be summoned, and that for four reasons- -(1) that he may be unable to discover the physician's mistakes; (2) that the physician may dominate over him, and continue surgeon as before; (3) that if necessary he may throw the blame of his errors past and future on the surgeon, and (4) that he may attribute all the honour to himself." Henry impartially draws a companion picture of the crafty surgeon, who tells his medical patients that physicians know nothing, and do nothing but talk and dose every one indiscriminately with purgatives "which are most unsuited for your case," etc. Such are the crafty and deceptive of both classes, but there are also scientific and experienced practitioners with whom it is a solace to consult. This is how a consultation should be conducted: "First the diseased part should be most carefully examined and felt, for, as Haly Abbas saith, 'surgical diagnosis consists in feeling with the hand and observing with the eye'; and let each do this in turn, repeating the examination if necessary, and pointing out to one another any noticeable signs both in the diseased part, and in the patient generally. Then let him who is of most authority, preferably a physician, say to the patient: 'Sir, we have carefully examined your case, and you ought to rejoice and be very glad that we are so many and such able men here, sufficient for a king, and the least of whom is fully competent to work out, follow up, and complete the cure of your disorder'. Then he should inquire into the circumstances of the case, saying: 'Sir, excuse us (non displiceat vobis nec habeatis pro malo), but how long is it since this disease attacked you?' Then let him ask other questions, as laid down in section 45, the others carefully attending. After this they should all go into another room where are none but themselves, that they may better discuss the truth, and that there be no witnesses of the discords and quarrels which sometimes happen. And let the chief among them call upon the others to speak in turn, beginning from the youngest or least, for if the greater speak first the others will fear to differ from them. He should ask what the disease is, what authors have made

mention of it, and where. Whether it is curable, and if so, how, etc. Take for example an abscess in a fleshy part; let him ask of what matter or humour it is; if of blood, in what stage, whether evacuation is indicated, and of what kind; if by venesection, in which vein and when, considering the stage of the disease, position of the moon and heavenly bodies, and an infinity of other matters."

One of the earliest signs of the revival of medicine was the restoration of the public or communal physicians, as at Bologna and Venice, the mercantile people of which latter city, with a keen eye for obtaining the best value for their money, did not hesitate to employ even unconverted Saracens. In 1436 the Emperor Sigismund decreed that every imperial city in Germany should have a public medical officer, who should be paid 100 gulden yearly from Church revenues, and attend the poor gratis, "for the high masters in physic never do this, and therefore they go to hell". The "archiatri of the palace," or royal physicians, were restored in the reign of the Emperor Charles the Bald, whose Jewish doctor, Zedekiah, was accused, probably with equal truth, of being a sorcerer and of poisoning his master. It is in this capacity that we meet with the last Greek practitioner who might trace some connection with the great men of old. Angelus of Cyprus, for seven years (1364-71) physician to Charles the Bad of Navarre, was "a very learned clerk, versed in the Latin tongue, and powerful in argument"; so his master suggested that he should use these qualities to ingratiate himself with his cousin, Charles V. of France, and take an early opportunity of poisoning that monarch. Rather than obey the physician fled from the court, and was never seen again, but report said that he had been overtaken and put to death by the king's order.

Charles the Bold of Burgundy had six physicians, one of whom always stood behind his chair and told him what he might eat.

UNPROFESSIONAL MEDICINE.

NOTE.

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The laws of Roger and Frederick and the regulations of the school of Salerno are given in the Collectio Salernitana. The obligation to recommend confession seems to have been especially distasteful to physicians. We find the ecclesiastical authorities first pointing out its utility even from a medical standpoint, "for many diseases are due to sin, and the cause being removed by confession and penance the effect will cease". This being apparently ineffectual they proceed to decree the lesser excommunication against those doctors who neglect this duty; and finally the aid of the secular arm was called in, and a fine of four oz. of silver imposed upon each omission.

The earliest mention of a "doctor" in the Salernitan archives is the following: "Obiit A.D. 1200. Magister Thomasius Saracenus, clericus Salernitanus, Doctor in Physica." Collectio, iii. 332.

XLII.-UNPROFESSIONAL MEDICINE IN THE

MIDDLE AGES.

IN mediæval medical writings we frequently come across the terms "laicus" and "idiota," applied to practitioners who had received no regular education, i.e., were not "clerks," and who were acquainted only with their native tongue. The Greek "idiot" was a man who took no part in State affairs, the medieval "idiot" was one who knew no Latin. But the words are also used to denote the amateurs of the healing art, who were as numerous then as now, and it may be interesting to consider some aspects of this unprofessional medicine as exemplified by kings, saints, bishops, priests, and the general public.

Henry of Mondeville distinguishes two classes of "idiotæ": (1) the proud and stupid who boast of their hereditary knowledge and experience, and oppose the orthodox practitioners in every way; (2) those whose circumstances have prevented their acquiring a regular education, but who respect the ordinary surgeons, are ready to learn from them. Besides these, however, there is a third class of amateur practitioners. "It is not very wonderful (says Henry) that poor men driven

by necessity take refuge under the cloak of surgery, since that art is in universal request, and the vulgar cannot distinguish the skilled from the ignorant. But it is more than wonderful that not only the aforesaid, but kings, princes, prelates, canons, curates, monks, dukes, nobles, and burghers should, without any previous knowledge, take in hand perilous cases of surgery, especially the cure of eye affections, which are most dangerous, difficult and fallacious. And through their errors, particularly those of rich men, monks, hermits, and recluses, in whom the vulgar have greatest trust, diseases curable in themselves become incurable, or at least worse than before. And sometimes they destroy the affected organs, and often kill the patient. But the people hold that the said monks and their like have a knowledge of surgery apart from experience infused into them by the grace of God, and if any one doubts this, he is reputed a heretic, or an infidel and infamous person."

The history of "touching" for scrofula by English sovereigns has been so often related that we may confine ourselves to a short account of the practice by French kings. In the opinion of St. Thomas Aquinas there is no better proof that Divine grace is given to anointed monarchs, than the undoubted fact that the power of healing diseases was thereby bestowed on that strange "eldest son of the Church," Clovis the Frank, A.D. 496. But he does not mention scrofula, and the earliest notice of a special power of healing that disease is probably the following passage from Abbot Guibert de Nogent, author of the famous Gesta Dei per Francos: "What a prodigy is that which we see practised by our sovereign lord Louis [the Fat, 1100-1137]. I have seen those who have swellings on the neck or elsewhere run in crowds to be touched by him, while I was present and trying to keep them off. But he, with his natural kindness, gently beckoned them to him, and humbly signed them with the sign of the Cross. His father Philip often performed

this glorious miracle, but lost the power through falling into some sin. I pass over what other kings do in this way, but

KINGS AND SAINTS.

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I know the King of England never attempts it." Henry IV. is said to have healed more than 1500 patients, and to have touched nearly four times as many every year. "After the ceremony," says an ancient chronicle, "the king wiped his fingers on a cloth dipped in wine and water, and then dined, though he seldom had much appetite thereto, because of the unpleasant smells and sights; but charity overcometh all things." The custom was continued till the Revolution, and when, about 1750, D'Argenson sent the ministers of Louis XV. details of a case which had actually recovered after being "touched," he received the crushing reply: Monsieur, the prerogative of the kings of France to cure scrofula is proved by such unquestionable evidence that it is unnecessary to confirm it by particular instances". Many cases of failure, however, occurred, even in the ages of faith, one of which is of special interest. In 1483 the crafty and superstitious Louis XI. sent for St. Francis of Paul, who had wrought many wonders in Italy, to heal him of the results of an apoplexy. That holy man suffered from scrofula, but the historian is obliged to confess that neither the saint could cure the king nor the king the saint.

66

The power of medieval saints to heal the sick, like that of the kings of France, is so notorious that it is needless to give examples; but one of their number has special claims to a place in the history of medicine, St. Hildegard of Bingen (1098-1179), who shares with her contemporary, Avenzoar, the honour of having first mentioned the itch mite. According to some modern writers she established a school of nurses (!), but there is no mention of this in her letters or authentic biographies. Her own patients, at any rate, required no nursing, for she cured them in the miraculous manner appropriate to her saintly character, and we are told that hardly any sick persons applied to her who were not instantly healed. But for the benefit of those less highly favoured, St. Hildegard wrote several medical books, of which the best known is the Physica, a description of the nature and medical properties of minerals, herbs, fishes,