CHAPTER XVI. The Influence of Christianity Upon the Evolution of Medicine

THE INFLUENCE OF CHRISTIANITY UPON THE EVOLUTION OF MEDICINE

The religion established by Jesus Christ in Judea during the early part of the first century remained confined within the limits of that region for a number of years, but already during the latter half of that period groups of Christians were to be found in every part of the Roman Empire, and in certain localities the membership of the new church had increased so greatly in numbers as to excite the alarm and hostility of the temple priests and of the governing officials. Persecutions, especially in the city of Rome and at the instigation of Nero, became more and more frequent and more and more pitiless, but they failed utterly to destroy the new religion, so firmly was it rooted in the followers of Jesus Christ. As a matter of fact its spread was checked for only a few years, and then its adherents increased in numbers more rapidly than ever. Neuburger, in his “History of Medicine,” makes the following quotation from the account which Dionysius of Alexandria gives of the great plague that occurred during the third century A. D.:

The majority of our brethren in their love for their neighbors did not spare themselves, but acted as a unit in their efforts to assist. They visited the sick without the slightest fear and gave them the very best of care, for the sake of Christ.... Among the non-Christians, however, the very opposite was true. As soon as any of their number fell ill they pushed them to one side, even those who were dearest to them, and, before they were more than half-dead, they threw them out into the street and took no care to bury the dead bodies.

Such an example of self-sacrifice and humanity--and there must have been very many similar examples--could not possibly have failed to make a profound impression upon the community at large. Daniel Le Clerc says that three physicians suffered martyrdom for their Christian faith during the reigns of the Emperors Marcus Aurelius, Lucius Verus and Commodus. They were Papila (of Pergamum), Alexander (of Lyons) and Sanctus (a contemporary of Galen), whose death was of a particularly cruel character. Credit should also be given to Christianity, says the same writer, for having established the rule that every community should assume the expense and responsibility of caring for its own poor and sick. This was a step of the greatest importance; and, at a still later period, when Christianity became largely an affair of the state, a complete hospital organization was effected, with the bishop as the chief officer and, under him, deacons and deaconesses. Such well-organized institutions proved to be of the greatest possible benefit to the advance of medical science. They were the worthy successors of those more ancient hospitals, the Aesculapian temples, which were first established by the Greeks in the pre-Hippocratic age, and they have continued in an unbroken chain from the institutions of those primitive times to the thoroughly well-equipped hospitals of the present day.

In 330 A. D. the new capital of the Roman Empire was established in Byzantium, afterward called Constantinople, and Rome, which for hundreds of years had been the metropolis of the world and the source from which a large part of Roman history had emanated, was given a subordinate position. Then followed, in 410 A. D., the conquest of the latter city by the Visigoths, a horde of uneducated Barbarians who had felt the might of Rome in previous years, and who now doubtless took immense satisfaction in humiliating her and in destroying her valuable possessions. There are good reasons for believing that, when the Emperor Constantine established his residence in Byzantium, the leading physicians of Rome followed him; and it is not likely that many of those who, for one reason or another, preferred to remain in the old capital, continued to do so after it became known that the Barbarians were approaching the city. But the migration of these physicians to the new capital did not mean a renewal there of the scientific activity which had characterized the growth of Greek medicine in Rome during the first two centuries of the Christian Era. It is probable that the fugitives, being obliged to travel with the smallest amount of baggage possible, left the major part of their books and papyrus rolls behind, hoping, no doubt, that they might be able at some later date to recover them. But the favorable occasion never arrived, and thus a great deal of valuable medical literature entirely disappeared. The loss, however, might have been even more serious than it was if the Christian church had not already (during the third century) begun to establish monasteries in secluded and inaccessible spots. It was to these institutions that not only books of a religious character, but also those relating to the science of medicine, were transported for safe keeping during the early Middle Ages. Farther on, I shall have occasion to refer to this subject again and to discuss more fully certain other benefits which accrued to medical science from these monastic institutions.

But while, on the one hand, the Christian church through the instrumentality of the monasteries was lending its aid to the preservation of the sources of medical knowledge, it was, on the other, doing its best to arrest all further evolution of that branch of science; not consciously, it must be admitted, but through a mistaken sense of its duty to God. Thus it came about that the Emperor Justinian I. (527–567 A. D.), acting under the narrow-minded advice of his ecclesiastical counsellors, closed the medical schools at Athens and Alexandria and at the same time withdrew the regular allowance of money which up to that time had been paid to the state physicians and to special scholars. A few years later, however (i.e., in the early part of the seventh century A. D.), some of the more highly educated physicians of Alexandria got together and made the attempt to organize a school of medicine in that city. A course of lectures was planned and sixteen of Galen’s works, carefully chosen for the purpose, were made the basis of the new course of instruction. The books selected were first carefully edited and simplified, and then commentaries were added in order that in their final shape these treatises might be better suited to the uses of students. The invasion of Alexandria by the Arabs, however, soon put an effectual stop to this promising attempt to revive Greek medicine.

In this brief sketch I have thus far mentioned only the more direct effects produced by the new religion upon the evolution of medicine. The indirect effects, however, were also in some cases of very great importance. At the beginning of her history there developed in the Christian church, among her chief men, a strong disposition to quarrel over dogmas. To apply the term quarrelsomeness to this tendency may easily convey a wrong impression. It was, more strictly speaking, a highly developed conscientiousness on the part of men whose minds were deeply imbued with the idea that they were rendering God a service by keeping what they believed to be the true and only religion free from errors of all kinds. It took many centuries to impress the leaders of the church with the fact that the religion of Jesus Christ, like the science of medicine or the natural sciences, was capable of development to an almost indefinite extent; and it is owing to our appreciation of this important fact that we moderns look with so much more lenient eyes upon the distressing, not to say cruel, events of mediaeval ecclesiastical history. At the time of which I am now writing, however, it was considered highly unchristian--especially for one holding authority in the church--to believe otherwise than as her doctrines taught; and accordingly, in the early part of the fifth century A. D., Nestorius, the Patriarch of Constantinople, was deposed from his high office by a Council of the church and imprisoned because he was unwilling to teach the doctrine of the miraculous birth of Jesus Christ. Those who accepted the view held by Nestorius--and they eventually became a very numerous and a very influential body of Christians--were driven out of Constantinople and compelled to seek homes in distant places. This affords, perhaps, an explanation of the fact that, during the eighth century A. D., many Nestorian Christians were found living in the eastern part of Syria and in Persia; and it seems fair to assume that these Christian communities represented to some extent the direct successors of those Nestorians who had taken refuge in this remote corner of Asia Minor three hundred years earlier. Furthermore, it is highly probable that there were Christian communities in this region several centuries before the Nestorians arrived, for it is believed that the Apostles James and Thomas visited Persia and the northeastern part of Syria in the course of their work as evangelists. It is not known, though, how many of the descendants of these earlier Christians adopted the peculiar beliefs of the Nestorian refugees.

And here it should be stated that the facts which have thus far been mentioned are not the only ones that throw some light upon the relationship subsisting between Christianity and the spread of medical knowledge to Western Europe. Those which remain to be considered are of two kinds, viz., facts relating to the origin of the Arabic Renaissance, and facts which show that the Christian church, from the fourth century onward, was contributing not a little, through the establishment of the great monastic orders, such as the Benedictines, the Dominicans, and the Franciscans, to the preservation if not to the further evolution of Graeco-Roman medical knowledge. I shall reserve for consideration in a later chapter this particular part of the history of medicine; and in the meantime I shall endeavor to describe the events which preceded and rendered possible the active study of Greek medicine on the part of the followers of Mohammed.

So far as history furnishes us with any information on the subject, the Nestorians who lived in Persia, Syria and Mesopotamia were Christians of a remarkably liberal type. They appear to have been an unusually peaceable people, for not only were they kindly disposed toward one another, but they seem to have been on the best of terms with their Jewish neighbors, who, like themselves, were eager after knowledge. Already at a very early period there existed at Djondisabour--a town which had been founded in the Province of Khorassan, in the northeastern part of Persia, about the year 260 A. D., by Sapor II., King of that country--a school in which the medicine of Hippocrates was taught. Freind, in his “History of Physick” (London, 1727), says that about the year 272 A. D. the Emperor Aurelian (Lucius Domitius Aurelianus), as a compliment to his daughter, who was the wife of the King of Persia, sent to Djondisabour, the city in which she resided, several Greek physicians; and Abulpharagius, the Arab historian (thirteenth century), intimates that these were the men who conducted the teaching in the newly established medical school. Another possibility suggests itself. After the death of Alexander the Great in Babylon (323 B. C.), from malarial fever, it is not unlikely that some of the numerous Greek physicians who accompanied the army in an official character, and who, we are warranted in believing, were exceptionally well educated, decided not to remain in that unhealthy district, but to settle in some of the neighboring towns (e.g., Nisibis in the hill country to the north of Babylon, or Sura to the east of the river Tigris); and that these men also contributed their share toward the planting and perpetuation of Greek medicine in this district of the Orient. However, the salient fact in this period of the history of medicine is this: When Almansur, the Caliph of Bagdad (712 to 775 A. D.), made up his mind to introduce Greek medicine into his kingdom and looked around for the ways and means of accomplishing this, he found at the city of Djondisabour men who were not only well versed in Greek medicine, but who at the same time were so thoroughly grounded in all departments of scholarship that they could at once begin the work of translating the writings of Hippocrates and other classical medical authors into Arabic, the language of the Mohammedans. But at this stage of affairs the existence of a serious obstacle was discovered. The writings which it was proposed to translate were not immediately obtainable, and it therefore became necessary to institute without delay a vigorous search for the books required. In order that the reader may appreciate fully the difficulties which Almansur had to overcome, in this matter of a scarcity of Greek originals, it seems best to pause at this point, and to review briefly some of the facts which bear upon the question at issue.

The Wholesale Destruction of Medical Literature during the Early Centuries of the Christian Era.--The invasion of Rome in 410 A. D. was one of the first events which entailed a serious loss of the Greek medical books that had been accumulating for several centuries in that city. Fortunately, not a few of these works were rescued in time by the church authorities and deposited for safe keeping in the various monasteries scattered all over the Roman Empire. A still more serious destruction of books occurred about the year 638 A. D., when Amrou, a famous Arabian warrior, captured Alexandria and--under the instructions of his master, Omar ben Khattab--destroyed the greater part of the contents of the famous libraries located in that city. The narrative of this event, as told by Lucien Le Clerc, is as follows:--

John the Grammarian, who was living at that time in Alexandria, held the following conversation with Amrou on a certain occasion: “You have inspected all the edifices of Alexandria, and have sequestrated all their contents. I have no objections to your appropriating everything that may be of use to you; there are certain things, however, which you may not wish to possess, but which are highly prized by us.”

“What are those objects?” inquired Amrou.

“The works on philosophy, which are contained in the public libraries,” John replied.

“I can do nothing about them without a special order from the Prince of Believers, Omar ben Khattab,” was the answer given by Amrou.

John’s wish having in the meantime been conveyed by the General to Omar, the latter sent this reply:--

“As to the books of which you speak, I have this to say. If their contents agree with what is written in the word of God, the books are of no use to us, the Holy Writ being sufficient for our guidance. But if they are at variance with God’s word, then surely they should be destroyed.”

Amrou therefore ordered all the books to be sent to the bathing establishments of Alexandria, to be used as fuel in heating the baths. So great was the number of books contained in the libraries that it took six months to consume them all. (Sismondi questions the correctness of this account.)

While the invasion of Rome by the Barbarians in the fifth century and the capture of Alexandria by the Arabs in the early part of the seventh gave rise to an enormous loss of valuable books relating to medicine and philosophy in general, these were by no means the only occasions when books were probably destroyed in great quantities. Wars were frequent in those days and towns were constantly being sacked. Everywhere throughout the East the modern traveler encounters the ruins of large cities, and in those cities--the centres, as they were, of wealth and culture--there must have been large collections of books. It is not at all strange, therefore, that when the Caliph Almansur made a serious beginning of the work which was to convert the Arabs into rivals of the ancient Greeks, he should have found a great scarcity of medical works which, after being translated, were to serve as manuals of instruction. However, his ambition was very great, his wealth almost inexhaustible, and his associates eager to aid him in realizing the renaissance which he had planned for his people; and, as will appear later on, he and those who aided him eventually succeeded in overcoming this apparently insurmountable obstacle.

Among the medical books which, upon the approach of the Goths, were carried from Rome and other cities to different monasteries for safe keeping there must have been very few that were written in Latin, and yet these were the only ones from which the monks individually could derive any benefit. Several centuries later, when all the monasteries of Italy and the East were visited by those who were searching eagerly for original manuscript copies of the Greek medical writers,--Hippocrates, Soranus, Rufus of Ephesus, Aretaeus, Dioscorides, Galen,--it was found that such copies existed in a number of these institutions, thus showing that the monks had been actuated by unselfish and far-seeing loyalty to the best interests of mankind when they rescued these particular treasures from the hands of the enemy. They themselves could make no use of them, being unable to read Greek, but they knew their priceless value to medical science.

The Latin treatises which they had also rescued, and of which they made excellent use during the succeeding centuries, were those of Celsus, Scribonius Largus, Pliny the Elder (to a slight degree only) and Caelius Aurelianus.