CHAPTER XV.

MONK PHYSICIANS—ITINERANT DOCTORS—SURGERY IN THE MIDDLE AGES. The treatment prescribed by the monks, who were ready to cure the body as well as the soul, consisted mainly of holy water, prayer, the touching of relics, and a number of decoctions of herbs, the properties of which they were acquainted with. Many of these physician monks wandered about the country devoting themselves to the wants of the sick. During the eleventh century hospitals began to spring up in various parts of the country and over Europe. They seem to have originated at the time of the crusades. Lacroix says: “The Johannists, and the brotherhoods of St. Mary and St. Lazarus devoted themselves to missions of charity in the East; in France, there were the brothers of St. Antony and of the Holy Ghost; and throughout the world the heroic chevaliers of St. John of Jerusalem or of the Templars, whose countless establishments combined the triple character of conventual church, almshouse, and fortress, and who, attired in a dress both military and monastic, wore a mantle similar to that seen in the statues of Æsculapius, as a sign of the double mission—beneficent and warlike—which they had sworn to fulfil”. Each of these orders had a special form of treatment, and took charge of specific diseases. Thus, the Templars paid special attention to those pilgrim soldiers and travellers particularly troubled with ophthalmia, scurvy, or those suffering from wounds. The Johannists professed the cure of epidemical disease and pestilence. The order of St. Antony looked after those stricken with dysenteries and those complaints known as St. Anthony’s fire, while the Lazarists treated leprosy, small-pox, and pustular fevers. The first school of nurses of which we have record, is one organised by Hildegarde, Abbess of Rupertsberg, who died 1180. These nuns gave great assistance in the hospitals. Thus the monks about the twelfth century tended the bodies as well as the souls, and even accompanied armies on military expeditions in that capacity. In the thirteenth century faculties were established at Montpellier, Salerno, and Paris, by the order of papal bulls, to grant degrees in medicine. In order to obtain the title of master physician, the candidate had first to become a clerk, then pass an examination before masters or doctors selected from the staff of the college by the Bishop of Maguelonne. The barbers at this time came to occupy an important position in medicine, and were promoted to the rank of subordinate surgeons, chiefly for blood-letting and minor accidents. In the fourteenth century medicine had rapidly progressed in Europe, and the celebrated physician and surgeon Lanfranc founded the St. Cosmo College at Paris, the examinations of which all surgeons were obliged to pass. A decree was also passed by the King of France in 1352 prohibiting any one who was not an apothecary, student, or mendicant monk from practising medicine. The king, we find, also exempted the master barbers from doing duty as watchmen, as “the barbers being nearly all of them in the habit of practising surgery, great inconvenience might arise if they were absent from their houses when sent for during the night”. In France, the little barbers, as they were called, travelled about on foot from village to village with a bag containing their drugs and remedies, while the great barbers, or sworn surgeons, astride their hacks with tinkling bells to announce their approach, wore long robes trimmed with fur, and other rich apparel. They were usually accompanied by an assistant and several servants, who carried their cases of instruments, which always included scissors, nippers, a probe or _éprouvette_, razors, lances, and needles. He also carried five kinds of ointments, _viz._, basilicon, apostles’ ointment, the white ointment, yellow ointment, and the dialtœa ointment for subduing local pain. Guy de Chauliac, who was physician to three successive popes, stated “he never went out on his visits without taking several clysters and plain remedies, besides gathering herbs in the field, so as to treat diseases in a proper manner”. Even at that early time the credulity of the public became imposed upon by quacks, and Lacroix tells us of an English surgeon, one Goddesden, who had two sorts of prescriptions, one for the rich and another for the poor; he sold at a high price to the barbers a so-called panacea, which the latter sold at a large profit, and this was simply a mixture of frogs pounded in a mortar. In one of his books there is a short chapter on _disagreeable_ diseases, as he terms them, “which work their own cure, and bring no grist to the doctor’s mill”. In the fifteenth century the practice of medicine became more and more influenced and dominated by the occult sciences, and especially astrology. All mankind was ruled by the stars, and the cause of various diseases was attributed to the conjunction of certain planets. “They believed the blood rose during the daytime towards the sun, and descended into the lower extremities at night; that at the third hour the bile subsided, so that its acid properties might not be mixed with the course of the blood; and that at the second hour the atrabilis, and in the evening the phlegm, subsided.” Such illusions and erroneous beliefs stopped the progress of science, and threatened to turn a noble art into mere charlatanry. In this country the surgeons mostly practised as apothecaries; and we are told that when Henry V. invaded France in 1415, the only surgeon he had in his camp was one Thomas Morstede, who was with difficulty induced to accompany the army, bringing with him twelve assistants. The sixteenth century saw an effort to throw off some of these errors which had grown round the art. The invention of printing helped largely in disseminating knowledge throughout Europe, and the followers of medicine assumed a higher position. [Illustration: AN APOTHECARY’S SHOP. FIFTEENTH CENTURY.] Towards the end of the fifteenth century Tachenius wrote: “There is no new thing under the sun whatsoever, therefore the followers of Hippocrates have handed out, and as it were midwifed into the world, the same was from the beginning though our eyes were not so clear-sighted as to discern it”. To which Stephen Pasquier replied in the following rhyme:— “Some Paracelse of novelty implead, For which, judged crime, he erst was banished, So Hippocrates, Chrysippus, and at Rome Asclepiade, too, were new. They’d all one doom. They who condemn new things condemn the old, Or else do both misjudge and are o’er bold.” During the crusades the surgeons naturally acquired a very large experience in the treatment of wounds—incised, lacerated, and contused. Baldwin was severely wounded before Jerusalem, having received a spear-thrust “through the thigh and the loins”. He fell fainting from his horse, but the most skilful leeches were summoned, “by whose art and skill the king and valiant athlete was enabled to recover from this deadly wound”. Baldwin was also wounded in the foot before Antioch, and the surgical talent available was baffled by the injury to such a degree that it was proposed to kill a Saracen after wounding him in the same part, so as to learn the proper course to pursue. Baldwin, however, refused to allow this crude attempt at experimental surgery to be made. There seem to be no medical records of the second crusade. In the third, the French king, Philippe Auguste, and our own Cœur de Lion suffered grievously from a disease, the symptomatology of which included extensive exfoliation of the skin, shedding of the nails, and loss of the hair. The disease is called _Arnoldia_ by the chroniclers, and is variously conjectured to have been leprosy or syphilis. It could hardly have been leprosy, for both the royal sufferers recovered, Cœur de Lion being killed eight years later at the siege of Chalus, and Philippe Auguste dying of quartan ague twenty-four years after Richard. Of the fourth crusade we have no medical details. In the fifth, St. Louis of France was accompanied by his private physician Dudon and other leeches; among them was a lady doctor or _phisicienne_ named Hernandis, who probably attended the queen in her confinement, which took place at Damietta. The expedition suffered terribly from scurvy, typhus, and other pestilences. The part played by water in the diffusion of disease would seem to have been recognised, though the methods of water examination would hardly satisfy a modern chemist. A piece of white linen was dipped in the water to be tested, and then dried; if there were any stains on the linen the water was condemned, but if not it was pronounced pure. The addition of four crushed almonds or beans was believed to make the water of the Nile safe for drinking. The method of disinfection adopted for the king’s tent was to fumigate it with a mixture of amber, chick peas, or lupine, which were macerated in wine, and then placed on live charcoal. In the sixth crusade, which took place twenty-two years later, vast numbers, including St. Louis himself, fell victims to ignorance of the elements of sanitation.