Great Surgeons Of The Medieval Universities

Strange as it may appear to those who have not watched the development

of our knowledge of the Middle Ages in recent years the most interesting

feature in the medical departments and, indeed, of the post-graduate

work generally of the medieval universities, is that in surgery. There

is a very general impression that this department of medicine did not

develop until quite recent years, and that particularly it failed to

develop to any extent in the Middle Ages. A good many of the historians

of this period, indeed, though never the special historians of medicine,

have even gone far afield in order to find some reason why surgery did

not develop at this time. They have insisted that the Church by its

prohibition of the shedding of blood, first to monks and friars, and

then to the secular clergy, prevented the normal development of surgery.

Besides they add that Church opposition to anatomy completely precluded

all possibility of any genuine natural evolution of surgery as a

science.



There is probably no more amusing feature of quite a number of

supposedly respectable and presumably authoritative historical works

written in English than this assumption with regard to the absence of

surgery during the later Middle Ages. Only the most complete ignorance

of the actual history of medicine and surgery can account for it. The

writers who make such assertions must never have opened an authoritative

medical history. Nothing illustrates so well the expression of the

editors of the Cambridge Modern History referred to more than once in

these pages that in view of changes and of gains such as these [the

jointing of original documents] it has become impossible for historical

writers of the present day to trust without reserve even to the most

respected secondary authority. The honest student finds himself

continually deserted, retarded, misled by the classics of historical

literature. Fortunately for us this sweeping condemnation does not hold

to any great extent for the medical historical classics. All of the

classic historians of medicine tell us much of the surgery of the

thirteenth and fourteenth centuries, and in recent years the

republication of old texts and the further study of manuscript documents

of various kinds have made it very clear that there is almost no period

in the history of the world when surgery was so thoroughly and

successfully cultivated as during the rise and development of the

universities and their medical schools in the thirteenth and fourteenth

centuries.



It is interesting to trace the succession of great contributors to

surgery during these two centuries. We know their teaching not from

tradition, but from their text-books so faithfully preserved for us by

their devoted students, who must have begrudged no time and spared no

labor in copying, for many of the books are large, yet exist in many

manuscript copies.



Modern surgery may be said to owe its origin to a school of surgeons,

the leaders of whom were educated at Salerno in the early part of the

thirteenth century, and who, teaching at various north Italian

universities, wrote out their surgical principles and experiences in a

series of important contributions to that department of medical science.

The fact that the origin of the school was at Salerno, where, as is well

known, Arabian influence counted for much and for which Constantine's

translations of Arabian works proved such a stimulus a century before,

makes most students conclude that this later medieval surgical

development is simply a continuation of the Arabian surgery that, as we

have seen, developed very interestingly during the earlier Middle Ages.

Any such idea, however, is not founded on the realities of the

situation, but on an assumption with regard to the extent of Arabian

influence. Gurlt in his History of Surgery (Vol. I, page 701)

completely contradicts this idea, and says with regard to the first of

the great Italian writers on surgery, Rogero, that though Arabian works

on surgery had been brought over to Italy by Constantine Africanus a

hundred years before Roger's time, these exercised no influence over

Italian surgery in the next century, and there is scarcely a trace of

the surgical knowledge of the Arabs to be found in Roger's works.



It is in the history of medicine particularly that it is possible to

trace the true influence of the Arabs on European thought in the later

Middle Ages. We have already seen in the chapter on Salerno that Arabian

influence did harm to Salernitan medical teaching. The school of Salerno

itself had developed simple, dietetic, hygienic, and general remedial

measures that included the use of only a comparatively small amount of

drugs. Its teachers emphasized nature's curative powers. With Arabian

influence came polypharmacy, distrust of nature, and attempts to cure

disease rather than help nature. In surgery, which developed very

wonderfully in the thirteenth and fourteenth centuries, Salerno must be

credited with the incentive that led up to the marvellous development

that came. With this, however, Arabian influence has nothing to do.

Gurlt, besides calling attention to the fact that the author of the

first great text-book on the subject not only did not draw his

inspiration from Arab sources, insisted that instead of any Arabisms

being found in his [Roger's] writings many Graecisms occur. The

Salernitan school of surgery drank at the fountain-head of Greek

surgery. Apart from Greek sources Roger's book rests entirely upon his

own experiences, those of his teachers and his colleagues, and the

tradition in surgery that had developed at Salerno. This tradition was

entirely from the Greek. Roger himself says in one place, We have

resolved to write out deliberately our methods of operation such as they

have been derived from our own experience and that of our colleagues and

illustrious men.