C.D. Warner, et al., comp. The Library of the World’s Best Literature.
An Anthology in Thirty Volumes. 1917.
French Medical Science during the Middle Ages
By Alfred Rambaud (1842–1905)
T
For a long time the Christians abandoned the study of medicine to the Arabs and Jews. It was to these infidel masters that later the most daring went to learn the elements of the science.
Charlemagne in 805 had prescribed the study of medicine in the monasteries. About the ninth century, the school of Salerno in Italy began to be famous throughout Christendom. In the tenth century some Jews founded the school of Montpellier, which in the thirteenth became a faculty. In 1200 the University of Paris was founded, which was not until later anything more than a faculty of medicine; but already in 1213 there was question of professors of medicine. The Church showed little favor to this science, which seemed an evidence of distrust toward Providence. “The precepts of medicine are contrary to Divine knowledge,” wrote St. Ambrose: “they condemn prayers and vigils.” The councils of the twelfth and thirteenth centuries forbade the study of this art to prelates and archdeacons, and only permitted it to the lower clergy. No clergyman could practice surgery, because it sheds blood. Boniface VIII. menaced with excommunication whoever should dissect a dead body.
Anatomy being proscribed; the natural sciences, such as botany, mineralogy, and chemistry, being in their infancy,—one can imagine our medical science of the Middle Ages. It consisted of prescriptions often childish and incomplete; observations borrowed from antiquity or from the Arabs. The prejudices and superstitions of the time played an important part in it. The doctors, also called physicians or mires, were also alchemists and astrologers. They taught that the brain increases and decreases according to the phases of the moon; that it has, like the sea, its ebb and flow twice a day. The purpose of the lungs was to air the heart, the liver was the seat of love, the spleen that of laughter. They made use of formulas and cabalistic words; they ordered strange remedies, such as the liver of a toad, the blood of a frog, a rat, or a goat; they sought universal remedies or panaceas; they bled people only upon certain days, and after having observed the position of the stars and the phases of the moon. Such-and-such a remedy was good for the noble but bad for the serf; the noble must purge himself with hyssop, the peasant with myrobolan. The one cured a fracture with an earth bolus; the other with the dung of his cattle.
Surgery was considered an inferior art. As the clergy was forbidden to exercise it, it was separated from medicine. It was abandoned to the practitioners who had not received degrees, and who were also barbers and even bath-keepers. Even in the seventeenth century, in 1613, there were corporations of surgeon-barbers. They shaved people, bled them, and bandaged their wounds. The surgeons traced their organization into a corporation back to St. Louis, but their Collège de Saint-Côme does not seem to date farther back than the fourteenth century. They were placed under the authority of the “king’s barber,” who had his delegates in all the towns of the kingdom.
Further, the doctors and surgeon-barbers served only the nobles and the rich. The people had their own therapeutics; in medicine, the remedies of wise women and sorcerers; in surgery, the bone-setters, who had charms and secrets for restoring broken limbs with ointments of their own composition, signs of the cross, and formulas. The bone-setter above all others was the executioner: since he understood so well how to break limbs, he ought to understand how to mend them. It was he who furnished a precious panacea,—the fat of the hanged.
They believed, too, that a donkey’s breath expelled all poison. Aching teeth they cured by touching them with a dead man’s tooth. To arrest hemorrhage or nose-bleed they dropped a key down the back. By spitting in the mouth of a living frog they stopped a cough.
Rather than apply to the doctor they had recourse to the apothecary, who, in spite of the prohibitions of the faculty, took a part in healing. Charlatans swarmed.
Religion too had its medicine, in which Christian beliefs were amalgamated with old pagan superstitions. Epilepsy was then called the sacred evil, the Divine evil. The epileptic was believed to be possessed by a demon; the only consideration was to drive out the evil spirit from him. Therefore the priest sprinkled him with holy water; and while the sufferer was rolling in convulsions, read the formula of exorcism. It is known that nervous maladies are easily communicated to persons with sensitive nerves; thus the demon driven from one body often gave himself the pleasure of entering into the body of a spectator, who writhed in his turn. Sometimes in revenge he entered into the exorciser. The possessed were also cured by a pilgrimage to Saint-Maur near Paris, by a novena at the church of Bon-Secours near Nancy, or by touching the holy cerement at Besançon.
Heaven was peopled with healing saints. If one had sore throat he addressed himself to Saint Christopher; if dropsy, to Saint Eutropius; if fever, to Saint Pernella; if insanity, to Saint Mathurin; if the plague, to Saint Roque; if hydrophobia, to Saint Hubert, the patron of the chase and of dogs. At the monastery of Saint Hubert, near Liège, a monk touched the patient with the saint’s stole, and cauterized him with “the key of Saint Hubert.”
Often the choice of the saint was determined by a kind of pun. For scurf (teigne) they addressed to Saint Aignan (pronounced “Saint Teignan”); for trouble with the eyes, to Saint Claire; for gout, to Saint Genou (genou, knee); for cramps, to Saint Crampan.
Certain maladies were even designated only by the name of the saint who cured them: thus Saint Virus’s dance, a nervous disease which we now call chorea; Saint John’s ill, which was epilepsy; Saint Anthony’s evil, which was canker; Saint Eloy’s evil, which was scurvy; Saint Firmin’s evil, which was erysipelas; Saint Lazarus’s evil, which was leprosy; Saint Quentin’s evil, which was dropsy; Saint Sylvan’s evil, which seems to have been a kind of eruptive fever.
The monks who practiced this medicine sometimes drew illicit profits from it. In the thirteenth century, those of Saint Anthony were accused of receiving into their hospitals only healthy people, upon whose bodies they painted apparent sores, and then sent them to solicit the charity of the faithful. Those of Saint Sylvan retained as serfs those who had recovered their health under the porch of their church. In order to increase the number of supplicants they forbade all competition. In 1263 they prohibited women from attempting “to heal those afflicted with Saint Sylvan’s evil, with the exception of the lord and any of his family”; for these could not be reduced to serfdom.
Kings too cured by touching: the King of England cured epilepsy; the King of France scrofula. The King of England, when he had added to his title that too of King of France, also cured scrofula. The heads of certain noble families, like that of the house of Aumont in Bourgogne, had the same gift. The progress of royal power put an end to these feudal healings.
Yet never would a truly serious medical science have been more useful than at certain epochs of the Middle Ages, when diseases raged which have since disappeared, and when those which still exist attained an unequaled violence. Then they ignored or neglected the most elementary principles of hygiene. The peasant lived on his refuse heap, huddled in with his beasts, like the wretched Irish peasant of to-day; the townsman lived in the stench of narrow streets. The clergy, by preaching contempt of the body, indirectly encouraged neglect of the most necessary care of it. Until toward the middle of the fourteenth century hemp and linen cloth was little used, even by the upper classes; and woolen fabrics in direct contact with the skin must have irritated it. The peasant was poorly nourished, and by way of meat had scarcely anything but salt provisions.
Such a regimen naturally favored skin diseases. In the tenth and eleventh centuries a scrofula or gangrene raged, which loosed the members of the body joint by joint. Ulcers, tetter, scurf, the itch were frequent. The poverty of the blood increased the number of the scrofulous. Leprosy, which began with the first Crusades, and later developed enormously, lasted throughout the Middle Ages. In 1250 the army of Saint Louis in Egypt was decimated by dysentery and scrofula.
Nervous diseases multiplied, incited by terror of the wars, by the spectacle of tortures, by fear of the devil and of hell, by the isolation and monotony of life in castle and cloister. There were epidemics of Saint Vitus’s dance, which seized upon entire populations and drew them into a mad round; frequent cases of epilepsy, the victims of which were thought to be possessed by devils; melancholia, or black sadness; lycanthropy, or mania of those who believed themselves changed into wolves, and who were called were-wolves; demonomania, which made thousands of unfortunates believe themselves in commerce with the infernal spirit; the mania of scourging; hallucinations taken for visions.
Small-pox first appeared in Gaul in the sixth century: from this disease, described by Gregory of Tours, died the children of Frédégonde. The Oriental plague or bubonic pest began to show itself about 540.
The black pest, also a bubonic pest, ran over all Europe in the fourteenth century, and destroyed a large part of the population.
In the fifteenth century the whooping-cough appeared, which in 1414 killed many old people; and the English sweating-sickness, which made many ravages down to the sixteenth century, but which then became limited to England, and to Calais which was occupied by the English.
Medical science remained powerless before these scourges: often it let rule a superstition which it shared. Those believed to be possessed of evil spirits were exorcised; those who were asserted to be sorcerers were burned. The lepers recommended to Saint Lazarus were confined,—sometimes in isolated huts, sometimes in leper-houses, but always away from other people. They made them wear a striking costume,—a red blouse; they covered their hands with gloves; they supplied them with a rattle to warn those who passed. The priest, when lepers were brought to him, forbade them to go barefoot, or to go elsewhere than on the broad thoroughfares, lest they should brush against travelers; to enter churches, or to bathe in streams. He consoled them, however, by recalling to them that their spiritual communion with Christians still subsisted. Then he pronounced prayers, turned a shovelful of earth upon their heads as a sign that they were cut off from the living, and offered them the sole of his shoe to kiss. Lepers could associate only with lepers, and marry only with lepers; and when they died, their huts were burned.
In the fifteenth century there seems to have been a reawakening of medical science. At Montpellier, under Charles VI., the body of a criminal was dissected for the first time in France. In 1484, an ordinance of Charles VIII. fixed at four years the duration of apprenticeship in the corporation of the grocers and apothecaries of Paris; for pharmacists or apothecaries formed a single corporation with the grocers, which had obtained second rank among the trades of Paris. An ordinance of Louis XII. distinctly separates the two professions. These are the origins of French pharmacy.