

receives the license of the Royal College of Physicians. 

and the membership diploma of the Royal College of 

Surgeons.* Equipped with these certificates he presents 

himself to the public as a doctor capable in every respect 

and equally trained in all branches of his art. Moreover 

each of these two qualifications may be granted by the 

corresponding corporation on its own account : f the 

examination in this case is easier, inasmuch as less importance 

is attached by the one examining body to anatomy 

and surgery and by the other to chemistry, physics, physiology 

and internal medicine. 

Other corporations proceed upon the same plan, granting 

diplomas in conjunction with other examining bodies or 

independently ; but some boards are satisfied more easily 

than others. Thus the Royal College of Physicians of 

Edinburgh only requires that the candidate should have 

dissected for six months, have attended lectures on physiology 

for three, the medical clinic for six, and the surgical 

for three months. The examination consists of two portions 

; in the first, anatomy, physiology and chemistry, and 

in the second, materia medica and pharmacy, general 

pathology and pathological anatomy, internal medicine, 

surgery, midwifery, forensic medicine and clinical medicine 

are the subjects in which the candidate's knowledge is 

tested. 

The Societies of Apothecaries demand of candidates 

that, in addition to having studied medicine, they shall 

have devoted special attention to the natural sciences and 

* Examining Board in England by the R. College of Phys. of ^.ondon and 

theR. C. of Surg, of England, London 1884. 

•j- The diploma of Member of the R. College of Surgeons is not now granted 

apart from the license of the R. College of Physicians except to students who 

commenced their professional studies prior to Oct. 1st, 1884. And the same 

may be said mutatis mutandis of the license of the R. College of Physicians.—• 

E. II. H.

ENGLAND—NORTH AMERICA. 517 

to chemistry and pharmacy, and have worked in a dispensary 

or a pharmaceutical laboratory. The Societies of 

Apothecaries of London and Dublin constitute medical 

examining boards. 

The apothecaries in England pursue the same course of 

study as the doctors and have a license to practise. This 

arrangement has probably developed out of the popular 

habit—which has existed in all ages—of seeking the first 

medical assistance at the hands of the apothecaries* 

The candidate has a free choice among the examining 

boards; he will probably decide upon that one which is 

nearest his home or the place where he has been pursuing his 

medical studies, or which makes the most moderate claims 

on his knowledge and his purse and is respected by the public. 

The Englishman will therefore in most cases try to get an 

English diploma, the Scotchman a Scotch, and the Irishman 

an Irish one : the more of these a man possesses, the greater 

the tribute paid to his knowledge and the greater the trust 

reposed in him by his patients. His position is still better 

if he is received amongst the members of a privileged 

medical corporation, receiving the title of " Member" or 

" Fellow" of the same. These titles are granted either 

after special examinations or are conferred upon suitable 

candidates after election by the Societies. Thus anyone 

who wishes to get the title of a Member of the Royal 

College of Physicians of London must submit to an 

examination which includes the same subjects as the 

examination for the license, but goes more deeply into 

them. From among the Members of this College the 

Fellows are chosen : the latter conduct the affairs of the 

College and represent it on public occasions. The Royal 

College of Surgeons of Englandf grants the Fellowship to 

those who have earned a right to it by passing two 

examinations, of which practical subjects, and especially 

* The Society of Apothecaries of London grants a diploma in Medicine, 

Surgery, and Midwifery registrable under the Medical Act, 1886.—E. H. H. 

t Calendar of the Royal College of Surgeons of England, London 1884.


anatomy and surgery, constitute the chief part, and also to 

those of its members who by their achievements and their 

character appear worthy of this distinction* Most of the 

other medical corporations elect their Members without 

imposing the condition of an examination : they, in this 

way, always have it in their power to select none but the 

ablest and most esteemed representatives of their pro 

fession. 

The universities alone are entitled to grant academical 

degrees. The conditions under which these are conferred 

differ in different places. Yet, as a general rule, the 

principle holds good that university examining boards 

attach greater importance to a scientific preliminary training 

than is the case in most medical corporations. Some 

universities, like Oxford and Dublin, even require that 

candidates for medical degrees should already have taken 

an academical degree in arts. 

Whoever wishes to become a Bachelor of Medicine of 

Oxford (Baccalaureus medicinae) must possess the degree 

of Bachelor of Arts, which in England has about the same 

significance as Doctor of Philosophy in Germany. To 

Obtain this degree a course of studies of three years' duration 

in Uteris humanioribus is required.t The medical 

* The Fellowship of the Royal College of Surgeons is however very rarely 

granted as an honorary distinction.—E. H. H. 

f To obtain the B.A. degree the candidate must have resided for 12 termswithin 

the university. There are three courses of examinations to choose from— 

(i) Responsions (or an Extra-University equivalent). Moderations, Divinity 

Examination (or an equivalent), and Final Pass Schools in three subjects. 

(ii) Responsions, Moderations, Divinity, and Honours in Literae Humaniores, 

Mathematics, Theology, Oriental Languages, Modern History, Jurisprudence, 

or any of the subjects of the Natural Science |School, viz.,. 

Chemistry, Physics, Animal Morphology, Animal Physiology, Botany. 

(iii) Responsions with an adciitional subject, Divinity^, the Preliminary 

Examinations of either the Jurisprudence or Natural Science Schools 

and Honours in one of the Honour Schools mentioned in the precedingparagraph. 

Fide " British Medical Journal," Sept. 5, 1891, and the " Oxford University 

Calendar."—E. H. H.


studies follow upon this, and last for four years. The. test 

required of the candidate for the degree of Bachelor of 

Medicine consists of two examinations, of which the first 

deals with normal human anatomy, comparative anatomy, 

physiology, physics, chemistry, and botany; the second 

with theoretical and practical medicine, the diseases of 

women and children, materia medica, surgery, midwifery, 

forensic medicine, and hygiene, and in addition some 

passages are set for translation. from the medical writings 

of the ancients, as, for example, from the Hippokratic 

collection, from GALEN, ARETÛS, or CELSUS, or else from 

one of these authors and a medical author of modern times. 

The degree of Bachelor of Medicine gives a right to 

practise medicine, and only those who possess this degree 

can proceed to the Doctorate; this, however, is not granted 

until the candidate has passed three years in medical 

practice, and has submitted a thesis upon a medical 

subject.* 

In other universities the tests are of a similar nature. 

The London University, the examinations of which have 

acquired a great reputation for thoroughness, does not 

insist upon the candidate for medical degrees possessing a 

degree in Arts, but only requires that such candidate shall 

have attained a certain proficiency in the natural sciences. 

Here the degree of Bachelor of Medicine is granted after 

the following examinations have been satisfactorily passed :f 

i. The Preliminary Scientific Examination, in which 

physics, inorganic chemistry, botany, and zoology are the 

subjects; 2. The Intermediate Examination, which follows 

two* years after the last-mentioned, and includes anatomy, 

physiology' with histology, materia medica, pharmaceutical 

and organic chemistry ; t 3. The Final Examination at the 

conclusion o| studentship, in which general pathology 

* For which a book published within two years of the candidate's application 

for the degree may be substituted.—E. H. H. 

t Assuming that the Matriculation Examination has been already passed. 

E. H. H.


and therapeutics, hygiene, surgery, internal medicine, mid 

wifery, and forensic medicine are dealt with. 

These examinations, like those carried on by other 

corporations, are partly oral, partly on paper; practical 

demonstrations and bedside examinations of patients, etc., 

are also made use of. Here also, as with the other 

privileged medical bodies, certificates are required of the 

candidates testifying that they have attended certain 

lectures and courses of instruction, clinics, and hospital 

practice. 

The degree of Bachelor of Medicine is the necessary 

preliminary to the other medical degrees. The doctorate 

is granted after some years have been passed in practice, 

and after a further examination in the various branches of 

medicine. Even the surgical degrees are only conferred on 

those who have passed the examinations required for the 

degree of Bachelor of Medicine. The degree of Bachelor 

of Surgery is obtained by passing an examination which 

deals principally with surgical anatomy and pathology, 

operative surgery, and the instruments used. The degree 

of Master in Surgery is conferred on anyone who being 

a Bachelor of Surgery has spent two to five years in the 

practice of surgery, either in a hospital or independently, 

and who succeeds in passing a further examination in the 

subjects above-mentioned. In the same way most other 

university examining bodies in granting surgical degrees 

impose the condition that the candidate must be legally 

qualified to practise as a doctor. At the Universities of. 

Durham and St. Andrew's a rule exists enabling doctors 

who have been in practice for 15 years, and are over forty 

years of age, to proceed to the degree of Doctor of 

Medicine by payment of 50 guineas after a comparatively 

very easy examination. 

The statistics of the results of examinations afford some 

opportunity of forming a judgment upon the importance 

and activity of the different examining bodies, and upon 

the localities selected by the majority of English doctors in

ENGLAND.—NORTH AMERICA. 52 I 

-which to prosecute their studies. We find that in the five 

several years, 1876-1880, at the University of Oxford, 6, 

10, 5, 6, 7 candidates received the degree of Bachelor of 

Medicine, and i, 1, o, 2, 2 that of Doctor of Medicine ; 

these numbers at Cambridge were, 13, 7, 9, 13, 16 and 5, 2, 

-6, 9, 7; at Durham, 2, 7, 9, 19, 13 and 2, 3, 1, 11, 10, while 

o, o, 2, 7, 4, took the degree of Master of Surgery; at the 

University of London the degree of Bachelor of Medicine 

was conferred on 23, 22, 25, 34, 39, that of Doctor on 

11, 8, 6, 12, 18; that of Bachelor of Surgery on 7, 3, 6, 6, 8 ; 

and that of Master of Surgery on 1, 1, 0,0, 1; during 

these years the Royal College of Physicians of London 

granted 90, 97, 68, 108, 79 candidates the license to 

practise, made 25, 23, 20, 14, 18 Members, and 12, 9, 13, 12, 

12 Fellows; the Royal College of Surgeons of England 

conferred the Membership on 406, 393, 361, 420, 404 

candidates, and the Fellowship on 29, 36, 21, 18, 30, giving 

also the license to practise dentistry to 20, 27, 27, 17, 19 

candidates; while the Society of Apothecaries licensed 

257, 206, 223, 216, 228 to practise medicine. The 

University of Edinburgh during the same period made 86, 

108, 115, 98, 134 Bachelors, 20, 34, 30, 33, 29 Doctors of 

Medicine, and 80, 100, 106, 98, 129 Masters in Surgery; 

at the Glasgow University these three categories were 

represented by 58, 62, 59, 57, 74; 23, 20, 11, 12, 16; 54, 

.56, 57, 54, 66; at Aberdeen by 41, 34, 57, 51, 48; 32, 46, 

30, 25, 35 ; 41, 34, 55, 48, 48 ; at St. Andrew's by 1, 2, 1, 

o, 3; 10, 10, 10, 10, 11, the first group in this case representing 

both Bachelors of Medicine and Masters of 

Surgery. The Royal College of Physicians of Edinburgh 

gave its license to 114, 99, 114, 145, 137, and in conjunction 

with the Royal College of Surgeons of Edinburgh to 

85, 116, 160, 156, 162, further in conjunction with the 

Faculty of Physicians arid Surgeons of Glasgow to 22, 13, 

21, 27, 30, and the same body made 23, 18, 2^, 19, 20 

Members, and 9, 11, 8, 6, 9 Fellows; the Royal College of 

Surgeons of Edinburgh elected 27, 31, 30, 41, 44 Fellows;


and the Faculty of Physicians and Surgeons of Glasgow 

conferred the license on 63, 34, 55, 71, 73, and the Fellowship 

on 15, 23, 10, 3, 5 candidates. The University of 

Dublin granted the license in medicine to 3, 2, o, 2, 4, that 

in Surgery to 1, 2, o, o, 3 candidates, and created 36, 44, 

29, 29, 40 Bachelors, and 20, 17, 14, 15, 10 Doctors of 

Medicine, 20, 18, 23, 23, 28 Bachelors, and 8, 5, 3, 3, 1 

Masters of Surgery. The Queen's (now Royal) University 

of Ireland created 53, 44, 47, 55, 64 Doctors of Medicine, 

and 47, 35, 35, 34, 44 Masters of Surgery; the King's and 

Queen's College of Physicians in Ireland gave the license. 

in midwifery to 99, 8g, 79, 76, 78, and in medicine to 108, 

86, 78, 88, 105, and elected 5, 2, o, 3, 4 Fellows; the. 

Royal College of Surgeons in Ireland gave the license in 

midwifery to ii, 8, 10, 9, 10, and in medicine to 97, 99,. 

106, 122, 103, and made 13, 5, 6, 15, 14 Fellows ; the 

Apothecaries' Hall of Ireland licensed 22, 24, 23, 34, 42 

candidates. These figures show that the number of doctorswho 

pass university examinations as compared with the 

number getting licenses from the medical corporations isin 

England approximately as 1 to 8, in Scotland as 4 to 3, 

and in Ireland as 1 to 2. 

To distinguish the various degrees and qualifications 

short forms are employed as is the case generally with titles, 

in England. Thus F.R.C.P means Fellow of the Royal 

College of Physicians; M.R.C.S., Member of the Royal 

College of Surgeons ; L.S.A., Licentiate of the Society 

of Apothecaries; M.B., Bachelor of Medicine; M.S.,. 

Master of Surgery; M.D., Doctor of Medicine; to this is 

generally added the name of the university from which the 

degree has been obtained. The English public knows the 

value and significance of the different kinds of medical 

diplomas existing in the country, and is reminded upon 

these points by the differences in the professional fees,, 

which are regulated by custom.* 

* Amongst general practitioners the fees are to a large extent regulated by 

the house rental of patients.—E. H. H.

ENGLAND.—NORTH AMERICA. 52,3 

If England has not always followed the progress made by 

other countries in regard to systematic medical instruction, 

she, on the other hand, has rendered the great service of 

creating the first satisfactory system of sanitary government. 

By the Public Health Act of 1875, the whole land 

was divided into sanitary districts presided over by local 

authorities. These have to take care that drainage, building 

operations, public and private privies, the cleansing of 

the streets, the drinking water supply, the food, underground 

dwelling places, inns, hospitals, graveyards, 

factories, etc., are conformable to the principles of public 

health, and they elect sanitary officers to supervise and to 

take any necessary action in these matters. Whoever 

desires an appointment of this kind must be legally 

qualified to practise. 

At most universities and examining boards examinations 

are held and diplomas granted in sanitary science. It is of 

advantage for anyone desirous of occupying the position 

of medical officer of health to possess such a certificate of 

proficiency in sanitary science. 

This organization is founded upon the principle of selfgovernment, 

and may be expected to yield important 

results in a country the people of which have for centuries 

been accustomed to manage their own affairs, are in 

possession of abundant national wealth, and understand 

the advantage of a rational care for the public health. 

[Before being permitted to register the commencement of 

medical study it is necessary for the student to have passed 

a preliminary examination in the subjects of general 

education as specified in the following list:—(1.) English 

language; (2.) Latin; (3.) Arithmetic, algebra, and EUCLID; 

(4.) Elementary mechanics; (5.) Either Greek, French, 

German, Italian, logic, botany, zoology, or chemistry. For 

the London student these requirements are satisfied by his 

passing the matriculation of the University of London, the


examination in arts of the Apothecaries' Society of London 

or the professional preliminary examination of the College 

of Preceptors. Examinations of British and Colonial 

universities are accepted by the General Medical Council if 

the above-mentioned subjects are shown to have been included. 

Students who propose to obtain medical degrees 

in the University of London should pass both the matriculation 

and the preliminary scientific examinations before 

commencing their regular medical studies. 

The following course of study is recommended at one of 

the chief Metropolitan schools for a student who enters in 

October, intending to obtain the double qualification of the 

"Conjoint Board" (L.R.C.P. Lond. and M.R.C.S. Eng.). 

It should be premised that the winter session extends from 

October 1st to March 31st, and the summer session from 

May 1st to July 31st. 

FIRST WINTER SESSION.—Lectures, etc.: Anatomy, 

Physiology, Chemistry, and Physics. Anatomical and 

Physiological Demonstrations. Dissections. Examinations: 

"Sessional" at Medical School in December and in 

March. Part III. (Elementary Anatomy and Physiology) of • 

the First Examination of the " Conjoint Board " in March. 

FIRST SUMMER SESSION.—Lectures, etc. : Materia, 

Medica, Practical Chemistry, and Practical Physiology. 

Examinations: "Sessional" in July, and Parts I. and II. 

of the "First Conjoint." 

SECOND WINTER SESSION.—Lectures, etc. .• Anatomy 

and Physiology, with Demonstrations and Dissections. 

Tutorial Class in Anatomy. Hospital Practice, Medical 

and Surgical. Examinations: "Sessional" in December 

and in March ; " Tests " and " Second Conjoint " in March. 

SECOND SUMMER SESSION.—Lectures, etc..- Hospital 

-Practice, Medical and Surgical. Midwifery. Practical 

Surgery. Examinations: Sessional in July. The course 

of instruction in , Elementary Clinical Medicine to be 

attended by Candidates for Out-Patient Clinical Clerkships.


THIRD WINTER SESSION.—Lectures, etc.: Hospital 

Practice, Medical and Surgical. Medicine, Surgery, and 

Surgical Pathology, Practical Surgery, Practical Course of 

Pathological Anatomy. Examinations : " Sessional " in 

December and March. Clinical Clerkship (if not held 

during July, August, and September) and Dressership in 

the Out-Patient Departments. Maternity cases may be 

attended at any time after the Lectures on Midwifery of the 

Second Summer. 

THIRD SUMMER SESSION.—Lectures, etc.: Hospital 

Practice, Medical and Surgical, with Clerkship or Dressership. 

Pathological Anatomy, Forensic Medicine, Ophthalmology. 

Examination : " Sessional " in July. 

FOURTH WINTER SESSION.—Lectures, etc..- Hospital 

Practice, Medical and Surgical, the special departments 

and post-mortem examinations. Clerkship or Dressership 

in special departments and post-mortem room. Instruction 

in Vaccination. Practical Course of Pathological Anatomy 

(if not taken in third winter). Clinical Lectures on Medicine, 

Surgery, and Diseases of Women. Obstetric Demonstrations. 

Diseases of Eye. 

FOURTH SUMMER SESSION.—Lectures, etc..- Hospital 

Practice, Medical and Surgical, and special departments. 

Clinical Medicine, Clinical Surgery, Mental Disease, Public 

Health and Sanitary Science. Tutorial Classes in Surgery, 

with operations on the dead body. Examination : " Final 

Conjoint" in Medicine, Surgery, and Midwifery. NOTE.— 

The three subjects may be taken at one examination.* 

When to such a scheme of work as this students add, as they 

often do, such supererogatory labours as are involved in the 

preparation for the very exacting First Fellowship examination, 

in the tenure of junior demonstratorships, and in assisting, 

general practitioners in dispensing and book-keeping, 

it can be easily understood that their time is fully taken up, 

and that it behoves them to take care that the mental tension 

is j regularly relaxed by appropriate recreation. 

* See St. Thomas's Hospital Medical School Prospectus, 1890-91.


Those who desire to get a degree of M.D. have the opportunity 

of acquiring it at one of eleven universities in the ' 

United Kingdom: Oxford, Cambridge, London, Durham, 

Victoria, Edinburgh, Glasgow, Aberdeen, St. Andrew's, 

Dublin, Royal. The University College of Medicine, Newcastle-on-Tyne, 

is affiliated to Durham University. The 

colleges of the Victoria University are Owen's College, 

Manchester; University College, Liverpool; and Yorkshire 

College, Leeds. 

The School of physic of Trinity College is the chief 

training ground for students of Dublin University; some, 

however, instead of studying at this their own school, take 

out their courses at the Carmichael College or the College 

of Surgeons. The Royal University of Ireland, like the 

London University, is a purely examining body. 

In spite of these numerous universities the conditions of • 

residence and other causes conspire to induce many qualified 

practitioners to take the more rapidly procurable medical i| 

doctorate of the University of Brussels. 

However much or little there may be in a name there i 

is no doubt that among the laity in England the letters J 

M.D. form a combination to conjure with. The London 

.student is at a peculiar disadvantage in regard to graduating 

in medicine inasmuch as the only degree-granting body in 

London—the London University—has by the duration and , 

severity of the curriculum placed its doctorate out of the 

reach of the large majority of students. 

On the other hand, as may be seen from the figures on a 

previous page, the Scotch student in his own country has 

facilities for taking this degree, of which he does not fail to 

avail himself, and the same may be said, though to a smaller 1 

extent, of the Irish student. A medical graduate of 

Glasgow or of the Royal University of Ireland occupief,| 

thus in the eyes of the public a favoured position as 

compared with a licentiate of the Royal Metropolitan 

Colleges or of the Apothecaries' Hall out of all proportion to 

the difference in their professional education.


The Report of the Royal Commission on Higher Educa 

tion in London gave official sanction to these complaints, 

declaring that " the demand for degrees attainable in 

London more easily than at present is a legitimate one, 

and it is desirable to provide for that want in some 

proper manner." The Royal Commissioners were of 

•opinion that the doctorate of the London University is an 

" honours" degree and that it is desirable that there should 

be in London a " pass" degree attainable, while at the 

same time they unanimously rejected the application of the 

Royal Colleges of Physicians and Surgeons for powers to 

confer degrees. 

The London student wants a " pass " degree granted on 

terms similar to those on which such degrees are given in 

Scotland and the provinces. It is quite easy to understand 

that the Convocation of London University objects to any 

measure which would tend in the slightest degree to 

depreciate the value of the degrees of which the graduates 

of that University are justly proud. 

How the legitimate grievance of the London student will 

ultimately be removed is not apparent. A joint request 

from such powerful Corporations as the College of 

Physicians, the College of Surgeons, and the Society of 

Apothecaries, for a Charter empowering them to grant 

medical degrees could hardly be refused by Government, 

and would solve the difficulty : this combination, is, how 

ever, just what it is difficult to secure. The exclusion of 

the Society of Apothecaries in any scheme for securing to 

the London Medical Corporations an extension of privileges 

in the way of granting degrees is to be deprecated as 

unjust and impolitic : unjust, as taking no account of the 

good work done by that Society in the past or of the 

continually improving character of its examinations; 

impolitic, for the inevitable result would be the competi 

tion, instead of the co-operation, of an examining body 

entitled to grant licenses in the three chief branches of 

practice.

528 MODERN TIM'ES. 

The formation of a Teaching University, independent of 

the University of London (and in which King's and 

University Colleges would occupy a prominent position), . 

has for long been held to be urgently demanded by many 

interested in the higher education. 

During the present year an important step has been taken 

towards satisfying these requirements by the foundation in 

and for London of the Albert University by virtue of her 

Majesty's prerogative. In it University and King's Colleges 

are to be colleges of all faculties, and the ten chief medical 

schools of London, including the London Medical School 

for Women, are to be colleges of medicine. No medical 

degree is to be conferred on any person who shall nof previously 

have obtained a qualification for registration under 

the Medical Acts. 'The medical schools are to be represented 

on the Council by one member for each school, while 

King's and University Colleges are to be each-represented 

on it by three members; the Council is empowered to 

provide for the representation of the Royal Colleges of 

Physicians and Surgeons should they signify to the Chancellor 

their desire to be so represented, and" is also at 

liberty to assign, should it think fit, a place or places to a 

member or members nominated by the Society of Apothecaries. 

Periods of residence and study, and examinations 

at other universities in the Queen's dominions, are to be , 

recognized as equivalent to such periods of study at the. 

Albert University as the Council shall determine from time 

to time. The growth and development of this youngest 

member of the academical family cannot far! to influence 

education in general and medical education particularly. „ 

Certain resolutions were passed by the General Medical 

Council on June 5th and 6th, 1890, which will become 

obligatory on every medical student who begins his medical 

studies after January 1st, 1892. In regard to medical 

education they ordain that professional study shall last for 

five years ; the first year may be passed at a university or 

teaching institution where physics, chemistry, and biology 

•¥ 

•*C . * ;


are taught; the fifth year should be devoted to clinical work, 

but of it the student may pass six months as pupil to a 

registered practitioner whose opportunities of imparting 

practical knowdedge are considered satisfactory by the 

medical authorities. The remaining resolutions are framed 

with the object of securing for the student a thorough and 

complete training in practical and clinical work. 

* In regard to professional examination the resolutions 

require that the time devoted to the practical part of all 

examinations should be extended ; that the examination in 

physics, chemistry and biology should be passed before 

the beginning of the second winter session; that there 

should be three professional examinations (antecedent to 

the Final Examination) which should be passed before the 

final year intended for clinical work ; that the Final Exami 

nation must not be passed before the close of the fifth year 

of medical study. 

In addition to the twelve Metropolitan Schools having 

a complete curriculum (in which number is included the 

London Medical School for Women) there are in London 

no less than thirty Ancillary Schools of Medicine in which 

departmental or preparatory subjects are taught. In the 

provinces, Birmingham, Bristol, Cambridge, Newcastle-on- 

Tyne, Leeds, Liverpool, Manchester, Oxford and Sheffield 

contain hospitals and medical schools. 

In Scotland there are four University Schools of Medicine 

—Edinburgh, Glasgow, Aberdeen and St. Andrew's. Uni 

versity College, Dundee, now forms part of St. Andrew's. 

Clinical instruction is given at the Royal Infirmary, Edin 

burgh, in medicine and surgery and in the various speciali 

ties. Clinical lectures and instruction are also given at the 

Edinburgh Eye, Ear and Throat Infirmary. At Glasgow 

the Western Infirmary, the Royal Hospital for Sick Chil 

dren, the Hospital and Dispensary for Diseases of the 

Ear, and the Ophthalmic Institution subserve clinical 

instruction. This is likewise imparted at the Aberdeen 

Royal' Infirmary and the Aberdeen Royal Lunatic 

M-M

53° 

MODERN TIMES. 

Asylum, in the latter institution during three months in 

summer. 

The School of Edinburgh enjoys present popularity and 

historic renown and attracts not only Scotch but English 

and Colonial students in great numbers. 

Some of the most prominent members of the staffs of 

London Hospitals have been trained and have graduated in 

Scotland and the services rendered by them to clinical in 

struction in the London schools are of the highest character. 

The clinical teaching of the late Dr. MURCHISON at St. 

Thomas's Hospital was of European celebrity and in 

thorough harmony with the traditions of the Scottish 

school. 

There are several centres of medical education in Ireland. 

Those in Dublin enjoy great repute and are much frequented) 

especially the School of Physic of Trinity College and the 

Ledwich School, at the latter of which night tuition is given. 

The Rotunda Hospital at Dublin constitutes one of the, 

most important schools of obstetrics and gynaecology in 

the world. The School of the Royal College of Surgeons i 

and the Carmichael School have recently improved their 

accommodation for students and their appliances for 

teaching. At the Mater Misericordiae Hospital, the largest * 

in Dublin, at Sir Patrick Dun's Hospital, the Adelaide 

Medical and Surgical Hospitals and other hospitals and 

dispensaries opportunities are afforded for clinical work 

and clinical instruction is given. 

In the prosperous town of Belfast the Queen's College 

School of Medicine affords facilities for acquiring a first- 

rate medical education. Here the courses of instruction are 

framed with a view to the requirements of those intending 

to present themselves for degrees at the Royal University 

of Ireland, but are nevertheless quite fitted for preparation^ 

for other qualifications. The social and scenic surroundings 

are all that could be desired while the cost of education^; 

and living is moderate. Cork also possesses a medical,, 

school and hospitals affording good opportunities of study,


especially if the student has in view the degrees of the 

Royal University. 

Anyone who is on the Medical Register is entitled to 

practise as a dentist but it is usual and advantageous to 

take a special dental diploma and to become L.D.S. or a 

Licentiate in Dental Surgery. This qualification can be 

obtained by itself but it is better if the student can see 

his way to taking the medical and surgical qualification 

of the conjoint board in addition. The special studies 

required for the dental diploma are: two courses of dental 

anatomy and physiology human and comparative; two 

courses of dental surgery; two courses of dental mechanics ; 

one course of metallurgy; practice of dental surgery in a 

recognized school for two years ; and an apprenticeship in 

dental mechanics to a competent practitioner. 

The conditions of admission into the Army Medical Service 

are that the candidate should be between the ages 

of twenty-one and twenty-eight, and in good health, that 

his.parents should be of unmixed European blood, that he 

should possess the double qualification to practise medicine 

and surgery, be registered under the Medical Act, and 

furnish satisfactory certificates as to character. He has 

then to undergo a competitive examination. The subjects 

are (i.) Compulsory and (ii.) Voluntary. The former include 

anatomy and physiology, surgery, medicine with therapeutics 

and diseases of women and children, chemistry and pharmacy 

and a practical knowledge of drugs. By this part of the 

examination the eligibility of the candidate for admission 

into the service is determined. The voluntary subjects are 

French, German, comparative anatomy, zoology, natural 

philosophy, physical geography, and botany. 

The conditions of entrance into the Indian Medical 

Service are similar, with the exception that the age limits 

are twenty-two and twenty-eight, and it is only required 

that the candidates should be natural-born subjects of her 

Majesty. Among the voluntary subjects in the examination 

for the Indian service Hindustani is included.


The successful candidates now proceed to Netley to go 

through a four months' course of instruction in military 

surgery, medicine and hygiene. They then pass a final 

examination, and their position on the list of those recom 

mended for commissions is determined by the combined 

results of the competitive and final examinations. The 

surgeons of the British Medical Service then pass to Alder- 

shot for instruction in ambulance drill and equitation. 

A further examination has to be passed on promotion to 

the rank of surgeon-major: this is with a view of testing 

the surgeon in such branches of knowledge as are essential 

to his continued efficiency as a medical officer. 

The conditions of admission into the Naval Medical 

Service resemble those for the army. After passing the 

competitive examination in London the successful candi 

date receives a commission as surgeon in the Royal Navy, 

and undergoes a course of naval hygiene at Haslar 

Hospital. 

A further examination has to be passed on promotion to' 

the rank of staff-surgeon. 

The special departments in the London Hospitals are . 

now most ably administered and opportunities are afforded 

to students of holding minor appointments in them. In 

addition to clinical teaching in the wards, clinical lectures 

are given on cases of especial interest by the physicians 

• and surgeons at frequent intervals. j 

«,:•• The beautifully exhibited and carefully catalogued i 

^pathological specimens in the museums afford unrivalled * 

-Opportunities for study : while practical research in physi 

ology and bacteriology has of late years become an estab 

lished feature at many medical schools. 

The rapid advance in therapeutics which is a charac 

teristic of the present time, has made it desirable that the 

qualified practitioner should be placed in a position to 

acquaint himself with new methods of treatment, and, 

facilities are afforded him for this in the courses of post 

graduate lectures which have recently been instituted and


which are delivered by men of eminence in the various 

specialities. 

The addresses given at the Annual Meetings of the 

British Medical Association—held in different cities and 

towns of the United Kingdom—as well as the papers read 

before branch meetings of the same Association help to 

keep the practising doctor abreast of recent inventions and 

discoveries bearing upon his work. 

The Harveian and Hunterian orations delivered once a 

year urbi et orbi while honouring the illustrious dead are 

eminently calculated by the high standard of rhetoric and 

of learning which frequently characterizes them, to inspire 

and instruct the living. 

The advances made in the education of doctors in Eng 

land within the present century has been accompanied by 

a continual improvement in the nursing staff of hospitals. 

The cleanliness and order of a ward in an English hospital 

are the outcome to a large extent of the high intellectual 

and moral standard required and found in the superintend 

ing and subordinate nurses. How far this happy result 

has been contributed to by the example and teaching of one 

devoted lady is a matter well known to her contemporaries 

and will not be forgotten by posterity. The lessons learnt 

among the sick and wounded of the Crimean war have 

borne rich fruit in more peaceful scenes. 

Thoroughness and practical efficiency are the distinguish 

ing features of English medical teaching of the present * 

day: every effort is made to make examinations of an 

objective character and high consideration is given to 

practical work in all branches. The example set by the 

metropolitan and provincial schools tends in an ever- 

increasing degree to be followed by the centres of study in 

India, by those of Sydney and Melbourne, Quebec and 

Montreal. 

How our hospitals, supported by voluntary contributions, 

liable to abuses as Jhey undoubtedly are, in common with 

other human arrangements, impress the foreigner, may be


exemplified by a passage written five years ago by the 

author of this work. Speaking of the English hospitals, 

he says, "In the erection and maintenance of these institutions 

the benevolence of the English people is most 

strikingly shown, while a brilliant example is set for the 

imitation of other nations."] 

The system of medical instruction prevalent in England 

has been imitated not only in those parts of the transatlantic 

continent which are under her rule, but wherever the English 

language and English culture prevail. 

In the United States of America medical teaching 

is also a matter of private enterprise. Several doctors 

living in the same locality unite for the purpose of imparting 

instruction in medicine, and give their pupils testimonials 

of proficiency. No one makes inquiries as to the 

qualifications of the teachers, or as to the result of their 

teaching. These schools consequently differ exceedingly 

in merit. According to a list made in the year 1882 there 

were in the United States at that time 114 medical schools 

and 13,321 students. 

Some medical schools enjoy, and justly so, a high reputaon. 

Such are the New York College of Physicians and 

Surgeons, founded in 1791, the University Medical College, 

which has existed since 1841, the Bellevue Hospital College 

at New York, the Massachusetts Medical College at Boston, 

and the Rush Medical College at Chicago. Along with 

these, however, there exist others which occupy a low 

position both intellectually and morally. The scandalous 

traffic carried on by many faculties in doctor's diplomas is 

well known. A newspaper of Philadelphia—where the 

abuse could be studied at its source—made a few years ago 

some incredible revelations upon this subject.* It is, there- 

* " A Doctor-Factory making full-fledged physicians for seventy-five dollars '* 

in the Philadelphia Record, 28th Feb., 1880.

FRANCE. 535 

fore, not a matter for surprise that American degrees in 

medicine should be regarded with distrust in Europe, and 

placed in the same category as those amiable but meaning 

less distinctions which are conferred on people dancing the 

cotillon. 

The education of the American doctors is, as a general 

rule, inferior to that of their European colleagues. Presi 

dent ELIOT thus expressed himself in a report (1871-2) :— 

" It is fearful to think of the ignorance and incompetence 

of most American doctors who have graduated at American 

schools. They poison, maim, and do men to death in 

various ways, and are unable to save life or preserve 

health."* The skilled doctors found, in America are in 

many cases of European origin, or at least have studied in 

Europe. Yet some departments of medical science, such as 

gynaecology and dentistry, have been prosecuted with great 

success in the medical schools of North America. More 

over, a gratifying endeavour is now everywhere being made 

to do away with the existing disabilities, and to introduce 

improvements into the system of medical education, 

following European models. 

FRANCE. 

WHILE in England and America, the principle that the 

State should not concern itself with things which can be 

equally well managed without its aid, is generally followed, 

the very opposite is the case in France. There the ruling 

powers feel themselves called upon continually to exercise 

a strict supervision over everything that takes place. Both 

the system of medical teaching and medical practice have 

been subjected to minute regulations at the hands of 

the authorities. Only in the days of the great revolution 

was this principle departed from : at that time, instead of 

Revue internat. de l'enseignement, Paris 1882, iv, p. 550.

53^ *' MODERN TIMES. 

parental protection degenerating at times into a paltry 

pedantry being extended to the profession, an unlimited freedom 

was permitted which led in the direction of anarchy. 

The doctors took an active part in the mighty political 

movements of that time.* Seventeen members of the 

profession belonged to the National Assembly, among them 

GuiLLOTlN—the inventor of the decapitating machine 

named after himt—a politician of very moderate views, and 

J. G. GALLOT, P. BLIN, SALLES, BEAUVAIS DE PRÂUX and 

others. In the Legislative Body of 1791 there were 22 

doctors, among them the celebrated surgeon TENON; in 

the National Convention of 1792, 39 seats were occupied 

by medical practitioners of whom BARAILLON, PANVILL1ERS, 

R. ESCHASSI^RIAUX, A. FOURCROY, M. A. BAUDOT, LEVAS- 

SEUR the obstetrician, E. LACOSTE and MARAT were the 

best known. When the Terrorists commenced their ghastly 

proceedings and celebrated their revolting and sanguinary 

orgies, the medical profession had to lament the sacrifice of 

numerous victims ; 104 of its members were executed and 

328 physicians and 540 surgeons were banished from 

France. PIERRE DESAULT, while holding his clinic in the 

Hotel Dieu, was seized in the midst of his pupils and cast 

into prison. But thanks to the energy of his friend 

FOURCROY, who found effective support in the Press, 

•DESAULT was soon again set at liberty. 

LAVOISIER, the great chemist, was not so fortunate. He 

died on the scaffold, although HALLE had in touching words , 

reminded his persecutors of the imperishable services 

rendered by him to science. Nous n'avons pas besoin de 

savants, was the reply of the president of the Court; the 

sentence of death was carried into effect and thereby 

France was robbed of one of her greatest men. 

Men of learning were not wanted and science was not in 

* C. SAUCEROTTE : Les me'decins pendant la revolution, Paris 1887. 

t Professor PUSCHMANN requests me (Oct. 1891) to correct this statement. , 

He says "this machine was not invented by GUILLOTIN, having been used 

during the middle ages in Germany, Scotland and Italy; he only advised the • 

French Parliament to make use of it."—E. H. H.

FRANCE. 537 

request. The smoky atmosphere of political fanaticism 

stifled the nobler emotions of humanity, and its devastating 

flame laid low all higher intellectual aspirations. 

The system of. medical education was pressingly in need 

of reform. Of the 18 medical schools possessed by France 

at the outbreak of the revolution scarcely one-half of them 

were known outside the towns in which they were 

situated and only those of Paris and Montpellier enjoyed 

any great reputation. The arrangements of the French 

medical faculties were inferior to those of other countries, 

and the French hospitals were on account of their unsanitary 

condition positively a by-word of reproach. The legislature 

interested itself in these questions.* A Bill introduced 

in 1790 contained many admirable suggestions for a reorganization 

of medical teaching ; thus it was demanded 

that both in teaching and in the examinations the French 

tongue should be exclusively used, that there should be 

perfect freedom given to the professors in teaching their 

subjects, that the lectures should be gratis, that there 

should no longer be any fixed duration of studentship, that 

the professors should be appointed by competition, etc. 

Instead of the 18 medical schools there were to be only 

four medical faculties, in Paris, Montpellier, Bordeaux, and 

Strassburg, but each of these was to be provided with at 

least 12 professorial chairs, and, in addition, in every 

department there was to be a lower order of medical 

school associated with a hospital.f Unfortunately these 

proposals never came to be the subject of debate. 

When radicalism came to be the dominant influence in 

the State men were no longer satisfied with improving the 

existing arrangements, but demanded their complete 

abolition. The place previously occupied by reform was 

now taken by revolution, qui vint tout renverser depuis le 

trone du roi de France jusqu' a I'humble chaire du pro- 

* L. LIARD in the Revue internat. de l'enseignement, Paris 1887, T. xiv, p. 

409 et seq. 

t DREIFUS-BRISAC in the Revue internationale de l'enseignement, Paris 

»88i,ii, 555 etseq..


fesseur et la banquette de I'etudiant, as SABATIER says. 

By the law of the 18th August, 1792, all universities,. 

faculties, and medical schools were abolished; and for this 

act next to no compensation was given. In medicine as 

in theology, morals, and other things a desire was shown 

to retrograde to the primitive condition of mankind. It 

was hoped thus to reintroduce the conditions which 

obtained in the times of the ancient Greek philosophers ; 

all that was really done was to open the gates to superstition 

and impudent quackery. The mistakes and deficiencies 

of scientific medicine were ridiculously exaggerated and 

were made use of for drawing up a heavy indictment 

against its representatives. In the National Convention a 

speaker rose to the sublime height of declaring that doctors 

should be dealt with like priests—both alike being mere 

jugglers.* The wars carried on by the Republic soon,. 

however, became the means of demonstrating how 

necessary and useful doctors are. When it was communicated 

to the National Convention that the army had 

lost about 600 doctors within 18 months, and that the 

troops in the Eastern Pyrenees were almost entirely devoid 

of medical assistance, it was decided to reopen some of the 

medical schools. By a law of the 14th of Frimaire, year 

III. (4th December, 1794) three medical schools were 

established at Paris, Montpellier, and Strassburg; they 

were called ecoles de sante. They were at first intended 

only a former les officiers de sante pour le service des 

hopitaux et specialement des hopitaux militaires et de 

marine. Every district of the country sent a pupil to these. 

military schools of medicine, and there, at the expense of 

the State, he studied medicine for three years. At Paris 

there were 300 students, at Montpellier 150, and at Strassburg 

100. 

The need of educated medical practitioners, however,. 

soon led to civilian students, not supported by the State,, 

being admitted for the purpose of receiving instruction. 

In 1796 the medical school at Paris was reorganized and. 

* P. FRANK, op. cit., vi, 1, Abth., S. 221.

FRANCE. 539 

provided with twelve professorships as follows: (i) 

anatomy and physiology; (2) medical chemistry and 

pharmacy; (3) medical physics and hygiene ; (4) surgical 

pathology; (5) pathology of internal diseases; (6) natural 

history in its bearings on medicine; (7) the art of surgical 

operations; (8) clinical surgery; (9) clinical medicine -y 

(10) clinique de perfectionnement; (11) obstetrics; (12) 

history of medicine and forensic medicine. In addition the 

director of the establishment gave lectures " upon the 

Hippokratic methods of treating acute diseases," and 

" upon rare cases of disease collected from history and 

practice," while the librarian gave a course of bibliography 

and subjected medical literature to a critical review.* 

Among the teachers were SABATIER, CHOPART, PiNELr 

CORVISART, BAUDELOQUE, LASSUS, and P A. O. MAHON, 

the last of whom held the professorship of the history of 

medicine. In 1799, it was proposed to create two new 

professorships, one of pathological anatomy the other of 

"philosophic medicale;" but this suggestion was not 

carried into effect. In 1798, an " ecole pratique" was 

associated with the institution, and there the students had 

t 

opportunities of practising dissection. Clinics of various 

kinds dealt with their education at the bedside in the 

practical treatment of patients, and for some diseases- 

sexual disorders for instance—special establishments were 

founded. Instruction was given gratis, and by a law of the 

22nd of Ventose, year X., was made accessible to everyone ;. 

but for the sake of propriety, only medical students were 

allowed to attend the clinics.7 

The medical school of Paris, under these conditions, rose 

rapidly in reputation, and in 1799 numbered 1,500 students. 

Examinations in the most important subjects taught ensued 

upon the conclusion of the period of study : these, how 

ever, were by no means compulsory. 

* A. DE BEAUCHAMP: Recueil des lois et reglements sur l'enseignement 

superieur, Paris 1880-85. 

t E. BEAUSSIRE : La liberte d'enseignement et l'universite sous la troisieme 

republique, Paris 1884.


Besides the regular practitioners who had enjoyed a 

systematic education at the schools of Paris, Montpellier, 

and Strassburg, there existed a great multitude of quacks. 

Everyone might practise medicine ; no one had any need of 

license or diploma. The state of things which was thus 

developed was sharply criticised by FOURCROY—at that time 

at the head of all affairs connected with public instruction 

—in a report drawn up by him, and dated 7th of Germinal, 

year XI. "La vie des citoyens," said he, "est entre les 

mains d'hommes avides autant qu'ignorants. L'empirisme 

le plus dangereux, le charlatanisme le plus dehonte, 

abusentpartout de la credulite et de la bonne foi. Aucune 

preuve de savoir et d'habilite n'est exigee. Les campagnes 

et les villes sont egalement infectees de charlatans 

qui distribuent les poisons et la mort avec une audace que 

les anciennes lois ne peuvent plus reprimer. Les pratiques 

les plus meurtrieres ont pris la place des principes de Vart 

des accouchements. Des rebouteurs et des meges impudents 

abusent du titre d'ofificier de sante pour couvrir leur ignorance 

et leur avidite ! "* 

The law of the 19th of Ventose, year XI. (10th March, 

1803), abolished these abuses by making the permission to 

practise medicine dependent upon passing satisfactorily certain 

examinations which were introduced for this very purpose, 

and which included anatomy and physiology, pathology 

and nosology, materia medica, pharmacy and chemistry, 

hygiene and forensic medicine, midwifery, surgery, and 

internal medicine. The student's knowledge of anatomy 

was tested by requiring him to put up a preparation, while 

the examination in the practice of medicine took place at 

the bedside. Two different classes of practitioners were 

established, namely—(i.) Doctors of Medicine and Surgery; 

and (ii.) Officiers de Sante. Whoever aspired to the diploma 

of doctor had to pass through the Lycee training before 

applying himself to the study of medicine, and then to 

occupy himself with the latter for four years. 

* RENE ROLAND: Les meMecins et la loi du 19 Vent6se, an XI, Paris 1883.

FRANCE. 541 

The Officiers de Sante formed an inferior class of prac 

titioners. They were not bound to furnish any proof of 

having received a general education, and they were per 

mitted to engage in,medical practice after only three years 

study at a medical school. But they also might be excused 

any such study, and it sufficed if they spent five years' 

working at a hospital, or six years in the service of a doctor. 

The examination which they passed dealt with anatomy, 

the elements of medicine, materia medica, and surgery, and 

was carried on exclusively in French. The doctors were 

allowed to settle down anywhere, the Officiers de Sante 

only in the country and in the department in which they 

were licensed to practise. They were, moreover, obliged in 

serious cases of illness and in the greater operations to call 

a doctor into consultation. 

CARRET, the legislator, apologized for the establishment 

of this class of practitioners in the following words : " Les 

habitants des campagnes ayant des mceurs plus pures que 

celles des villes, ont des maladies plus simples qui exigent 

par ce motif moins d'instructions et moins d'apprets." 

The Officiers de Sante were trained chiefly at the hospital 

schools which came into existence in several towns of 

France,, and received a definite organization under the 

name of £coles secondaires. 

The lower class of apothecaries also received the requisite 

instruction at these establishments, while for the pharma 

ceutists of the first class three special schools were founded 

at Paris, Montpellier, and Strassburg which were, in many 

respects, in close relation with the medical schools at those 

places. The schools of medicine last mentioned were in 

1808 once more promoted to the position of medical facul 

ties, and were incorporated with the University of France. 

This creation of Napoleon was not a university in our 

sense of the word, but, as it were, the headquarters of all 

the establishments and boards of education throughout the 

country. It was approximately equivalent to what is now 

known as a department for the regulation of education. A


Grand Master stood at the head of the University of France. 

This dignity passed or was changed into that of Minister of 

Instruction. A council was appointed to assist him, in the 

capacity of consulting authority in educational matters, 

while a considerable number of General Inspectors supervised 

and controlled the particular schools. The whole 

country was divided into 26 university districts, everyone 

•of which formed the seat of an academy (or higher 

educational establishment), with a Rector, Academic 

Council, and Inspectors. This strictly uniform method of 

organizing instruction had the great advantage of helping 

to strike a balance among the various educational levels in 

the different parts of France, and of applying, in educational 

matters, the principles of order and equity throughout 

the country. 

This arrangement was maintained after the overthrow of 

the empire, and in the. course of time experienced only 

those improvements suggested by the needs of culture or of 

the State. Each faculty, from this time forth, conferred 

three degrees, those, namely, of Bachelor, Licentiate, and 

Doctor. Only the two last, when acquired in the department 

of medicine, gave the right to practise. The hospital 

schools were only allowed to grant the title of Officier de 

Sante. The professorships were obtained by competition, 

but in the year 1810 in the case of candidates of known 

literary and scientific merit the process of subjecting them 

to the prescribed examination, or of making them compose 

a thesis, was dispensed with. 

The hostile attitude afterwards assumed against LOUIS 

XVIII. by the medical faculty of Paris, and the riotous 

scenes which ensued thereupon, led to the doors of the 

schools being closed in 1822. When thrown open once 

more in the following year the faculty was reorganized. 

The staff of teachers consisted of 23 professors in ordinary 

and 36 agreges, of whom 24 were en exercise and 12 en 

stage. In 1824 the Ministry of Public Instruction was 

established, and to this the medical faculties and schools

FRANCE. 543 

were subordinated. During the next 50 years the organi 

zation of medical teaching in France was but little changed. 

Only under the third Republic were endeavours made to 

render it more extensive and complete. 

At the present time France possesses six medical 

faculties at Paris, Montpellier, Nancy — established in 

1872, after the University of Strassburg had, with the 

province of Alsace, been transferred to Germany—at 

Lille, Bordeaux, and Lyons (since 1877), where formerly 

lower class medical schools existed. Besides these, there 

are 18 medical ecoles preparatoires, the present designa 

tion of what were formerly called ecoles secondaires. 

They are situated at Marseilles, Nantes, Toulouse, Amiens, 

Angers, Arras, Besancon, Caen, Clermont, Dijon, Grenoble, 

Limoges, Poitiers, Rheims, Rennes, Rouen, Tours and 

Algiers, and are partly de plein exercise, that is, with 

opportunities for a complete course of medical study and 

in part merely preparatory schools. They are differently 

equipped in regard to appliances for study and in the con 

stitution of the teaching staff. The ecoles de plein exer 

cise have at least 17, the others 12, professors in ordinary. 

Between the former class and the medical faculties the 

only essential difference consists in the fact that they have 

not—like the faculties—the power of conferring the degree 

of doctor of medicine. But besides this the faculties are 

State institutions, whereas the other medical schools bear 

a municipal character. 

The students of medicine who desire to get legally 

qualified to practise attend the faculties or the ecoles de 

plein exercise, but are also permitted to pass a portion of 

the period of studentship at the ecoles preparatoires; in 

like manner the candidates for the position of Officier de 

Sante are admitted as students at the faculties, or at the 

other medical schools; but while the diploma of Doctor 

can be obtained at the faculties only, the qualification of 

an Officier de Sante can be got at any medical school. 

There is a comparatively small attendance at the ecoles


preparatoires. Of the 21 establishments of this kind which, 

existed in 1845, 18 had less than 40 students, six less than 

25, and the school at Rheims only 15. A similar state of 

affairs exists in the provincial medical faculties; for Paris 

monopolizes almost all the higher teaching. 

In 1877 there were in France 4,447 medical students, of 

whom 3,835 pursued their studies in Paris, while all the* 

other medical faculties together numbered no more than 

612 students. By the promotion of several preparatory 

schools to medical faculties which has been effected in the 

last few years this proportion has been to some extent 

changed. In 1881-82 Paris had 2,413, Bordeaux 155, 

Lyons 165, Montpellier 154, Nancy 83, and Lille 54 medical -v, 

students. In addition, 756 candidates for the qualification 

of Officier de Sante attended lectures of the various medical 

faculties. At the remaining educational establishments V. 

there were in all 632 students, of whom 306 were preparing 

themselves for the doctorate and 326 for the qualification • 

of Officier de Sante. Thus the total number of students of 

medicine of both categories reached at that time 4,412, of 

whom 3,330 had in view the diploma of Doctor, 1,082 

wished to become Officiers de Sante. .% 

As early as 1826 a proposal was made to the legislative t, 

assembly to abolish the lower class of practitioners,; but 

without result. In 1847, a g a i n , the doctors of medicine 

presented a petition begging that the Officiers de Sante 

(who at the same time applied for an extension of their 

privileges) should cease to form a recognized class of 

medical men. 

Once more, in 1864, an attempt was made to do away 

with the institution of Officiers de Sante ; but they found 

an advocate in BONJEAN,, who declared " A des malades « 

simples et pauvres il faut un meaecin. pauvre et simple 

comme eux, qui puisse compren.dre le langage, le besoin de 

ses modestes clients, qui, ne dans une condition peu Slevee," 

habitue" des son enfance a la vie sobre des chaumieres}'; 

ayant conquis son grade a peu de frais, puisse se contenter^

FRANCE. 545 

d'une modique retribution. L'officier de sante est dans les 

meilleures conditions pour remplir cette mission de modeste 

devouement; il se fera d'autant plus aisement le con 

fident, le conseiller, le consolateur du pauvre, qu'il en est 

presque le compagnon." 

For all that, the number of Officiers de Sante in France 

diminished year by year. In 1847 there were 7,456 of 

them, in 1872 only 4,653, while the number of Doctors 

, rose between the same years from 10,643 to 10,766. The 

disappearance of this grade of practitioners appears, 

therefore, to be only a question of time. 

The medical faculty of Paris stands at the head of all 

the medical schools; it has the most abundant supply of 

material and appliances for teaching, and the best arrange 

ment of studies. Its teaching staff consists at the present 

time of 33 professors in ordinary (titulaires) and a great 

number of agreges, who correspond nearly to the Austrian 

professors extraordinary. 

Of the professors in ordinary, 1 represents anatomy, 

1 histology, 1 physiology, 1 medical chemistry, 1 natural 

history in its bearing on medicine, 1 medical physics, 

1 pharmacology, 1 general pathology and therapeutics, 

1 materia medica, 1 internal and 2 external pathology, 

1 pathological anatomy, 1 comparative and experimental 

pathology, 1 midwifery and gynaecology, 1 operative 

surgery, 1 hygiene, 1 forensic medicine, and 1 the history 

of medicine, while 4 conduct the surgical clinic, 4 the 

medical clinic, 1 the gynaecological clinic, 1 the clinic for 

diseases of children, 1 that for diseases of the sexual 

organs, 1 the clinic for diseases of the eye, 1 that for 

mental diseases, and 1 that for diseases of the nervous 

system. They draw yearly salaries of 15,000 francs, and 

are nominated, on being proposed by the faculty, from 

among the number of the agreges. 

The latter assist and represent the professors in ordinary 

in teaching and during the examinations, and, when they 

are commissioned to lecture, receive the pay of 6,ooofr. a 

N N


year. They are divided into three classes—the agreges 

" stagiaires," "en exercise," and " libres." For the first 

three years after their election they have neither rights nor 

duties, and are called stagiaires. They then are promoted 

into the list of active agreges, corresponding in number to 

the professors in ordinary ; as agreges en exercise their 

duties are to give lectures and to act as examiners, and 

they are in receipt of pay. After they have been actively 

engaged in these duties for six years or even longer they 

become agreges libres, and are no longer obliged to give 

lectures or to perform any other services, they receive no 

pay, and only enjoy the privilege that they are qualified 

like the other agreges for nomination to the position of 

Professor in Ordinary. 

Preferment to the position of agrege is the result of 

competition between numerous candidates, which, however, 

takes place only in Paris. This was formerly usual also in 

appointments to professorships in ordinary; since 1852, 

however, it has been limited to the election of agriges 

and of officials of a similar kind. Every legally qualified 

doctor who belongs to the French nation and has completed 

his twenty-fifth year is at liberty to take part in this 

competition. The competitor hands over his scientific 

compositions to a Commission, the members of which are 

professors and other learned men; he also, being left 

entirely to himself and without any aid from books, writes 

an essay on a question which has been set him, and, finally, 

he delivers a lecture upon a subject which has been sug 

gested to him three hours previously. The Commission 

then makes a selection from among the candidates in 

accordance with their performances, so that the number of 

those selected shall not exceed three for each vacant ap 

pointment. These have once more to undergo an examinar 

tion, which consists of practical research, the delivery of a 

lecture, and the composition of a treatise on a given subject, 

which has to be prepared within a stated time. 

The candidature for the position of agrege is never

FRANCE. 547 

undertaken with a view to the representation of one special 

department of medical science, but a definite number of 

branches are grouped together. The agreges, conformably 

to this arrangement, are separated into four divisions: of 

these the first includes anatomy and physiology ; the second 

the natural sciences, physics, chemistry, and pharmacology ; 

the third pathology and therapeutics, internal medicine, and 

State-medicine; and the fourth the surgical departments 

with midwifery. 

In 1884 the teaching staff of the medical faculty of Paris 

consisted of 120 professors; at Lyons there were 64; at 

Bordeaux, 50; at Douai-Lille, 45; at Montpellier, 43; and 

at Nancy, 41. The faculty of Lyons had no less than 25 

professors in ordinary. 

From all.this it is evident that the medical schools of 

France are richly supplied with teachers, and that the 

Government spares no expense in providing them. In 

Paris the salaries of the professors of the medical faculty 

amount in the aggregate to nearly 70o,ooofr. a year, a sum 

far in advance of that expended on the medical faculties in 

many other countries. The same admirable care is shown 

in furnishing the medical faculties with appliances and 

aids for teaching. The medical schools of Paris and 

Lyons, which I can speak of from personal experience, are 

arranged in a most exemplary manner. 

Teaching is carried on in Paris partly at the Ecole de 

Medecine, where the theoretical lectures of the professors 

are delivered, partly at the Ecole Pratique, at which the 

establishments for practical work have been centred, and 

partly in the various hospitals in which the clinics are 

held. 

The large airy dissecting rooms, well supplied with water, 

good light, and in every respect answering the hygienic 

requirements of the present day, contain 682 work-places. 

Besides the Director, who is at the same time a Professor 

of Anatomy, eight prosectors and twenty-four assistants are 

at work there, introducing the students to the art of


dissecting and watching over their progress. Moreover, 

each-of the prosectors gives three lectures a week, and each 

of the assistants one lecture, the subjects of which are chosen. 

in accordance with a plan sketched out by the Director. 

These lectures of the prosectors and assistants are in close 

connection with one another, and together serve to review 

the whole of the science of anatomy; they form the most 

important part of the teaching of anatomy. The posts of 

prosector and assistant are filled by competitive examination. 

Whoever aspires to become a prosector must be a 

legally qualified practitioner, and must undergo a written 

and oral examination on anatomy, histology, physiology,. 

and operative surgery, must put up an anatomical and a. 

histological preparation, and must perform two surgical, 

operations upon the dead body. The assistantships are alsoconferred 

after competition, and are entrusted to older 

students who show ability. The students are bound to 

appear regularly at the anatomical lectures of the prosectors 

and assistants, and also to practise dissection methodically 

for three hours daily, and they subject themselves to much 

unpleasantness if they neglect these observances. 

The practical work in the school of anatomy claims threewinters. 

During the first two, normal human anatomy is 

studied, during the last winter operative surgery on the 

dead body. For this the student pays a fee of 100 francs. 

The abundant supply of material for instruction, the 

strict manner in which the attendance and work of the 

students are looked after, the close connection between 

theory and practice, the application of anatomical facts to. 

practical medical science and especially to surgery, and 

the continual personal instruction given by the teachers. 

lead to remarkable results. The medical students of Paris 

acquire as a rule a thorough knowledge of anatomy which 

has inestimable advantages in regard both to their further 

technical training and to their success afterwards in the 

practice of their profession. 

There exists in Paris a special Anatomical Institute for

FRANCE. 549 

the professors, the hospital doctors and their assistants : 

this has no connection with the Ecole Pratique intended for 

•students but is conducted by a professor of anatomy and 

his assistants and is used for making post-mortem exami 

nations, for practising operative surgery, and for scientific 

research. There are laboratories, museums and work-rooms 

for teaching physiology, histology, physics, chemistry and 

the natural sciences : the natural history museum and the 

botanical garden are made to serve the same purpose. 

There are also professorships of physiology and the 

natural sciences at the College de France and at the Ecole 

Normale— an educational establishment for teachers of 

advanced subjects : the professors give lectures, and faci 

lities are extended to the students of the medical faculty 

to attend them. 

The 14 clinics, which are under the direction of the pro 

fessors in ordinary and are thus an essential feature of the 

official course of instruction, are not centred in one 

hospital but are divided amongst the Hotel Dieu, the 

Charite, the Pitie, the Clinique d'Accouchements, the 

Hopital des Enfants Malades, the Necker, Cochin, and 

Salpetriere Hospitals, and the Hopital du Midi. Every 

medical student is bound to take part, during the last two 

years of his studentship, in the medical visits to one hospital 

and to perform the small services which are there assigned 

to him. 

The directors of the assistance publique assign the 

doctors who give in their names to them for this service 

to the various hospitals of Paris. 

The arrangements at the other medical faculties and 

schools of France are of a similar character to those existing 

in Paris. 

The student of medicine must on beginning his technical 

studies show that he has received a satisfactory general 

education. He is on this account required to possess the 

diploma of Bachelier es Lettres which nearly corresponds 

to the "Leaving-Certificate" (Abiturienten-Zeugniss) of the


German gymnasiums, and in respect of his knowledge of 

mathematics and the natural sciences to have taken the 

degree of Bachelier es Sciences.* 

The period of studentship extends over four years; it is 

not divided into semesters but into courses of two or three 

months' duration which are attended in a prescribed order. 

The student is obliged to work practically at physics, 

chemistry, and the natural sciences in his first year; at 

anatomy, histology, and physiology in the second and 

third years; and at pathological anatomy, operative 

surgery, and clinical and hospital work in the fourth year. 

This period of study at the hospitals is termed stage. 

The examinations in the various subjects formerly took 

place at the end of each year. This arrangement was however 

abolished in 1878 and another adopted in its place, 

according to which five examinations have to be passed. 

The first includes physics, chemistry, and natural history 

and takes place at the end of the first year; the second 

embraces anatomy, histology, and physiology and follows 

partly in the course of the third year, partly at its conclusion. 

The third examination deals with surgical pathology, 

midwifery, and operative surgery, and also with general 

pathology and the pathology of internal diseases; the 

fourth, with hygiene, forensic medicine, therapeutics,. 

materia medica and pharmacology : and the fifth involves 

the examination of cases in the surgical, medical and 

obstetric clinics with their treatment and the performance 

of a post-mortem examination. The candidate must also 

show his knowledge of normal anatomy by putting up a 

preparation, and his surgical skill by the performance of an 

operation on the dead body. Finally he is obliged to write 

a thesis upon a subject chosen by himself and to submit it 

to the Faculty. He is then advanced to the degree of 

Doctor of Medicine. 

The aspirant to the position of Officier de Sant6 requires 

a less advanced general education : he is required to write 

* Programme de Vexamen baccalaure'at es sciences, Paris 1885.

FRANCE. 551 

a treatise in French without mistakes of spelling and 

to answer questions upon the most important facts in 

natural science, physics and chemistry. The period of 

studentship for Officiers de Sante likewise extends over 

four years. The curriculum is nearly the same as for the 

future doctors of medicine except that less stress is laid 

upon the theoretical side of studies especially in histology, 

physiology and pathological anatomy. The examinations 

are of a corresponding character, and are limited to the 

main points and principles of subjects.* 

The French military doctors were formerly educated at 

Strassburg, and attended the lectures of the medical faculty 

there. In 1872 a rule was made that the military medical 

students should be distributed among 11 medical schools 

and should receive instruction there with the other medical 

students; but in 1883 in place of this two ecoles pre 

paratoires du service de sante were founded at Bordeaux and 

Nancy for the education of doctors for the army. The 

students of these schools participate in the teaching given 

by the medical faculties at the places mentioned ; they are 

obliged to spend five years in study, and are looked after 

and helped in their work by older military medical officers 

who act as tutors in the various subjects of study. When 

they have finished their studies and have obtained the 

degree of doctor they are transferred for the completion of 

their professional training to the ecole d'application con 

nected with the great military hospital of Val de Grace, 

where they serve in the wards for eight months and lay in 

a stock of experience in practical medicine. 

The system of medical education in France possesses 

along with many advantages, among which the excellent 

anatomical and clinical training of students must be 

especially mentioned, also certain lamentable defects. Thus 

it seems strange that, according to the curriculum of study, 

the first year of studentship should be devoted entirely to 

* Indications sommaires des conditions a remplir pour l'obtention des grades 

de docteur en me'de'cine, d' officier.de sante, etc., Paris 1884.

552 

MODERN TIMES. 

the sciences ancillary to medicine and that attendance 

upon lectures on anatomy should not be commenced 

until the second year. In this way the study of medical 

science itself is confined to three years, a period within 

which it does not seem possible to digest and assimilate 

:;uch rich intellectual food as is contained in the matter 

taught during that time. Then, as the second examination 

which deals with anatomy and physiology falls at the end 

of the third year, and the student has been till then chiefly 

occupied in preparing for it, there remains not much more 

than one year for training in practical medicine. 

A prolongation of the period sanctioned bylaw is the 

natural result of this, and is indeed rendered necessary by 

the three last examinations. 

A more serious flaw in the system of medical teaching 

in France lies in the way in which the teaching staff of a 

medical school is selected and made up. Competition, the 

form of candidature where all have equal chances, no doubt 

affords a better guarantee than do other methods of ap 

pointment to vacant offices, against the evils of favouritism, 

patronage, and nepotism : moreover in cases where it is a 

question of obtaining the position of agrege, or the office 

of prosector or assistant, in short an admission to the 

active list of university teachers, it is as a general rule quite 

justifiable and indeed an excellent way of finding out and 

estimating the ability and knowledge of the individual 

candidates. But to select only a specified number of 

candidates to compete seems to be a method not calculated 

to promote the end in view, for it is not possible to make 

distinctions quite in harmony with the demands of justice 

and equity between numerous candidates of nearly similar 

qualifications, and the scientific capacity of the selected 

candidates shows marked differences in different years. 

As little is it possible to justify the division of those 

aspiring to the position of agrege into four groups corre 

sponding to the different branches of learning as is the case 

at the present day: for many subjects, as for instance the

FRANCE. 553 

history of medicine, hygiene, and state-medicine, can with 

equal justice be put into one or another division. By the 

present arrangement a scientific man who has distinguished 

himself in his speciality may fail to get on the active list 

of university teachers. 

The regulation that the competitive examinations for 

the position of professeurs agreges to all the medical 

faculties and schools of France must be held in Paris is 

especially bad. For by this arrangement the candidates 

who are trying for the position of teachers in the provinces 

are obliged to make a lengthened stay in Paris, and are 

subjected to unnecessary expense; all the medical faculties 

and schools, except that of Paris, suffer in their dignity 

and interests, inasmuch as the decision upon weighty 

questions of appointment is committed into the hands of 

persons who are ignorant of the local needs, and finally the" 

heavy burden of these competitive examinations is thrown 

upon the Paris faculty, and is felt to be the more oppressive 

inasmuch as that body has already too many claims upon 

its resources in the examination of the crowds of students 

resident in the capital. On these grounds it has already for 

some time been wished that the competitive examinations 

-should be held not in Paris only but at every medical 

faculty, that the teaching staff of every-medical school 

should have the right of making suggestions as to the 

filling up of vacancies in their own body, and that candidates 

who in the competition satisfy the examiners should be 

qualified for admission not merely to one faculty but to 

any medical school in the capacity of teachers, and should 

not be obliged to undergo another examination* 

In appointing professors in ordinary competition has 

-rightly been abolished, for here it is not a question of 

persons whose fitness as teachers and investigators it is 

necessary to examine into, but of men of learning whose 

-scientific performances are things well known in profes- 

* Revue internationale de l'enseignement, Paris 1882, T. iii, p. 126, 533.— 

DREIFUS-BRISSAC : Rev. int., Paris 1887, T. xiv, p. 469 el seq.

-554 

MODERN TIMES. 

sional circles. Each medical school must see that it gets 

the best ability available to fill these positions. It is, there 

fore, inadvisable that the teaching staff should, in the pro 

posals which for this purpose they submit to the minister, 

be limited to the professeurs agreges who are in office at 

their own faculty. Such a rule leads to a local exclusive- 

ness in the particular medical school, and to the danger 

that an intellectual congelation may supervene in it. It is 

just the change of theory and doctrine, produced and 

favoured by the free interchange of professors, which keeps 

intellectual life fresh and sensitive to every movement 

which promises to lead to some desirable end. On the 

., other hand it may not unfrequently happen in consequence 

" of the present arrangement that a man of remarkable attain-- 

ments, working at a small academy in France, is deprived 

of the opportunity of exercising his talents in a larger sphere 

of activity, where he might accomplish great things for 

science and for his country. 

It therefore appears highly desirable that the faculties. 

should, in regard to this matter, be freed from these limita 

tions, and that in proposing men to fill vacancies in the 

professorships in ordinary, they should be at liberty to take 

into consideration, with a view to election, the ordinary 

professors and agregfc of all the medical faculties and 

schools. In this case, should a man, hitherto not engaged 

in academic teaching, appear in any special circumstances. 

to be the most suitable candidate for a professorship, the 

nomination of such person for the office would be permitted. 

This course has exceptionally been adopted, for example, 

when the professorship of the History of Medicine, founded 

at Paris in 1870, was conferred upon C. DAREMBERG, dis 

tinguished for his profound knowledge of the medical 

science of the Greeks. 

The French should study the arrangements which exist 

in regard to these questions in Germany and Austria, and 

when these appear worthy of imitation they should intro 

duce them into their own country.

AUSTRIA-HUNGARY 555 

AUSTRIA-HUNGARY. 

IT was not until the 18th century that the system of medical 

education in Austria got rid of those features characteristic 

of the middle ages, which had exercised a restricting and 

narrowing influence upon its development. It had up to 

that time rested exclusively in the hands of the doctors' 

guild—the union which included all medical men entitled 

to practise, and which was designated as the Faculty. 

From amongst the members of this society the professors 

were chosen, and their election was confirmed by the 

University Consistory. The latter, which corresponded 

nearly to the University Senate of the present day, had 

been dominated by the power of the clergy ever since the 

Order of Jesuits had, by the Pragmatic Sanction of 1623, 

acquired a preponderating influence in all questions of 

education. 

The professors of medicine drew but miserable salaries, 

and were therefore obliged to support themselves by 

medical practice. At the same time their scientific work, 

except in the case of a few, was of an insignificant character. 

In a report upon the University of Vienna, laid before the 

Government in 1688, it is remarked " that in this University 

of Vienna for so many years hardly anything has been heard 

from its professors of law and medicine, who have neglected 

to bring forward or publish any subject connected with 

their sciences. The University of Vienna might as well be 

asleep, or no such seat of learning exist in Vienna at all. 

On the other hand, it is notorious how indefatigable and 

industrious the professors at other high schools in Germany 

are, what fine books they write, and what useful works they 

get printed and published."* 

There was a complete lack of the appliances and estab 

lishments required for the study of medicine, and even the 

* KINK :. Geschichte der Universitat zu. Wien, Wien 1854, i, 398.

556 

MODERN TIMES. 

I 

lectures were given so irregularly that the teachers of 

medicine were in 1689 and 1727 reproved by the Government 

for their idleness. Various attempts made to remedy 

this unsatisfactory state of affairs in 1629, 1687, and 1726 

did not meet with success. In 1718, the medical faculty 

of Vienna proposed to adopt practical instruction, at the 

bedside, at post-mortem examinations, and in the regular 

practice of dissection, to erect a collegium chymicum and 

lay out a botanic garden, to appoint assistants in the 

hospitals, to raise the. salaries of the professors, and to 

•summon distinguished teachers from abroad* But the 

horror with which a change of system was regarded by the 

ruling classes, and the want of sufficient money to pay 

for the necessary arrangements prevented the completion 

•of these designs. 

The great Empress, MARIA THERESA, who amid the 

grievous embarrassments and wars which shook her throne, 

found time and energy to take thought for improvements 

in law and administration, directed her attention to these 

matters. She commissioned her private physician, 

GERHARD VAN. SWIETEN, who enjoyed her complete confidence, 

to investigate the defects in teaching at the Vienna 

University. 

In a report which he drew up on this subject he referred 

to the cause of the existing evils, which he considered to 

lie in the dependence of the university upon the Church 

and the Guild., He demanded that the State should be 

complete master in its own house and should direct and 

watch over medical education. The proposals which he 

submitted to the Empress met with her approval, although 

in giving it she had doubtless to sacrifice some convictions 

which had become endeared to her by tradition and train 

ing. 

In the Edict of Reform, of February 7th, 1749, it was 

decreed that thenceforth the professors of medicine should 

no longer be appointed by the University Consistory, but 

* ROSAS: Geschichte der Wiener Hochschule, Wien 1843,11,232.


by the Empress, that their salaries should be increased to 

a reasonable amount, and paid out of the Imperial treasury, 

and that their duties and teaching as a whole should be 

under the control of a director representing the Govern 

ment. 

G. VAN SwiETEN himself undertook this important office 

in Vienna; in other faculties it was entrusted to high 

officers of State. They presided also at meetings of the 

Guild Colleges, .and at the examinations of doctors, 

surgeons, apothecaries, and other practitioners. At the 

same time the medical faculties were equipped with the 

necessary appliances for teaching. At Vienna a botanic 

garden and chemical laboratory were established, and the 

regular practice of dissection and clinical teaching was 

introduced. The ceremonies connected with taking a 

degree, which on account of the ecclesiastical observances 

associated with them, had led to the necessity of expending 

the considerable sum of 1,000 gulden, and had consequently 

compelled many students to take their doctor's degree in 

foreign countries, were now simplified and confined to 

special occasions, and the whole system of examination 

was subjected to closely prescribed regulations. The other 

medical faculties of the Empire were soon after this re 

organized after the pattern of the Vienna school, and 

provided with professorships and the necessary establish 

ments. G. VAN SwiETEN advanced to the head of the 

entire system of medical education, and acquired an 

influence which extended itself over the administration of 

teaching in all its branches. 

When the Emperor JOSEPH II. ascended- the throne 

there commenced a period of innovations in these matters 

succeeding one another with great rapidity, occasionally 

even pressing too quickly upon each other's footsteps. All 

limitations which had rendered it difficult for non-Catholics 

to take academical degrees, were abolished, and the degrees 

themselves were deprived of their religious character, the 

salaries and pensions of the professors were brought into


•conformity with those of other officials, special academical 

jurisdiction was done away with, and members of the 

university were made amenable to the ordinary law, and 

instead of lecture fees, which were discarded, a system of 

paying a definite amount every month was introduced into 

the universities. All the universities of the monarchy 

were made equal in rank, and the same rights and 

privileges were accorded to the diplomas and certificates 

of them all : a law which, however, a few years later was 

modified to the extent of limiting practice in Vienna to 

those doctors and advocates who had passed examinations 

at the University of Vienna. 

The Emperor devoted himself with great zeal to the 

improvement of medical teaching and of the educational 

establishments connected with it. He lamented the 

neglect shown to the study of surgery by the doctors, and 

the unsatisfactory training of surgeons, and he recognized 

what a great mistake it was to rigidly separate surgery from 

internal medicine. He discerned that the best means of 

removing the defects of medical teaching lay in the reunion 

of these two branches of the general science, and 

in the blending together of physicians and surgeons. With 

this object he caused to be carefully drawn up a plan of 

studies for these two classes of students, which fixed the 

period of study at four years, and, with slight modifications 

in the two cases, required from both a knowledge of 

all branches of medicine. 

The promotion of the school for military doctors—the 

Josefinum—to a medico-chirurgical faculty with the rights 

and rank of a university and its association with a surgical 

academy contributed very much to raise the surgical profession, 

both scientifically and socially. 

There arose at the same time a class of inferior country 

practitioners, bound only to a two years' course of study ; 

these with the name of surgeons accepted also the social 

position hitherto held by that class. 

In this manner a complete metamorphosis was brought


about in the system of medical education and in the social 

relations of the medical profession, the main features of 

which have been preserved until modern times. Several 

other measures, such as the abolition of the degree of 

bachelor and of the inaugural dissertation—for the latter a 

practical examination at the bedside being substituted • 

formed very appropriate improvements in medical educa 

tion. The erection of the General Hospital at Vienna—the 

abundant material for instruction afforded by it being made 

available for clinical teaching—and, the foundation of the 

Military Hospital which was devoted to the same purpose 

as the Josefinum, rendered possible the splendid successes 

which the Vienna school of medicine has since achieved. 

JOSEPH II. also established the Deaf and Dumb Institute, 

the Foundling Hospital and the Veterinary Hospital in 

Vienna, and caused hospitals to be erected in Prague, 

Graz, and other large towns of the empire and to be made 

use of for the education of doctors. He also built per 

manent military hospitals in Milan, Mantua, Prague, Briinn, 

Olmiitz, Pesth, Koniggratz, Lemberg, Hermannstadt and 

other places. " Whatever can be devised to cure sick and 

wounded humanity, to alleviate suffering and to preserve 

life has been a subject never neglected by me; every 

individual man has been precious to me," were his words 

on taking leave of the army a few days before his death. 

The beneficent creations of this Emperor, who even if he 

did make mistakes was at all times filled with an earnest 

desire to make his people happy, give him a claim upon the 

gratitude of mankind. His good deeds have outlasted his 

plans and, performances in the field of politics and to this 

day bear testimony to the noble prince who lived for his 

people non diu sed lotus, as is said on the monument which 

has been erected to him in his capital* 

The reaction which set in against his political schemes 

was also directed against the measures he had taken in 

TH. PUSCHMANN : Die Medicin in Wien wahrend der letzten hundert Jahre, 

Wien 1884, S. 53 et seq.


the administration of education. "A commission for the 

arrangement of studies " was convoked, and was charged 

with the task of. leading educational matters once more 

back into the old familiar track. Party spirit asserted. , 

itself in medicine, and made an attempt to regain the 

influence which it had once possessed in the educationof 

doctors. A desire was shown to restore the former relations 

between physicians and surgeons, to relegate the latter to a' 

dependent and subordinate position and once more to sever 

the bond of union between surgery and internal medicine,. 

which had been accomplished by the curriculum of 1786. 

It was asserted that these two branches of medical science 

were too heterogeneous and too extensive for it to be 

possible for one man to be master of both in an equal/* 

degree. In regard to the Josefinum the objection was 

raised that it was too expensive and was certainly not of 

equal repute with the medical faculties of the universities. 

But its total abolition was not ventured upon: for 

the country could not afford to dispense with the only 

institution which concerned itself with the supply of 

military, doctors in the midst of the prolonged wars in 

which Austria was involved at that period. Moreover, 

daily experience showed how necessary and important a¥ 

knowledge of surgery is, and to degrade that science ap-': 

peared to be an act by no means suited to the spirit of the _ 

age. The complaints directed against the Vienna General . 

Hospital had more justification. The improvements whicly 

were thus brought about proved to be to the advantage of\ 

that establishment. No alteration was made in the medical 

curriculum, although it was in many respects in need of 

reform* On the other hand the professors were given 

strict instructions as to the way in which they should con^ 

duct their teaching and the text-books were mentioned^ 

which were to form the basis of their lectures. The directorate 

of studies was abolished, but being reintroduced a 

* Freimuthige Betrachtungen viber den medicinischen Unterricht an der 

hohen Schule zu Wien, 1795.


few years later it formed as before the board of inspection 

for the affairs of the faculties and conducted the whole 

system of education. 

In 1804 the period of study for students of medicine and 

of the higher surgery was extended from four to five years 

and it was decreed that the first three years should be 

devoted to theoretical training, and the last two principally 

to attendance at the clinics. At the same time it was 

notified that no one should be admitted to the study of 

medicine who had not during three years previously 

attended^ lectures on ''philosophy" at the university and 

'had acquired a satisfactory general education. Every 

teacher was obliged to spend at least half-an-hour every 

week in satisfying himself by questioning his pupils, that 

the substance of his lectures had been understood and 

assimilated by them. At the end of every half-year public 

examinations of the students were held, and it depended 

•upon the result of these whether they should be per 

mitted to attend the regular course of lectures for the 

following half-year. Moreover, the regulations for the 

qualifying examination, held at the conclusion of the 

period of studentship, were made more severe and 

the examiners were admonished to apply them strictly and 

conscientiously. 

In 1810 a new medical curriculum was arranged in 

which those subjects which had lately been added to the 

course of study were included. According to this medical 

"students had to attend classes on the following subjects 

during the periods specified : 1st year, introductory course 

on medico-chirurgical study, natural history in its bearings 

on medicine, botany and systematic anatomy; 2nd year, 

more advanced anatomy and physiology, general chemistry, 

pharmacy and animal chemistry ; 3rd year, general patho 

logy and therapeutics, aetiology, semeiology, materia 

medica et chirurgica, dietetics, the art of prescribing, 

midwifery, general and' special surgery, surgical instru 

ments, bandaging and ophthalmology; 4th and 5th years, 

O O

562 

MODERN TIMES. 

special pathology and therapeutics of internal diseases, 

veterinary science, forensic and state medicine. During 

the last mentioned period attendance at the clinics was 

required. 

Those who were training for country doctors (Landarzte) 

were obliged during the first year to attend the introductory 

course on medico-chirurgical study, lectures upon 

theoretical surgery, anatomy, physiology, general pathology 

and therapeutics, materia medica et chirurgica, dietetics, 

the art of prescribing, and bandaging; during the second 

year they had to attend courses of operative surgery, 

forensic medicine, midwifery and veterinary science, and 

to visit the medical and surgical clinics. Their period of 

studentship was afterwards prolonged by one year. The ^ 

students were left at liberty to judge for themselves 

whether they should attend the obstetric clinic or not, and 

the same was permitted in regard to their attendance upon 

lectures on several other subjects. On every subject of 

primary importance it was required that on five days in 

every week a lecture of one hour's duration should be 

o-iven ; twice that time was devoted to instruction given in 

the medical and surgical clinics. 

Care was also taken that what was taught should be 

rendered more easily comprehensible by demonstrations • 

and practical work. The students made botanical excur- "i 

sions under the guidance of their teachers, worked in the 

chemical laboratory, practised dissection of the human ; 

body, attended post mortem examinations and performed;; 

operations on the dead body. Dissecting rooms were 

erected where they were wanted : but the students had to 

bear the expense involved in procuring the necessary sub 

jects for dissection. 

Whoever was a candidate for the degree of Doctor of 

Medicine was obliged, first of all, to submit the history of 

two cases which he had himself treated in the clinic, then 

to undergo an examination on the subjects laid down in 

the curriculum, and finally to compose a dissertation and.

AUSTRIA-HUNGARY. 563 

• to defend by argument a position taken up on a point of 

.medical science. 

The examination for the doctorate of surgery differed 

from this chiefly in the circumstance that instead of 

internal medicine, surgery formed the chief subject and the 

candidates had to perform two surgical operations on the 

dead body. 

When a Doctor of Medicine desired to take the degree of 

Doctor of Surgery or vice versa, he had only to pass a 

supplementary examination which was concerned with 

questions which had been too little dwelt upon in the 

previous examination. The demands made upon those 

who were satisfied with the title of Master of Surgery 

were of a less severe character. And the case was the 

.same with the country doctors. A' diploma in ophthalmic 

surgery was also granted, but the class of rupture-curers, 

:so-called, was abolished. 

In 1822 the period of studentship at the Josefinum was also 

lengthened to five years for the greater and to three years 

for the lesser course, and the curriculum which had been 

introduced at the medical faculties was made the founda 

tion of the teaching there. The institution consequently 

received the right of granting all academic degrees. The 

•order of studies for the year 1833 gives evidence of no 

essential alteration either in the teaching or in the exami 

nations; but ophthalmology received more attention than 

previously. 

In 1845 a commission of experts was appointed and 

took counsel together upon the faults in the system of 

medical teaching and made proposals for improvements. 

But before any final decision was arrived at the year 1848 

was reached, and during it a complete revolution was 

effected in these matters. The professors of the Vienna 

medical faculty submitted a plan of reform for medical 

study,to the newly created Ministry of Education: in it 

attention was drawn to the inconvenience of both the 

College of Teachers and the Associated Doctors of Vienna

5 6 4 

MODERN TIMES. 

being designated as the Medical Faculty, and of the pro. 

fessors being excluded from the most important offices, as 

from those of Rector, Dean and Director of medical studies,. 

and being almost entirely unrepresented in the University 

Consistory. 

They demanded that the professors in ordinary, as in 

German universities, should form a college to be in imme- 

1 diate correspondence with, and only subordinate to, the 

Ministry ; that this college should independently deliberate 

upon questions of teaching and despatch other business-;: 

should hold examinations and confer academical degrees ; 

1 that the professorships shou]d_be filled up not by competition, 

butbyimdtato ; thjtthâpôint.ments of professors 

« ( ~^xMb^rm^nt, and should be forfeited only in con- 

SeqJIeJcTofdilto 

J duty; that the ordinary and extraordinary professors who 

represented subjects laid down in the curriculum should be 

properly remunerated by the State, " so that being freed 

from the care of having to earn Jtheir own Jbfâd.tb^yjaagr 

be able toappiy their minds to science, and especiallyJa, 

the a^ncementot The subjects they represent; " that the 

scientific'es'tablishments should be equipped and endowed 

in a way suitable to their requirements; that freedomshould 

be granted both in teaching and in learning, the , 

teachers not being bound to follow particular text-books nor 

the students compelled to attend certain lectures or to get 

their professional education exclusively in the schools of 

the country ; that the six-monthly examinations should be 

abolished ; that the Dean of the faculty should preside at 

the medical examinations and the Rector at the conferring 

of degrees ; that the Dean should be chosen from among 

the number of the professors in ordinary and by them ; that 

the connection between the university and the doctor's 

guilds should be severed, and the medical corporations 

cease to have any influence upon professional education. 

Baron E. VON FEUCHTERSLEBEN, the author of the wellknown 

"Dietetics of the Mind," who was employed in


teaching psychological medicine at the Vienna University, 

was requested to undertake the direction of the Ministry of 

Education ; he, however, declined the post of minister, 

heing, as he says in his autobiography, " convinced that in 

view of the changes of ministry resulting from a representa 

tive system, and having regard more particularly to the 

circumstances of the time, it was of no use for a minister to 

think that he would be at liberty to prosecute any work 

without interruption, although such is precisely the indis 

pensable condition of success in undertaking a reform of a 

broad and sweeping character." He was therefore content 

to occupy the position of Under-Secretary of State in the 

Ministry of Education, and during the short period of his 

official activity brought about a number of important 

reform's. 

Thus he introduced the teaching of natural science into 

the gymnasia; he prolonged by two years the period of 

•studentship at these establishments, by arranging that the 

course of philosophy, which hitherto students had gone 

through at the university, should now be made part of the 

studies of the gymnasium ; he succeeded in establishing 

freedom for both teachers and students at the universities; 

he did away with the competitive method of filling up pro 

fessorships, and took care that the appliances for teaching 

and the collections of the Josefinum were handed over to 

the Vienna medical faculty when the former institution was 

abolished. 

In 1849 the law for the organization of the academic 

authorities was promulgated* according to which the 

arrangement of studies was placed under the direction of 

the professorial staff of the various universities. The staffs 

are composed of all the ordinary professors and of as many 

of the extraordinary professors as shall not exceed half the 

number of the ordinary, together with two representatives 

of the private lecturers, who, however, possess merely con- 

G. THAA : Sammlung der fur die osterreichiscben Universitaten giiltigen 

Gesetze und Verordnungen, Wien 1871, i, 69 et seq.

566 

MODERN TIMES. 

sultative functions. The Dean, who is elected from among 

the professors in ordinary, presides at their meetings ; he 

in many respects takes the place of the former Director of 

Studies, a functionary whose office has been abolished. 

In Vienna and Prague some remnants of influence were 

preserved for the doctors' guilds and medical corporations, 

inasmuch as they were still regarded as parts of the 

university and were designated as faculties, and received • 

the privilege of electing a Dean, who had a seat and vote 

in the assembly of professors, and co-operated with them in 

the medical examinations. It was not until 1873 that a 

complete separation was effected between the doctors' 

guilds on the one hand and the faculties and universities 

on the other.* The doctors' guilds from this time forth 

have been nothing but medical clubs, concerning them 

selves with the management of their property, the granting 

of pensions, etc., but without any official obligations. 

As early as 1848 the abolition of the inferior education 

given to the country doctors was mentioned in a ministerial 

decree as a measure desirable on principle.t But many 

difficulties stood in the way to prevent this being carried 

out. People could not help being afraid that if the schools 

intended for the education of the country doctors and 

inferior class of surgeons were suddenly closed a decided 

deficiency in the number of practitioners would be brought 

about, and they consequently wished to provide substitutes 

in time. Then the courses of instruction which had 

hitherto been given at the universities of Vienna and 

Prague for the country doctors were discontinued, while 

the medico-chirurgical schools at Graz and Innsbruck were 

shortly afterwards promoted to actual medical faculties, 

and were incorporated with the universities of those places. 

The other establishments of this kind which existed at 

Salzburg, Olmiitz, Laibach, Lemberg, and other places 

were o-radually closed.. With this the lower class educa 

tion came to an end. 

* THAA op. cit., S. 615 et seq. t THAA op. cit., S. 497


From this time onwards an opportunity for the study of 

medicine was afforded only at the universities. At the 

present time medical faculties are possessed by the 

universities of Vienna, Prague, Graz, and Innsbruck, where 

the German language is employed for teaching; by the 

newly-created Czech university at Prague; by the Polish 

academy at Cracow ; and by the two Hungarian univer 

sities at Buda Pesth and Klausenburg; none is possessed 

by the high schools of Lemberg, Agram, or Czernowitz. 

The Josefinum after being shut up in 1848, and opened 

again in 1854, was closed once more in 1870, as it was 

thought that with the introduction of general compulsory 

military service there would be no lack of military doctors. 

This assumption has, however, not been realized, and 

perhaps some day the re-establishment of a school for 

military surgeons will become a matter of necessity. A 

military power of the rank of the Austrian Empire requires 

a school for its medical officers, as is shown by the 

examples of France, Prussia, and Russia. Its features and 

organization may differ from those of the Josefinum, but 

its existence is a matter in which the country and the 

army are both interested. 

The number of existing medical faculties stands in no satis 

factory proportion to the extent and population of the Austro- 

Hungarian monarchy. The attendance at them is conse 

quently large to an extraordinary degree. Of late years the 

average number of students at Vienna has been considerably 

over 2,000. The cause of this lies partly in the good repu 

tation enjoyed by the school and teachers, partly in the 

circumstance that many poor students think that, in the 

capital, they will find pecuniary support or opportunities of 

earning money by giving lectures, etc. PETER FRANK* long 

ago lamented the very prevalent custom of giving lectures 

in this way—and it is especially prevalent in Vienna—for 

by it medical students are withdrawn from their proper 

tasks and driven into a kind of work which is without any 

* P. FRANK op. cit., vi, 1, S. 336.


value to them in advancing their professional education. 

Unless they are extraordinarily gifted they are apt to 

suffer shipwreck on these rocks, and never to finish their 

studies at all. 

It can easily be understood that crowded lecture rooms 

and clinics are not conducive to the study of medicine; 

for here it is important to see well, and closely to observe, 

every object and every patient and to follow the 

course of every experiment intelligently. With a view 

to remedy the inconvenience resulting from the fact that 

the space at disposal is insufficient for the number of 

students, it has been suggested to limit their number* but 

the difficulty of fixing upon any proper or suitable limit to 

the number of students to be admitted and still more the 

natural dislike to anything like a forcible suppression of 

the popularity of the University of Vienna have not failed 

to deter the authorities from trying such an experiment. 

The medical faculty of Vienna must not be measured by 

a scale adapted for a provincial university. Its history, its 

arrangements and its abundant supply of material for teaching 

have created for it a world-wide reputation. It forms 

one of the few centres which attract representatives of the 

various peoples of the monarchy, and by its geographical 

position it seems designed to be the means of transmitting 

to the East the scientific medicine of Europe, a task of 

high import in the history of civilization. The degradation 

of the medical school of Vienna would be a crime against 

the State, against science, and against humanity. 

If there is a want of the necessary space for teaching, it 

must be supplied by extending the present premises or by 

erecting new buildings. Preventive measures may also be 

necessary to keep unsuitable persons away from the 

university lest the good corn be choked by weeds. These 

ends might be secured by raising the lecture fees, which 

are smaller in Austria than in any other country,—not with 

a view of increasing the incomes of the professors, but 

* TH. BILLROTH: Aphorismen, Wien 1886.


chiefly to enlarge and improve the schools—by making the 

examinations more severe, and by other means. 

At the same time it is surely desirable that some new 

medical schools should be erected to relieve the over 

crowding of the medical faculties. This might be done, 

for instance, in Salzburg, once the seat of a university,* 

where the necessary .buildings and appliances for teaching 

exist already in a measure, or at least could be easily 

found, and where moreover the enchanting beauty and 

magnificence of the surrounding country would attract 

students from far and wide, even from abroad; or again in 

Briinn or Olmiitz, in Lemberg or Czernowitz, in Agram, 

and in one or two places in Hungary. Some of these 

towns already possess several faculties, so that they only 

want the addition of medical faculties to become complete 

universities. 

In 1872 new regulations for medical examinations were 

published by which separate diplomas for the different 

branches of medicine were abolished. Up to that time 

there were Doctors of Medicine, Doctors and Masters of 

•Surgery, accoucheurs, and oculists, but as early as 1843 it 

was decreed that diplomas in surgery, midwifery, and 

ophthalmology should be granted only to such candidates 

as were already Doctors of Medicine, or if they belonged to 

the lower category of doctors to such as had taken the 

degree of Master of Surgery. With the abolition of this 

lower category of practitioners it was resolved for the 

future to educate only one class of doctors enjoying the 

same preliminary training, following the same course of 

studies, examined by the same rules, and advanced finally 

to the title of Doctors of Medicine, with which was asso- 

-ciated the. right to practise all branches of their art. 

Whoever wishes to be admitted to the study of medicine 

must have finished his studies at the gymnasium, and have 

passed the " maturity " examination. The period of student- 

* J. MAYR : Dieehemalige Universitat Salzburg, 1859.—L. SPATZENEGGER: 

Die Salzburger Universitat, Salzburg 1872.

57° 

MODERN TIMES. 

ship at the university is five years. The examinations are 

held partly during that period, partly afterwards. They 

begin with examinations in natural history, on the subjects 

of mineralogy, botany, and zoology, which can be passed 

in the course of the first year. Those only who have 

satisfactorily passed these can present themselves for the 

professional examinations proper. The first of these latter 

includes physics, chemistry, anatomy and physiology. It 

consists of a thorough theoretical examination in these 

subjects, and involves the putting up or the demonstra 

tion of an anatomical and microscopical preparation, the 

performance of a chemical analysis, and the explana 

tion of physical and physiological apparatus. This 

examination must not be entered for before the termi 

nation of the second year, while the second and 

third rigorosen cannot be passed until after the con 

clusion of the period of studentship. The candidate 

on entering his name is obliged to submit proofs that 

he has attended the medical and surgical clinics each 

during four semesters and each during two semesters as 

assistant, also that he has attended as assistant, for at least 

one semester each, both the obstetric and the ophthalmic 

clinics and that he has passed the first rigorosum satis 

factorily. The second deals with general pathology and 

therapeutics, pathological anatomy and histology, pharma 

cology, and internal medicine, and involves a practical 

examination on pathological anatomy at the dead body or 

with the aid of preparations'; the candidate is also-. 

required to examine several patients; and a thorough 

investigation is made into his theoretical knowledge 

of the above-mentioned four branches of science. The 

third rigorosum embraces surgery, ophthalmology, 

gynaecology, and forensic medicine, and is divided into 

practical examinations at the bedside and in the post 

mortem room, that is to say the clinical examination of 

patients, bandaging, operations on the dead body, experi 

ments with models, etc., together with a theoretical


examination upon the four branches of science forming the 

subject of the test. 

After the candidate has passed these examinations he 

receives the degree of Doctor and a license to practise his 

profession. 

The professors of the various subjects act as examiners 

in the three professional examinations: a commissioner, 

nominated by the Government, who is a doctor of medicine 

and usually a high official of the sanitary service, is charged 

with the duty of watching the examinations in the interests 

of the public. The duration and character of the exami 

nations and the amount of knowledge required to pass 

them have, however, been thoroughly explained and ac 

curately laid down* 

Doctors who desire to devote themselves to the public 

sanitary service are obliged to furnish proofs that after 

taking their degree they have held appointments for at 

least two years in a public hospital, or have been in 

general practice for three years, that they have acquired a 

knowledge of psychological medicine and have learned to 

vaccinate with skill. They have then to pass an examina 

tion in hygiene, sanitary law, forensic medicine, pharma 

cognosy, toxicology, chemistry and veterinary regulations : 

this examination is partly written, partly oral, and partly of 

a practical character.t 

Excellent arrangements exist at the Vienna University 

for the education of skilful surgical operators. In 1807 a 

regulation was made that six students of medicine who had 

completed their studies in an exemplary manner should be 

employed in the surgical clinic for two years and should 

receive instruction in the performance of surgical opera 

tions on the dead and living subject. During this period 

they drew a yearly stipend' of 300 gulden with residence 

found, and they entered into an engagement to practise 

their profession in their own country. The rulers of 

* THAA, op. cit., Supplem.-Heft, S. 647 et seq., 090 et seq. 

t Reichsgesetzblatt 1873, 29th. Marz, Stuck 12.


many of, the crown lands founded similar appointments for 

students who were natives of those places and who wished 

to settle there again. It was hoped by these means to 

train up a class of skilled and experienced surgeons who 

afterwards might be able to do good work as university 

teachers, as directors and principals of hospitals and 

surgical wards, as sanitary officials or as private practitioners 

in the different parts of the empire. 

At the same time a similar arrangement was instituted at 

the Josefinum, so that the army might be supplied with 

expert operators. 

When a second surgical clinic was founded at the 

Vienna medical faculty a number of students was appropriated 

to this too for the purpose of being trained as 

operators. 

Since 1870 these appointments have been made only 

for one year: but on the recommendation of the professors 

of the surgical clinic they may be extended to two 

or three years. The candidates must be doctors of medicine 

and must show in an examination on anatomy and 

surgery that they have the gifts necessary for the vocation 

of an operator. To only a proportion of them is any 

stipend paid: the others study at their own expense. At 

neither of the two surgical clinics must the number of them 

exceed eight. 

Similar arrangements were in 1882 made in the obstetric 

clinics of the University of Vienna with the object of 

insuring the education of skilful operators in the depart 

ment of midwifery- 

Certain considerations, suggested by the Austrian system 

of medical education, have often given rise to discussions 

in the Press. In the first place, the lectures and examinations 

upon the sciences which are used as a preparation for 

the study of medicine occupy more time than appears justifiable 

when we consider the curriculum of the gymnasia: 

for by this so many hours are given up to instruction in 

the natural sciences that the assumption may fairly be


made that the students when they enter the university 

bring with them a general preliminary training in the 

natural sciences which, at least in mineralogy, botany and 

zoology, is so extensive as to make it superfluous to spend 

almost the entire first year on these subjects, as is now 

frequently done.* The arrangement in virtue of which 

these examinations and also the first rigorosum are passed 

during the period of studentship is attended with certain 

disadvantages ; for many students are induced thereby to 

spend time in preparing for them which they ought to 

devote to attending lectures. 

The custom, usual until recently, of students performing 

their military service during the period of their studentship 

was conducive to still worse results. They were, it is true, 

made military medical pupils at the garrison hospitals,. 

being thus employed in the sanitary service; but they were 

really quite destitute of the requisite medical knowledge. 

They were thus withdrawn from the systematic course of 

study without any corresponding advantage accruing either 

to themselves or to the army. By the new military law the 

students of medicine are bound to serve for six months in 

the ranks and for six months as doctors in the military 

medical department. The former period can be got over 

during studentship-—during one summer semester, the 

latter manifestly only after the completion of study. To 

avoid the interruption of study caused by the military 

service in the ranks it is to be wished that this could be 

undertaken either before the beginning or after the end of 

the university career. Complaints are made in Vienna 

that attendance on the lectures is irregular on the part of 

the students and an effort should be made to remove the 

causes which lie at the root of this state of affairs. It is 

conceivable that the system of assistantships now usual at 

the clinical institutions which are attended by hundreds of 

students is not of a character calculated to satisfy the 

* Betrachtungen uber unser medicinisches Unterrichtswesen, Wien 1886,. 

S. 14.


requirements of medical education; some arrangement 

similar to the stage in the medical schools of France 

and England might be thought of to supply this defect* 

Whether, in view of the want of this, the present method 

of examination in practical medicine, in which no provision 

is made for the prolonged observation and treatment 

of patients, is sufficient to enable an examiner to decide 

upon the fitness of a candidate for medical practice, is a 

matter which may reasonably be doubted. 

If after the' last rigorosum there were still another final 

examination embracing the most important subjects which 

had been taught, it would serve not only as a check upon 

the previous examinations but would render it possible to 

make a final summing up of the candidate's knowledge. 

The Austrian administration of education, eagerly desirous 

as it is of improving the system of medical training and of 

rendering it complete by the erection of new schools and 

the foundation of new professorships, must extend a benevolent 

indulgence to these remarks and excuse them on the 

ground of the author's interest in the subject which is great 

enough to have evoked them. 

THE GREATER AND LESSER GERMAN STATES 

BEFORE THE FOUNDATION OF THE GERMAN 

EMPIRE. 

THE condition of political dismemberment into which th 

ancient German Empire had fallen, and the autonomy of 

the various countries which had composed it led to the 

foundation of numerous academies, many of which for long 

dragged on a miserable existence. They lacked both 

teachers and pupils, and they possessed neither appliances 

for teaching nor assured incomes to meet indispensable 

requirements. They were therefore not much missed when 

* Even P. FRANK (vi, Abth. 2, S. 2G6) was anxious that all members of the 

junior medical staff at the Vienna General Hospital should be authorized to 

give clinical instruction.

THE GERMAN STATES. 575 

they finally succumbed " partly through the effects of 

chronic disease, partly as the result of violent suppression 

which at times took the form of amalgamation with other 

universities."* 

This fate befell the university of Biitzow, which in 1789 

was united with the academy of Rostock, those of Stuttgart 

merged with the Tubingen high school in 1794, of Bonn 

abolished the same year, of Koln, Treves, and Mainz, 

which came to an end in 1798, of Bamberg, Dillingen, 

Fulda, and Duisberg, abolished the first in 1803, the last 

three in 1804. 

The following towns lost their universities in the years 

indicated: Helmstadt, Rinteln, and Altdorf in 1809, Frankfort-on-the-Oder 

in 1811, Paderborn in 1815, Erfurt in 

1816, Wittenberg andEllwangen in 1817, and Herborn and 

Miinster (where, however, a theological and a philosophical 

faculty continued to exist) in 1818. 

The political revolutions of that period, which introduced 

frequent changes in the map of Germany and assigned 

different parts of the country now to this and now to that 

State, exerted great influence upon the system of medical 

education. Certain universities, such as those of Salzburg, 

Innsbruck, Wiirzburg, and Freiburg, were subjected to continued 

changes of organization, a circumstance by no means 

conducive to the development of teaching. These conditions 

were not improved until peace was obtained, and the 

organization of States established by its means had begun 

to assume a permanent form. 

Besides the two great powers of Austria and Prussia 

there existed from this time forth the kingdoms of Bavaria, 

Wurtemberg, and Saxony, the first with its University of 

Landshut (which till 1802 was situated at Ingolstadt and in 

1826 was removed to Munich), and those of Wiirzburg and, 

of Erlangen, the second with its academy at Tubingen, and 

the third with high schools at Leipzig and Hanover, 

together with the University of Gottingen ; then there were 

* J. v. DOLLINGER: Die Universitaten sonst und jetzt, Miinchen 1867.


the grand duchies of Baden, with universities at Heidelberg 

and Freiburg, of Mecklenburg with the University of 

Rostock, of Hesse, with that of Giessen ; also the electorate 

of Hesse, with the University of Marburg, and the Saxon 

duchies with the University of Jena, the duchy of Schleswig-Holstein, 

united with Denmark, with its high school at 

Kiel, and a great number of States without universities. 

The system of medical teaching in the various countries 

was, in spite of certain local peculiarities, in general of a 

fairly uniform character. The methods adopted in Austria 

and Prussia, after the period of French ascendency had 

been forgotten, served as a model for most of the other 

States, though from time to time efforts at originality were 

manifested, and were attended with remarkable results. 

Accurate information is afforded concerningthe education 

of doctors in- Bavaria at the conclusion of last century by 

the curricula of medical study drawn up for the University 

of Ingolstadt for the years 1774, 1776, 1784, and 1799.* 

According to these students who aspired to the degree of 

doctor of medicine were required to receive a preliminary 

education in " philosophy," and then to undergo a three 

years' course of professional study. They were examined 

every three months, and the examination immediately preceding 

the degree lasted for five hours. After 1788 a 

doctorate of surgery as well as of medicine was granted. 

But it was not until 1807; after Bavaria had been made a 

kingdom, that the degrees were no longer conferred 

imperiali et pontificia auctoritate, but regia auctorik 

Under the Montgelas Ministry a new organization was 

given to the universities of Bavaria which reflected the 

modes of thought of the Napoleonic age. By a stroke of 

the pen the ancient historical division of the four faculties 

was erased, and all subjects of teaching were put into one 

or other of two classes, the first including all those branches 

of knowledge which can be held to form part of a general 

education, the second embracing those subjects which form 

* PRANTL op. cit. i, 676 et seq.


preparatory discipline for a definite vocation in life. Each 

of these classes was divided into four sections. The first 

class was made up of (i) philosophy and kindred subjects ; 

(ii) mathematics and the natural sciences ; (iii) history; (iv) 

ancient and modern languages : the second class consisted 

of (i) knowledge necessary for the education of the religious 

teachers of the people, i.e., theology; (ii) law; (iii) political 

economy and finance ; (iv) medicine. 

The teaching staffs were composed of ordinary and 

extraordinary professors, and of private tutors "for the 

purpose of assisting and of being educated to become 

regular teachers." 

Each section elected a member to the Senate which con 

ducted the affairs of the university. This classification 

corresponded with the earlier one in so far that the first 

class embraced the subjects represented by the philosophic 

faculty, and the second was made up of the other faculties. 

It lasted for a few years and then was by degrees replaced 

by the older form. 

The system of medical education was regulated by the 

legislative enactment of the 8th of September, 1808. This 

decreed " that no one is to be admitted to medical practice 

who has not passed examinations in that department of 

medicine in which he wishes to work." At the same time 

a rule was made "that the treatment of wounds should for 

the future be practised by those persons only who had 

learnt the medical science," and the universities were 

ordered " not to grant a degree in surgery to anyone who 

had not already taken one in medicine." 

' The period of studentship at the university lasted three 

years. At the conclusion of every semester, examinations 

were held on the subjects prescribed in the curriculum. If 

they were not passed satisfactorily they had to be submitted 

to again. After the termination of study an examination 

was held in which several questions had to be answered, 

if possible, in Latin, the candidate receiving no assistance; 

and a patient had to be examined and treated in the clinic; 

P P

578 

MODERN TIMES. 

finally the candidate's theoretical knowledge on all the 

subjects taught was tested. If the candidate aspired to the 

degree of Doctor of Surgery as well as Doctor of Medicine 

he had also to perform an operation on the dead body and 

to apply a bandage. With the composition of an essay 

and the defence of theses proposed to him, all demands on 

the candidate's knowledge, which preceded the granting 

of the degree, were satisfied. This, however, by no means 

carried with it a legal right to practise, for the young 

doctor had still to improve himself in practical medicine 

during two years in the wards of a hospital, or under the 

guidance of a busy practitioner, and after that to undergo 

an examination which consisted, firstly, of a qualifying 

part in which ten questions on internal medicine, surgery, 

midwifery, veterinary science, and forensic medicine had 

to be answered on paper under strict rules of isolation, a 

case of illness to be investigated and questions to be 

answered orally; and secondly of a competitive part the 

object of which was to select the ablest candidates with a 

view to securing them for the service of the State, and 

which was limited chiefly to paper work under strict rules 

of isolation, upon subjects connected with practical 

medicine. 

Doctors acquired practical ability as obstetricians in a 

lying-in establishment. 

Besides doctors of medicine there were "country 

practitioners" and surgeons who were taught in special 

schools. 

A new order of studies and examinations for medical 

students was promulgated on the 30th of May, 1843. In 

this it was decreed that after a course of two years' study 

at the university they should pass the "admission' 

examination, which embraced the subjects of zoology, 

botany, mineralogy, chemistry, and physics. Then the 

special medical studies began, which after three years— 

that is, in all, a five years' course of university study—were 

terminated by an examination. In anatomy the studenl


was required to open one of the great cavities of the body 

and to demonstrate the viscera contained therein, also to 

describe one preparation dissected by himself, and certain 

others illustrating the anatomy of the bones, vessels, or 

nerves : in the other branches the examination was oral. 

After this followed the biennium practicum, a period 

passed principally in the clinics and great hospitals, and 

devoted to training in special departments of medicine. 

At the conclusion of the biennium practicum the final 

examination took place; this superseded the qualifying and 

competitive examinations which were abolished. The 

candidate who presented himself for this had to furnish 

proofs that he had treated three medical and three surgical 

cases in the clinic and had attended three confinements, 

and he was obliged to submit reports of these cases before 

being admitted to the examination. 

This consisted of (a) a practical part, viz., performing 

three surgical operations on the dead body, applying three 

bandages, and carrying out three obstetric operations on a 

model; (b) an oral examination on (1) anatomy and physio 

logy* ( 2 ) pharmacology and dispensing, (3) general patho 

logy and therapeutics, (4) special pathology and thera 

peutics of internal diseases, (5) surgery, (6) midwifery, 

(7) veterinary science, and (8) forensic medicine and 

hygiene; (c) some paper work, the questions set being 

upon the eight subjects above mentioned, and the candidate 

being isolated. To this were added successively the hand- 

ing-in of an essay, the defence of theses, and the granting 

•of the degree. 

The student was thus obliged to attend the university 

for seven years before getting the doctor's degree which 

also gave the right to practise. It was sufficient moreover 

to entitle him to hold an appointment in the sanitary ser 

vice, no further examination being required for this. The 

faculties had complete control over the examinations. 

The regulation for examinations dated 22nd June, 1858, 

substituted for the " admission " examination, one in the

58o MODERN TIMES. 

natural sciences which was passed after the first year of 

studentship and which like the former embraced zoology, 

botany, mineralogy, chemistry and physics. The second 

examination, which took place after four years' professional 

study and consequently after attendance at the university 

for five years, differed from the earlier form in that, besides 

on anatomy, the candidate's knowledge was tested practically 

on internal medicine, surgery, ophthalmology and 

midwifery, he being called upon to treat two medical, two 

surgical and one ophthalmic case during eight days, to perform 

one ophthalmic and two other surgical operations on the 

dead body, to apply two bandages, to examine two pregnant 

women, to make two diagnoses, to perform two operations. 

on the obstetric model, and to attend-two confinements.. 

In the oral examination anatomy and physiology formed 

independent subjects ; pathological anatomy was associated 

with general pathology and the history of medicine with 

general therapeutics, while veterinary science, forensic 

medicine, and hygiene were omitted. 

The biennium practicum was curtailed to one year,. 

which was devoted to attending lectures on forensic medicine, 

state medicine, the treatment of mental diseases andt 

veterinary science, to training in special departments, and 

to practical work in the policlinics. Many during this 

period also served as assistants in a hospital or with an 

official of the sanitary department. The State examinatioa 

was held at the end of the " practical year." This took. 

place only in Munich and there only once a year. It was. 

conducted by a Commission composed of professors,. 

medical officials, and practising doctors nominated by the 

Ministry, and included (i) special pathology and thera- ^ 

peutics, (2) surgery, (3) midwifery, (4) psychological medicine, 

(5) state medicine, and (6) veterinary science, and. 

was both oral and by writing. On passing this the license 

to practise was granted* 

* Regierungsblatt f. d. Konigreich Bayem i8c8, S. 2189 et seq., 1843, S- 

433- 1858, S.-873.


After the foundation of the German empire medical study 

and examinations were arranged upon a uniform plan in the 

different states which composed it. These, however, 

retained the right of making legal regulations for the 

education of those doctors who were to be employed in the 

public sanitary service. For this purpose a law was 

promulgated in Bavaria in the year 1876, which ordained 

that candidates for the medical appointments in the service 

of the State must give proof, both orally and by writing, of 

their knowledge of forensic medicine, public hygiene, 

sanitary regulations, and psychological medicine. In the 

kingdom of Wiirtemberg the students of medicine used 

formerly to pass their first examination at the conclusion of 

the course of study. It was both oral and on paper; it 

took place before the medical faculty of Tiibingen, and was 

divided into three parts: (1) on the natural sciences, 

including zoology, botany, mineralogy, physics, chemistry, 

anatomy, and physiology; (2) on medical subjects 

represented by general and special pathology, pathological 

anatomy, and therapeutics, and (3) on surgical subjects, 

dealing with special surgical pathology, operations, and 

topographical anatomy* Upon this followed a year of 

wider practical training, devoted to hospital work or to 

travelling in pursuit of scientific knowledge, and then the 

State examination, which was held by the medical college 

of Stuttgart, and consisted of medical, surgical, and obstetric 

portions : it was not only conducted orally and on paper, 

but was also of a practical character, patients being 

examined and treated, and operations performed on the 

dead body and on models. 

In the Grand Duchy of Baden, also, a license to practise 

was acquired by passing a State-examination, for the most 

part theoretical, and conducted by a commission, which was 

generally composed of members of the medical college. 

The doctorate was quite independent of this, and was 

* V. A. RIECKE : Das Medicinalwesen des Konigreichs Wiirtemberg, Stuttgart 

1856.


conferred by the medical faculties : it constituted little m 

than a barren title, and was consequently not sought after 

by many practitioners. 

In the kingdom of Saxony there were formerly, in addition 

to the doctors who had taken degrees and had been 

educated at the university of Leipzig, medicinae practici, 

surgeons, and accoucheurs, who received instruction at the 

Medico-Chirurgical Academy of Dresden, a society which 

arose out of the Collegium Medico-Chirurgicum in 1815 

and endured until 1864. The medicinae practici were an 

inferior class of doctors for internal diseases, and had a 

right of settling down only in very closely circumscribed 

areas. The surgeons were allowed to practise surgery 

anywhere, but midwifery only if they had passed the prescribed 

examination. The medicinae practici could get a 

license to engage in surgical and obstetric practice on 

passing examinations in these departments of medical 

science. 

Anyone after finishing his studies at the gymnasium and 

entering the university for the purpose of studying medicine, 

could after two years present himself for the examination 

for the degree of Bachelor, which nearly corresponded 

to the tentamen physicum of to-day ; he could then at the 

conclusion of his studies submit to the "approbation" 

examination held by the medical faculty and leading to the 

doctor's degree; the latter examination embraced all the 

most important subjects which had been taught and made 

pretty high claims upon the candidate's knowledge. 

In the Saxon duchies there used formerly to be Stateexaminations 

which were held by examination commissioners. 

in the chief towns of the different countries. 

It was not until 1862 that Weimar, Coburg-Gotha and 

Altenburg agreed to hand over all business connected with 

examinations to the medical faculty of Jena. The qualifying 

examination embraced the most important branches of 

medical science, was associated with practical work, 

clinical demonstrations, etc., and concluded with the con-


ferring of the diploma of Doctor, upon the strength of 

which the governments of the different States granted a 


In the kingdom of Hanover the physicians were trained 

at the University of Gottingen, and the surgeons, who stood- 

on a lower educational footing, at the Surgeons' School at 

Hanover. The former went up for the examination for 

the Doctorate after some seven semesters : this dealt with 

all the chief departments of medicine but did not give a 

right to practise. This license could only be obtained by 

passing the State-examination which was held by a com 

mission nominated by the Government. 

In Mecklenburg* also there existed formerly in addition 

to the physicians who were educated, and took degrees, at 

the University of Rostock, a class of surgeons who received 

a more or less restricted license to practise their art by 

passing an examination before the Medical College. The 

license, to practise was granted by the government to the 

Doctors of Medicine on the strength of their diplomas. 

This arrangement of examinations was however altered to 

suit the pattern of the examination arrangements in 

Prussia even before the German imperial laws were intro 

duced. 

In the Grand Duchy of Hesse there was only one class of 

doctors. The study of medicine was not allowed until 

after the conclusion of the studies at the gymnasium. 

The medical examinations consisted of the following:— 

(i) The examination in natural science; this included 

mineralogy, botany, zoology, physics, and chemistry; 

(ii) the examination in anatomy, which was theoretical 

and practical, and very thorough; (iii) the final exami 

nation, which consisted of paper work, clinical work in 

the wards, and a part held viva voce, in which all depart 

ments of medical science came into consideration, with the 

exception of anatomy. Then followed writing an essay, 

* DORNBLUTH : Darstellung der medicinischen Polizeigesetzgebung, Schwerin 

'834-


taking part in disputations, and finally the doctor's degree, 

which carried with it the right to practise. 

In those German States which did not possess medical 

schools, such as Oldenburg, Brunswick, Hamburg, Liibeck, 

etc., there were boards of examiners made up of officials in 

the sanitary service and doctors of position, and the right 

to practise was granted by them. 

PRUSSIA AND THE PRESENT GERMAN 

EMPIRE. 

THE Brandenburg-Preussen monarchy during the course of 

the 18th century gained a prominent position as a political 

and military power. The idea of a strong ruling authority 

in the State which should be paramount in all departments 

of administration, and should conduct affairs with a view 

to the common weal broke upon men's minds at an early 

date in this country, and was diffused throughout all classes 

of the population. The system of medical education was 

not uninfluenced by this tendency. 

As early as the year 1725 a State-examination was introduced, 

and was no doubt necessary on account of the 

inconsiderate manner in which medical diplomas were at 

that time granted in many places.* It was, however, 

limited to anatomy and the description of a case of disease 

which had been observed by the candidate. To this was 

afterwards added an oral examination upon the most important 

parts of medical science. In 1798 the regulation 

was made that instead of writing out a case two patients 

should be examined in the presence of the examiner and 

treated by the candidate for four weeks. The period of 

studentship was fixed at a minimum of three years. 

A complete organization of medical studies and examinations 

was effected in the year 1825. According to this 

* L. v. RONNE und H. SIMON : Das Medicinalwesen des Preussischen Staates, 

Breslau 1844, i, 344 et seq.

PRUSSIA AND THE GERMAN EMPIRE. 585 

several categories of practitioners were distinguished ; fOr 

instance the doctors who had received diplomas and who 

were entitled either to practise medicine only or medicine 

in conjunction with surgery, and surgeons of the first and 

second class, who were also entitled to practise midwifery 

and ophthalmic surgery if they had passed the necessary 

examinations. 

The doctors with diplomas were educated at the universities. 

On matriculating it was necessary for the student to 

furnish a proof that he had completed his course of study at 

the gymnasium and had passed the " leaving " examination. 

He had then to devote himself during four years to medical 

study and during the last year to attendance on the clinics. 

There were the following examinations: (1) the tentamen 

fhilosophicum which was introduced in 1826, included 

logic and psychology, physics, chemistry, mineralogy, 

botany and zoology, and was held by the professors of the 

faculty of philosophy in the presence of the dean of the 

medical faculty; (2) the tentamen medicum and examen 

•rigorosum which consisted of a written portion, precautions 

being taken that the candidate received no help, and an oral 

.examination, and which dealt with every subject which had 

been taught: these, if passed successfully, entitled the 

candidate to his degree; (3) the State-examination which 

took place only in Berlin and gave the right to practise. 

While the tentamen medicum was held before the dean 

and the rigorosum before the professors of the medical 

faculty, at the State-examination " theoretically and practically 

educated men of science from all branches of medicine" 

were employed as examiners. Professors and other 

university teachers were intended to be excluded on 

principle from examining, and at most were admitted as 

examiners only in subjects which they did not teach. No 

member of this Examination-Commission, which was appointed 

annually by the Ministry, was at liberty to exercise 

his functions longer than two years. 

The State-examination was composed of several parts,


' * ' >\ ' 

of which the 'first dealt with anatomy, the situs viscerum 

being demonstrated by the candidate who had also to make 

a dissection and to explain preparations which were placed 

before him; the second part dealt with internal medicine 

and consisted of the examination and treatment of two 

patients during 2-3 weeks, to which were added questions 

upon other cases of disease, and of an inquiry into the candidate's 

knowledge of the art of prescribing; in the third 

two cases of surgical interest were examined and treated 

in the same way; and the fourth, the final viva voce examination, 

once more took all subjects taught into consideration 

and served as it were to control the preceding examinations. 

Hereupon the license to practise medicine was 

granted. 

Whoever desired to engage in surgical practice also wasobliged 

to submit to another examination in operative 

•surgery which was interpolated between the second and 

third parts of the State-examination and consisted of the 

.•candidate writing a surgical essay, giving proof of his 

' knowledge of instruments and of the art of operating,. 

.'.Applying a bandage and performing two operations on the 

'•dead body. If the candidate passed this examination with 

' great credit he .received the diploma of " operator :" if hedid 

mot distinguish himself he received the diploma of 

medical practitioner and surgeon. The title of "operator" 

was abolished in 1855. 

The " surgeons of the first class " were not obliged to be 

' possessed of such a good general education and had tostudy 

for three years at a medical faculty or a medicochirurgical 

school ; they were however excused one year 

of studentship if they had previously been employed for 

two years as surgeons of the inferior category. They 

received a license to practise internal medicine and surgery 

after passing the State-examination. The latter was regulated 

upon the same principles as that for the doctors with 

university diplomas, and differed from it only in not presupposing 

a knowledge of the natural sciences and in

PRUSSIA AND *THE GERMAN EMPIRE. 587 

making less extensive'dlaims ilpon professional knowledge. 

It was conducted in the German language whereas the 

university doctors sustained a part of their examination in 

Latin. The " surgeons of the second class " got the knowledge 

required for their calling partly through the instruction 

received from a master of their art, partly by serving 

at the military hospitals and infirmaries or by attending a 

few lectures at a medical faculty or medico-chirurgical 

school. At their examination, which was held by the provincial 

medical colleges, they were required to answer on 

paper, without assistance, three questions upon general 

points in physiology, materia medica et chirurgica, and the 

art of prescribing, upon the means of resuscitating the 

apparently dead, the assistance to be rendered in sudden 

accidents, the provisional measures to be taken on the outbreak 

of epidemics, etc. ; they were also asked to give • a 

demonstration of the situs viscerum, to make a dissection^' 

and to explain preparations placed before them, to perform, 

a small operation on the dead body, to apply a bandage . 

and to diagnose frequently occurring pathological conditions -^.y 

such as inflammation, suppuration, hernia, fractures • an


made compulsory for those doctors who possessed no 

•surgical diploma. It consisted of answering on paper two 

or three questions upon the anatomy and physiology of the 

eye, performing some ophthalmic operations upon the dead 

body, showing a knowledge of the instruments in use and 

undergoing a viva voce examination in ophthalmic science- 

Only doctors with university diplomas or surgeons of the v 

first class who were authorized to practise all departments 

of medicine received appointments in the public sanitary 

•service. The former were entitled physici, the latter 

forensic surgeons. Candidates for these appointments had 

to write four essays on subjects connected with medical 

jurisprudence, several months being allowed them for the 

task, to perform a dissection in a medico-legal case, to 

make a visit of inspection to a druggist's shop, to give 

practical proof of their diagnostic and therapeutic skill in 

veterinary science, and to pass an examination in Statemedicine. 

In 1850 a regulation was made that only such 

doctors as had got their qualification in the State-examination 

with exceptional merit should be admitted at once to 

the examination for the position of physicus, the others 

had to wait some years. 

This system of examinations, complicated by such a 

variety of combinations, was attended by many drawbacks. 

It divided doctors into a number of different groups, 

rendering disputes difficult to avoid, it degraded the 

faculties, vexed the university teachers by making them 

the objects of unjust suspicion, inasmuch as it made a point 

of excluding them from acting as examiners at the Stateexamination, 

while the examining boards which had this 

duty cast on them were overworked, persons were nominated 

examiners who were but seldom competent or suitable 

for the office, and the candidates were oblip-ed to make 

a long stay in Berlin, and so put to much expense. These 

causes, combined with the advancing development of 

medicine, and influenced by the spirit of the age, which 

demanded equalization of position and rights, led to a


partial change in the system of medical study and exami 

nations. 

In the years 1848 and 1849 the medical schools of 

Breslau, Greifswald, Miinster, and Magdeburg, which had 

up to that time served, together with the medical faculties,. 

as places for the education of surgeons, and had been 

founded only a few decades before, were closed and done 

away with, so that for the future no more practitioners of 

this kind were produced. 

The law of the 8th of October, 1852, ordained that from 

that time forth there should be only one class of doctors, 

who should be obliged to pass all the examinations, and 

consequently be entitled to practise all branches of medicine.. 

They were to be educated at the university only, and to 

pass the tentamen philosophicum, the tentamen medicumy 

the examen rigorosum, and, finally, the State-Examination.. 

The last consisted of the identical parts which had up till 

this time composed the examination prescribed for the 

doctors with university diplomas and the surgeons ; but 

the portion which dealt with clinical surgery was merged 

with the examination upon operative surgery and the 

examination on midwifery was made a special part of the 

State-examination. This consisted therefore of examinations 

on anatomy, medicine, surgery and midwifery, and a 

final examination to which only those were admitted who 

had passed the others creditably. Some changes rendered 

necessary by the scientific requirements of the times were 

afterwards introduced into this arrangement of examinations. 

Thus in 1856 the anatomical examination assumed 

another form by the subject of physiology being added to 

it, and consisted of an anatomical part devoted to a practical 

testing of the candidate's knowledge of osteology and 

splanchnology (situs viscerum) together with the preparation 

of a dissection to show the course of nerves, and a 

physiological part including histology 

In 1861 the tentamen philosophicum was abolished and 

its place taken by the tentamen physicum, in which

59° 

MODERN TIMES. 

anatomy, physiology, physics, chemistry, and the descriptive 

natural sciences (mineralogy, zoology, and botany) 

formed the five subjects on which candidates were examined. 

The examination took place under the direction of the dean 

of the medical faculty, and was passed after the second 

year of studentship. In i860 it was decreed that any 

•candidate entering his name for the State-examination 

should furnish proofs that he had attended, in the capacity 

of assistant, both surgical and medical clinics during two 

semesters each. The eXamen rigorosum continued to exist 

in an unaltered form as an affair of the faculty and independent 

of the State-examination. 

At the beginning of* the present century some of the 

universities of Prussia appeared superfluous by reason of 

the inadequate number of students attending them, and the 

vicinity of other .academies more favourably situated.,i phu-s 

in 1805 the University of Erfurt with 41 teachers H^m^red 

only 21 students, and that of Duisburgwith 12 teachers the 

same number of 21 students ; somewhat better attended 

were the universities of Frankfort-on-the-Oder with 21 

teachers as against 174 students in the year 1797; of 

Erlangen with 40teachers and 202 students; of Konigsberg 

•with 26 teachers and 346 students, and of Halle with 48 

teachers and 762 students. After the universities of Duisburg 

and Erfurt had been abolished, and that of Erlangen in 

Bavaria had ceased to exist, and Wittenberg had been 

united with Halle and Frankfort-on-the-Oder with Breslau, 

there remained of the ancient universities only Konigsberg, 

Halle, and Breslau; at the last-mentioned a medical faculty 

was founded for the first time in 1811. To these were 

padded the University of Greifswald, which came under 

Prussian rule with Swedish Pomerania, and those of Berlin 

a;nd Bonn which, were newly-founded. 

, ;;r The University of Berlin assumed a definite form in 1810 

•'•'at a time when the State, as a result of the defeats of Jena 

'"•andÂuerstadt, was reduced in extent to the half of its 

former dimensions, and was partly occupied by foreign


troops. It was certainly a remarkable phenomenon that at 

such a period of general overthrow the thought of erecting 

temples to knowledge should have occurred to men's minds; 

it shows what courage—what moral and intellectual power 

—these men possessed, and how firmly and surely they 

hoped and built upon the hope of the restoration of the 

State* 

The medical faculty of the University of Berlin was 

developed out of the Collegium Medico-Chirurgicum, at 

which, in 1806, before the outbreak of the war, there was a 

teaching staff of eighteen ordinary and two extraordinary 

professors. The faculty took over a portion of the teaching 

staff and some of the schools, taking care to improve and 

complete the educational establishment by summoning to 

their assistance distinguished and learned men like REIL, 

Hu-FELAND, RUDOLPHI, and others, and by making some 

necessary additions to the schools of science. The establishment 

for the education of doctors for the army at Berlin, 

which, at the instigation of G6RCKE, had been provided ip 

1795 with an excellent organization^ was associated with 

the university in such a way that the students of the former 

attended the lectures at the latter. These students were 

divided into those who were being educated for medical 

degrees and those who were passing the course of instruction 

required for " surgeons of the first class." With the 

abolition of the latter category of doctors, the training of 

such for the army came also to an end. The institution 

serves at the present day as a boarding-house for students 

under the direction of military medical officers. The 

students receive from the State lodging and instruction 

gratis, and even get pecuniary support, to a certain extent, . 

during their studies ; and in return they incur the obligation. 

of serving for a certain number of years in the army. The 

* RUD. KOPKE: Die Griindung der Friedrich-Wilhelms-Universitat zu Berlin, 

Berlin i860. 

f J. D. E. PREUSS: Das K. Preuss. medicinisch-chirurgische, Friedrich-. 

Wilhelms-Irrstitut zu Berlin, Berlin 1819, S. 28 et seq. .,


supervision of the students is given to military medical 

officers who are distinguished for talents and ability; they 

accompany their pupils to the lectures, go over the subjects 

with them again, and thus get an opportunity of making 

their own acquirements sounder and more extensive. To 

this arrangement the science of our day owes many distinguished 

investigators and university teachers. 

The youngest of the Prussian universities is that of Bonn, 

which -was founded in 1818. It was a want much felt by the 

western provinces, widely separated as they are from the 

eastern ; the former possessed no academy, with the exception 

of the theologico-philosophical school of Minister. The 

political events of 1866 brought about an increase in the 

number of Prussian universities by the addition of those of 

Gottingen, Kiel, and Marburg, which, with Hanover, Sehleswig-Holstein, 

and the former electorate of Hessen, came 

under the Prussian administration. 

When, after-the famous victories of i870,Elshss (Alsace) 

was reunited to Germany, the University of Strassburg was 

reorganized after the pattern of German uniyersities, and 

included in their number. Equipped with abundant material • 

for teaching and a distinguished staff of teachers, it has 

soon acquired for itself a prominent place among the high 

schools of Germany. 

With the institution of the North German Confederation, 

which was, by the adhesion of the South German States in 

1871, expanded into the German Empire, there followed a 

uniform organization in medical studies and examinations. 

By paragraph 29 of the law regulating trades and professions 

of June 21 st, 1869, it was decreed that only the 

supreme authorities of those Confederate States which 

possessed one or more universities should be entitled to 

grant licenses to practise medicine, and then only to persons 

who had passed the State-examination.* 

This can be passed at any of the universities belonging 

* H. EULENBERG : Das Medicinalwesen in Preussen, Berlin 1874,8. 306 

et seq.


to the German empire. The examining commissioners are 

nominated annually by the presiding Ministry ; among them 

are found experts in all branches of medicine, the professors 

and teachers of the different universities being chosen by 

preference, together with a president who conducts and 

keeps a watch over the proceedings. The medical colleges 

and examination commissions, which had up to this time 

held the State examination in the chief towns of the different 

Confederate States, ceased to exercise this function, and the 

State-examination in medicine was simply changed into a 

university examination supervised by State-officials. 

Whoever desires to present himself for this examination 

must furnish proofs that he has gone through the gymnasium 

course of study, passed the tentamen physicum, acted as 

assistant at the clinics, and attended four cases of labour. 

On the other hand he is no longer obliged, as'was formerly 

the case, to undergo the examen rigorosum and to take the 

doctorate. It is true the right of granting this, degree, after 

passing an examination, has been retained by the faculties ; 

but this can now be done as well after as before the State- 

examination, arid is nothing more than an ancient custom — 

no longer a fOrm prescribed by law. 

The State-examination was divided into five parts. The 

first included anatomy, 'physiology, and pathological 

anatomy, and involved the demonstration of an osteological 

and;a splanchnologieal preparation and the dissection of a 

" part" to exhibit the nerves ; the candidate was required 

to answer questions set him in histology and physiology, and 

to put up and describe a histological preparation ; he had 

to perform a post-mortem examination and to make a 

report of the pathologico-anatomical results arrived at; he 

had also to make a histological preparation of diseased 

tissue: the second part dealt with surgery and ophthalmo 

logy and involved the treatment of two patients by the 

candidate during eight days with written reports on the 

cases ; he had to answer questions set him on surgical 

subjects and perform an operation on the dead body, to 

>.Q Q

594 

MODERN TIMES. 

answer questions on fractures and dislocations, to apply a 

bandage and to examine and treat a case of ophthalmic 

disease : the third part was concerned with medicine in a 

similar way and involved the treatment of two cases of 

disease; the candidate had also to answer numerous questions 

on materia medica, toxicology, and the art of prescribing 

: the fourth part dealt with midwifery and 

gynaecology and involved attendance on a case of labour, 

the treatment of a woman during the puerperal period, and 

the performance of an obstetric operation on the model : 

the fifth part consisted of the final viva voce examination 

which embraced general and special pathology, surgery, 

materia medica and State-medicine or hygiene. The 

subjects upon which the candidates were required to 

furnish answers were to some extent decided by lot. 

Whoever passed the State-examination satisfactorily was 

entitled to call himself medical practitioner (Arzt) but not 

to assume the title of Doctor of Medicine. If anyone 

desires the latter distinction he lias to get it from some 

medical faculty. The conditions under which this is 

granted differ in different places. The demands on a 

candidate's knowledge are represented as a general rule by 

an oral examination on the most important branches of 

medical science, by the composition of an essay in German, 

instead of Latin as was formerly the case, and by the argu 

mentative defence of certain theses. 

The regulations of June 2nd, 1883, introduced numerous 

important alterations into this system of examination. In 

the first place it was decreed that mineralogy should be 

omitted from the list of subjects for the tentamen physicum, 

since all governments and faculties were agreed "that 

mineralogy of all branches of natural science is of least 

use to the future doctor, and the little it is necessary he 

should know about it is taught him in the lectures on 

chemistry and materia medica." The examination in 

zoology and botany was 'also curtailed, and it was ordered 

that only one question should be put upon these two


subjects. This was done from the conviction that it is 

impossible to assign the sarhe importance in medical study, 

or to allow the same title to a place in the medical cur 

riculum, to botany and zoology as to physics and 

•chemistry, to say nothing of anatomy and physiology: 

that moreover it appears unjust to require from a medical 

student in his fourth semester satisfactory work in the 

•extremely wide field of botany and zoology, in addition to 

an adequate knowledge of anatomy, physiology, physics 

and chemistry: and that it is impossible for him to satisfy 

the demands made upon his knowledge of these two 

sciences by a professor who makes one or both of them his 

special study, unless indeed he neglects for their sake 

branches of knowledge of far higher importance to his 

future career. On these grounds it was even proposed to 

•exempt medical students from any examination at all in 

zoology and botany, or else to have any such examination 

conducted not by professors of these sciences but by a 

member of the medical faculty. 

These considerations led to a resolution to require of the 

student only that he should possess in zoology a knowledge 

of the outlines of comparative anatomy and physiology, 

and in botany a general acquaintance with the system 

of classification of the vegetable kingdom, having especial 

regard to officinal plants, together with a knowledge of the 

outlines of vegetable anatomy and physiology. It need 

hardly be said that persons who have taken the degree of 

Doctor in the natural sciences at a German university are 

excused the examination in these subjects in the tentamen 

fihysicum. The tentamen physicum is an oral examination 

and does not involve any practical work. 

At the same time the conditions for admission to the 

State-examination were made more severe and another 

method of subdividing it wals introduced. The candidate 

must now, when he puts his nairie down for it, furnish proof 

that he has devoted at least nine semesters to medical study, 

instead of eight as was formerly the case, and that he has


59 

acted as assistant in the surgical, medical, and obstetric 

clinics for two semesters in each and one semester in the 

clinic for diseases of the eye; also that at least foursemesters 

have elapsed since he passed the tentamen 

physicum. In 1887 it became necessary for him to show 

that he had acquired the requisite skill in the performance 

of vaccination. 

The State-examination is divided into the following 

parts: (1) normal anatomy; (2) physiology; (3) pathological 

anatomy and general pathology ; (4) surgery and 

ophthalmology; (5) internal medicine and therapeutics;: 

(6) midwifery and gynaecology; and (7) hygiene. In 

anatomy, physiology and pathological anatomy the 

examination is carried on by only, one examiner; in theother 

subjects by two. The examination appears to havebeen 

made rather more severe than formerly in certain 

subjects, such as anatomy, surgery, and midwifery. If a 

candidate fails in any subject he must present himself for 

re-examination within a certain fixed time : if he fails to do 

so, he loses all advantage from having passed in the subjects 

on which his knowledge had satisfied the examiners. 

Some of the regulations in this system of examination" 

cannot fail to provoke our criticism. The first to do so isthat 

fixing the period of studentship at nine semesters,. 

whereas only a few decades previously this period in many 

of the Confederate States covered ten semesters. Since 

that time medical science has greatly developed in alldirections, 

and the demands made upon the knowledge of 

doctors have not on that account become less, but on the 

contrary have extraordinarily increased. If we wish resettle 

a precise period for the duration of studentship, ten 

semesters are the least we can demand. 

Again, the semester which at present is given up tomilitary 

service falls generally in the period of studentship 

required by law and is reckoned as part of it: this arrangement 

is unjustifiable for while performing their military 

duties the students are prevented studying by having other


tasks to execute which monopolize all their bodily and 

mental powers. 

The decree that medical studies must be carried on to 

their termination exclusively in the universities of the 

German empire excited surprise. Such a regulation could 

be easily understood in the case of law students who after 

wards become State-officials : but permission should be 

granted to those who are destined for the medical pro 

fession—a calling of an international character—to visit 

foreign universities to complete their education or to 

enlarge their intellectual horizon.* It has hitherto been 

ûite characteristic of the German race to accept and 

assimilate the intellectual achievements of other peoples 

and by no means to shut their eyes to them. 

The doctorate in Germany takes up a singular position 

in relation to the system of medical examinations. Inas 

much as it neither confers the right to practise nor is a 

•condition upon which admission to the State-examination 

depends, it appears to be really superfluous. If the object 

is to satisfy the prejudices of the public by preserving 

amongst practitioners the title of Doctor it ought to be 

granted to everyone who has passed the State-examination. 

If it is intended to be a mark of distinction for remarkable 

scientific attainments it is desirable that the claims on the 

knowledge of those who are candidates for it should be dis 

tinctly higher than they are. 

It is an extraordinarily happy and suitable arrangement 

to intrust the management of the examinations chiefly to 

the faculties, the members of which are for the most part 

without any doubt elected on account of their special per 

sonal acquirements, and at the same time to preserve to the 

authorities of the State a proper amount of that influence 

which they are empowered and intended to use in the 

interests of the public. 

Some particular points in the arrangement of the exami 

nations could no doubt be improved. Thus it may be 

* K. KOESTEU : Die Freiziigigkeit der Studierenden der Medicin, Bonn 1884.


doubtful whether two examiners are required in the subjects 

dealing with practical medicine while one examiner is sufficient 

in each of the other subjects,lbecause by this arrangement 

too great demands are made upon clinical material 

but scantily available' in many .places )f again, two equally 

qualified examiners are hardly ever to be found at the same 

place ; and finally the supervision or control of one examiner 

by the other does not appear to be more necessary here 

than in the subjects connected: with the theory of medicine. 

So 'too the present form of the last part of the Stateexamination 

is unsatisfactory. Hygiene has no more claim 

to be admitted as a subject for examination than have psychological 

medicine, forensic medicine, veterinary science 

and other branches of medical study. 

On the other hand in spite of these few faults—and the 

justice of the criticism has perhaps still to be proved—the 

German system of medical education presents so many 

advantages that it justly serves as a pattern which other 

lands are glad to imitate. 

ITALY. 

THE system of medical teaching in Lombardy and Venetia 

was organized in former times completely after the Austrian ; 

model. The medical faculties of Padua and Pavia stood 

in intimate relation to the universities of the other 

countries belonging to the Austrian crown and gained 

from them both inspiration and assistance on the path of 

intellectual progress. The princes of the Austrian reigning 

house, as is remarked by LODER,* directed " their efforts 

towards good organization and satisfactory maintenance of 

the public medical institutions." 

In the States of the Church, medical study lasted for four 

years in accordance with a decree of Pope LEO XII. dated 

* E. V. LODER : Uber arztliche Verfassung und Untefricht in Italien .i. J. 

1811, Leipzig 1812.

ITALY. 599 

1824; after this period had elapsed the Doctorate of Medi 

cine could be conferred. Anyone desiring only the degree 

of Doctor of Surgery studied one year Jess and occupied 

himself principally with the subjects required for his future 

calling. The license to practise was not conferred at the 

same time as the degree, but the biennium practicum had 

first to be passed and was spent in visiting the clinics and 

in hospital work. 

In Tuscany the custom prevailed that medical students 

should attend the Universities of Siena or Pisa during four 

years and then betake themselves to Florence to continue 

their studies; here, in the institution connected with the, 

Ospedale di S. Maria Nuova, they had an opportunity of 

getting a more extended and complete education in medi 

cine. The lectures which had to be attended at the uni 

versity were accurately laid down. Examinations held at 

the end of every year were the means of deciding whether 

a student should be admitted to the lectures of the follow 

ing year. After the conclusion of the period of studentship 

the State-examination had to be passed in Florence : it con 

sisted of an oral part on theoretical subjects and of a prac 

tical clinical part. Then followed the composition and 

defence of theses, the promotion to the degree of Doctor, 

and the license to practise. 

Similar conditions prevailed in other Italian States. 

The influence of Austria and France, which made itself 

felt in many branches of the administration, was noticeable 

also in the arrangements of medical study. 

When the national aspirations of Italy were satisfied and 

the different parts of that country were united into one 

political whole, a uniform organization in medical teaching 

became a possibility. It became a reality on the 16th 

November, 1859, and was the first stone laid in a great 

edifice of culture, the advantages of which are becoming 

every day more apparent. 

At present Italy possesses 17 universities maintained by 

the State, and 4 supported by towns or provinces. The

600 MODERN TIMF.S. 

State universities are divided into those of first and second 

rank. To the first class belong the academies of Rome, 

Naples, Turin, Bologna, Padua, Pavia, Pisa, and Palermo; 

to the second those of Genoa, Modena, Parma, Macerata, 

Siena, Cagliari, Sassari, Catania, and Messina. The latter 

are partly incomplete, that is, are not provided with all the 

faculties, and possess fewer professorships and a smaller 

number of students than the former. The so-called free 

universities are at Perugia, Urbino, Camerino and Ferrara. 

We must also mention the Instituto Superiore of Florence, 

which is connected with clinical and other medical institu 

tions, and offers facilities for the study of medicine. 

There is everywhere an absence of the theological 

faculty, for the training of the clergy was in 1873 taken 

away from the universities and handed over to the epis 

copal seminaries. 

Four faculties are recognized, namely, the legal, medical, 

that representing mathematics and the natural sciences, 

and the linguistic-historical. The study of medicine 

is continued over six years. The students must on 

matriculation give proof of having received a preliminary 

education. If they have not passed through the gymnasium, 

and the lyceum, which nearly corresponds to the three 

upper classes of the gymnasium in Germany, and have 

received no equivalent education elsewhere they are 

admitted to attend the lectures, but not to the examinations 

or to the degree. A plan of studies is recommended to the 

students, but its adoption is not made compulsory. They 

are examined only in the most important departments of 

medical science, and this takes place immediately after the 

termination of the course of study. The examination is 

held by the professors who teach the subjects examined 

upon, two specialists acting as assistants to each professor. 

After having in the course of the period of studentship 

passed the different special examinations in the subjects 

taught, which are both theoretical and also of a practical 

nature—dealing for example with descriptive and patho-

SPAIN AND PORTUGAL. 601 

logical anatomy, surgery, internal medicine and midwifery 

—they receive a license to practise medicine. In order to 

get the doctorate the practitioners must compose an essay 

and support several theses by argument. 

The teaching staffs of the medical faculties are composed 

of ordinary and extraordinary professors, who are distin 

guished only by the difference in the amount of the stipends / 

which they draw ; of incaricati, who are commissioned to 

teach some special subject; and of private teachers. The 

appointment to the professorships is ordinarily the result j 

of competition in written and oral examinations, or merely f 

the production by the candidates of any scientific work I 

they may have done. In cases where it is a question of a 

learned man of acknowledged reputation, candidature is 

disregarded, and he is summoned to occupy the professorial 

chair.* 

SPAIN AND PORTUGAL. 

IN Spain, too, the custom of granting the right to practise 

particular branches of medicine has been given up. At the 

present day there exists but one class of doctors, the 

licenciados en medicina y chirurgia, along with persons 

•of inferior position w 7 ho render surgical aid, amongst whom 

may be numbered the practicantes (surgical assistants) and 

the dentistas. Anyone beginning the study of medicine 

must furnish proof that he has received a general scientific 

preliminary education, and must possess the degree of 

Bachiller en artes. Medical study may be pursued through 

out at the universities, but this is not compulsory. 

Medical faculties exist at the academies of Madrid, 

Barcelona, Granada, Salamanca, Santiago de Compostela, 

Seville, Cadiz, Valencia, Valladolid and Saragossa. The 

•students devote the first year of studentship to the natural 

* TOMMASI-CRUDELI in the Riv. Clin, di Bologna, 1876.—Regio decreto N 

2621, Roma 1884. 

! 

i


sciences, physics, and chemistry, and the following six 

years to medical subjects. After this they are subjected to 

an examination consisting of three parts, the first being 

theoretical, and embracing all branches of medicine, and 

the two others being of a practical character, and held 

partly at the bed-side, partly in the post-mortem room. 

The candidate receives on passing this the license to. 

practise, but not the degree of doctor. If he desires the 

latter he is obliged to study for another year, devoting this 

time to the completion of his medical education, and toattending 

lectures on the history of medicine, medical 

geography,- hygiene, biology and many other subjects i 

finally he has to compose an essay and to support theses by 

argument. The title of Doctor is only granted to those 

practitioners who manifest an active interest in the advance 

of science: it affords no advantage in practice, and is 

sought for only by those who aspire to professorships or 

high positions in the public sanitary service. 

Portugal has a medical faculty at Coimbra and two 

medico-surgical schools at Lisbon and Oporto. They differ 

from one another in the first being more richly supplied 

with the means of instruction and with professorships than 

the two last and alone having the right to grant the title of 

Doctor. The school of Lisbon, by reason of the great 

hospital which has been consigned to it for teaching purposes, 

enjoys the reputation of giving a superior education 

in practical medicine and more particularly in surgery. 

There is now only one class of doctors, since the licenciati 

minores who had but a limited right to practise have 

been abolished. No one is admitted to the study of medicine 

until he has shown in an examination that he has 

received a certain amount of general education. Attendance 

on lectures is compulsory. The curriculum demands 

five years' work. Examinations are held at the end of 

every year, and upon the result of these promotion into

HOLLAND AND BELGIUM. 603. 

a higher class depends. The examinations are both 

theoretical and practical and in some respects very strict 1 

thus the candidate is required to treat 10 patients during 

20 days independently. The result being satisfactory 

the license to practise is granted. The title of Doctor is 

indicative of a more complete scientific education. It is 

required in the case of those, for instance, who are desirous 

of teaching at the medical faculty of Coimbra. To get it 

the candidate has to pass an examination and write an 

essay. The professors are the examiners. The professor 

ships are conferred after competition.* 

HOLLAND AND BELGIUM. 

VARIOUS classes of doctors were formerly educated in 

Holland, and were licensed to engage partly in medical,. 

partly in surgical practice, and to settle either in the 

country only or anywhere they pleased. They acquired 

their professional knowledge either at the universities or 

at the medical schools which were in connection with cer 

tain hospitals. In 1865 a law was passed ordering that,. 

from that time forth, doctors should not be licensed to 

practise special branches of the healing art, but should 

practise medicine as a whole and should possess an uncon 

ditional right of settling where they pleased.f At the 

same time the hospital schools were abolished and the 

education of doctors handed over to the medical faculties. 

At the present time Holland possesses the three univer 

sities of Leyden, Utrecht and Groningen which are suppor 

ted by the State, and the Municipal Academy of Amsterdam 

which arose out of the Athenaeum;—a high school the his 

tory of which reaches back to 1632,—and which in 1877 

was raised into a university.J 

* B. A. SERRA DE MIRABEAU : Mcmoria historica e commemorativa da 

faculdade de medicina, Coimbra 1872. 

t Das Medicinalwesen im Konigreich der Niederlande, Haag 1870. 

X Revue internat. de l'enseignement, Paris 1881, i, 77 et seq.


Whoever approaches the study of medicine must have 

completed his course of studies at an advanced grammar 

school or at the gymnasium, or else must furnish satis 

factory evidence that he is in possession of a sufficient 

preliminary" education. The period of studentship lasts 

generally for six years. The license to practise medicine 

is only acquired by passing the State-examination which is 

held by Examination Commissioners, teachers from the 

different medical faculties being nominated as such. This 

is preceded by the first and second examination in natural 

science, the first being devoted to physics, chemistry and 

botany, the second to anatomy, physiology, histology, 

materia medica and general pathology. 

The State-examination itself is divided into a theoretical 

part which deals with pathological anatomy, pharmaco 

dynamics, special pathology and therapeutics, hygiene, the 

theory of surgery and of midwifery, and into a practical 

part which consists of work at the bedside and in the post 

mortem room. Before presenting himself for this the 

candidate must show that he has received clinical instruc 

tion during two years and has attended at least twelve 

labours, of which two have been completed with the aid of 

instruments.* 

The doctorate of medicine is conferred by the medical 

faculties independently of the State-examination ; the can 

didates for this are required to have passed the gymnasium 

course in Uteris humanioribus. The examinations for the 

doctorate have regard not only to professional skill but 

also to medical learning; they presuppose a more thorough 

general education and go more deeply into the natural 

sciences and into the different departments of medicine 

itself than the State-examination. On this account the 

Doctorate of Medicine carries with it a license to practise.f 

* Geneeskundige Wetten, Zwolle 1882, Gesetz vom 28. Dez. 1878. 

f Wet van d. 28 April 1876, tot regeling van het hooger onderwijs, Zwolle 

1884.

HOLLAND AND BELGIUM. 6oZ 

The Dutch system of medical teaching differs essentially 

from that of Belgium which shows many points of resem 

blance to the French. There are, however, in Belgium 

no officiers de sante, no practitioners of an inferior class, 

but only one class of doctors educated at the university. 

Two out of the four universities of the country, those 

namely of Ghent and Liege,* are supported by the State : 

the remaining two are not so maintained. The University 

of Louvain bears a religious character, and is directed and 

maintained by the clergy: the University of Brussels,. 

which was created by the Liberal party in 1834, owes its 

maintenance to the city and to certain rich patrons. 

As a general rule the gymnasium course precedes medical 

study which may be completed within seven years. The 

medical studies begin with the natural sciences, physics, 

chemistry, and philosophy. The curriculum is for the most 

part regulated by the examinations, inasmuch as the sub 

jects required for one examination are all taken together.. 

The teaching consequently is so disposed as to form a 

practical preparation for the examination as in the medical 

schools of England. The first medical examination deals 

with descriptive and comparative anatomy, physiology,. 

embryology, histology, and pharmacology, is combined with 

' practical demonstrations, and is called the candidate's 

examination. Three examinations are required for the 

Doctorate of Medicine, which carries with it the license to 

practise ; the first deals with general pathology and thera 

peutics, special medical pathology, and pathological 

anatomy; the second is upon surgical pathology, hygiene,. 

and forensic medicine; and the third embraces clinical 

medicine and surgery, diseases of the eye and of the sexual 

organs, and dermatology, together with practical midwifery 

and operative surgery, being partly theoretical and partly 

practical. 

The professors of the faculty are now the only examiners, 

whereas formerly commissions for examining were formed,, 

* A.LEROY: L'universite'de Liege, 1869.


being composed in such a way that half the members of 

every commission belonged to the local faculty, and the 

other half were professors of another faculty. The principle 

here followed was that of associating the teachers of the 

State University with those of the free academies in one 

examining board, with the view of securing in this manner 

a desirable uniformity in the education of doctors. There 

exists also at Brussels a central examining commission, to 

which those candidates resort who have no proofs to show 

of preliminary scientific education; for admission to professional 

study and to the university is free to every one 

who can read and write. On a person entering his name 

for the medical examinations he is only required to show 

that he has attended the surgical and medical clinics during 

two years and the obstetric clinic for one year. The 

teaching staffs consist of ordinary and extraordinary professors 

and agreges speciaux, who are nominated for three 

years, and receive a small stipend; these have taken the 

place of the former charges de cours. 

SWITZERLAND. 

FORMERLY every canton had its own laws and regulations 

controlling the admission to medical practice. Some 

cantons required a State-examination to -be passed, which 

was held before an examining commission formed of the 

local doctors ; in others a certificate that such had been 

already passed in another canton or country, or the production 

of a diploma of Doctor of Medicine sufficed; in 

some even this was unnecessary, and anyone who asserted 

that he possessed the requisite ability was permitted to 

engage in practice. 

It was not until 1867 that an agreement, ratified by the 

Federal Council, was entered into by most of the cantons 

by which the medical examinations at the Swiss universities

SWITZERLAND. 607 

were recognized as sufficient to confer the right to practise 

medicine throughout the country. 

Nowhere do there exist so many academies and high 

schools in proportion to the population as in Switzerland. 

On the one hand there are the universities of Basle, Zurich, 

•and Berne,* where teaching is carried on in German; on 

the other hand, the university of Geneva and the academies 

of Lausanne and Neufchatel, in which the lectures are de 

livered in French. The four universities, and since recently 

the academy of Lausanne, possess medical faculties. The 

universities of Zurich, Berne, and Geneva have only been 

founded during the course of the 19th century, and their 

medical faculties have been developed out of medical and 

surgical schools. They are at the present day in the same 

position in regard to teachers and the appliances for teach 

ing as their sister-institutions in Germany. 

The medical examinations are arranged after the German 

pattern, and are held at Basle, Berne, Zurich, Geneva, and 

Lausanne. The members of the examination commissions 

are selected from the professors of the medical faculties and 

from practitioners of proved ability, and are nominated for 

the period of four years. The examinations are as follows : 

(1) in natural science, comprising physics, chemistry, 

botany, and zoology, with comparative anatomy ; (2) the 

anatomical and physiological, which is at least as severe as 

in Germany; and (3) the special medical examination, 

which, like the immediately preceding one, is partly prac 

tical, partly oral or on paper, and embraces pathological 

anatomy, medicine, surgery, midwifery and gynaecology, 

ophthalmology, forensic medicine and hygiene, materia 

medica, and mental diseases.t It is noteworthy that the 

conditions of admission to the medical examinations are 

stricter than in other countries, for the candidate is re 

quired to furnish procf that he has attended lectures on the 

most important branches of medicine, has taken part in 

* ED. MULLER : Die Hochschule Bern von 1834-1884, Bern 1884. 

f Verordnung der eidgenoss. Medicinalpriifungen vom 19. Marz 1888.


practical work, and has not Only attended the medical,. 

surgical, and obstetric clinics each for two semesters and the 

clinic for diseases of the eye for one semester, but also that 

he has worked in the clinic for mental diseases" for one 

semester, and- has acted as assistant in the policlinic. 

The doctor's degree is not connected with this profes- 

, sional examination, but is conferred by the medical faculties 

on the candidate passing another examination and writing 

an essay. 

: DENMARK-, NORWAY/ AND SWEDEN, 

MEDICAL teaching in •Derfma'rk is organized on the same 

plan as in Germany, and Austrja. Medical students on 

entering the university of Copenhagen must produce a 

^certificate of having passed the "maturity" examination of 

a Danish gymnasium • then they apply themselves to the 

study of philosophy, the natural sciences, physics and 

cheniistry, and are examined in these subjects. , It is only , 

after this that real,medical study begins. 

The examinations which have to be passed before a 

license to practise is granted take place before the medical 

faculty in the presence, of Censors appointed by the 

government who deliver judgment upon the candidate's 

fitness. The examinations- consist of a part devoted to 

paper work, in which the candidate has to write, without * 

assistance, of any kind, three essays upon subjects of practical 

medicine,;, of a practical'* portion consisting of a dissection, 

the examination and treatment of several patients *' 

and the performance of an operation on the dead, body J 

and of an oral examinatibnûpoh the most important depart-, 

ments of medicine. -* 

As a general rule it is only those who desire to engage in 

academical teaching or to

DENMARK', NORWAY AND SWEDEN. 609 

Every doctor of medicine is privileged to give lectures at 

the university. The professorships are filled up after competition. 

Very much the same system prevails in Norway. Here, 

too, it is usual for practitioners to rest satisfied with the 

license to practise and, but seldom to aspire to the degree 

># of Doctor. The country possesses a university at Chris'tiania 

founded in 1811 and.completed in 1815. Matricula 

tion takes place only after the satisfactory' completion of 

the course of study at a gymnasium. The university studies 

-begin in all the faculties with an advanced course upon 

subjects of general science : from two to three semesters 

are devoted to this/during which time the student has an 

opportunity to make up* his mind as'to' the choice of a profession. 

The period of" medical studentship lasts commonly for 

seven years and is* divided by examination's into three parts. 

The first is devoted to zoology, botany, physics, chemistry, 

anatomy and physiology ; the second is. occupied with the 

studyof pharmacology and. toxicology, general and special 

pathology and pathological anatomy 1 , surgical pathology, 

ophthalmology and dermatology; during the third the sub 

jects engaging attention are clinical practice, forensic medi 

cine and hygiene ; the examinations are oral, on paper, and 

practical. Anyone, passing these satisfactorily is given a 


The doctor's degree' is- only granted for extraordinary 

scientific attainments and is associated" with the right of 

lecturing at the university. .: In. the year 1,888 there were in 

the whole of Norway no more than 14 doctors of medicine. 

In Sweden medical instruction is given in the medical 

faculties of the universitie's of Upsala and Lund and at the 

Medical and Surgical Carolina" Institute which was founded 

in 1750 and at the present day is used chiefly for clinical 

education. A certificate of having passed.the "maturity" 

examination in Uteris humanioribus at the gymnasium is 

required from the students, 

• R R

6lO MODERN TIMES. 

The course of study for medical students is approximately 

the same as in the German universities; only in consequence 

of the length of the vacations the lectures upon the 

various subjects extend over more time. Generally from 

nine to ten years intervene between leaving the gymnasium 

and beginning medical practice. The student applies himself 

in the first place during three semesters to physics, 

chemistry, botany and zoology, and is examined in these 

subjects. He now passes from the philosophical to the 

medical faculty and devotes about four years to the study 

of anatomy, physiology, medical chemistry, histology, 

pharmacology and general pathology. He is obliged to 

dissect and to engage in practical work in the physiological, 

chemical, histological and pathological laboratories, 

while he is at liberty to please himself in regard to attendance 

at the theoretical lectures, which are given gratuitously. 

The examination which closes this portion of the period of 

studentship embraces the above-mentioned subjects as well 

as the history of medicine, and is partly oral, partly practical. 

The medical candidate, as he is henceforth called, 

devotes the following semester to attending the clinical 

institutions — in short to perfecting his education in 

practical medicine. He is obliged to direct- his attention 

also to various special subjects such as medical psychology, 

•the diseases of children and syphilology, to assist in postmortem 

examinations in cases of pathological and forensic 

interest and to attend the hygienic exercises. The examination 

upon these subjects, which is not generally passed 

until from three to four years after the " candidate's " examination, 

confers, if the result is satisfactory, the right to 

engage in practice. 

The degree of Doctor of Medicine is only required in the 

case of those practitioners who desire to teach at the university 

or to get posts in the higher branches of the sanitary 

service : it is granted on writing a scientific treatise and 

maintaining, in discussion, the positions taken up in it; it 

is, however, conferred only by the two universities, not by

RUSSIA. 6ll 

the Carolina Institute. On the other hand the last has the 

right to hold the " candidates' " and " licentiates' " examinations 

and to grant the ordinary license to practise. 

RUSSIA. 

•So late as last century Russia still drew her doctors fo 

most part from foreign countries* There was, however, a 

school founded in Moscow for the education of surgeons as 

early as the year 1706, in the time of PETER THE GREAT : 

this was connected with the hospital there, and possessed an 

anatomical theatre and a botanical garden. The first 

university with a medical faculty arose also in Moscow, 

in the year 1755. On the other hand the university connected 

with the Academy of Sciences at St. Petersburg 

did not deserve the name, but was nothing more than a 

gymnasium, in which some courses of lectures on law were 

held; indeed the attendance was but small, the number of 

students under the directorship of the Princess DASCHKOW, 

an the year 1783 amounting only to two.f During the 

19th century the medical faculties of the universities of 

Kiew, Charkow, and Kasan have been founded, and in these 

teaching is carried on in Russian ; the Polish university of 

Warsaw has also been Russianized. The most recent 

addition to the Russian universities is that of Tomsk in 

Siberia, which was opened for students in September, 

1888, and at first possessed only a medical faculty. The 

university of Helsingfors, in Finland, and that of Dorpat 

also belong to the Russian Empire; in the former the 

Swedish, and in the latter the German language prevails.! 

* W. M. v. RICHTER: Geschichte der Medicin in Russland, Moskau 1817, 

111, 91 et seq.—A. BRUCKNER : Die Arztein Russland bis z. J. 1800, St. Petersburg 

1887.-J. TSCHISTOWITSCH : Geschichte der ersten medicinischen Schulen 

in Russland, St. Petersburg 1883. 

t Count D. A. TOLSTOI in his Contributions towards a Knowledge of the 

.Russian Empire, St. Petersburg 1886, p. 217. 

X Die deutsche Universitat Dorpat, Leipzig 1882.


To these must be added the Medical and Surgical Academy 

at St. Petersburg, where the military medical officers are 

trained. 

Anyone who intends to follow the medical calling must 

have completed the course of study at a gymnasium before 

he is admitted to professional study. The period of studentship 

lasts five years. In addition to the examinations, which 

are held to test the student's knowledge on the subjects 

of the lectures they have been attending, there is in the 

middle of the period of studentship an examination which 

corresponds to the German tentamen physicum ; the examination 

for the license to practise takes place at the conclusion 

of the course of study, and embraces the most important 

departments of medicine, being both oral and of a practical 

character.. Those who, having got the license to practise,. 

aspire to the Doctorate have their knowledge tested more 

severely* 

GREECE AND THE CHRISTIAN LANDS OF THE 

BALKAN PENINSULA. 

THE University of Athens was founded in 1837, during the 

reign of King OTHO, and was organized on the German 

model. A certificate of having passed the "maturity" 

examination of a Greek gymnasium was required before 

matriculation. Medical studies generally demand ^ five 

years, the first of these being devoted to the ancillary 

sciences. The preliminary examination is held at the 

conclusion of the first year, and includes physics, chemistry, 

and natural history. The examination for the degree of 

Doctor deals with normal anatomy, physiology, general 

pathology, materia medica, medicine, surgery, midwifery, 

forensic medicine, and hygiene, but is not associated with 

practical demonstrations. After the degree there follows a 

* Allgem. Statut der K. russ. Universitaten vom 23 August 1884, Peters 

burg 1884.

FINAL CONSIDERATIONS. 613 

year of practical training, and then the practical examina 

tion, which consists principally of the treatment of patients, 

the performance of operations on the dead body, etc., and, 

if passed satisfactorily, confers the right to practise- 

There formerly existed in Roumania only a military 

medical school, the most gifted pupils of which were sent to 

foreign universities to complete their studies. At the 

present day the country possesses the two universities of 

Bukharest and Jassy, each one of which is provided with a 

•medical faculty.* Connected with the former there is a 

school of pharmacy. Bukharest also possesses a veterinary 

college. The completion of the gymnasium course is a 

necessary preliminary to the study of medicine. The 

period of studentship at the university lasts five years. 

The examinations embrace all departments of medicine, 

are both theoretical and practical, and are conducted by the 

professors. These concluded satisfactorily, the candidate 

receives the doctorate, which carries with it a license to 

practise all branches of medicine. 

The Servian University of Belgrade as yet has no 

medical faculty. 

FINAL CONSIDERATIONS. 

ON looking at the abundant supply of facts which serve to 

throw light on the systems of medical teaching prevalent at 

different periods and in various countries the question 

naturally suggests itself: " Where is medical education now 

carried on in the best and most appropriate way?" The 

question, however, as little admits of an answer as does 

that which asks which is the best form of government, or 

the best religion. While a republic appears most suited 

for one nation, and has been preserved by it for centuries, 

others require a monarchy, perhaps even despotic rule. 

The case is similar with the arrangements for medical 

* Revue internat. de l'enseignement, Paris, iv, p. 251 el seq.


education. The condition of general culture, the historical 

traditions and the geographical position of the country, 

together with the state of its finances and the character of 

its population are here matters of great importance. 

, It may be permitted, however, to take this opportunity of' 

discussing certain general questions, which, even if the 

solution of them is unattainable, are fit to engage our atten 

tive and serious consideration. 

A principle which is of the utmost consequence in the 

preliminary education in general knowledge given to those 

intended for the medical profession, and one which must 

under all circumstances be firmly maintained, is that such 

education shall be in no way inferior to that required for the 

other learned professions, for theology, for law, for philo 

logy, etc. The doctor must possess that measure of general 

knowledge which satisfies the highest demands in the country 

he lives in. The nature and extent of these demands 

depend upon the conception formed of general education, 

and this differs and has differed according to place and 

time. 

Inasmuch as in most civilized countries of the present 

day this conception has been developed under the influence 

of the humane letters, it follows that the study of antiquity 

with the help of the Greek and Latin languages has come 

to form the real foundation of general education. It is true 

that this system, which was in high favour during the 16th 

century, in the 17th and 18th centuries wjs_subjected_to N 

considerable limitations. TJie--^dd-en_stimulus jyv^n^J^ 

the study^^he_nâtm^^scênces and the development of 

national literatures forced men to give consideration to 

otiieT'subJects as elements of education. Wherever these 

Tiew subjects were not merged into the educational system 

till then in vogue there appeared, separating the schools 

devoted to ancient and modern learning respectively, a 

cleft, which the course of time has enlarged into a chasm. ' 

The advocates of the former declared that the educational 

value of ancient literature depends chiefly upon the forms


of language in which it is conveyed, the study of which, * 

sharpens the intellect and exercises the thinking powers.,, 

Assuming the correctness of this assumption, the reflection 

that eight or nine years of life are devoted to this study 

must give us pause. The end aimed at stands in no 

reasonable relation to the time spent in reaching it. At 

any rate we are at liberty to ask whether the toilsome and 

tedious journey over the linguistic rocks of Greek and *, 

Latin literature is the only path by w 7 hich the wished-for 

goal can be reached. There have existed at all times and 

there exist at the present day numberless remarkably 

clever people who have never learnt Greek or Latin; and 

the converse proposition may be stated with equal truth. 

Why should not other branches of knowledge, especially 

mathematics, be suitable for developing and sharpening 

the intellect ? 

The object of a good system of instruction should be to 

train the mind and at the same time to pay due attention 

to the requirements of life. It is well known that the 

classical gymnasia with their arrangement of studies only 

partially satisfy this demand.* Most of the objections 

which have been raised against them depend upon this 

fact. What above all things is demanded at the present 

day, is that greater attention should be paid to practical 

matters in teaching, for this is to the advantage not only of 

the future doctor and man of science but also of the 

theologian and lawyer,—-of everyone, in fine, whose calling 

comes into touch with practical life. In most countries 

these requirements have been taken into account either by 

modifying the course of the classical gymnasia through the 

adoption of new subjects of instruction or by enlarging 

them into schools of a mixed character, with practical 

classes added and running side by side with the subjects 

* BEZOLD and ESMARCH in the Tiigl. Rundschau 1885, No. 286, 1886, No. 68. 

—TH. PUSCHMANN in the Tagl. Rundschau, Berlin 1886, No. 168, 169.—E. 

HAECKEL: Realgymnasium and Formalgymnasium in the Tagl. Rundschau 

1887, No. 152.—W. PREYER : Naturforschung und Schule, Stuttgart 1887.

6l6 MODERN TIMES. 

previously taught. With a view to this the Realschulen 

were founded in Germany, some of which have by the 

extension of their fields of instruction, taken the new 

form of Realgymnasien, and are distinguished from their 

classical sister-schools chiefly by the fact that in them the 

Greek language has ceased to be taught and the time thus 

gained is devoted to the natural sciences, etc. 

There is no doubt whatever that the German Realgymna- 

sium in its present form affords a better preliminary educa 

tion for the study of medicine than does the classical 

gymnasium; and yet the students of the former are at 

present refused admission to medical study, this privilege 

being exclusively reserved for those who have satisfactorily 

finished their course at the classical gymnasium. 

There have not been wanting attempts to enable students 

leaving the Realgymnasien to enter forthwith upon the study 

of medicine. The Prussian Government consulted both the 

medical faculties and the medical practitioners upon this 

subject but the answers received proved by a large majority 

to be unfavourable to the Realschulen. Of the nine medical 

faculties of Prussia which expressed opinions in i86g on 

the desirability of admitting students leaving the Real 

schulen to medical study, only four (Gottingen, Greifswald, 

Kiel and Konigsberg) voted in favour of the proposal, four 

(Berlin, Breslau, Halle and Marburg) voted against it, and 

one (Bonn) refrained from voting. Of the 163 medical 

societies of Germany which "were requested to pronounce 

opinions upon this matter in 1879, three only voted for the 

proposal unconditionally, three with certain limitations, 

seven others only on the condition that those who had 

passed the Realschulen should have equal access to the 

other faculties, while the remaining 150 voted against the 

proposal, 98 of these, however, on the understanding that 

the classical gymnasia should be reformed. 

The cause lying at the root of this expression of opinion 

was not prejudice in favour of education by means of the 

ancient classics but regard for the preservation of the social 

i: 

ix".


position of the medical profession. This, it might justly be 

feared, would be in danger of impairment if it were pro 

nounced that for doctors a preliminary education in science 

only is necessary, such an education being, according to 

views very widely prevalent, of a value inferior to that 

which is found necessary in the case of the other learned 

professions. Unfortunately in certain places the mistake 

was made of not treating this as the only objection 

but, at the same time, of bringing an indictment against 

the Realschulen by alleging that they had no ideal aims, 

and engendered superficial and narrow views in the minds 

of their pupils—accusations which naturally met with a 

sharp denial from the parties concerned.* 

The question of admitting students leaving the Real 

gymnasien to the university can only be answered in one 

way—by throwing open all the faculties to them and by 

recognizing their general education as equivalent to that 

given by the classical gymnasia. Justice demands this 

course, for the curriculum of the Realgymnasium is as good 

as that of the classical sister-institution ; it is also a duty 

owed to those youths who are not naturally fitted for the 

study of the ancient languages. Can we consider it justi 

fiable in the case of one showing a remarkable gift for natural 

science and promising to make an excellent doctor, to throw 

a stumbling-block in his path because he does not possess 

-as much knowledge of the Greek and Latin languages as a 

philologist considers necessary for his future profession ? 

A uniform plan of general education is certainly very 

convenient for systematizing school-teaching, for it serves 

as a sort of intellectual cathetometer, showing at a glance 

the height of a student's attainments ; necessary or con 

formable to nature, it certainly is not. The differences of 

inclinations and of talents shows that there is not one 

single and only method of intellectual education. 

* P. WOSSIDLO in the Padagogischen Archiv, Stettin 1880, H. 2.—E. 

SPECK: Die Berechtigung der Realschul-Abiturienten zum Studium der 

JVIedicin in the Padagogischen Archiv 1883, H. 9, 10.

6l8 MODERN TIMES. 

In many countries the dual system has been introduced 

into schools, and opportunities of entering the university 

are offered the students of both divisions. In Germany 

this is still striven against, although in intelligent and un 

prejudiced circles the fact does not fail to be recognized 

that uniformity of preliminary education is untenable in the 

long run. For some time now the classical gymnasium has 

ceased to form the only preliminary school of the educated 

classes, for the polytechnic high schools and certain of the 

higher grades of official appointments have been made 

accessible to those who have passed through the Real 

schulen , moreover the Cadet Academies intended for the 

training of officers have renounced the classical form of 

education and have adopted the curriculum of the Real 

gymnasien. The circumstance of granting to the Real 

gymnasien a position equal to that of the classical schools. 

and of giving equal rights to the students leaving them will 

not therefore, as is asserted in many quarters, lead to a. 

division among the students, but on the contrary will tend 

to unite all classes of educated men on the grounds of a 

preliminary education not identical, it is true, but neverthe 

less equivalent. 

It is manifest that the satisfactory educational results 

which were formerly achieved by the grammar school and 

the classical gymnasium were dependent not upon the 

matter taught but upon the thorough method of teaching 

it. The more their plans of study were compelled, in con 

sequence of the adoption of new subjects, to fall away from 

this principle so much the more frequently were complaints 

heard as to the faulty and unsatisfactory education of the 

scholars. At the present day these complaints are levelled 

against the teachings in all subjects, not excepting the 

ancient tongues. This is most pronounced in the case of 

the Austrian gymnasia, which, with the object of preserving 

the uniformity of preliminary education, have endeavoured 

to associate the teachings of the classical schools with 

that of the Realgymnasien, and in doing so have to

FINAL CONSIDERATIONS. "$* 619 

struggle with difficulties arising out of the polyglot 

character of the country. 

Persevering work in a limited field of knowledge produces 

thoroughness, a quality which must be instilled into the minds 

of the young. Whether we use the ancient or the modern 

languages, mathematics, or some other science, for the 

purpose of attaining this end may perhaps be a matter of 

indifference, and should be determined by the requirements 

of the time and in accordance with the inclination and 

talents of the individual student. 

This opportunity may be taken for offering some criti 

cisms upon both the- Realgymnasien and the classical 

schools. In the first place the overcrowding of the 

curriculum with lectures cannot be approved of from the 

hygienic point of view. To compel boys and young men 

to sit at their desks for thirty-two hours a week, and 

perhaps also to spend some hours daily in preparing their 

school exercises at home, cannot fail to act injuriously upon 

their bodily development. The increasing short-sighted 

ness, the pale cheeks and narrow chests of the students 

afford convincing evidence of this. In no class of the 

gymnasium should the number of lecture hours exceed 

twenty-four or twenty-six a week if the bodies of the 

students are to be kept healthy and their minds clear. 

Boys must be allowed time for recreation, and they must 

have the opportunity afforded them of developing their 

individual aptitudes* And here the wish may be expressed 

that more time should be devoted to gymnastics and bodily 

exercise generally at schools than has hitherto been the 

case: it must be confessed that much has been done in this 

respect of recent years : but much still remains to be done 

before the requirements of hygiene are satisfied. 

One great mistake in the gymnasia of Germany and the 

* * 

* Zeitung f. d. hohere Unterrichtswesen Deutschlands, Leipzig 1883, No. 48. 

—HASEMANN: Die Uberburdung der Schiiler, Strassburg 1884.—Centralbl. f. 

allgem. Gesundheitspflege, her. v. Finkelnburg, Jahrg. iii, H. 7, 8.— Cf. P. 

FRANK op. cit. vi, Th. 3, S. 260.

•620 MODERN TIMES. 

schools of many other countries lies in the neglect of 

objective teaching. They store the memory, exercise the 

understanding, and develop the thinking faculties ; but 

they forget to arouse the powers of observation and to 

sharpen the senses. In so doing they discountenance 

means most effective in the education of the mind and of 

the highest importance in many callings—that of the 

engineer, for example, of the doctor, or of the man of 

science. It appears therefore desirable that instruction in 

geography, mathematics and the natural sciences should be 

combined with practical demonstration, and that the sub 

jects dealt with should, as far as possible, be rendered 

evident to the senses. Instruction in drawing is here of 

especial value. Museums should be enlarged by the addi 

tion to them of pictures, models, etc., and in this way the 

senses exercised as well as the understanding.* 

In many English educational establishments and in many 

Swiss and Swedish schools there are workshops for the 

mechanical arts, in which students can learn how to .make 

use of tools and of their own hands. If these places are 

properly conducted they are the source of great pleasure 

and of still greater profit to the pupils, as they are the 

means of imparling to them a dexterity invaluable in prac 

tical life. What a sorry spectacle is afforded by many a 

man of learning—judge or priest, as the case may be—who 

can scarcely sharpen his pencil without cutting his fingers! 

It is noteworthy that such people are almost only to be 

found in Germany and those countries in which such 

methods of education for the young are entirely neglected. 

Finally, the organization of the gymnasia provokes the 

question, whether it Can be right and expedient, from an 

educational point of view, to associate boys of ten and 

young men of nineteen in the same school and to subject 

* V. HUETER in the Pad. Arch. 1879, H. 9.—W. FLEMMING in the Pad. 

Arch. 1883, No. 7.—J. ROSENTHAL: Die Vorbildung zum Uuiversitats-studium 

in the Pad. Arch. 1885, H. 4.—LUNGE in the Zeitschr. des Vereins deutscher 

Ingenieure, Bd. 29, S. 854 et seq.

FINAL CONSIDERATIONS. 62 I 

them to the same discipline and the same laws. In Southern 

Germany and Austria the gymnasium course used to be 

divided into two parts, and for each a separate school- 

building was provided ; this is still done in Italy.* The 

object in view when making the division into an upper and 

lower gymnasium is that the course of instruction given 

at each of these institutions shall be complete in itself. 

This offers the advantage that for those students who have 

to leave the gymnasium before finishing the whole course of 

study a natural and easy exit is secured; they are pre 

served from the anomaly of entering life with a curtailed 

and quite insufficient training. At the same time a rational 

halting-place on the educational journey is provided for 

those who desire to get minor appointments in the official 

service, to attend a technical school, etc. 

The task of giving the pupils a systematic and prac 

tical education in general subjects would thus be entrusted 

to the masters of the Unter-gymnasium, by means of a 

course of five years' training in the use of the mother tongue, 

for which the study of a second language—Latin—is indis 

pensable, together with elementary mathematics and the 

most important facts and doctrines of religion, history, 

geography, and the descriptive natural sciences, drawing 

lessons being given with the object of strengthening the 

powers of observation; while the authorities of the Ober- 

gymnasium would be expected to give clear expression to the 

classical or scientific character (as the case might be) of the 

instruction afforded by them. The Ober-gymnasium might be 

organized in such a manner that the classical and scientific 

subjects should run in parallel courses ; all the pupils being 

taught together in most of the subjects, such as the mother- 

tongue, religion, history and geography, modern languages 

and drawing, and only divided in order that one division 

should be \taught Latin and Greek and the other mathe- 

* An arrangement of this kind was demanded in the Ministerial scheme, 

which was made the basis of the discussions on the reorganization of the higher 

schools held in Berlin, April 16th to May 14th, 1849.


matics and the natural sciences* Arrangements similar 

to these exist, in the Danish, Swedish, and Norwegian 

gymnasia. But those who have completed the course of 

study at either of the two divisions of the Ober-gymnasium 

must be allowed the same privi-leges, and all the faculties 

must be accessible to both classes of students alike. 

While in most civilized States provision is made by legal 

enactments that doctors shall have a preliminary education 

in general knowledge, it seems nowhere to have 

occurred to legislators how extremely important it is that 

only sound and healthy men should devote themselves to 

the medical calling. This is explained by the way in which 

the education of the body is generally neglected in our 

modern civilized life. In the Bavarian medical regulations 

of the year 1808 it was decreed "that only such persons 

-shall be admitted to the study of .medicine as have their 

bodies and senses free from defects." Youths afflicted with 

chronic lung disease, heart disorder, and other organic 

affections, or any of whose senses had not been developed 

or had become defective, were excluded from medical 

study; for such persons are at a disadvantage in the 

examination and .treatment of the sick and speaking 

generally in all professional work, they are prone to succumb 

to the various injurious influences they meet with, 

and are not in a position to confer the benefits which are 

expected of them. For the student and for the practitioner 

a healthy and strong frame is most requisite. Disease 

sours the disposition and steals away the animal spirits; 

how necessary are these to the doctor both for himself and 

for others ! The tone of his mind often finds a responsive . 

note in the patients he attends. 

The course of studies for medical students has, through 

custom and the requirements of science, assumed approximately 

the same form in different countries. It begins with 

the natural sciences—the so-called ancillary sciences of. 

* TH. PUSCIIMANN in the Deutschen medicinischen Wochenschrift, Berlin 

1883, No. 49.—E. RINDFLEISCII in the Tagl. Rundschau 1887, No. 209.


medicine—and with anatomy and physiology. In other 

words, the structure and functions of the human organism 

and its place in Nature form the groundwork of medical 

study. But the student ought to bring with him from 

school as much knowledge of the natural sciences as shall 

render it unnecessary for him to apply himself to the 

elements of mineralogy, botany, and zoology at the univer 

sity; he must here confine himself to reviewing these 

sciences in their relations to medicine. Since physics and 

chemistry can be only lightly touched upon at the gymna 

sium, the student of medicine must go deeply into these 

subjects at the university, because there the abundant 

material for instruction offers him the best opportunity for 

study, .and a knowledge of these matters is indispensable 

for the proper understanding of the different branches of 

medical science. 

Anatomy and physiology form as it were the pillars which 

support the whole structure of medical education. These 

sciences must be treated with exhaustive thoroughness and 

be made the permanent intellectual property of the student 

by means of lectures combined with demonstration and 

experiment and by giving him opportunities of engag 

ing in practical work. The review of anatomical facts from 

comparative, topographical, and surgical standpoints gives 

an opportunity of checking and confirming knowledge 

acquired in the lectures on systematic anatomy and in 

actual dissection, while histology completes it in relation 

to the more delicate structure of the body which is only 

recognizable by assisted vision. If physiology is taught 

with reference to its high importance for practical medicine 

the interest taken by students in the facts of the science is 

greatly increased. The first part of medical study which 

deals with the normal relations of the body concludes with 

the subject of embryology. 

In the study of medicine proper it is of primary import 

ance to get an insight into the nature of diseases and morbid 

states. The lectures on general and special pathology afford


opportunities for this. Pathological anatomy demonstrates 

on the dead body the changes which have taken place as 

the result of particular diseases, and experimental pathology 

teaches us the original diseases and their mutual relations. 

Unfortunately it has come to bethought in many universities 

that theoretical lectures on . internal diseases, on 

surgery, ophthalmology, midwifery and other parts of practical 

medicine are unnecessary. It is quite* true that highly 

elaborated discourses going much into detail may be confusing 

and wearisome^ to beginners; for such, all that is 

wanted is a short, concise review of the most important 

facts ; this however is indispensable before the commencement 

of clinical teaching although it is in the latter course* 

of instruction that the more profound knowledge o'f any 

particular subject must be gained. . # . , 

Lectures on materia medica, pharmaco-dynamics, general 

therapeutics, dietetics and b*alneology should also precede 

the clinical teaching. It is a very suitable arrangement for 

students to learn to make up prescriptions with their own 

hands in an apothecary's shop or a pharmaceutical laboratory, 

as is done at Munich in the Reisingerianum. 

The course on diagnosis and the preparatory clinic make 

the students acquainted with the methods in use in the in- * 

vestigation of disease and show on simple uncomplicated* 

cases how maladies may be recognized and treated. The 

preparatory clinic fills a gap in the curriculum but is only 

indispensably necessary in the great medical schools, and . 

indeed only admits of being arranged in places where there 

is a great mass of clinical material to be deal£ with and the,number 

of students makes it desirable to separate* the", 

patients into numerous divisions. 

The surgical clinic pre-supposes more particularly a 

knowledge of surgical instruments and skill in applying ' 

bandages ; a student attending this must have been taught 

and have himself performed operations on the dead body. 

In the clinic for diseases of the eye acquaintance with 

the use of the ophthalmoscope is requisite; it is also 

'M


necessary for the student to have taken part in a course 

of operations on the eye. 

•Knowledge of midwifery is gained in the obstetric clinic 

and by means of operations performed on the model. 

Attendance on the special clinics for mental diseases and 

diseases of the nervous system, for diseases of the skin and 

of the sexual organs, for laryngeal and aural affections, for 

diseases of childhood, etc., must be reserved for the last 

semesters of studentship. 

The students of the clinics are divided into beginners 

whose functions are purely receptive, and into assistants 

who are more advanced . students and co-operate in the 

examination and treatment of the sick. The latter class 

get opportunities for prolonged observation of cases of 

disease and thus get accustomed to performing the minor 

duties required in the care of the sick. 

Policlinical work succeeds to clinical instruction and 

forms as it were the bridge which leads to medical practice. 

In giving over a portion of the practice amongst the poor 

to the policlinical institutions an opportunity is afforded to 

the assistant of becoming familiar with the claims which 

are made upon a doctor attending a case and of gaining 

that certainty of judgment which is necessary tor his 

independent practice. 

Lectures dealing with forensic medicine, hygiene, sanitary 

control, medical legislation, medical statistics, veterinary 

science and comparative medicine, medical geography and 

the history of medicine belong also to the close of the 

student's career. 

The two last subjects are at present only taught at a fewuniversities. 

While lawyers, theologians, philologists 

architects, artists, officers, in short all the higher profes 

sional classes, apply themselves diligently to the study of 

the history of their science or art,* most doctors think that 

• The veterinary surgeons in Germany have since . 88 , been obliged to show 

a knowledge of the history of their science, but no similar historical educa 

SLrt their dis,inguished coiea - s - ° — s r ^ s 

s s


they have nothing to learn from the history of medicine. 

They do not know how many discoveries and inventions 

have been obliged to be remade, because in the course of 

time they had been forgotten : the history of the plastic 

operations affords a striking example of this. 

But the study of the history of medicine is not only 

useful and necessary for medical research; it is also of high 

ethical value in the education of students, for it teaches 

them reverence and admiration for the intellectual struggles 

and achievements of our forefathers, and completes the 

educational edifice by the addition of a high watchtower 

from which an extensive survey of facts and events 

may be made. It is, therefore, the duty of educational 

authorities to extend a more favourable recognition to the 

claims of this subject than has hitherto been the case. 

Only a few decades ago the history of medicine used to be 

taught at the universities of Berlin, Breslau, Halle, Konigsberg, 

Greifswald, Marburg, Gottingen, Heidelberg, Wiirzburg, 

Erlangen, Munich, Strassburg, Berne, Prague, and 

Vienna, while at the present time there are at most only two 

or three of these universities at which lectures on this subject 

are held—or perhaps only announced. Although men like 

BRUCKE, DU BOIS-REYMOND, CHARCOT, HELMHOLTZ, 

HYRTL, VIRCHOW, WUNDERLICH, ZIEMSSEN and others 

have borne testimony to the value and importance of the 

history of medicine no attempt is made to direct the 

attention of students to the subject, and it is looked upon 

as superfluous to train and appoint professors to teach it. 

BILLROTH himself, who formerly declared " that the great 

medical faculties should make it a point of honour to take 

care that lectures on the history of medicine are not missing 

in their curricula,"* considers them now merely ornamental 

appendages, and is opposed to the professor of this 

subject being a member of the College of Medical Professors 

in the enjoyment of full rights, because he considers 

* TH. BILLROTH : Lehren und Lernen der medicinischen Wissenschaften 

Wien 1876, S. 80.—Wiener Klinische Wochenschrift, 1888, No. 36 6 Dec.


that the work of this department of teaching is less than 

that of others. But the duties of a German professor are not 

confined to teaching: he must also work as an investigator 

for the advancement and extension of his science. A wide 

and hitherto but little cultivated field of labour is here open 

to the historian of medicine. 

Medical geography, too, a subject which for teaching 

purposes may be combined with the history of medicine, 

presents to the teacher and investigator a number of pro 

blems which press for solution in view of the increasing 

intercourse with foreign lands. 

It is difficult to decide how much time should be devoted 

to medical education : this depends upon the natural gifts 

and the application of students, upon the quantity and 

quality of the teachers and appliances for teaching, and 

upon many other circumstances. In subjecting a student 

to no constraint in his choice of lectures, and leaving him 

completely at liberty to get his knowledge how and where 

he pleases, it is assumed that, like a reasonable and 

prudent man, he will follow the advice which is offered 

him by persons of special experience in these matters. 

But if from want of intelligence or from carelessness he is 

inclined to neglect such advice there is nothing to prevent 

his doing so. The result is seen in a defective education, 

the opportunity to remedy which he cannot perhaps find, as 

the period of his studentship draws to a close. If he does 

not make good his deficiencies before he enters medical 

practice the patients who fall into his hands have to suffer 

accordingly. 

Unlimited freedom for the student in choosing what 

lectures he shall attend nowhere has such bad results as 

in the study of medicine; for here the health and lives of 

men are at stake. 

In some countries—and among them such as pride 

themselves upon their liberal institutions—freedom of this 

kind has been discountenanced, and a curriculum has been 

Jaid down for medical students, and is closely adhered to.


Even in Germany and Austria this freedom is at least so far 

controlled that proof is required from students entering 

their names for examination, that they have attended the- 

most important clinics during several semesters. It would 

be well to issue similar regulations for other departments. 

of medical teaching, attendance on which is indispensable 

for a doctor's education. Can we imagine anyone learning 

anatomy and physiology without the personal assistance of 

a teacher? It is highly desirable for students to participate 

in the instruction given with regularity and attention, and 

to make the matter taught them their own.* In small 

universities, where teachers and students are brought more 

nearly together, this occurs naturally ; the danger of students 

escaping instruction exists chiefly at the great universities- 

But so many difficulties surround all systems of control 

that they have had to be abandoned.t 

The results of teaching are more surely guaranteed if the- 

students are induced to take a more active part by means- 

of occasional questions asked and answered, as is usual 

in subjects associated with practical demonstration. Still 

more is this the case if a disputation is held just after 

the conclusion of the week's lectures, during which the 

students, in the presence of the teacher or his assistants,. 

can discuss the subjects which have been lectured upon, 

rectify any misconceptions, and be enlightened on things- 

which they have not been able to understand. This form 

of teaching—more suited to the school than to the academy 

—has been preserved at the military medical schools, andl 

has even been introduced into the universities, where it is 

practised in the schools of philology, history, and law, and 

in the scientific clubs and societies. It would serve the 

same purpose if students at the end of a course of lectures- 

* Formerly, as is the case now, there was no lack of complaint as to the 

irregular attendance on lectures. VICQ D'AZYR in his time declared that 

"students enter their names for, but do not attend, the lectures." GRUNER'S. 

Almanach f. Arzte, Jena 1791, S. 142. 

f G. SCHMOI.LER in the Jahrbuch f. Gesetzgebung, Leipzig 1886, H. 2, S- 

286 et seq.


on any subject, and consequently while the impression is 

•fresh, were permitted to pass an examination held by 

the teacher or his representative. The certificates given 

-after passing such would bear valuable testimony as to the 

way the period of studentship had been passed, and would 

•enable the examiners, who have to decide upon the fitness 

•of candidates to engage in practice, to form a preliminary 

•opinion upon their professional education. 

The examination for the license to practise ought to ex 

tend over all branches of medicine, and to include all the 

subjects with which it is necessary that a practising doctor 

-should be familiar. If, after the conclusion of the first part 

-of the period of studentship devoted to training in the 

natural sciences, an examination is held on natural history, 

physics, chemistry, anatomy, and physiology, it ought to be 

made a rule that no one shall be admitted to the lectures on 

.actual medical subjects before he has passed such examina 

tion ; for, failing this, the time he should spend in medical 

study is devoted to preparing for the examination in science. 

In the examinations which take place after the conclusion 

of the period of studentship, and which precede the granting 

•of the license, great weight is justly laid on practical proofs 

of ability ; the candidate is given the opportunity of showing 

that he understands how to make practical use of the medical 

•knowledge he has acquired by the demonstration of anato 

mical preparations, attendance at necropsies, the examina- * 

tion and treatment of patients, the performance of surgical 

•and obstetrical operations, etc. The questions which are 

set perhaps touch lightly upon the candidate's knowledge 

•of other subjects as well; but they depend too much upon 

•contingencies to form a satisfactory or sufficient test of his 

.general professional education. For this purpose a final 

viva voce examination is necessary to act as complementary 

to, and as a check upon, the preceding practical examina 

tion, and to pass all departments of medicine in review. 

There is no doubt that persons who are teachers of the 

various subjects of examination are more suited to act as


examiners than persons who are not specially concerned 

with these branches of knowledge. Those only who are 

masters of a subject know how to put proper questions 

upon it and correctly to estimate the value of the answers 

given* It is therefore best to entrust the carrying on of 

examinations to the teaching-staffs of the medical faculties 

and schools. But the Government of the State claims, even 

in this department of educational administration, to act as 

counsel for society watching the proceedings in its interest,. 

and taking care that doctors are educated in such a way as 

to be equal to the demands of their calling. 

The question at once presents itself whether doctors 

should be educated in institutions conducted by the State or 

independent of it. The answer is that in every case power 

of control over studies and examinations should be conceded 

to the State, to be made use of in the interest of the population. 

While in the examination for the license to practise,. 

the chief question is to determine whether the candidate 

possesses the requisite ability for his calling, in granting 

the degree of Doctor of Medicine severer demands should 

be made on scientific knowledge, and the candidate for this 

academical honour should be required to show that his 

acquirements exceed those of ordinary practitioners. The 

examination, which affords him this opportunity, should 

therefore go thoroughly into the various branches of medical 

• science, and should touch upon subjects which, like the 

history of medicine and medical geography, are disregarded 

in the examination for the license, being desirable, 

but not indispensable, subjects of medical education. 

In the same way Care should be taken that only works of 

scientific value are accepted as essays for the doctorate.. 

The custom of requiring that they should be written in Latin 

has been given up nearly everywhere, and rightly so ; for, 

as J. V DOLLINGER says,f " in the devious by-paths of the 

* PRUNELI.K : Discours des etudes de me'decine, Paris 1816, p. 21. 

f J. v. DOLLINGER : Die Universitaten sonst und jetzt, Miinchen 1867, S.. 

16.

FINAL CONSIDERATIONS. 63 I 

impoverished modern form of this idiom, confused ideas and 

barren thoughts find safe concealment; commonplaces 

intolerable in a German dress appear quite respectable 

when seen through a veil of Latin." 

If the title of Doctor of Medicine is a distinction, con 

ferred for scientific merit and characteristic of the ilite of 

the medical profession, it should also be looked upon as an 

indispensable prerequisite for everyone who aspires to 

occupy a position of importance in the public sanitary ser 

vice, in the medical department of the army, or on the staff 

of a hospital, or who desires to be a teacher at any medical 

faculty or school. The last-mentioned position should, for 

the rest, be open to anyone who is able to point to meri 

torious services in any sphere of knowledge, and who, in 

virtue of these and of his personal character, gives a 

guarantee that he will prove to the advantage and honour 

of the institution at which he desires to labour. 

The necessary requirements of a medical school having 

been satisfied by appointing and paying a staff of teachers, 

it can prove nothing but desirable and advantageous if men 

of training and ability come forward to increase its teaching- 

power of their own free will and without claiming remunera 

tion. The private teacher (Privat-Docent) is merely given 

the right, but must by no means be under an obligation, to 

teach, so long as he is not specially commissioned to do so 

and to fill up a gap in the curriculum. His work is a pre 

paration for the professoriate, to which he may be after 

wards called if he distinguishes himself as a teacher and 

investigator. But only a few reach this goal: for intellect, 

patience, and money are all wanted : and whoever is not 

provided with these three things had better renounce the 

idea of undertaking a calling which treacherously entices 

him with hopes, the fulfilment of which he awaits in vain. 

It is quite right that in appointments to vacant professor 

ships the claims of the private teachers should be con 

sidered in the first place : for thus the danger of appointing 

men unsuited or unqualified for the position is avoided. It


is a dangerous thing to entrust such a post to anyone who 

has up to that time had no practice or experience in teaching. 

The division of professors into ordinary and extra 

ordinary as is usual in the universities of Germany and 

other countries is less justifiable. The extraordinary 

professors are inferior to the ordinary in rank and pay, and 

beyond the title have, scarcely any greater privileges than 

the private teachers. To this category belong the repre 

sentatives of the so-called subordinate departments, certain 

teachers whose duty it is to supplement and complete the 

instruction in some of the principal departments, and those 

private teachers who have received the title of professor as 

a reward for their services. There is no doubt that it is an 

act of injustice to punish a professor because he devotes 

his powers to teaching a subject which is not of primary 

importance to the profession. When men who are counted 

amongst those who are an honour to science are thus dealt 

with it is not only cruel but also unreasonable. Their un 

selfish efforts should be recognized and assisted, not 

crushed and paralyzed by a mortifying and unjust restraint. 

Against making the position of the representatives of the 

subordinate departments equal to that of those who teach 

the principal subjects, it is urged that the claims upon the 

teaching-powers of the two sets of professors differ in 

degree: but such things cannot be estimated in the same* 

way as the work of day-labourers, according to the number 

of hours put in. 

It is above all things difficult to determine what depart 

ments of medical science can be considered subordinate 

in the curriculum. Formerly even midwifery, ophthalmo 

logy, and pathological anatomy were so considered. 

Opinions are divided as to whether many departments 

of medical science, as for example histology, forensic 

medicine, dermatology, laryngology, etc., should be con 

sidered principal or subordinate subjects. Much will also 

depend upon the size of the school: for it is clear that'


medical faculties like those of Paris, Vienna, or Berlin 

must not be measured by the same rule that suffices for 

small medical schools. In the latter many an arrangement 

must be neglected and many a professorial chair left un 

occupied which in the former are necessary, nay, indis 

pensable. The Frankfort Congress and the Reform 

Society of Jena refused to acknowledge the division of 

professors into ordinary and extraordinary, and declared that 

there should, in reason, be only two classes of academical 

teachers, namely, the professors and the private teachers : 

the former being commissioned to teach by the school and 

being paid for it, the latter doing so of their own free will 

and receiving no indemnification for their services. This by 

no means prevents certain private teachers being granted 

the title of professor in recognition of their labours :,but 

they should be promoted to the name only, not to the pro 

fessorial rank and rights. 

The professors form the College of Teachers, having 

direction and charge of the affairs of the faculty or school. 

Each member of this college has equal rights in debating 

and voting, whether he is the representative of a so-called 

chief department or of some narrowly circumscribed 

speciality: for in general educational matters every one of 

them is competent to form an opinion, and in questions 

which concern a particular department all due weight will 

be given to the judgment of an expert. The fear that in 

consequence of the great number of the members of the 

College of Teachers " the interest in the welfare of the 

faculty as a whole will be blunted," is entirely unfounded. 

The transactions of Parliaments, in which hundreds of 

representatives of the people'from all parts of the country 

co-operate, show that such joint work is possible " without 

loosening the bonds of a common interest." There is far 

greater danger that with a numerically small College of 

Teachers the deliberations will assume a quasi-domestic 

character and be biassed by personal considerations to 

such an extent as to be injurious to the general weal.


Differences of opinion are produced among the members 

of a College of Teachers by the variety of their intellectual 

gifts, by peculiarities of character, and by the scientific 

work they may have done : the result of their discussions 

is thereby beneficially influenced. 

Differences in the stipends of the professors are equally 

natural and just, and are influenced by the services they have 

rendered to science, the results of their teaching, and the 

time they have to devote to it. On the other hand it is 

impossible to approve of the extreme diversity in the 

income of professors which is produced by the system of 

lecture-fees; for the number of the audience depends 

chiefly upon whether the subject of the lecture is or is not 

one which is of use for examinations, and is but seldom 

affected by the merit of the lecturer. If he has to deal with 

a science but little popular, he will find himself surrounded 

by only a small circle of pupils, even although he possesses 

splendid gifts of eloquence, a powerful personality, and a 

world-wide fame. The students are bound in the first 

instance to apply themselves to those subjects which offer 

a secure foundation for their future life-work. To reproach 

them, on this account, with a shallow materialism, would 

be foolish : for they are, in this, only performing a duty 

they owe to themselves and to their families. But it is 

quite as senseless to reward or punish the lecturer for cir 

cumstances over which he has no influence, by assigning to 

him more or less of the money received as lecture fees. 

This diversity of payment can hardly be justified by any 

difference in the effort expended, as C. HASSE has pointed 

out ;* for this is much the same whether the audience con 

sists of two or two hundred. 

The custom of assigning the lecture-fees to the professors 

is also objectionable from an ethical point of view. The 

ideal aspect of a teacher's calling is degraded if the com- 

* C. HASSE: Die Mangel deutscher Universitatseinrichtungen und ihie Besserung, 

Jena 1887, S. 28 et seq.


mercial side of it is brought so prominently into view. 

"These fees are represented to us as being merely the 

reward which is considered everywhere in society as un 

questionably due to a man in the successful exercise of his 

talents. But it is a reward not honourable but degrading 

to a teacher."* 

It is the duty of the State to put an end to this system.. 

It should require that money received from persons attend 

ing educational establishments supported by itself should 

be spent on the improvement of such establishments. How 

much could be done in increasing the appliances for teach 

ing, in the support of scientific work, in the augmentation 

of stipends, in short in curing the serious disease from 

which, as WALTER PERRY said in the English House of 

Commons, the German universities suffer—the want of 

money,—if the income derived from the lecture-fees were 

so employed ! A wise educational policy will attack this 

problem and carry out the necessary reform while sparing 

the acquired rights of the individual, thus earning the 

thanks of the German people who love their universities 

and are acutely sensitive to every cloud which dims the 

pure light of their fame. 

No human arrangements are free from faults. A strenuous 

effort to improve and render perfect what already exists 

constitutes the task of life. Where can such endeavours 

be more justified or demanded than in dealing with the 

education of doctors on whose knowledge and ability the 

health and lives of men are so greatly dependent ? 

" The most precious capital of states and of society is 

man. Every individual life represents a definite value. To 

preserve, to maintain it intact as far as possible, up to the 

* H.J. v. WESSENBERG: Die Reform der deutschen Universitaten, 2 Aufi% 

Wiirzburg 1886, S. 39.—So also P. FRANK (op. tit. \i, Th. r, S. 290 et seq.} 

enters a protest against lecture-fees. The arguments brought forward in favour 

of them by the Minister Jos. UNGER in the Austrian House of Representatives 

on 28 January, 1876, have failed to convince me of the propriety of this arrangement.


•unalterable limits of its duration, is not only a precept 

which humanity teaches; it is the duty of every commonwealth 

in its own peculiar interest." In these words the 

Crown Prince RUDOLPH of Austria, unhappy in his early 

death, struck the key-note of a policy which sounds like 

the Evangel of times to come.

Abano, P., 213, 282. 

Adala, 199. 

Abdel-Letif, 163, 174. 

Abderrahman, 161. 

Abella, 201. 

Abercrombie, 477. 

Abernethy, 503. 

Abu Bekr, 154. 

Abulfarag, 156, 162. 

Abulkasem, 163, 164, 165, 166, 167. 

Achilles, 36. 

Achillini, 295. 

Ackermann, 381. 

Adalberon, 198. 

Adala, 200. 

Adalbert, 214. 

Adanson, 445. 

Addison, 477. 

Adelmus, 203. 

Adhad ed Daula, 173. 

Êgidius v. Corbeil, 202, 211, 214. 

jÊneas Sylvius, 288. 

iEschrion, 94, 100. 

Ae'tius, 152. 

Afflacius, 205, 210. 

Agathias, 158. 

Agenio, O., 245. 

Agrate, M., 32-3. 

Agricola, G., 293. 

Agricola, R., 290. 

Ahron, 158. 

Aichholtz, 329. 

Aigel, J., 2so. 

Albert V. of Bavaria, 311. 

Alberti, 298, 324. 

Albertini, 370, 400. 

Albertus Magnus, 282. 

Albinus, 94. 

Albinus, B. S., 405, 407, 465. 

Alcuin, 191, 194. 

Alexander of Macedon, 18, 72, 73. 

Alexander (of Damascus), 95. 

Alexander Severus, 98, 130, 132. 

Alexander of Tralles, 152. 

Alexander III., Pope, 280. 

Alexander VI., Pope, 225. 

Alexippos, 68. 

Alphonso VIII., 231. 

INDEX OF NAMES. 

Algizar, 170. 

Alhazen, 162. 

Ali Abbas, 163, 179. 

Ali Ben Issa, 173. 

Alibert, 477. 

Alkibiades, 51. 

Alkinani, 156. 

Alkmaeon, 45. 

Alcon, 125. 

Alphanus, 199, 21c. 

Alpini, P., 303. 

Amici, 460. 

Ammann, 365. 

Ammianus, 74. 

Ammonios, 80, 113, 116. 

Amontons, 351. 

Ampere, 458. 

Anaxagoras, 46. 

Andral, 469, 476. 

Andreas, 79. 

Andromachus, 106, 132. 

Anglicus, Cardinal, 222. 

Annesley, 477. 

Anselm of Havelberg, 213. 

Anthimus, 185. 

Antoninus Pius, 112, 129. 

Antyllus, ns, 118. 

Apollo, 34, 86. 

Apollonii, 113. 

Apuleius, 151. 

Aquapendente, Fab. 298. 

Arago, 349, 458. 

Aranzio, 297, 307. 

Archagathos, 88, 130. 

Archelaos. 51. 

Archimatthacus, 203, 210. 

Arculanus, 240. 

Ardem, J., 270, 272. 

Aretaeus. no, in, 152,519. 

Arfvedson, 457. 

Argelata, P. de, 251, 268. 

Aristophanes, 39, 50. 

Aristotle, 45, 51, 52, 57, 58, 72, 77,. 

104, 158, 160, 292, 335, 463. 

Arktinos, 35. 

Aselli, 358, 405. 

Asklepiades, 89-91, 104. 

Asklepios, 34-42, 50, si, 86.

638 INDEX OF NAMES. 

Asoka, 17. 

Astruc, 255, 381. 

Athenseus, 92. 

Attalus III., 81. 

Auenbrugger, 371, 473. 

Augustis, Quiricus de, 253. 

Augustus, i 29. 

Austrigildis, 189. 

Avenzoar, 163, 164, 166, 182. 

Averroes, 163, 179, 180. 

.Avicenna, 163, 166, 179, 240, 333. 

Bacchios of Tanagra, 79. 

Bachtischua, 158, 172, 181. 

Bacon, Roger, 283. 

Bacon, Francis,340,341,382, 384,439. 

Badia, 360. 

Baer, K. E. v., 450, 466. 

Baeren>prung, 477. 

Baglivi, 363. 

Baillou, 311. 

Backer, A., 407. 

Balard, 482. 

Baldinger, 381. 

Balthasar de Tuscia, 235. 

Baraillon, 536. 

Barbarus, 95. 

Bartb, Jos., 407, 428. 

iBarthez. 462. 

Bartholinus, E., 342. 

Bartholinus, T., 358, 371. 

Bartholomseus, 210. 

Bartholomseus Anglicus, 282. 

Basedow, 477. 

Basil, St., 147, 149. 

Bateman, 477. 

Bathurst, 361. 

Batsch, 449. 

Baudeloque, 539. 

Baudot, 536. 

Bauhin, 307. 

Bavarius, 283. 

Bayle, 476. 

Baynard, 374. 

Beaumor.t, 469. 

Beauvais, Vincent de, 282. 

Beauvais de Pre'aux, 536. 

Becher, 345. 

Becher, J., 400. 

Becquerel, 469. 

Beda, 153. 

Beer, G. J., 428,490. 

Beethoven, 441. 

Bell, 465, 470,471. 

Bellini, 356, 359, 365. 

Belon, 294. 

Bencio, H., 283. 

Benedetti, A., 274, 303, 311, 326. 

Benedictus Crispus, 196. 

Benedict, St., 142, 192. 

Bccnesch de Waitmuel, 234. 

Benevieni, 371. 

Bennet, 374. 

Bent, 376. 

Berengar of Carpi, 245, 295, 324. 

Bergmann, 345. 

Beringer, 415. 

Bernard, 104. 

Bernard, CI., 468, 469, 476. 

Bernhard, St., 214. 

Berres, 465. 

Bertapaglia, L., 268. 

Bertharius, 192, 196. 

Berthollet, 454. 

Berti, 347. 

Bertin, 356. 

Bertuccio, 246. 

Berzelius, 455, 456. 

Bessarion, 287. 

Bichat, 462, 465. 

Bidloo, 405. 

Biett, 477. 

Billroth, 626. 

Birkman. 396. 

Bischof, J. R., 477. 

Bischoff, Th., 466. 

Black, 453. 

Blasius, 485. 

Blin, 536. 

Blondlot, 469. 

Blumenbach, 103, 442, 448, 462, 467. 

Blundell, 489. 

Bodenstein, A. v., 339. 

Boeck, K. W., 477.' ' 

Boer, L., 492. 

Boerhaave. 368, 370, 381, 412, 427. 

Boethus, 95, 125. 

Bohemund, 198. 

Bonn, 366. 

Bonacoiuoli, L., 306. 

Bonjean, 544. 

Bjniface VIII., Pope, 245. 

Bonet, 371. 

Bonn, 466. 

Bonnet, 366, 448. 

Boot, A. de, 369. 

Bordeu, 37c, 462. 

Borelli, AIL, 351, 354, 359, 362, 368. 

Borgia, Lucrezia, 306. 

Borgognoni, 268, 271. 

Boisieri, 415. 

Bose. 35 1. 

Botallo, 301. 

Boitoni, A., ss3.

Bouilland. 376. 

Bourgois, L., 429. 

Boyer, 467. 

Boyle, Rob., 342, 344, 345, 347, 374. 

Braid, 484. 

Brambilla, 408. 

Branca, 273, 304. 

Brandis, 374. 

Braun, A., 445. 

Breschet, 465. 

Bretonneau, 476. 

Brewster, 460. 

Bright, 477. 

Brisseau-Mirbel, 445. 

Brissot, P., 307. 

Broussais, 461. 

Brown, J., 461, 462. 

Brown, R., 445. 

Briicke, 626. 

Briinninghausen, 485. 

Brunhilda, 186. 

Brunner, 355. 

Bruno, G., 382. 

Brunus Longoburgensis, 268. 

Brunschwyg, H., 338. 

Buch, L. v., 444. 

Buchhom, 491. 

Budd, 477. 

Buddha, 16. 

Buddhadaso, 17. 

Bulaeus, 190. 

Buffon, 367, 408, 448. 

Burdach, 442. 

Burke, 513. 

Burzweih, 143. 

Buschius, 289. 

Cselius Aurelianus, 110, 151. 

Caelius Aurelius, 192. 

Caesar, 129, 511. 

Caesarius v. Heisterbach, 214. 

Calcker, Jan van, 324. 

Caldani, 364. 

Calenda, Costanza, 201. 

Calmeil, 478. 

Calvin, 315. 

Camerarius, 342, 380. 

Camper, P., 365, 406. 

Canamusali, 167. 

Canani, 295, 324. 

Candolle, A. P. de, 445. 

Canton, J., 351. 

Cardanus, Hieronymus, 294. 

Carlisle, 455. 

Carminati, 362. 

Carret, 541. 

Carus, K. G., 442, 449, 471. 

INDEX OF NAMES. 639 

Cascellius, 122. 

Casimir, 235. 

Casper, 493. 

Cassebohm, 357. 

Casserio, 298, 324. 

Cassiodorus, 142, 191. 

Cassius Felix, 151. 

Cato, 84, 87, 88, 97, 146, 186. 

Cavendish, H., 345, 453. 

Caventon, 482. 

Cellini, Benvenuto, 324. 

Celsus, 80 93, 101, 113, 116, 118, 122, 

206, 272, 302, 519. 

Celt.es, Conrad, 290. 

Cesalpini, 293, 321. 

Cesi, Federigo, 385. 

Cesio, C.j 405. 

Chabas, 19. 

Chalid ben Jazid, 157. 

Chamberlen, 379. 

Chanak, 160. 

Charaka, 8-15, 160. 

Charcot, 626. 

Charlemagne, 159, 190, 19,1, 194. 

Charles of Anjou, 261. 

Charles IV., Emperor, 225, 226, 234. 

Charles V., Emperor, 310. 

Charles IX. cf France, 219, 332. 

Charmis, 125. 

Charondas, 66. 

Chassaignac, 485. 

Cauliaco, Guidode, 242/246, 25 1, 268, 

271, 272, 273, 274, 283. 

Chaussier, 462. 

Cheiron, 34, 36. 

Cheselden, 378, 379, 405. 

Chevalier, 460. 

Chiarugi, 478. 

Childebert, 148. 

Chirac, 360. 

Chladni, 46 1. 

Chopart, 376, 486, 539. 

Christison, 493. 

Chrysippos, 75. 

Chrysolaras, 287. 

Chrysostom, St., 146. 

Cicero, 1, 85, 286, 511. 

Ciucci, 378. 

Civialcc'378, 488. 

Claudis, 133, 146. 

Clelancl, 489. 

Clement V., Pope, 217. 

Clement VI., Pope, 258. 

Clemot, 487. 

Clocquet, 484. 

Cock burn, 370. 

Cole, W., 359.


Colombo, R., 298, 323, 327, 357. 

Come Frere, 378. 

Commodus, 95. 

Comte, A., 443. 

Condillac, 383. 

Conolly, J., 478. 

Conrad von Schiverstadt, 235. 

Conrad, King, 211. 

Conrad, Cardinal, 215, 216. 

Conring, 397. 

Constantine, 98. 

Constantinus African us, 197, 210. 

Copernicus, 293. 

Copho, 203, 21c. 

Corra, 173, 181. 

Corradi, A., 246. 

Cortona, Pietro da, 405. 

Cornarus, D., 339. 

Cortesi, 305. 

Corvi, G., 282. 

Corvisart, 473, 476, 539. 

Cotugno, 3 s 7. 

Courtois, 482. 

Cowper, W., 356. 

Crassus, 89. 

Cranach, Lucas, 2()o. 

Crato von Crafftheim, 339. 

Cronstedt. A. v., 444, 

Cruikshank, 455. 

Cruveilhier, 477. 

Cullen, 461. 

Cumano, M., 268. 

Curio, 334. 

Currie, 374. 

Cusanus, Nicolas, 294. 

Cuvier, 449, 450. 

Cyius, 18. 

Czolbe, 443. 

Daguerre, 460. 

Dalton, 454, 455. 

Damokrates, 106. 

Dante, 282. 

Daran, 378. 

Daremberg, 291, 554. 

Darius, iq, 45, 66. 

Darwin, E., 462. 

Darwin, Ch., 45 1. 

Daschkou, 611. 

Daubeuton, a08. 

D'Avtcllino-Caraciolo, 437. 

Daviel, 379. 

Davy, H., 455-45^- 484- 

Deisch, 431. 

De Keyser, 407. 

Deleau, L., 490. 

De l'Isle, R., 444. 

Delpech, 487, 488. 

Demetrios of Apamea, 79. 

Demetrius, 132. 

Demetrius Pepagomenus, 153. 

Dtmokedes, 45, 66. 

Demokritos, 47, 90, 383. 

Demosthenes, 1 18. 

Demours, 357. 

Deroldus, 198. 

Desault, 536. 

Descartes, 348, 382. 

Desfosses, 482. 

Desiderius, 198. 

Despars. J , 282. 

D'Estouteville, Cardinal, 28r. 

Deventer, H. v., 378. 

Deyl, H. van, 4(0. 

Deymann, 406. 

Dhanvantari, 12. 

Diaulos, 126. 

DitfTennach, 497, 498. 

Diogenes, 46. 

Diokles of Karystus, 78. 

Dionis, 377, 429. 

Dionysias, 50. 

Dioskoiides, 107, 151, 191,322. 

Dodonaeus, 311. 

Dodart, D., 361, 365. 

Dollinger, 442, 449. 

Dollinger. J. v., 500, 630. 

Dolaeus, 374. 

Dollond, 460. 

Dondi, G. de, 282. 

Donatus, 189. 

Dorothea Sibylla, 430. 

Douglas, J., 355. 

Drakon, 5 1. 

Drebbel, 346. 

Drelincouit, 357. 

Dscholdschol, Ibn, 167. 

Du Bois-Reymond, 326. 

Duchenne, 477- 

Dudith, Bishop, 308. 

DiArer, Albrecht, 29c, 324. 

Dufay, 350, 408. 

Dumas, 437. 468, 489. 

Dupu)tren, 487. 

Durand, 115. 

Dus£, 379. 

Dutrochet, 447, 469. 

Dutthagamini, 17. 

Duverney, 357, 365, 367, 4c6. 

Eberle, 469. 

Ebers, 20, 22, 24. 

Echter, Julius, 314. 

Egebtrg, 488. '

Ehrenberg, 448, 466. 

Ehrenritter, 428. 

Eir, 186. 

Elinus, 200, 

Eliot, 535. 

Elisha, 29. 

Elolathes, 44. 

Else, 376. 

Empedokles, 45. 

Ennana, 19. 

Enricus de Padua, 199. 

Epicurus, 104. 

Epimarchos, 45. 

Epione, 35. 

Epiphanius, 74. 

Erasistratos, 75-79, 92. 

Erasmus of Rotterdam, 290. 

Erastu's, 334. 

Ermerius, 53. 

Eros, 122. 

Errands, Ch., 405. 

Eschasse'riaux, 536. 

Esquirol, 478. 

Estienne, Ch., 324. 

Eudemos, 79. 

Eudemus (philosopher), 95. 

Euelpistus, 113. 

Euenor, 69. 

Euclid, 159, 511. 

Euler, L., 349. 

Eunapios, 82. 

Euripides, 50, 52, 511. 

Euryphon, 49. 

Eustachius, 296, 298, 324. 

Fabiola, 147, 148. 

Fabricius, 448. 

Fabricius (Fabry v. Hilden), 376, 

428. 

Fahrenheit, 351. 

Falcucci, Nic, 282. 

Faloppius, 296, 327. 

Falret, 478. 

Fannius, 122. 

Fantoni, 377. 

Faraday, 456, 458. 

Fechner, 443. 

Ferdinand III. of Spain, 232. 

Ferdinand the Catholic, 247. 

Ferdinand II., 351. 

Ferrein, 365. 

Feuchtersleben, v., 564. 

Fichte, 441. 

Filkin, 376. 

Flourens, 468, 469, 484, 

Floyer, 374. 

Fludd, 346. 


Fohmann, 465. 

Folz, 283. 

Fontana, 371, 404. 

Fontano, 326. 

Forat Ben Schannatha, 157. 

Fotster, 448. 

Fothergill, 371. 

Fourcroy, 4^4,.536, 540. 

Foville, 478. 

Francke, 390, 395. 

Franco, P., 303, 304, 307. 

Frank, Peter, 404, 407, 434, 475, 493,. 

S&7- 

Franklin, 351. 

Francis I.. 313, 331, 335. 

Fraunhofer, 460. 

Freidank, 320. 

Freind, 152, 190, 381. 

Frerichs, 477. 

Freseatorius, 311. 

Fresnel, 349, 460. 

Fried, 432. 

Frederick I., Emperor, 221, 245. 

Frederick II., Emperor, 207, 210, 216, 

220, 238, 244, 261, 266, 305. 

Frederick the Wise, 313. 

Froriep, 367. 

Fuch?, C. H., 477. 

Gaertner, 445. 

Galen, 21,30, 53, 77, 78, 81,93-105, 

117, 122, 124, 125, 132, 144, 151, 

156, 160, 163, 191, 193, 203, 204, 

208, 240, 241, 243, 250, 295, 298, 

3°2. 333, 334, 396, 436, 47°. 5'9- 

Galileo, 346, 352. 

Gall, 471, 478. 

Gallici, J., 235. 

Gallot, 536. 

Garbo, Dino di, 225, 240, 282. 

Garbo, Tomasso di, 282. 

Gaiiopontus, 200, 210. 

Gassendi, 347, 383. 

Gaub, 412. 

Gauss, 459. 

Gautier d'Agoty, 405. 

Gavarret, 469. 

Gay-Lussac, 455, 456, 458. 

Gaza, T., 287. 

Geber, 162. 

Geiger, 482. 

Gellius, 74, 126. 

Genga, 405. 

Georgios of Trebezond, 287. 

Gerbert d'Aurillac, 194, 213. 

Gersdorf, v., 301, 338. 

Gessner, Conrad, 333, 

T T

642 INDEX 

Gevicka, Nicolaus de, 235. 

Gibbon, 147. 

Giliani, A., 245. 

Gilavun El Mansur, 175. 

Gilbertus Anglicus, 282. 

Girard, 37. 

Girtanner, 461. 

Gisulf, iq8. 

Givaka, Komarabhakka, 16. 

Gladstone, 495. 

Glauber, 344. 

Glaucon, 192. 

Glaukias, 68, 80. 

Glisson, 355. 363, 369. 

Gmelin, 456, 469. 

Golnitz, 228. 

Gonguhrolf, 186. 

Gorcke, 59 1. 

Goethe, 154, 416, 441, 445- 

Gordon, 282. 

Gorgias, 113. 

Graaf, R. de, 356. 

Gradibus, de, 251, 283. 

Graefe, C. F., 488. 

Graefe, A. v., 490, 491. 

Grapbeus, Benvenutus, 274. 

Gray, S., 350. 

Gregoire, 379. 

Gregory of Nazianzus, 147. 

Gregory of Tours, 149. 

Gregory, J., 348. 

Grew, 342. 

Griesinger, 478. 

Griffon, 305. 

Grimaldi, 348. 

Grimaud, 462. 

Gruithiusen, 488. 

Gruner, 381. 

Guaineri, A., 282. 

Guarna, Rebecca, 201. 

Guericke, Otto v., 347. 

Guglielmus de Bononia, 199. 

Guglielmusde Ravegna, 199. 

Guidi, 322. 

Guillemeau, J., 307, 324. 

Guillotin, 536. 

Guinter of Andernach, 325. 

Guiscard, 198. 

Guislarn 478. 

Guizot, 185. 

Guntram, 189. 

Gustavus Adolphus, 388. 

Guttenberg, 291. 

Guyot, 377. 

Hadrian, 129. 

Haen, A. de, 370,412, 415. 

OF NAMES. 

Haeser, 153. 

Hahn, 374. 

Hadji Khalfa, 159, 179. 

Hakim, 161. 

Hakim, Biimrillah, 171. 

Hales, Stephen, 359, 372, 447. 

Halevi, Judah, 212. 

Hall, M., 348. 

Hall, Marshall, 471. 

Halle, 436. 

Haller, 197, 354, 3 6 3. 367, 372, 377. 

381, 400, 406, 407,412, 418, 461. 

Ham, 366. 

Hamann, 442. 

du Hamel, 345, 353, 446. 

Hammer-Purgstall, 173. 

Harder, 361. 

Hare, 513. 

Harting, 348. 

Hartmann v. d. Aue, 199, 214. 

Hartnack, 460. 

Hartsoeker, 366. 

Haroun al Raschid, 159. 

Harvey, 3-57, 358, 366, 371, 503. 

Hassey, C, 634. 

Hauy, 444. 

Havers, Clopton, 353,405. 

Hazon, 402. 

Hebra, F., 477. 

Hedschadsch, 157. 

Hegel, 442. 

Henry I. of France, 194. 

Henry VI., Emperor, 270. 

Henry IV., 219. 

Henry VIII., 421. 

Heister, Lorenz, 430. 

Heliodorus, 115, 116, 117. 

Helm, 469. 

Helmholtz, 461, 491, 626. 

Helmont, 344, 368. 

Henke, A., 493. 

Henle, 466. 

Henshaw, 361. 

Hensler, 381. 

Heraklides, 8o, 90. 

Heraklitos, 46. 

Herder, 441. 

Heribrand, 193. 

Hermann, J., 449. 

Hermanus Contractus, 213. 

Hermann von Treysa, 235. 

Hermes, 122. 

Heron, 113. 

Herodikas, 63. 

Herodotus, 34. 

Herophilos, 76, 77, 78, 79. 

Hesiod, 34.

INDEX OF 

Hesse, 482. 

Heurne, Otto v., 411. 

Heurteloup, 488. 

Hewson, 360. 

Hieronymus, 148. 

^Highmore, 354. 

Hikesias, 79. 

Hildegard, St., 196. 

Hildegard, 190. 

Himly, 491. 

Hippokrates, 1, 34,43,45,48-72, 113, 

152, 158, 191, 192, 193, 208, 241, 

242, 264, 334, 396. 

Hisinger, 455. 

Hodgson, 476. 

Hoffmann, F., 345, 368, 374, 390, 410, 

4'3>4i9>427- 

Holbein, Hans, 290. 

Homberg, W., 345. 

Homer, 34, 68, 83, 511. 

Honein, 160, 182. 

Honestis, C. de, 253. 

Honorius III., Pope, 280. 

Hook, Rob, 343, 348, 349, 354, 355. 

Hope, 476. 

Horace, 84, 511. 

Horenburg, E., 430. 

Hrabanus Maurus, 195, 196. 

Hrafn Sweinbiornsson, 187. 

Hufeland, 591. 

Hugo, 225. 

Humboldt, Alex, v., 448, 455. 

Hume, D., 383. 

Hunczovsky, 417. 

Hundt, Magnus, 251. 

Hunter, J., 373, 378, 404, 407, 448, 

45°, 47S-. 

Hunter, W., 356, 406. 

Huschke, 465, 471. 

Hutchinson, J., 470. 

Hutten, U. v., 289, 310. 

Huygens, 342, 349. 

Hygieia, 35, 42, 86. 

Hyginus, 122. 

Hyrtle, 328, 626. 

Ibn-el-Beithar, 163, 182. 

Ibn Tulun, 174. 

Ikkos, 63. 

Ingenhouss, 447. 

Ingigerd, 187. 

Ingvar, 187. 

Innocent III., Pope, 228, 259. 

Ion of Chios, 50. 

Isa ben Ali, 167. 

Isidor cf Seville, 153. 

Ismael ben Elisha, 30. 

NAMES. 643 

Israeli, 183. 

Itard, 490. 

Jackson, 484. 

Jacobi, 478. 

Jacobus Foroliviensis, 240. 

Jager, F., 491. 

James, St., 150. 

Janssen, 348. 

Jaso, 35. 

Jenner, 480. 

Jesensky, 328. 

Johann, 193. 

Johannes Actuarius, 153, 333. 

John of Bohemia, 220. 

John Frederick of Saxony, 314. 

Joseph II., Emperor, 404, 424, 428, 

435-478, 5S7> 559- 

Joseph, 197. 

Joshua, 197. 

Julian, 148, 152. 

Julius III., Pope, 317. 

Julius, Duke of Brunswick, 314, 

Juncker, Joh., 416. 

Jussieu, 408, 445. 

Justinian, 141. 

Kafur, 175. 

Kallisthenes, 68. 

Kant, 437,441, 443. 

Karlstadt, 339; 

Karneades, 79. 

Kay, John, 421. 

Kempelen, 365. 

Kepler, 293, 294, 364. 

Kergaradec, 474. 

Kerckring, 354, 355, 366, 372. 

Kesra Nuschirvan, 143, 158. 

Ketham, 25 1. 

De Keyser, 407. 

Kielmeyer, 442, 448, 450. 

Kieser, 442. 

Kirchhoff, 460. 

Klaproth, 451. 

Klein, J. T, 343. 

Kleist, 351. 

Klinkosch, 353. 

Klopstock, 395. 

Knox, 513. 

Kohler, 37. 

Kolliker, 466. 

Konr, 186. 

Kopp, 452. 

Koyter, 298, 324. 

Kramer, W., 490. 

Kratevas, 80. 

Kratzenstein, 365.

644 

Krinas, 125- 

Ktesias, 49. 

Kiihlewein, 53. 

Kunkel, 345. 

Kyper, A., 411, 412. 

INDEX OF NAMES. 

Labrosse, 408. 

Lacoste, 536. 

Lactantius, 292. 

Ladmiral, J., 405. 

Laennec, 474. 

Laguna, 304. 

Lairesse, Gerard de, 405. 

Lamarck, 348, 349. 

Lamballe, 493. 

Lamettrie, 383. 

Lancisi, 356, 370, 371, 372, 407, 412, 

417. 

Lanfranchi, 270, 271. 

Lange, F. A., 384. 

Langenbeck, 488. 

Laplace, 347, 459. 

Larrey, 485, 486. 

Laskaris, C, 287. 

Lassus, 539. 

Latham, 476. 

Latini, B., 282. 

Latreille, 448. 

Lavoisier, 346, 452, 453, 536. 

Leake, J., 430. 

Le Blon, 405. 

Leclerc, D., 381. 

Leclerc, L., 177. 

Le Dran, 376. 

Leeuwenhoek. 342, 353, 354, 3,5, 

357,359- 3 66 , 373- 

Legallois, 469. 

Lehmann, 4(19. 

Leibnitz, 366, 383, 386, 395. 

Lelli, E., 405. 

Lemnius, 332. 

Leo XII., 598. 

Leo African us, 159, 177. 

Leonardo da Vinci, 289, 294, 322, 

324, 3? 1 - 

Leopold, Emperor, 385. 

Leopold V. of Austria, 270. 

Lepsius, 20. 

Lequin, N., 377. 

Leroy d'Etiolles, 488. 

Lessing, 395, 441. 

Leukippos, 46. 

Levasseur, 536. 

Lev ret, 379. 

Leyer, G., 396. 

Leyser, A., 335. 

Libanius, 139. 

Libavius, 344. 

Lichtenstein, 448. 

Lieberkdhn, 404. 

Liebig, 457,468,484. 

Lieutaud, 400, 407. 

Link, 445. 

Linnaeus, 342, 343, 373, 448. 

Lisfranc, 486. 

Littre, 53. 

Livius Eutychus, 132. 

Lobstein, 475. 

Locke, J., 382. 

Longinus, 152. 

Lonicerus, A., 280. 

Lorrain, C, 381. 

Lotichius, 393. 

Lotze, 443. 

Louis, 375. 

Louis, P. A., 477. 

Louis the Pious, 190. 

Louis the Simple, 198. 

Louis IX. of France, 245. 

Louis XI. of France, 320. 

Louis XII. of France, 331. 

Louis XIII. of France, 408, 410. 

Louis XIV. of France, 217, 377, 386. 

Louis XVI. of France, 415. 

Louis XVIII. of France, 542. 

Lower, 355. 

Lucian, 116, 127. 

Lucius, 95. 

Lucretius, 90. 

Luder, P., 289. 

Ludwig, C. G., 371. 

Lurcz, H., 235, 281. 

Luther, 285, 319, 338. 

Lyell, 450. 

Lykurgos, 68. 

Lykus, 100. 

MacDowell, 493. 

Macer Floridus, 196. 

Machaon, 35, 36. 

Macrizi, 172, 174, 175, 177. 

Maggi, 300. 

Magendie, 468, 471. 

Magnus, 132. 

Magnus, 457. 

Mahan, 159. 

Mahon, P. A. O., 539. 

Maimonides, 163, 166, 179, 180, 212. 

Malacarne, 467. 

Malpighi, 342, 343, 354, 355, 356, 

358, 360, 361, 365, 366. 

Malus, 460. 

Mamun, Al, 159, 160. 

Manfred, 211.

Mankah, 160. 

Manlius Cornutus, 125. 

Mansur, Al, 158. 

Mantias, 79. 

Marat, 536. 

Marbod, 196. 

Marcellus Empiricus, 151. 

Marche, Marg. de la, 429. 

Marchettis, 362. 

Marcus Marci of Kronland, 349. 

Marcus Antonius, 89. 

Marcus Aurelius, 95. 

Mareschal, 420. 

Marggraf, 345. 

Maria Theresa, Empress, 556. 

Marianus, 157. 

Marileif, 189. 

Marinus, 100. 

Mariotte, 347, 365. 

Maristania, Ibn el, 174. 

Martial, 113, 122, 126. 

Martianus, 244. 

Martin V., Pope, 232. 

Martin von Wallsee, 235. 

Martinez, 405. 

Mascagni, 465. 

Masona, 147. 

Matthysen, 487. 

Mandeville, Sir J., 257. 

Maurus, 211. 

Maximilian I., Emperor, 313. 

Mayer, J. R., 473. 

Mayor, 474. 

Mayou, 363. 

Mazza, 202. 

Meckel, 449, 475. 

Medici, Cosmo de, 328. 

Medici, Lorenzo de, 226. 

Medici, Maria de, 429. 

Megenberg, K. v., 282. 

Meges, 113. 

Meghavana, 17. 

Meibom, 357, 397. 

Mein, 482. 

Meissner, 482. 

Melanchthon, 285,314,339. 

Melanchthon, S., 334, 339. 

Meletius, 153. 

Mende, 493. 

Mendelssohn, 180. 

Menekrates, 106. 

Menghini, 360. 

Menokritos, 69. 

Mercuriade, 201. 

Mersenne, 347. 

Meiue, 159, 172. 

Metrodoros, 45, 69, 77. 


Meyen, 445. 

Meyer, E., 106, 170, 181, 190, 196, 

197. 

Mezler, 381. 

Michelangelo, 289, 323. 

Michelet, 378. 

Middeldorpf, 485. 

Miereveld, M. v., 407. 

Mistichelli, 361. 

Mithridates", 80, 81, 89. 

Mitscherlich, 456,457. 

Mittelhauser, 431. 

Moawiyah,' 156. 

Moehsen, 381. 

Mohl, H.,445, 446. 

Mohs, 444. 

Moldenhawer, 445. 

Moliere, 436. 

Molyneux, 359. 

Mommsen, 120. 

Mondeville, H. de, 242, 268, 283. 

Mondino, 246, 250, 295. 

Monnier, Le, 351. 

Monro, 391. 

Montagna, B., 251. 

Montaigne, 436. 

Monte, G. da, 332. 

Monteggia, 493. 

Montespan, de, 429. 

Montgelas, 576. 

Morand, 376. 

Moreau, 486. 

Morel, 375, 478. 

Moreland, 349. 

Morgagni, 372, 405, 407. 

Morley, David, 213. 

Morveau, Guyton de, 454. 

Moses, 26. 

Mottawakl, 173. 

Moulin, A., 359. 

Mozart, 441. 

Muhammed, 155, 18c. 

Muhammed, Ben Ali Ben Farak, 179. 

Miiller, O. F., 448. 

Miiller, Johannes, 449, 466, 471, 475. 

Mulder, 167. 

Munk, 180. 

Murillo, 381. 

Musa, 129, 133. 

Musandinus, 211. 

Muscio, 104. 

Musculus, 319. 

Musschenbroek, 351. 

Myrepsus, Nicolaus, 153, 253. 

Nachmanides, 212. 

Natgeli, 446.


Napoleon I., 541. 

Nasse, C. F., 478. 

Nebsecht, 24. 

Nees v. Esenbeck, 442. 

Neckam, A., 196. 

Nero, 132. 

Newton, 347, 349, 352,363. 

Nicephorus, 159. 

Nichols, 431. 

Nicholson, 455. 

Nicolaus, 189. 

Nicolaus Praepositus, 211, 258, 274. 

Nicolas IV., Pope, 216. 

Nicolas V., Pope, 288. 

Niepce, 460. 

Nikander, 80. 

Niketas, 153. 

Nikon, 93. 

Ninon de PEnclos, 410. 

Nollet. 469. 

Nuftr.J., 307. 

Numa, 85, 120. 

Numesianus, 94. 

Nureddia, 174. 

Oberhauser, 460. 

Oddo, M., 332. 

Odin, 186.' 

Oersted, 442, 458. 

Ohm, 458, 461. 

Oken, 442, 450. 

Olympics, 116. 

Omar, 156. 

Onasilos, 68. 

Orfila, 493. 

Oribasius, 152, 185. 

Origen, St., 142. 

Orlandus, 224. 

Orosius, 140. 

Ortolf of Bavaria, 284. 

Oseibia, Ibn Abu, 158, 163, 167, 173, 

r hl 

is- 

Qsiander, 432, 493. 

©thman, 154. 

Othmar, St., 149. 

Otho of Greece, 612. 

Ovid, 336, 5 11 - 

Paaw, P., 298. 

Palfyn, 379. 

Pallas, 448. 

Pallavicini, 244. 

Palucci, 427. 

Panakeia, 35, 42. 

Pander, 45c, 466. 

Pandukabhayo, 17. 

Panum, 489. 

Panvilliers, 536. 

Papin, 35°- 

Paracelsus, 308, 309, 338, 343, 368, 

3^9- 

Pare, 300, 301, 302, 304,307, 375, 376. 

Park. 376. 

Parrhasios, 323. 

Pascal, 347. 

Passarotti, 3., 324. 

Patroklos, 36. 

Paul of Merida, 275. 

Paula, 147. 

Paulsen, 395. 

Paulus iEgineta, 153, 206, 302. 

Pecquet, 347, 358. 

Pelletier, 482. 

Pelops, 94, 100. 

Perikles, 50, 289. 

Perrault, 365. 

Perry, W., 635. 

Peter the Great, 404, 611. 

Peters, H., 409. 

Petit, 375, 378- 

Petrarch, 211, 286, 336. 

Petroncellus, 210. 

Petrus, 189, 198. 

Petrus Lemonensis, 220. 

Peucer, C, 339. 

Peyer, 355, 361. 

Peyronie, La, 420. 

Pfolspeundt, H., 271, 273. 

Phaenarete, 64. 

Pheidias, 50. 

Philinos, 80. 

Philip Le Bel, 242, 268. 

Philippos of Akarnania, 68. 

Philippe Auguste of France, 202. 

Philip the Bold, 245. 

Philip William, Prince of Orange, 376^ 

Philiskus, 112. 

Philolaos, 44. 

Philo, 106. 

Philostratos, 63, 112. 

Philoxenos, 79, 113. 

Photius, 153, 160. 

Piedimonte, Francesco di, 282. 

Pindar, 34. 

Pinel, 462, 478, 539. 

Piorry, 473. 

Pirchpach, O, 339. 

Pirkheimer, W., 290. 

Pirogoff, 486. 

Pitcaim, 361, 368, 509, 510. 

Placilla, 148. 

Platearii, 21 o. 

Plato, 50, 52, 54, 56, 60, 61, 62, 63, 

6 4, 65, 70, 72, 383.

Platter, 251, 260, 311, 319, 324, 326, 

327, 329. 

Plencicz, 373, 415. 

Pliny, 79, 85, 93, 97, 117, 12c, 123, 

124, 125, 151. 

Plossl, 460. 

Plutarch, 85, 122, 127. 

Podaliiios, 35, 36. 

Poggendorff, 346. 

Pois, Jean de, 281. 

Polybos, 51. 

Polykleitos, 52. 

Polykrates, 66. 

Pontus, 200. 

Porta, G., 294. 

Portal, 381, 407. 

Pott, 378, 503. 

Pourfour du Petit, 357. 

Poussin, Nicholas, 381. 

Pravaz, 482. 

Praxagoras of Kos, 75. 

Prevost, 489. 

Priestley, 452, 453., 

Pringle, 373, 412. 

Prochaska, 471. 

Profatius, 2 16. 

Proust, 454. 

Prudentius, 140. 

Psellus, 153. 

Puccinotti, 197. 

Purkinje, 352, 466, 491. 

Puftnann, M. G., 423. 

Pyrrhon, 79. 

Pythagoras, 44, 293. 

Quatremere, 170. 

Quesnay, 360. , 

Quintus, 94, 100. 

Quittenbaum, 488. 

Rachid Eddin Ibn Aszuii, 179. 

Rafael Sanzio, 289, 323. 

Ragenifrid, 198. 

Ramus, P., 332. 

Ranuccius, 224. 

Rapallo, Bernardo di, 302. 

Rasori, 462. 

Rathke, 466. 

Rau, J. J., 427. 

Ray, J., 343. 

Rayer, 477. 

Redi, F., 343, 366. 

Regters, T., 407. 

Reichert, 466. 

Reiff, W., 306. 

Reil, J. C, 462,478, 591. 

Remak, 466, 477. 


Rembrandt, 381, 406. 

Remelin, Joh., 405. 

Renan, E., 507. 

Renaudot, Th., 412. 

Reni, G., 322, 381. 

Renzi, S. de, 197, 199. 201, 261. 

Reoval, 189. 

Reuchlin, 290. 

Reusner, 369. 

Rhazes, 118, 163, 166, 173, 182, 240, 

320. 

Richardus, 146. 

Richelieu, 413. 

Richer, 193, 198. 

Richter, A. G., 425, 427. 

Ricord, 477. 

Ridley, H., 356, 371. 

Ristorio dArezzo, 282. 

Riva, G., 408. 

Rivinus, Q., 355. 

Robiquet, 482. 

Rochlitz, Dedo v., 270. 

Rodolfus, 199. 

Roederer, 432. 

Roschlaub, 461. 

Roslin, E., 306. 

Roger, 174. 

Rokitansky, 443, 475, 477. 

Rolando, 205. 

Rolfink, W., 400. 

Romberg, 477. 

Rondelet, 294, 326. 

Roonhuyse, H. v., 378, 430. 

Rosa, Salvator, 381. 

Rose, 457. 

Rosenmiiller, 467. 

Rossi, de, 323. 

Rousseau, 384. 

Rousset, 304. 

Rubens, 381. 

Rudbeck, 358. 

Rudolph, Crown Prince, 636. 

Rudolphi, 448, 591. 

Rueff, J., 306. 

Rufus, 49, 100, 101, 110, 203. 

Ruggiero, 205. 

Rumford, 459. 

Runge, 482. 

Ruysch, F., 354, 355, 357. 404, 405, 

43°- 

Sabatier, 538, 539. 

Sabinus, 314. 

Sabur Ben Sahl, 172. 

Saladin of Asculum, 253. 

Saleh ben Baleh, 160. 

Saliceto, Gulielmus de, 244, 268.


Salimbeni, 244. 

Salisbury, J. de, 214, 228, 241. 

Salles, 536. 

Salomonus Ebrasus, 199. 

Salvianus, 140. 

Samachschari, 169. 

Sanchez, R., 412. 

Sanctorius, 346, 361, 370. 

Sandifort 407. 

Sanson, 487. 

Santo, Mariano, 302. 

Santorini,356, 357, 405. 

Sarto, Andrea del, 323. 

Satyrus, 94, 100. 

Savary, 349. 

Saviard, 375. 

Savigny, 378. 

Savonarola, 282. 

Scarpa, 465, 491. 

Schacht, L., 411, 412. 

Schaprout, Chasdai, 212. 

Scheele, 345. 

Scheiner, 364. 

Schelling, 441. 

Scherer., 469. 

Scheuchzer, 444. ••:' 

Schiller, 441. 

Schleiden, 446. 

Schtnid, K., 196. 

Schmidt, Ad , 428, 490. 

Schmucker, 375, 376. 

Schneider, C. V., 354. 

Schonlein, 476. 

Schopenhauer, 442. 

Schrevelius, E.,411. 

Schroder v. d.,Kolk, 478. 

Schultze, M., 466. 

Schultze, J. H., 381, 397. 

Schwann, 446, 466. 

Schwcigger, 456, 458. 

Scipio Africanus, 120. 

Scottus, Michael, 199. 

Scoutetten, 485. 

Scribonius Largus, 106. 

Seckendorff, 395. 

Secq, R. Le, 337. 

Se'dillot, 488. 

Seebeck, 458. 

S6guin, 482. 

Seleucus, 112. 

Seleukos, Nikator, 78. 

Selligue, 460. 

Semmelweiss, 492. 

Senac, 355, 371. 

Senebier, 477. 

Seneca, 83, 127. 

Senfft, 391. 

Serapion, 80. 

Serenus Samonicus Qu, 127. 

Sergius, 95, 158. 

Serres, 477. 

Serturner, 482. 

Servet, 296, 298, 308, 315, 336, 357. 

Servin, 337. 

Seth, Simon, 153. 

Seutin, 486. 

Severus, 95. 

Sextius Niger, 106. 

Sextus Placitus Payrensis, 151. 

Siebold, 430. 

Siebold. C. C, 391, 354. 

Siegemundin, Justine, 430. 

Sigismund, Emperor, 278. 

Sigrdrifa, 186. 

.Sigurdr, 186. 

Simon of Genoa, 118, 237. 

Simon, G., 493. 

Simon, O., 488. 

Simpson, 484. 

Sims, Marion, 493. 

Sinclair, 347. 

Si vert, 403. 

Sixtus IV., Pope, 247. 

Skoda, 473, 476. 

Slevogt, 380. 

Sloan, Sir H., 408. 

Snell, 348. 

Snorri Sturluson, 187. 

Sobiesk, J., 404. 

Sobki, 182. 

Sommering, 408, 464, 465. 

Sofia, S. di, 249, 282. 

Sokrates, 50, 64, 72. 

Solano di Luques, 370. 

Solingen, Corn., 377. 

Solomon, 28. 

Sonnerat, 448. 

Sophokles, 50. 

Soranus, 52, 119, 140, 151, 193. 

Sostratus, 113. 

Soubeyran, 484. 

Soupart, 485. 

Spallanzani, 362, 367. 373. 

Spigel, v. d., 298, 324. 

Spinoza, 180, 382. 

Sprengel, 37, 197. 

Spurzheim, 478. 

Stahl, 345, 368, 390, 462. • 

Stainpeis, M., 240, 251, 255. 

Stalpert v. d. Wiel, 374. 

Stengel, 396. 

Steno, N., 342, 354, 355, 356, 357, 

3 6 2, 363. 

Stephanus, 157.

Sterne, L., 431. 

Stertinius,*L., 125. 

Stertinius Xenophon, 131, 133. 

Steubing, 394. 

Stevinus, 346. 

St. Hilaire, G., 449. 

Stilling, B., 465. 

Stobaeus, 77. 

Stobbe, 397. 

Storck, A., 374. 

Stokes, 47>6. 

Stoll, M., 402, 407, 415, 473. 

Strabo, 130. 

Straten. W. v. d., 412. 

Stratokles, 112. 

Stratonicus, 94. 

Stromeyer, 487. 

Stryk, 390. 

Suidas, 95. 

Susruta, 8-14. 

Swammerdam, 343, 355, 360, 366. 

Swieten, G. van, 412, 414, 427, 556, 

557- 

Swift, 384. 

Sydenham, 368. 

Sylvaticus, M., 251, 282. 

Sylvius, 296, 336. 

Sylvius (de le Boe), 36B, 369, 411. 

Syme, 485, 486. 

Symmachus, 113. 

Symmachus, Pope, 259. 

Tacitus, 184. 

Tagliacozzi, 304, 305, 488. 

Talbot, 460. 

Taranta, 282. 

Tardieu, 493. 

Tartaglia, 294. 

Tenon, 536. 

Tertullian, 90. 

Teta, 24. 

Tetulus Graecus, 199. 

Textor, 486. 

Thaddaeus Florentinus, 221, 282,320. 

Thaun, Phillip de, 196. 

Theden, 375. 

Themison, 9 1 . 

Thenard, 456. 

Theodocus, 157. 

Theodoric, 142. 

Theodore II., 189. 

Theodorus Priscianus, 120, 123, 151. 

Theokritos, 75. 

Theophanes, 116. 

Theophanes Nonnus, 153. 

Theophilus Protospatharius, 203. 

Theophrastos, 106. 


Theopompos, 48. 

Thessalos, 51, 68, 99, 124. 

Thibault, 3^6. 

Thilenius, 378. 

Thomasius, 390, 395. 

Thomas Cantimpratensis, 275. 

Thrka, 32. 

Thukydides, 50. 

Tiedemann, 449, 465. 

Timon, 82. 

Titian, 324. 

Touche, G. de la, 428. 

Tournefort, 408. 

Tornamira, 282. 

Torre, della, 282, 322. 

Torricelli, 346. 

Torrigiano, 282. 

Thoth, 20. 

Toynbee, 490. 

Traube, 473, 476, 477. 

Tribunas, 143. 

Tiiller, 381. 

Trithemius, 290. 

Troost, Corn., 407. 

Trotula, 201, 206. 

Trousseau, 476. 

Truchsess, O. v., 314. 

Trusianus, 240. 

Tryphon, 113. 

Tudela, Benjamin von, 202, 213. 

Tulp, 378, 406. 

Turquet de Mayerne, 344. 

Uarda, 24. .^ ., .. 

Ulrich, Duke, 328. •'#,&•*£*'. 

Unger, 446. ^ , /^ V 

Valens, 131. 

Valentin, 466. 

Valentinian, 131, 1-39, 149. 

Valleix, 477. 

Valleriola, 311. 

Valliere, de la, 429. 

Vallisneri, 366. 

Valsalva, 357, 365, 371. 

Valverde de Hamusco, 324. 

Varignana, B , 282. 

Varro Terrentius, 93. 

Vasco de Gama, 310. 

Vauquelin, 454. 

VeitI, 486. 

Velasquez, 381. 

Velpeau, 467. 

Venel, 378. 

Vesalius, 323, 324, 325, 326, 327, 328, 

329, 332, 33(>- 

Vespasian, 129. 

W W

• 6 •j *"!•' . "F 

5 ..VlIDEXQ f?'.NAMES. 

Vetter, 475.,- •••. W **,* 

Vicq d'Azyr, 448.' ? 

Vieussens, 355, 35*6, 35.7, 360, 371, 

400. ; 

Villanbva, Arnaldus de, 213. 275, 

' - fi% 29 3- 

Vindicianus, 151. . 

Virchbw, T45, 256, 259,475, 626. 

ViscoBjjfe G., 225. 

Vitalis Ordericus, 190. 

VitoX§7. 

VogM, R.A., 416. ''" 

Volkma-np, 469. 

Voltl, 458. 

. 701^6,383,384. 

T* 

h..yf%g n &> R '» 466. . 

Waimar, 198. 

Walafridus Strabo, 193, 196. *• 

Waldenberg, 470. 

Wall, 350. ,:,;.., 

'.ylallace, 451. ^F 

Wallerius, 444,^* 

Walter, J. G., 404. 

Walter, 251. 

Walther, 235. 

Wandelaer, J., 406. 

^Warner,-375. 

**> Weber, Ed., 469, 470. 

Weber, E. H., 469. 

• Weber, W., 470. 

• Weikard, 39 r. 

Weiss, 444. 

Weitbrecht, 354. 

Weschf r, 69. 

Wharton, 355. 

Whistler, 369. 

White, 376, 486. 

Whytt, 364. 

Young, 460. 

Yperman, J., 270, 273. 

El'Welid Be'n Abd-el-Malik, 172. 

Wentzel, 379,1428, 490. 

Zerbi, 295. 

Wepfer, J. J., 356, 371, 374. Zeuxis, 79. 

Werlhof, 369, 390,407, 413. 

Ziemssen, 626. 

Werner, A. G., 444. 

Zinn, 357. 

i- 

William of Bavaria, 318. 

William the Conqueror, 198. 

William of Montpellier, 214. 

Winkler, J. H„ 351, 

Wilde, W. R., 490. 

Willan, 477. ' % 

Willis, 356, 363, 364, 36S, 369; 373. 

Wilson. E.,.477. 

* Winslow, 355, 402. 

Wintarus, 196. 

Wintrich, 473. 

Wirsung, 355. 

Wohler, 457, 468. 

Wolff, C. F., 367. 

Wolff, Christian, 383. 

Wollaston, 455, 460. 

Wood, A., 482-. • ' 

Woolhouse, 379. ,. 

Worcester, Marquess of, 349. 

Worm&O., 354. 

Wrisberg, 357. 

Wunderlich, 474, 475, 626. 

Wurtz,. F., 338. 

Wustenfeld, 170, 182. 

Xenokrates, 109. 

Xenophon, 68, 511. 

H. K. Lewis, 136, Gower Street, London.

^-^•^•ftffi" 

*-3 

&Et 

~A> 'F OlTiLk i «£*

ORIENTAÇÕES PARA O USO 

Esta é uma cópia digital de um documento (ou parte dele) que pertence 

a um dos acervos que fazem parte da Biblioteca Digital de Obras Raras e 

Especiais da USP. Trata-se de uma referência a um documento original. 

Neste sentido, procuramos manter a integridade e a autenticidade da 

fonte, não realizando alterações no ambiente digital – com exceção de 

ajustes de cor, contraste e definição. 

1. Você apenas deve utilizar esta obra para fins não comerciais. Os 

livros, textos e imagens que publicamos na Biblioteca Digital de Obras 

Raras e Especiais da USP são de domínio público, no entanto, é proibido 

o uso comercial das nossas imagens. 

2. Atribuição. Quando utilizar este documento em outro contexto, você 

deve dar crédito ao autor (ou autores), à Biblioteca Digital de Obras 

Raras e Especiais da USP e ao acervo original, da forma como aparece na 

ficha catalográfica (metadados) do repositório digital. Pedimos que você 

não republique este conteúdo na rede mundial de computadores 

(internet) sem a nossa expressa autorização. 

3. Direitos do autor. No Brasil, os direitos do autor são regulados pela 

Lei n.º 9.610, de 19 de Fevereiro de 1998. Os direitos do autor estão 

também respaldados na Convenção de Berna, de 1971. Sabemos das 

dificuldades existentes para a verificação se uma obra realmente 

encontra‐se em domínio público. Neste sentido, se você acreditar que 

algum documento publicado na Biblioteca Digital de Obras Raras e 

Especiais da USP esteja violando direitos autorais de tradução, versão, 

exibição, reprodução ou quaisquer outros, solicitamos que nos informe 

imediatamente (dtsibi@usp.br).

0"T' LAERT> "! - USP

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?