Appendix Ii

Bull of Pope John XXII., issued February 18, 1321, as a charter for the Medical Department of the University of Perugia.

"While with deep feelings of solicitous consideration we mentally revolve how precious the gift of science is and how desirable and glorious is its possession, since through it the darkness of ignorance is put to flight and the clouds of error completely done away with so that the trained intelligence of students disposes and orders their acts and modes of life in the light of truth, we are moved by a very great desire that the study of letters in which the priceless pearl of knowledge is found should everywhere make praiseworthy progress, and should especially flourish more abundantly in such places as are considered to be more suitable and fitting for the multiplication of the seeds and salutary germs of right teaching. Whereas some time ago, Pope Clement of pious memory, our predecessor, considering the purity of faith and the excelling devotion which the city of Perugia, belonging to our Papal states, is recognized to have maintained for a long period towards the Church, wishing that these might increase from good to better in the course of time, deemed it fitting and equitable that this same city, which had been endowed by Divine Grace with the prerogatives of many special favours, should be distinguished by the granting of university powers, in order that by the goodness of God men might be raised up in the city itself pre-eminent for their learning, decreed by the Apostolic authority that a university should be situated in the city and that it should flourish there for all future time with all those faculties that may be found more fully set forth in the letter of that same predecessor aforesaid. And, whereas, we subsequently, though unworthy, having been raised to the dignity of the Apostolic primacy, are desirous to reward with a still richer gift the same city of Perugia for the proofs of its devotion by which it has proven itself worthy of the favour of the Apostolic See, by our Apostolic authority and in accordance with the council of our brother bishops, we grant to our venerable brother, the Bishop of Perugia, and to those who may be his successors in that diocese, the right of conferring on persons who are worthy of it the licence to teach (the Doctorate) in canon and civil law, according to that fixed method which is more fully described and regulated more at length in this our letter.

"Considering, therefore, that this same city, because of its convenience and its many favouring conditions, is altogether suitable for students and wishing on that account to amplify the educational concessions hitherto made because of the public benefits which we hope will flow from them, we decree by Apostolic authority that if there are any who in the course of time shall in that same university attain the goal of knowledge in medical science and the liberal arts and should ask for licence to teach in order that they may be able to train others with more freedom, that they may be examined in that university in the aforesaid medical sciences and in the arts and be decorated with the title of Master in these same faculties. We further decree that as often as any are to receive the decree of Doctor in medicine and arts, as aforesaid, they must be presented to the Bishop of Perugia, who rules the diocese at the time, or to him whom the bishop shall have appointed for this purpose, who having selected teachers of the same faculty in which the examinations are to be made, who are at that time present in the university to the number of at least four, they shall come together without any charge to the candidate and, every difficulty being removed, should diligently endeavour that the candidate be examined in science, in eloquence, in his mode of lecturing, and anything else which is required for promotion to the degree of doctor or master. With regard to those who are found worthy, their teachers should be further consulted privately, and any revelation of information obtained at such consultations as might redound to the disadvantage or injury of the consultors is strictly forbidden. If all is satisfactory the candidates should be approved and admitted and the licence to teach granted. Those who are found unfit must not be admitted to the degree of doctor, all leniency or prejudice or favour being set aside.

"In order that the said university may in the aforesaid studies of medicine and the arts so much more fully grow in strength, according as the professors who actually begin the work and teaching there are more skilful, we have decided that until four or five years have passed some professors, two at least, who have secured their degree in the medical sciences at the University of Paris, under the auspices of the Cathedral of Paris, and who shall have taught or acted as masters in the before-mentioned University of Paris, shall be selected for the duties of the masterships and the professorial chairs in the said department in the University of Perugia, and that they shall continue their work in this last-mentioned university until noteworthy progress in the formation of good students shall have been made.

"With regard to those who are to receive the degree of doctor in medical science, it must be especially observed that all those seeking the degree shall have heard lectures in all the books of this same science which are usually required to be heard by similar students at the University of Bologna or of Paris, and that this shall continue for seven years. Those, however, who have elsewhere received sufficient instruction in logic or philosophy having applied themselves to these studies for five years in the aforesaid universities, with the provision, however, that at least three years of the aforesaid five or seven year term shall have been devoted to hearing lectures in medical science in some university and according to custom, shall have been examined under duly authorized teachers and shall have, besides, read such books outside the regular course as may be required, may, with due observation of all the regulations which are demanded for the taking of degrees in Paris or Bologna, also be allowed to take the examination at Perugia."

INDEX

Abdallah, 41

Abdominal wounds, 98

Abella, 157

Abulcasis, 35, 78

Abul Farag, 33

Adalbert of Mainz, 63

Adale, 41

Ægidius, 64

Ægina, Paul of, 6, 27, 33, 138, 146, 149, 184, 186

Æginetus. See Ægina, Paul of

Ætius, 4, 28, 138, 146

Aëtius, 27

Albert the Great, 110

Albertus Magnus, 14, 18

Alcohol, 194

Alessandra Giliani, 164

Alexander of Tralles, 4, 27, 29, 146

Alexandria, 33

Ali Abbas, 35

Alphanus, 41

Anæsthesia, 100, 104, 105, 120

Anselm of Havelberg, 63

Anthemios, 5

Antiseptic surgery, 104 wine as, 101

Arabian culture, 8 surgeons, 149

Arabians, 139

Arabs, 46

Archbishop of Lyons, 63

Arculanus, 147, 150

Ardern, John, 85, 123, 127

Aretæus, 186

Argelata, Pietro d', 125

Aristotle, 18 study of, 16

Armato, Salvino de, 152

Arnold de Villanova, 66 aphorisms of, 67

Arsenic in syphilis, 124

Artificial teeth, 142

Asepsis, 95, 101

Asylums, 191

Aue, Hartmann von der, 64

Aurelius Celsus, 26

Authorities of medieval physicians, 20

Authority, influence of, 12

Autointoxication, 83

Avenzoar, 35, 77

Averroes, 35

Avicenna, 35, 47, 76, 149

Baas, 181

Bachtischua, 7

Bacon, Roger, 14, 110

Bandages, stiffened, 123

Barber surgeons, 115

Bartholomæus Anglicus, 81

Bartholomew on causes of insanity, 192

Basil Valentine, 84

Baths, 32 for melancholia, 184

Bedlam, 188

Bedlamites, 201

Belisarius, Hospital of, 171

Benedictine convents, 159

Bernard de Gordon, 70, 72, 153

Bernard of Morlaix, 49

Bile in eye diseases, 152

Bladders of animals, 78

Bleeding, 55, 84

Blood-letting, 32

Bologna, 40

Bones, number of, 54

Bougies, 123

Branca, 106 Antonio, 107

Bruno da Longoburgo, 96

Brunschwig, Hieronymus, 135

Bubonic plague, 77

Calomel, 85

Care of the insane, 34, 183, 189

Care of the sick, 24, 25

Cassiodorus, 25

Cataract, 151

Cautery, 100, 126

Celsus, Aurelius, 26

Charter of the University of Perugia, 212

Chauliac, Guy de, 11, 66, 71, 72, 105, 109, 118, 123, 139, 140, 153, 167

Christian hospitals, 24

Cleanliness, 95

Clyster apparatus, 127

Cold compresses, 30

Compilation, 3

Constantine, 36, 45

Contrecoup, 92

Convents, Benedictine, 159

Corbeil, Gilles de, 64

Cosmetics, 77

Crusades, 89, 181

Dental instruments, 143

Dentistry, 138

Depressed fractures, 93

De Renzi, 37, 41, 44, 45, 47, 76, 155, 156

Diabolic possession, 195, 196

Diet, 31, 36 for melancholies, 185

Dioscorides, 26

Dioscoros, 5

Diphtheria, 27, 128

Diseases of nervous system, 30 of women, 156

Drainage, 97 tubes, 125

Duke, Robert, 46

Duns Scotus, 110

Dura mater, infection of, 93

Ebers Papyrus, 137

Education, characters of medieval, 12

Elias, 41

Elinus, 41

English, King of the, 40

Epileptic conditions, 30

Exorcism, 195

Eye diseases, bile in, 152 wash, urine of infants as, 152

Fabiola, Hospital of, 171

Fee, law as to, 44

Fever, 32

Filaria medinensis, 77

Fistulæ, 100

Fistulas, 127

Four masters of Salerno, 47, 91

Fracture of the skull, 91 of the thigh, extension in, 123

Fractures of the skull, 94 depressed, 93

Frederick II., 42 law of, 43, 206

Gaddesden, John of, 70, 119

Galen, 18, 19, 26, 47, 72, 116

Gariopontus, 41

Gerssdorff, Hans von, 135

Gilbert, 69

Giovanni of Arcoli, 143

Glaucoma, 152

Gonorrhoea, 123

Gregory, Major, 189 of Tours, 181

Guarna, Rebecca, 157

Guerini, 142, 143

Guido of Montpellier, 64

Gurlt, 9, 47, 69, 90, 93, 95, 96, 99, 106, 110, 113, 121, 146, 156

Guy de Chauliac. See Chauliac

Guy of Montpellier. See Montpellier

Hæmoptysis, 30

Hangman's rope, 28

Hare-lip, 134

Hartmann von der Aue, 64

Headache, 30

Hemicrania, 30

Herbs, 26

Hernia, 68 operations too frequent, 122 radical cure of, 121 reduction of, 122

Hernias, 99

Herodotus, 137

Hippocrates, 26, 47

Holy Ghost Hospital, 172

Hospital, 64, 65 at Lübeck, 178 for lunatics, 187 of Bedlam, 188 of Belisarius, 171 of Fabiola, 171 of Pope Symmachus, 171 of St. Basil, 170 of St. Jean, 178 of Tonnerre, 176

Hospitals, 169 Christian, 24 for lepers, 181 of the Holy Ghost, 172 royal, 174

Hotel Dieu, 188

"Hudibras," 107

Hugh of Lucca, 96, 104

Humours, 54

Hymns, Latin, 48

Hysteria, 34

Indian surgeons, 106

Infection of dura mater, 93

Infirmaries in monasteries, 24

Inhalations, steam, 29

Insane, care of the, 34, 183, 189

Insanity, 194 lash for, 198

Intestine, suture of, 134

Intestines, wounds of, 99

Italy the postgraduate medical centre, 118

John of Salisbury, 64 of Gaddesden, 70, 119

King of the English, 49

Laceration of the middle meningeal artery, 92

Lanfranc, 11, 80, 96, 110

Lash for insanity, 198

Latin hymns, 48

Law as to fee, 44 of Frederick II., 43, 206

Lepers, hospitals for, 181

Ligatures, 125

"Lilium Medicinæ," 73

Linear cicatrices, 101

Lister, Lord, 103

Louis IX., 110

Lübeck, hospital at, 178

Lunatics, hospital for, 187

Lucca, Hugh of, 96, 104

Lyons, Archbishop of, 63

Manzolini, Madame, 165

Mad dog, 68, 80

Magnetism, 15

Maimonides, 35, 79

Medical oath, 44 schools at universities, 74 superstitions, 22

Medici, 164

Medicine and surgery, relations of, 115 popular, 22

Medieval education, characters of, 12 medicine, periods of, 21 textbooks, 88

Melancholics, diet for, 185

Mental defectives, colonies for, 202

Meningeal artery, laceration of, 92

Mercuriade, 157

Mercury, use of, 123

Mesue, 47

Methrodoros, 5

Metrorrhagia, 33

Middle Ages, limits of, vii

Milk, 29, 52 bath, 78

Monasteries, infirmaries in, 24

Mondeville, Henri de, 11, 66, 114, 116

Mondino, 96, 164

Monte Cassino, 39

Montpellier, Guy de, 10, 61, 173

Moorish physicians, 62

Morbus Gallicus, 124

Morley, Henry, 17

Morgagni, 84

Muratori, 76

Nasal cautery, 148 polypi, 147 speculum, 149

Nature study, 13

Needling for cataract, 151

Nefretykes, 85

Nerve suture, 113

Nervous system, 30

Nicaise, 166

Nose, surgery of the, 106

Number of bones, 54 of veins, 54

Nurses, order of, 180

Nutrition per rectum, 77

Oath, medical, 44

Oesophagus tube, 123

Ophthalmology, 151

Opium, 29

Order of nurses, 180

Ordronaux, 47, 50

Oribasius, 28

Orthodontia, 139

Pagel, 56, 127, 194

Pammachius, 171

Paris, 40, 110

Passavant, Jean, 111

Paul of Ægina, 6, 27, 33, 138, 146

Peregrinus, 15

Perineum, rupture of, 157

Perugia, Charter of the University, 212

Pfolspeundt, Heinrich von, 133, 134

Physician, conduct of the, 58

Physicians, Moorish, 62

Pitard, Jean, 114

Plague, bubonic, 77

Plastic surgery, 106, 134

Polypi, nasal, 147

Pontus, 41

Pope Symmachus, Hospital of, 171

Popular medicine, 22

Power, D'Arcy, 127

Psycho-analysis, 196

Pure drug law, 43

Pus, 103

Puschmann, 56

Putrefaction, 97

Rabies, 81, 128

Rectal feeding, 78 surgery, 127

Red light treatment, 70, 82

Regimen, 48, 49 sanitatis, 47

Renal disease, 85

Rhazes, 35, 148

Roger, 42, 56, 70, 90, 103

Roland, 56, 103

Rolando, 91

Roman medicine, origin of, 2

"Rosa Anglica," 70

Rupture of the perineum, 157

St. Basil, Hospital of, 170

St. Benedict, 24

St. Bernard, 63 of Clairvaux, 161

St. Hildegarde, 160

St. Jean, Hospital of, 178

Saintsbury, Professor, 48

Salerno, 7, 37, 75, 155 curriculum at, 38

Salerno, school of, 57

Salicet, William of, 96, 105

Salisbury, John of, 64

Salvino de Armato, 152

Santa Sophia, architect of, 5

School of Salerno, 57

Scotus, Duns, 40

Sects in surgery, 116

Sick, care of the, 24, 25

Skin of the snake, 28

Skull, fractures of, 91, 94 opening the, 92

Smallpox, 35, 70

Snake, skin of, 28

Sore throat, 31

Spectacles, 73, 152

Steam inhalations, 29

Stiffened bandages, 123

Students, 65

Superstitions, medical, 22

Surgeon, training of, 117

Surgeons, Arabian, 140 barber, 11 Indian, 106 temperance in, 97

Surgery, antiseptic, 104 of the nose, 106 plastic, 106, 134 rectal, 127 sects in, 116

Surgical specialities, 136

Syphilis, 123 arsenic treatment of, 124

Tagliacozzi, 107

Taranta, Valesco de, 71

Tartar, removal of, 141

Teeth, artificial, 142 cleaning of, 140 filling of, 145 preservation of, 139, 144 straightening of, 139

Temperaments, 54

Temperance in surgeons, 97

Testicle excision in hernia operations, 121

Tetanus, 130

Textbooks, medieval, 88

Theodoric, 70, 96, 102, 113

Therapeutics, 23

Thigh, fracture of, 123

Thomas Aquinas, 110

Thyroid gland, 28

Tonnerre, Hospital of, 176

Tooth-powder, 140

Tracheotomy, 147, 150

Trallianus, 4

Trephining, 93, 94

Trichiasis, 153

Trotula, 155

Truss, 73, 122

Union by first intention, 100

Universities, medical schools at, 74

Urine of infants as eye-wash, 152

Use of mercury, 123

Uvula, affections of the, 150

Valentine, Basil, 84

Valesco de Taranta, 71

Veins, number of, 54

Vicious sexual habits, 28

Vigo, John de, 145

Viollet le Duc, 176

Virchow, 171, 174, 181

William of Salicet, 96, 105

Wine as antiseptic, 101

Women, diseases of, 156 in medicine, 10 physicians, 166 professors, 155 students, 155

Wood dogge, 129

Wood-hound, 193

Wounds, abdominal, 98 dry treatment of, 125 of intestines, 99 treatment of, 98

Yperman, 123, 131

PRINTED IN GREAT BRITAIN BY BILLING AND SONS, LTD., GUILDFORD

FOOTNOTES:

Fordham University Press, New York, 1911.

Popular Science Monthly, May, 1911.

Philadelphia: Lippincott, 1871.

The Latin lines run thus:

Si vis incolumem, si vis te reddere sanum, Cures tolle graves, iras crede profanum. Parce mero--coenato parum, non sit tibi vanum Surgere post epulas; somnum fuge meridianum; Ne mictum retine, nec comprime fortiter anum; Hæc bene si serves, tu longo tempore vives.

English translations of the Regimen were made in 1575, 1607, and 1617. The two latter were printed; the former exists in manuscript in the Library of Corpus Christi College, Oxford. The opening lines of the edition of 1607 deserve to be noted because they are the origin of an expression that has been frequently quoted since.

The Salerne Schoole doth by these lines impart All health to England's King, and doth advise From care his head to keepe, from wrath his harte. Drink not much wine, sup light, and soone arise. When meat is gone long sitting breedeth smart; And after noone still waking keepe your eies, When mou'd you find your selfe to nature's need, Forbeare them not, for that much danger breeds, Use three physitians still--first Dr. Quiet, Next Dr. Merry-man, and third Dr. Dyet.

Some of these old medical traditions come down to us from many more centuries than we have any idea of until we begin to trace them. Ordinarily it is presumed that the advice with regard to the taking of small amounts of fluid during meals comes to us from the modern physiologists. In "The Babees Book," a volume on etiquette for young folks issued in the thirteenth century, there is among other advices, as, for instance, "not to laugh or speak while the mouth is full of meat or drink," and also "not to pick the teeth with knife or straw or wand or stick at table," this warning: "While thou holdest meat in mouth beware to drink; that is an unhonest chare; and also physick forbids it quite." It was "an unhonest chare" because the drinking-cups were used in common, and drinking with meat in the mouth led to their soiling, to the disgust of succeeding drinkers. All the generations ever since have been in slavery to the expression that "physic forbids it quite," and now we know without good reason.

The book called "The Hundred Merry Jests" suggests that the wagtail is light of digestion because it is ever on the wing, and therefore had, as it were, an essential lightness.

International Clinics, vol. iii., series 28.

"Historical Relations of Medicine and Surgery down to the Sixteenth Century." London, 1904.

The subsequent disuse of anæthesia seems an almost impossible mystery to many, but the practically total oblivion into which the practice fell is incomprehensible. This is emphasized by the fact that while it dropped out of medical tradition, the memory of it remained among the poets, and especially among the dramatists. Shakespeare used the tradition in "Romeo and Juliet." Tom Middleton, in the tragedy of "Women Beware Women" (Act IV., Scene i., 1605), says:

"I'll imitate the pities of old surgeons To this lost limb, who, ere they show their art, Cast one asleep, then cut the diseased part."

"Physicke is so studied and practised with the Egyptians that every disease hath his several physicians, who striveth to excell in healing that one disease and not to be expert in curing many. Whereof it cometh that every corner of that country is full of physicians. Some for the eyes, others for the head, many for the teeth, not a few for the stomach and the inwards."

The Ebers Papyrus shows that special attention was paid to diseases of the eyes, the nose, and throat, and we have traditions of operations upon these from very early times. Conservative surgery of the teeth, and the application of prosthetic dental apparatus, being rather cosmetic than absolutely necessary, might possibly be expected not to have developed until comparatively recent times; but apart from the traditions in Egypt with regard to this speciality, which are rather dubious, we have abundant evidence of the definite development of dentistry from the long ago. The old Etruscans evidently paid considerable attention to prosthetic dentistry, for we have specimens from the Etruscan tombs which show that they did bridge work in gold, supplied artificial teeth, and used many forms of dental apparatus. At Rome the Laws of the Twelve Tables (circa 450 B.C.) forbade the burying of gold with a corpse except such as was fastened to the teeth, showing that the employment of gold in the mouth for dental repair must have been rather common. We have specimens of gold caps for teeth from the early Roman period; and there is even a well-confirmed tradition of the transplantation of teeth, a practice which seems to have been taken up again in the later Middle Ages, and then allowed to lapse once more until our own time.

Dr. Petells, discussing this use of livers (Janus, 1898), says that there has been some tendency to revert to the idea of biliary principles as of value in external eye diseases.

"Gesammelte Abhandlungen aus dem Gebiete der Oeffentliche Medizin," Hirschwald, Berlin, 1877.

See Walsh, "The Thirteenth, Greatest of Centuries," New York, seventh edition, 1914.

Burdett, "Hospitals and Asylums of the World."

London, 1909.

To be found in Huillard-Brehollis' "Diplomatic History of Frederick II. with Documents" (issued in twelve quarto volumes, Paris, 1851-1861).

Under logic at this time was included the study of practically all the subjects that are now included under the term the seven liberal arts. Huxley, in his address before the University of Aberdeen, on the occasion of his inauguration as rector of that university, said: "The scholars (of the early days of the universities, first half of the thirteenth century) studied grammar, rhetoric, arithmetic and geometry, astronomy, theology and music." He added: "Thus their work, however imperfect and faulty, judged by modern lights, it may have been, brought them face to face with all the leading aspects of the many-sided mind of man. For these studies did really contain, at any rate in embryo--sometimes, it may be, in caricature--what we now call philosophy, mathematical and physical science and art. And I doubt if the curriculum of any modern university shows so clear and generous a comprehension of what is meant by culture as the old trivium and quadrivium does." Science and Education Essays, p. 197. New York, D. Appleton and Co. 1896.

A tarrenus or tarrene in gold was equal to about thirty cents of our money. Money at that time had from ten to fifteen times the purchasing power that it has at the present time. An ordinary workman at this time in England received about four pence a day, which was just the price of a pair of shoes, while a fat goose could be bought for two and a half pence, a sheep for one shilling and two pence, a fat hog for three shillings, and a stall-fed ox for sixteen shillings (Act of Edward III. fixing prices).

The University of Perugia had already achieved a European reputation for its Law School, and this Papal document was evidently meant to maintain standards, and keep the new Medical School up to the best criteria of the times. The original Latin of this document, as well as of the Law of Frederick II., may be found in Walsh, "The Popes and Science," Fordham University Press, New York, 1908. They are quoted directly from the official collection of Papal Bulls.

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BLACK'S MEDICAL DICTIONARY. Edited by JOHN D. COMRIE, M.A., B.Sc., M.D., F.R.C.P.E., Editor of the "Edinburgh Medical Series." Sixth Edition, completing 40,000. Revised and much enlarged. Containing 431 Illustrations, 12 being full-page in colour. Demy 8vo, cloth.

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THE POCKET CLINICAL GUIDE. By JAMES BURNET, M.A., M.D., M.R.C.P.E. Second Edition. Foolscap 16mo (4-1/8 by 2-3/4 inches), cloth.

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TEXT-BOOK OF OPERATIVE SURGERY. By DR. TH. KOCHER. Third English Edition, greatly increased. Translated by HAROLD J. STILES, M.B., F.R.C.S. (Edin.), from the 5th German Edition. Containing 415 Illustrations, many with colour introduced. Super royal 8vo, cloth.

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