No error in the choice of these healing means seems to have diminished their efficacy. When Prof. Buckland, the eminent osteologist and geologist, discovered that the relics of St. Rosalia at Palermo, which had for ages cured diseases and warded off epidemics, were the bones of a goat, this fact caused not the slightest diminution in their miraculous power.
Other developments of fetich cure were no less discouraging to the evolution of medical science. Very important among these was the Agnus Dei, or piece of wax from the Paschal candles, stamped with the figure of a lamb and consecrated by the Pope. In 1471 Pope Paul II expatiated to the Church on the efficacy of this fetich in preserving men from fire, shipwreck, tempest, lightning, and hail, as well as in assisting women in childbirth; and he reserved to himself and his successors the manufacture of it. Even as late as 1517 Pope Leo X issued, for a consideration, tickets bearing a cross and the following inscription: "This cross measured forty times makes the height of Christ in his humanity. He who kisses it is preserved for seven days from falling-sickness, apoplexy, and sudden death."
Naturally, the belief thus sanctioned by successive heads of the Church, infallible in all teaching regarding faith and morals, created a demand for amulets and charms of all kinds; and under this influence we find a reversion to old pagan fetiches. Nothing, on the whole, stood more constantly in the way of any proper development of medical science than these fetich cures, whose efficacy was based on theological reasoning and sanctioned by ecclesiastical policy. It would be expecting too much from human nature to imagine that pontiffs who derived large revenues from the sale of the Agnus Dei, or priests who derived both wealth and honours from cures wrought at shrines under their care, or lay dignitaries who had invested heavily in relics, should favour the development of any science which undermined their interests.[301]
[301] See Fort's Medical Economy during the Middle Ages, pp. 211- 213; also the Handbooks of Murray and Baedeker for North Germany, and various histories of medicine passim; also Collin de Plancy and scores of others. For the discovery that the relics of St. Rosaria at Palermo are simply the bones of a goat, see Gordon, Life of Buckland, pp. 94-96. For an account of the Agnes Dei, see Rydberg, pp. 62, 63; and for "Conception Billets," pp. 64 and 65. For Leo X's tickets, see Hausser (professor at Heidelberg), Period of Reformation, English translation, p. 17.
V. Theological Opposition To Anatomical Studies.
Yet a more serious stumbling-block, hindering the beginnings of modern medicine and surgery, was a theory regarding the unlawfulness of meddling with the bodies of the dead. This theory, like so many others which the Church cherished as peculiarly its own, had really been inherited from the old pagan civilizations. So strong was it in Egypt that the embalmer was regarded as accursed; traces of it appear in Greco-Roman life, and hence it came into the early Church, where it was greatly strengthened by the addition of perhaps the most noble of mystic ideas--the recognition of the human body as the temple of the Holy Spirit. Hence Tertullian denounced the anatomist Herophilus as a butcher, and St. Augustine spoke of anatomists generally in similar terms.
But this nobler conception was alloyed with a medieval superstition even more effective, when the formula known as the Apostles' Creed had, in its teachings regarding the resurrection of the body, supplanted the doctrine laid down by St. Paul. Thence came a dread of mutilating the body in such a way that some injury might result to its final resurrection at the Last Day, and additional reasons for hindering dissections in the study of anatomy.
To these arguments against dissection was now added another--one which may well fill us with amazement. It is the remark of the foremost of recent English philosophical historians, that of all organizations in human history the Church of Rome has caused the greatest spilling of innocent blood. No one conversant with history, even though he admit all possible extenuating circumstances, and honour the older Church for the great services which can undoubtedly be claimed for her, can deny this statement. Strange is it, then, to note that one of the main objections developed in the Middle Ages against anatomical studies was the maxim that "the Church abhors the shedding of blood."
On this ground, in 1248, the Council of Le Mans forbade surgery to monks. Many other councils did the same, and at the end of the thirteenth century came the most serious blow of all; for then it was that Pope Boniface VIII, without any of that foresight of consequences which might well have been expected in an infallible teacher, issued a decretal forbidding a practice which had come into use during the Crusades, namely, the separation of the flesh from the bones of the dead whose remains it was desired to carry back to their own country.
The idea lying at the bottom of this interdiction was in all probability that which had inspired Tertullian to make his bitter utterance against Herophilus; but, be that as it may, it soon came to be considered as extending to all dissection, and thereby surgery and medicine were crippled for more than two centuries; it was the worst blow they ever received, for it impressed upon the mind of the Church the belief that all dissection is sacrilege, and led to ecclesiastical mandates withdrawing from the healing art the most thoughtful and cultivated men of the Middle Ages and giving up surgery to the lowest class of nomadic charlatans.
So deeply was this idea rooted in the mind of the universal Church that for over a thousand years surgery was considered dishonourable: the greatest monarchs were often unable to secure an ordinary surgical operation; and it was only in 1406 that a better beginning was made, when the Emperor Wenzel of Germany ordered that dishonour should no longer attach to the surgical profession.[302]
[302] As to religious scruples against dissection, and abhorrence of the Paraschites, or embalmer, see Maspero and Sayce, The Dawn of Civilization, p. 216. For denunciation of surgery by the Church authorities, see Sprengel, vol. ii, pp. 432-435; also Fort, pp. 452 et seq.; and for the reasoning which led the Church to forbid surgery to priests, see especially Fredault, Histoire de la Medecine, p. 200. As to the decretal of Boniface VIII, the usual statement is that he forbade all dissections. While it was undoubtedly construed universally to prohibit dissections for anatomical purposes, its declared intent was as stated in the text; that it was constantly construed against anatomical investigations can not for a moment be denied. This construction is taken for granted in the great Histoire Litteraire de la France, founded by the Benedictines, certainly a very high authority as to the main current of opinion in the Church. For the decretal of Boniface VIII, see the Corpus Juris Canonici. I have also used the edition of Paris, 1618, where it may be found on pp. 866, 867. See also, in spite of the special pleading of Giraldi, the Benedictine Hist. Lit. de la France, tome xvi, p. 98.
VI. New Beginnings Of Medical Science.
In spite of all these opposing forces, the evolution of medical science continued, though but slowly. In the second century of the Christian era Galen had made himself a great authority at Rome, and from Rome had swayed the medical science of the world: his genius triumphed over the defects of his method; but, though he gave a powerful impulse to medicine, his dogmatism stood in its way long afterward.
The places where medicine, such as it thus became, could be applied, were at first mainly the infirmaries of various monasteries, especially the larger ones of the Benedictine order: these were frequently developed into hospitals. Many monks devoted themselves to such medical studies as were permitted, and sundry churchmen and laymen did much to secure and preserve copies of ancient medical treatises. So, too, in the cathedral schools established by Charlemagne and others, provision was generally made for medical teaching; but all this instruction, whether in convents or schools, was wretchedly poor. It consisted not in developing by individual thought and experiment the gifts of Hippocrates, Aristotle, and Galen, but almost entirely in the parrot-like repetition of their writings.
But, while the inherited ideas of Church leaders were thus unfavourable to any proper development of medical science, there were two bodies of men outside the Church who, thoug
h largely fettered by superstition, were far less so than the monks and students of ecclesiastical schools: these were the Jews and Mohammedans. The first of these especially had inherited many useful sanitary and hygienic ideas, which had probably been first evolved by the Egyptians, and from them transmitted to the modern world mainly through the sacred books attributed to Moses.
The Jewish scholars became especially devoted to medical science. To them is largely due the building up of the School of Salerno, which we find flourishing in the tenth century. Judged by our present standards its work was poor indeed, but compared with other medical instruction of the time it was vastly superior: it developed hygienic principles especially, and brought medicine upon a higher plane.
Still more important is the rise of the School of Montpellier; this was due almost entirely to Jewish physicians, and it developed medical studies to a yet higher point, doing much to create a medical profession worthy of the name throughout southern Europe.
As to the Arabians, we find them from the tenth to the fourteenth century, especially in Spain, giving much thought to medicine, and to chemistry as subsidiary to it. About the beginning of the ninth century, when the greater Christian writers were supporting fetich by theology, Almamon, the Moslem, declared, "They are the elect of God, his best and most useful servants, whose lives are devoted to the improvement of their rational faculties." The influence of Avicenna, the translator of the works of Aristotle, extended throughout all Europe during the eleventh century. The Arabians were indeed much fettered by tradition in medical science, but their translations of Hippocrates and Galen preserved to the world the best thus far developed in medicine, and still better were their contributions to pharmacy: these remain of value to the present hour.[303]
[303] For the great services rendered to the development of medicine by the Jews, see Monteil, Medecine en France, p. 58; also the historians of medicine generally. For the quotation from Almamon, see Gibbon, vol. x, p. 42. For the services of both Jews and Arabians, see Bedarride, Histoire des Juifs, p. 115; also Sismondi, Histoire des Francais, tome i, p. 191. For the Arabians, especially, see Rosseeuw Saint-Hilaire, Histoire d'Espagne, Paris, 1844, vol. iii, pp. 191 et seq. For the tendency of the Mosaic books to insist on hygienic rather than therapeutical treatment, and its consequences among Jewish physicians, see Sprengel, but especially Fredault, p.14.
Various Christian laymen also rose above the prevailing theologic atmosphere far enough to see the importance of promoting scientific development. First among these we may name the Emperor Charlemagne; he and his great minister, Alcuin, not only promoted medical studies in the schools they founded, but also made provision for the establishment of botanic gardens in which those herbs were especially cultivated which were supposed to have healing virtues. So, too, in the thirteenth century, the Emperor Frederick II, though under the ban of the Pope, brought together in his various journeys, and especially in his crusading expeditions, many Greek and Arabic manuscripts, and took special pains to have those which concerned medicine preserved and studied; he also promoted better ideas of medicine and embodied them in laws.
Men of science also rose, in the stricter sense of the word, even in the centuries under the most complete sway of theological thought and ecclesiastical power; a science, indeed, alloyed with theology, but still infolding precious germs. Of these were men like Arnold of Villanova, Bertrand de Gordon, Albert of Bollstadt, Basil Valentine, Raymond Lully, and, above all, Roger Bacon; all of whom cultivated sciences subsidiary to medicine, and in spite of charges of sorcery, with possibilities of imprisonment and death, kept the torch of knowledge burning, and passed it on to future generations.[304]
[304] For the progress of sciences subsidiary to medicine even in the darkest ages, see Fort, pp. 374, 375; also Isensee, Geschichte der Medicin, pp. 225 et seq.; also Monteil, p. 89; Heller, Geschichte der Physik, vol. i, bk. 3; also Kopp, Geschichte der Chemie. For Frederick II and his Medicinal-Gesetz, see Baas, p. 221, but especially Von Raumer, Geschichte der Hohenstaufen, Leipsic, 1872, vol. iii, p. 259.
From the Church itself, even when the theological atmosphere was most dense, rose here and there men who persisted in something like scientific effort. As early as the ninth century, Bertharius, a monk of Monte Cassino, prepared two manuscript volumes of prescriptions selected from ancient writers; other monks studied them somewhat, and, during succeeding ages, scholars like Hugo, Abbot of St. Denis,--Notker, monk of St. Gall,--Hildegard, Abbess of Rupertsberg,--Milo, Archbishop of Beneventum,--and John of St. Amand, Canon of Tournay, did something for medicine as they understood it. Unfortunately, they generally understood its theory as a mixture of deductions from Scripture with dogmas from Galen, and its practice as a mixture of incantations with fetiches. Even Pope Honorius III did something for the establishment of medical schools; but he did so much more to place ecclesiastical and theological fetters upon teachers and taught, that the value of his gifts may well be doubted. All germs of a higher evolution of medicine were for ages well kept under by the theological spirit. As far back as the sixth century so great a man as Pope Gregory I showed himself hostile to the development of this science. In the beginning of the twelfth century the Council of Rheims interdicted the study of law and physic to monks, and a multitude of other councils enforced this decree. About the middle of the same century St. Bernard still complained that monks had too much to do with medicine; and a few years later we have decretals like those of Pope Alexander III forbidding monks to study or practise it. For many generations there appear evidences of a desire among the more broad-minded churchmen to allow the cultivation of medical science among ecclesiastics: Popes like Clement III and Sylvester II seem to have favoured this, and we even hear of an Archbishop of Canterbury skilled in medicine; but in the beginning of the thirteenth century the Fourth Council of the Lateran forbade surgical operations to be practised by priests, deacons, and subdeacons; and some years later Honorius III reiterated this decree and extended it. In 1243 the Dominican order forbade medical treatises to be brought into their monasteries, and finally all participation of ecclesiastics in the science and art of medicine was effectually prevented.[305]
[305] For statements as to these decrees of the highest Church and monastic authorities against medicine and surgery, see Sprengel, Baas, Geschichte der Medicin, p. 204, and elsewhere; also Buckle, Posthumous Works, vol. ii, p. 567. For a long list of Church dignitaries who practised a semi-theological medicine in the Middle Ages, see Baas, pp. 204, 205. For Bertharius, Hildegard, and others mentioned, see also Sprengel and other historians of medicine. For clandestine study and practice of medicine by sundry ecclesiastics in spite of the prohibition by the Church, see Von Raumer, Hohenstaufen, vol. vi, p. 438. For some remarks on this subject by an eminent and learned ecclesiastic, see Ricker, O. S. B., professor in the University of Vienna, Pastoral-Psychiatrie, 1894, pp. 12,13.
VII. Theological Discouragement Of Medicine.
While various churchmen, building better than they knew, thus did something to lay foundations for medical study, the Church authorities, as a rule, did even more to thwart it among the very men who, had they been allowed liberty, would have cultivated it to the highest advantage.
Then, too, we find cropping out every where the feeling that, since supernatural means are so abundant, there is something irreligious in seeking cure by natural means: ever and anon we have appeals to Scripture, and especially to the case of King Asa, who trusted to physicians rather than to the priests of Jahveh, and so died. Hence it was that St. Bernard declared that monks who took medicine were guilty of conduct unbecoming to religion. Even the School of Salerno was held in aversion by multitudes of strict churchmen, since it prescribed rules for diet, thereby indicating a belief that diseases arise from natural causes and not from the malice of the devil: moreover, in the medical schools Hippocrates was studied, and he had especially declared that demoniacal possession is "nowise more divine, nowise more infernal, than any other disease." Hence it was,
doubtless, that the Lateran Council, about the beginning of the thirteenth century, forbade physicians, under pain of exclusion from the Church, to undertake medical treatment without calling in ecclesiastical advice.
This view was long cherished in the Church, and nearly two hundred and fifty years later Pope Pius V revived it by renewing the command of Pope Innocent and enforcing it with penalties. Not only did Pope Pius order that all physicians before administering treatment should call in "a physician of the soul," on the ground, as he declares, that "bodily infirmity frequently arises from sin," but he ordered that, if at the end of three days the patient had not made confession to a priest, the medical man should cease his treatment, under pain of being deprived of his right to practise, and of expulsion from the faculty if he were a professor, and that every physician and professor of medicine should make oath that he was strictly fulfilling these conditions.
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