of his temperament, for that is a cause of stone." This is not the first mention of salivary calculus, for Avenzoar (Theisir, ii. 2) says: "I saw a stone formed under a man's tongue which hindered his speech. On its removal he recovered his speech. It is generated by gross humours which gradually harden till they are like stone.”

The assertion that Gaddesden was the first English court physician appears to rest upon the well-known account of how he cured the king's son of small-pox. This is so often quoted in English that we may here give the author's own words. "Capiatur ergo scarletum rubrum, et qui patitur variolas involvitur in illo totaliter, vel in alio panno rubro; sicut ego feci quando Inclyti Regis Angliæ filius variolas patiebatur, curavi ut omnia circa lectum essent rubra, et curatio illa mihi optime successit, nam citra vestiga variolarum sanitati restitutus est."

Gaddesden's love of lucre is shown by his devoting a special section of his work to "disagreeable diseases which the doctor can seldom make money by," and the same characteristic is unpleasantly evident in the writings of the first important English surgeon, John of Arderne.

John of Arderne was born 1307, and practised from 1349 to 1370 at Newark. Then he went to London, and wrote surgical treatises of which, however, only a small part has been printed in an English translation by J. Reid, 1588.

Though he often quotes his predecessors, such as Gordon, Lanfranc and the Salernitan Platearius, he relies largely on his own experience of which the following is an example: "There was a man smitten on the shin, but the skin was not broken; but after the third day it swelled and began to grieve him; then he went unto one unskilled, until he had in his leg a great round hole and deap (sic) and full of black filth like unto burnt flesh. So when he came to me I cured him thus. First I washed the place with white wine warmed, in which was sodden croppes of the herbe colewort, and juice of plantain. Afterwards I put to a plaster made of plantain, ruberbe, parsley, honey, rye meal and white of egg mingled together: the place being mundified I put to powder 'creoferoberon' with a plaster of black soap, sulphur and arsenic. If any man be smitten on any part of the leg violently without wounding, as often happens either by a horse or a stone

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or club or such like, it is good in the beginning to anoint the place and bring out the bruised blood thereof, and after to apply plasters repressing the pain and swelling. . . . Take for your cure as much as you can get, with good assurance for your money when you have done."

According to Arderne he was the only man of his time in England or beyond seas who could cure fistula in ano. He describes two methods by incision and ligature, and a number of instruments of his own invention, which appear, however, to be merely old forms under new names. He declares that he never took less than 100 shillings for the cure, while from great and worthy men he required 100 marks (£68 13s. 4d.) together with an annual pension of 100 shillings; immense fees considering the value of money at that time. But John of Arderne (says Malgaigne) was not content with boasting himself the inventor of two operations for fistula in ano, perfectly well known to his predecessors. All the world does not suffer from fistula, and to make money quickly one must find something of universal application. So he declares that everybody would be immensely benefited by taking an enema twice or thrice yearly. And it is no use to go to the Italians for this purpose. The operation requires a perfect master of the art, such as himself, assisted by appropriate instruments, such as the new and improved syringes which he has invented, and he concludes with a list of fees.

The work of Bernard of Gordon is considered here, not because there is any evidence that he was of British origin, for, in spite of such authorities as Haller and Puschmann, there seems no reason to doubt the unanimous assertion of French historians that he was born at Gordon in Guienne, but because his Lily gave rise to Gaddesden's Rose, which it at least equals in scientific value.

All that we really know of him is to be found in the preface to his Lilium Medicina, which, he says, he began to write in 1305 having then been for twenty years professor of medicine at Montpellier.

Here are his remarks "On the sting of the bee": "Bees and wasps have stings, and in the parts pricked there arise pain, swelling, and burning heat. Wasps do not leave their stings in the wound, but bees do, and live not long after. They rarely sting unless injured, and then they join together and help one

another like an army. The king of the bees (rex apum) has no sting. And though they are bloodless animals, yet is their poison of a 'hot' character, wherefore cold things should be placed on the wound, such as iron, or lead cooled in vinegar, or mallow juice, or barley flour and coriander made into a paste with vinegar, or other cooling applications."

The following, says Gordon, is the best eye-salve which it had pleased God to reveal up to his day. Take of sileris montani (spindle tree?), marjoram, euphrasy, rue, celandine, fennel, each 3 oz.; zinzi (?) spikenard, long pepper, cloves, tuciæ extinctæ (?) sarcocolla in asses milk, lign-aloes, each 1 oz.; gall of eagle, hawk, and mountain goat, each 1 oz.; balsam, half an oz.; honey 1 oz. Mix and allow it to digest in a hot sun forty days. It is of such virtue that it will enable an old man (decrepitum) to read small letters without spectacles (sine ocularibus). "Glasses called spectacles" (vitrea vocata conspicilia) are mentioned by Arnald of Villanova in his commentary on the Salernitan Regimen Sanitatis, written about the same time.

Gordon is the first to mention the modern form of truss. After reduction of the hernia, he says, let the patient wear a "brachale ferreum cum lingula ad modum semicirculi, et paratum sicut oportet," a passage which is transcribed without acknowledgment by John of Gaddesden. Though the mediæval physicians rarely experimented upon animals, they were sometimes able, thanks to the jurists and theologians, to make interesting observations on men. Thus Gordon remarks that when Jews are hung up by their feet, if you give them anything to drink, it will ascend to their stomachs, whence he concludes that that organ possesses a special attractive faculty.

The following were the eight diseases then recognised as contagious: "Febris acuta, phthisis, pedicon, scabies, sacer ignis, anthrax, lippa, lepra, nobis contagia præstant."

NOTES.

Gilbertus Anglicus, Compendium Medicina, Lyons, 1510; there is a good account of him in the Histoire Littéraire de la France, vol. xxii. John of Gaddesden, Rosa Anglica, Augsburg, 1595. Freind discusses him very fully in his History of Physic. For John of Arderne see Arcæus. A Method of Curing Wounds, by J. Read, London, 1588. Further extracts

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may be found in South's Craft of Surgery, 1888, Daremberg Histoire des Sciences Médicales, i. 300, Malgaigne, introduction to his edition of Ambrose Paré. Bernardus de Gordonio, Lilium Medicinæ, Frankf., 1617. The impartial Haeser calls him a Scotchman in his larger, and a Frenchman in his smaller medical history, but see the Histoire Littéraire de la France, xxv

APPENDIX VI.

ANCIENT AND MEDIEVAL MEDICAL PRESCRIPTIONS.

IN describing ancient forms of medical treatment, even serious historians are apt to lay special stress upon methods which are strikingly superstitious, ludicrous, or disgusting, and this is, naturally, still more the case with popular writers. We are thus liable to make what is, perhaps, a somewhat unfair estimate of the medical skill of our ancestors, for though such methods were undoubtedly more prominent then than now, it would be a mistake to suppose that they were commonly employed by the better class of practitioners. The remedies mentioned in the following pages are, for the most part, standard prescriptions which are known to have been widely used, and they seem in many cases to have been well adapted for the objects in view, the chief objections, from our modern standpoint, being the number of the ingredients, and the largeness of the dose.

The first place must be given to the famous theriac, which had its origin in the universal antidote of Mithridates, and received its final form from Andromachus, archiater to the Emperor Nero, who added, among other things, what was considered its most valuable ingredient, viper's flesh. Space will not suffice for the entire prescription, but of the seventy-five substances included therein, the most important were opium, squills, castoreum, saffron, rhubarb, gentian, and ginger. It was used not only as an antidote to poisons, especially the bites of venomous beasts, but also to prevent and cure nearly all internal disorders. According to Galen it first became popular in Rome, under Marcus Aurelius, who took it regularly himself, and gave it to all his friends. He declares that its power to counteract the poison of

venomous animals is unquestionable, for "those who have the power of life and death have frequently tested it on condemned criminals, and always with success". He himself was unable to experiment with it on men, but tested it on cocks with the same result, the birds who had taken the theriac were unaffected by the bites of vipers, the others died. The drug was largely used throughout the middle ages, both among Arabs and Christians. We have seen the great Avenzoar applying it to the pimples on his nose, and the following is an interesting case of its use in the renaissance epoch, related by Thaddaeus Dunus (1523-1613): "We were sitting before the fire after dinner, when the nurse came and brought my wife the baby. When she pressed it to her as mothers do, she felt a prick like a needle in her left middle finger (for there was a scorpion in the baby's clothes). The pain and terror was so great that she nearly fainted, and almost dropped the baby in the fire, but the nurse ran up and caught it. As soon as she got up she fainted, and began to sweat, and to swell up so that she was well nigh suffocated. She made signs that I should loosen her dress, and then I saw the cause of the mischief, for the scorpion fell on the hearth. I ordered them to catch him, and then pounded him up into a plaster for the wound. Now, I had with me some excellent theriac, juicy and aromatic, which King Francis [I. of France] has had made for himself and his courtiers. I gave her a dose of this in wine, laid laurel leaves soaked in wine on the finger, and in two hours she was well. But if the scorpion had stung the baby there would have been no hope, so terrible and deadly is his poison." Its use survived even the overthrow of the Galenic system. "I have seen a dose of theriac given every day to all the patients in the hospital at Montpellier; while the lecture halls of that metropolis of medicine resounded with invectives against it," writes Bordeu in the middle of the last century. Bordeu himself is inclined to believe in it: "Old and experienced practitioners frequently use it, and not seldom successfully". As late as the close of the century, in some towns of France and Holland, the theriaca Andromachi was prepared annually with special formalities, in the presence of the mayor and town council.

Galen tells us that the first important narcotic compound