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the great Albucasis, and he admits that his work on surgery is mainly compiled from their writings, "with the addition of a few things which, according to my moderate intelligence, seemed to be useful. For we are like children on the neck of a giant, who see all the giant sees and something besides." His contemporaries, he says, "follow one another like cranes, and despise everything not sanctioned by custom and authority, forgetting that Aristotle declares, in the second book of his metaphysics, that these are the two great hindrances to the discovery of truth". But most of them know nothing of Aristotle, and both surgeons and physicians so neglect their general education, that, if they persist in doing so, he will not be surprised to see tanners and carpenters deserting their trades and taking to physic. A good surgeon should be acquainted with liberal studies, with medicine, and, above all, with anatomy; "he should be courteous and condescending, bold in security, cautious in time of danger, avoiding impracticabilities, compassionate to the infirm, benevolent to his associates, circumspect in prognosis, chaste, sober, pious and merciful, not greedy of gain, no extortioner, but looking for his fee in moderation, according to the extent of his services, the ability of his patient, the result of his treatment, and a proper sense of his own dignity". The surgeons of the preceding century had been little more than wound curers, and, as we have seen, were divided into sects according to their various modes of dealing with such injuries; but in Guy's work other branches of the art, and especially the treatment of fractures and dislocations, which was comprised under the curious term "Algebra," first became prominent, and we find many practices recommended which are generally supposed to have been of much later origin. Thus, he advises that bandages should be stiffened by being dipped in white of egg; he suspends fractured limbs in a sort of cradle, cunabulum aut suspensorium"; and he treats fractures of the thigh not only by long splints, but also by the pulley and weight, "ad pedem ligo pondus plumbi transeundo chordam super parvam polegeam". One of the most striking objects

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of the hospital ward seems to have originated with him, for he recommends that a rope should be suspended over the patient's bed to assist him in lifting or turning himself.

The following was Guy's mode of treating chronic ulcers: "Wash the ulcer and the parts round it with alum water; then apply a thin sheet of lead of the size of the ulcer, and bandage firmly. It works wonders in all ulcers and cancerous dispositions, and how often I have gained honour thereby He knows who knoweth all things."

The philosopher Seneca notices with just censure a custom among the physicians of his day of writing letters of advice to patients they had never seen. The habit is not yet extinct, but it formed only one, and that the least important, source of the medical "consilia" of the fourteenth and fifteenth centuries. Others consist of extracts from the case books of distinguished physicians, published for the benefit of their colleagues and successors, while a third class comprises answers to inquiries sent by country practitioners or former pupils to celebrated professors, who thus became the prototypes of the modern consultant. The "consilia" are far superior in interest and originality to the old compilations, and mark an important step towards the reproduction of the clinical observations of Hippocrates. The chief writers were Italians Gentilis of Foligno (died of the "black death" 1348), Antony Cermisone (died 1443), and Bartholomew Montagnana († 1470), all three professors at Padua, but we must confine ourselves to one or two examples from the first and last named authors. A typical "consilium" begins with a brief description of the patient, his temperament, and his disease; it then suggests what may be the causes of this, and warns him of the dangers he incurs if he does not follow the advice given under the heads of regimen, diet, and drugs. respectively.

Gentilis lays by far the greatest stress on the last. Here is his "consilium" "for one gone mad through excess of joy. (1) Make a syrup of decoction of borage, bugloss, endive, dodder and senna leaves in sugar and water. Dose 2 to 3 oz.

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in a little warm water; (2) a similar decoction with the addition of poppy-heads to be taken at bed-time; (3) an embrocation for the head composed of violets, aloes, poppyheads and seeds, lettuce leaves, camomile, and nenuphar, boiled in barley-water; (4) numerous cupping glasses should be applied to his neck, shoulders, and buttocks; (5) it will be of great advantage if you can produce hæmorrhoids; (6) make a julep of borage and bugloss, of which let him drink frequently." The following is the shortest of the 305 “consilia" of Bartholomew Montagnana: "A lady with an ulcer in her ear, discharge of pus, noises, and decrease of hearing. There is great fear that this will result in complete deafness, which may be prevented thus: Let her avoid over-eating, and refrain from pastry, milk, and all milk foods, from boiled fish, especially tench and eels, and from vegetables and stewed meats, above all at night. She must avoid sweet wines, and must add one-fourth water to what she does drink, refrain from active exercise after food, and must not hang her head down. As to medical treatment: (1) Let her be bled to four or five ounces from the right cephalic vein, or that between the thumb and index of the right hand; (2) a rhubarb pill in the morning; (3) a poultice, chiefly of powdered asarum root, to be applied locally for about half an hour daily; (4) an oil, two or three drops of which are to be run into the ear four times a day; (5) another purgative pill at bed-time; (6) some drops of cyclamen juice to be used for ten days alternately with the above oil. By so continuing the patient will be cured ad laudem Dei Omnipotentis. Amen."

Another "consilium" is addressed to an English abbot, who proposes to go on a pilgrimage to Jerusalem. The first thing he will have to fear, says Bartholomew, is sea sickness, and he recommends as a preventive confection of quinces with coriander to be taken after meals. If this fails and sickness comes on, he should tie bandages tightly above his knees and elbows, and put a large cupping glass "in medio stomachi" but without scarification. He may further use a suppository containing scammony and colocynth, the action of which

may be hastened by plunging his feet suddenly in cold water. After this let him anoint his belly with one of the following ointments (a long list of ingredients including quince and coriander, in which he seems to have great faith). Then comes a variety of internal medicines, syrup of barberries, peppermint, etc., and finally advice as to food, which should be light and easily digested, such as chickens, young pigeons and the like. The other inconveniences the unfortunate abbot must expect are diarrhoea, headache, thirst, sleeplessness, exhaustion, want of appetite, and loss of flesh, for each of which appropriate advice is given.

NOTE.

The custom of boiling bodies is mentioned by Gibbon (cap. xlix.), and more fully by Haeser, i. 736. A contemporary writer tells the following story of the plague in Barbarossa's army: “A certain man was boiling his brother, when a friend sent to borrow the cauldron for a similar purpose, but he replied that he could not spare it, for after cooking his brother he should want to be cooked in it himself; which was also done". Henry of Salzburg, in Migne's Patrologia, vol. cxcvi., p. 1549.

Mundinus, Anatomia, Marburg, 1541. Guy of Chauliac tells us "Mondino of Bologna, who wrote on anatomy and practised it often, and my master, Bertrucius, acted thus: The body being placed on a table he made four lectures over it. In the first the nutritive organs were considered, for they are most corruptible, in the second the spiritual members (i.e., lungs, heart), in the third the animate members (brain, etc.), and in the fourth the extremities" (quoted by Burggræve, Précis sur l'Histoire de l'Anatomie, Ghent, 1840). In the editions with which I am acquainted, Guy (Chirurgia, i. 1) mentions Bertrucius only, "Et ipsam (anatomiam) administravit multoties magister meus Bertrucius in hunc modum; collocato corpore mortuo in scamno, etc."; but doubtless his master, Mondino, practised in the same way. Gentilis Fulgineus, Consilia, Venice, 1503; Barth. Montagnana, Consilia Medica, Venice, 1497. The opinion of honourable practitioners of all ages as to the giving of medical advice by letter may be expressed in the language of Henry of Mondeville: "It is not safe, nor in accordance with the art, or with a right conscience, for a surgeon to give curative advice in serious cases to patients whom he has not seen; but he may, if he has legitimate excuse, give palliative counsel".

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XXXIX.-MEDIEVAL MILITARY MEDICINE.

SURGERY, and indeed the whole art of healing, owes much to war, that greatest of vivisectors, and this alone would justify our turning aside from time to time to consider military medicine. Tacitus tells us that the ancient Germans betook themselves after a fight to their mothers and wives, who did not hesitate to count and examine their wounds. They, doubtless, also employed some mode of treatment, though the tempting emendation of exsugere—to suck outfor exigere is not accepted by scholars. In the Lay of Nibelungs more regular practitioners make their appearance, for we hear that "those skilled in leechcraft were offered silver without weight and bright gold for healing the heroes after the battle," but this was not till they had returned home from the expedition. Some idea of the actual practice on the field may, perhaps, be gathered from an interesting passage in the companion poem, Gudrun, the German Odyssey. Here the old warrior, Wate, officiates as army surgeon, “for he had learned leechcraft from a wild woman,' so he first dresses his own wounds, and then, taking an herb of marvellous power, and a plaster which he carried about with him in a box, he binds up those of his comrades; and so many did he cure, says the poet, that, had he been in a large army, "it would have taken camels to carry the gifts he would have got ".

The military surgery of the Northern nations is closely similar. When St. Olaf was slain in Sticklestad fight, August, 1030, Thormod the skald was struck by an arrow in the left side, and retired to a barn, where he found women tending the wounded. One of them was boiling leeks in a pot and giving the broth to her patients, to see whether the wounds had reached the belly, for then they would smell of leeks. She asked Thormod why he did not get some one to look to his hurt, but he answered that he was not handsome enough for women to care for him, and had no presents to give. Then she took a pair of tongs and had a pull at the