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[the physician] should question the messenger who has summoned him upon the circumstances and the conditions of the illness of the patient; then, if not able to make any positive diagnosis after examining the pulse and the urine, he will at least excite the patient's astonishment by his accurate knowledge of the symptoms of the disease and thus win his confidence."
At the end of these preliminary instructions there is a rather diplomatic—to say the least—bit of advice that might perhaps to a puritanic conscience seem more politic than truthful. Since the old professor insists so much on not disturbing the patient's mind by a bad prognosis or any hint of it, and since even some exaggeration of what he might think to be the serious outlook of the case to friends would only lead to greater care of the patient, there is probably much more justification for his suggestion than might be thought at first glance. He says, '' When the doctor quits the patient he should promise him that he will get quite well again, but he should inform his friends that he is very ill; in this way, if a cure is affected, the fame of the doctor will be so much the greater, but if the patient dies people will say that the doctor had foreseen the fatal issue."
The story of the medical school of Salerno, even thus briefly and fragmentary told, illustrates very well how old is the new in education,—even in medical education. There is scarcely a phase of modern interest in medical education that may not be traced very clearly at Salerno though the school began its career a thousand years ago, and ceased to attract much attention over six hundred years ago. We owe most of our knowledge of the details of its organization and teaching to De Renzi. Without the devotion of so ardent a scholar it would have been almost impossible for us to have attained so complete a picture of Salernitan activities. As it is, as a consequence of his work we are able to see this first of modern medical schools developing very much as do our most modern medical schools. There has been an accumulation of medical information in the thousand years, but the ways and modes of facing problems and many of the solutions of them do not differ from what they were in the distant past. The more we know about any particular period, the more is this brought home to us. It is for this that study of particular periods and institutions of the olden time, as of Salerno, grows increasingly interesting, because each new detail helps to fill in sympathetically the new-old picture of human activity as it may be seen at all times.
Probably the most important representative of the medical school at Salerno, certainly the most significant member of its faculty, if we consider the wide influence for centuries after his time that his writings had, was Constantine Africanus. He is interesting, too, for many other reasons, for he is the first representative, in modern times, that is, who, after the incentive of antiquity had passed, devoted himself to creating a medical literature by translations, by editions, and by the collation of his own and others' observations on medical subjects. He is the connecting link between Arabian medicine and Western medical studies. The fact that he was first a traveller over most of the educational world of his time, then a professor at the University of Salerno who attracted many students, and finally a Benedictine monk in the great abbey at Monte Cassino, shows how his life ran the gamut of the various phases of interest in the intellectual world of his time. It was his retirement to the famous monastery that gave him the opportunity, the leisure, the reference library for consultation that a writer feels he must have near him, and probably also the means necessary for the publication of his works. Not only did the monks of Monte Cassino itself deles
vote themselves to the copying of his many books, but other Benedictine monasteries in various parts of the world made it a point to give wide diffusion to his writings.
As a study in successful publication, that is, in the securing of wide attention to writings within a short time, the career of Constantine and the story of his books would be extremely interesting. Medieval distribution of books is usually thought to have been rather halting, but here was an exception. It was largely because Benedictines all over the world were deeply interested in what this brother Benedictine was writing that wide distribution was secured for his work within a very short time. His superiors among the Benedictines had a profound interest in what he was doing. The great Benedictine Abbot Desiderius of Monte Cassino, who afterwards became Pope, used all of his extensive influence in both positions to secure an audience for the books—hence the many manuscript copies of his writings that we have. It is probable that Constantine established a school of writers at Monte Cassino, for he could scarcely have accomplished so much by himself as has been attributed to him. Besides, his works attracted so much attention that writers of immediately succeeding generations who wanted to secure attention for their works sometimes attributed them to him in order to take advantage of his popularity. It is rather difficult, then, to determine with absolute assurance which are Constantine's genuine works. Some of those attributed to him are undoubtedly spurious. What we know with certainty, however, is that his authentic works meant much for his own and after generations.
Constantine was born in the early part of the eleventh century, and died near its close, having lived probably well beyond eighty years of age, his years running nearly parallel with his century. His surname, Africanus, is derived from his having been born in Africa, his birthplace being Carthage. Early in life he seems to have taken up with ardor the study of medicine in his native town, devoting himself, however, at the same time to whatever of physical science was available. Like many another young man since his time, not satisfied with the knowledge he could secure at home, he made distant journeys, gathering medical and scientific information of all kinds wherever he went. According to a tradition that seems to be well grounded, some of these journeys took him even into the far East. During his travels he became familiar with a number of Oriental languages, and especially studied the Arabian literature of science very diligently.
At this time the Arabs, having the advantage of more intimate contact with the Greek medical traditions in Asia Minor, were farther advanced in their knowledge of the medical sciences than the scholars in the West. They had better facilities for obtaining the books that were the classics of medicine, and, with any desire for knowledge, could scarcely fail to secure it.
What was best in Arabian medicine was brought to Salerno by Constantine and, above all, his translation of many well-known Arabian medical authors proved eminently suggestive to seriously investigat