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cation on what had been the highest development of Roman civilization.
The influence of the Arabs on Western civilization, and especially on the development of science in Europe, has been much exaggerated by certain writers. Closely in touch with Greek thought and Greek literature during the eighth, ninth, and tenth centuries, it is easy to understand that the Arabian writers were far ahead of the Christian scholars of Europe of the same period, who were struggling up out of the practical chaos that had been created by the coming of the barbarians, and who, besides, had the chance for whatever Greek learning came to them only through the secondary channels of the Latin writers. Rome had been too occupied with politics and aggrandizement ever to become cultured. In spite of this heritage from the Greeks, decadence took place among the Arabs, and, as the centuries go on, what they do becomes more and more trivial, and their writing has less significance. Just the opposite happened in Europe. There, there was noteworthy progressive development until the magnificent climax of thirteenth century accomplishment was reached. It is often said that Europe owed much to the Arabs for this, but careful analysis of the factors in that progress shows that very little came from the Arabs that was good, while not a little that was unfortunate in its influence was borrowed from them with the translations of the Greek authors from that language, which constituted the main, indeed often the only, reason why Arabian writers were consulted.
With the foundation of the medical school of
Salerno in the tenth century, the modern history of medical education may be said to begin, for it had many of the features that distinguish our modern university medical schools. Its professors often came from a distance and had travelled extensively for purposes of study; they attracted patients of high rank from nearly every part of Europe, and these were generous in their patronage of the school. Students came from all over, from Africa and Asia, as well as Europe, and when abuses of medical practice began to creep in, a series of laws were made creating a standard of medical education and regulating the practice of medicine, that are interesting anticipations of modern movements of the same kind. Finally a law was passed requiring three years of preliminary work in logic and philosophy before medicine might be taken up, and then four years at medicine, with a subsequent year of practice with a physician before a license to practise for one's self was issued. In addition to this there was a still more surprising feature in the handing over of the department of women's diseases to women professors, and the consequent opening up of licensure to practise medicine to a great many women in the southern part of Italy. The surprise that all this should have taken place in the south of Italy is lessened by recalling the fact that the lower end of the Italian peninsula had been early colonized by Greeks, that its name in later times was Magna Græcia, and that the stimulus of Greek tradition has always been especially favorable to the development of scientific medicine.
Salerno's influence on Bologna is not difficult to trace, and the precious tradition of surgery particularly, which was carried to the northern university, served to initiate a period of surgery lasting nearly two centuries, during which we have some of the greatest contributions to this branch of medical science that were ever made. The development of the medical school at Bologna anticipated by but a short time that of a series of schools in the north Italian universities. Padua, Piacenza, Pisa, and Vicenza had medical schools in the later Middle Ages, the works of some of whose professors have attracted attention. It was from these north Italian medical schools that the tradition of close observation in medicine and of thoroughly scientific surgery found its way to Paris. Lanfranc was the carrier of surgery, and many French students who went to Italy came back with Italian methods. In the fourteenth century Guy de Chauliac made the grand tour in Italy, and then came back to write a text-book of surgery that is one of the monuments in this department of medical science. Before his time, Montpellier had attracted attention, but now it came to be looked upon as a recognized centre of great medical teaching. The absence of the Popes from Italy and the influence of their presence at Avignon made itself felt. While culture and education declined in Italy in the midst of political disturbances, they advanced materially at the south of France.
For our generation undoubtedly the most interesting chapter in the history of medieval medicine is that which tells of the marvellous development of surgery that took place in the thirteenth and fourteenth centuries. Considerable space has been devoted to this, because it represents not only an important phase of the history of medicine, and recalls the names and careers of great makers of medicine, but also because it illustrates exquisitely the possibility of important discoveries in medicine being made, applied successfully for years, and then being lost or completely forgotten, though contained in important medical books that were always available for study. The more we know of this great period in the history of surgery, the more is the surprise at how much was accomplished, and how many details of our modern surgery were anticipated. Most of us have had some inkling of the fact that anæsthesia is not new, and that at various times in the world's history men have invented methods of producing states of sensibility in which more or less painless operations were possible. Very few of us have realized, however, the perfection to which anæsthesia was developed, and the possibility this provided for the great surgeons of the later medieval centuries to do operations in all the great cavities of the body, the skull, the thorax, and the abdomen, quite as they are done in our own time and apparently with no little degree of success.
Of course, any such extensive surgical intervention even for serious affections would have been worse than useless under the septic conditions that would surely have prevailed if certain principles of antisepsis were not applied. Until comparatively recent years we have been quite confident in our assurance that antisepsis and asepsis were entirely modern developments of surgery. More knowledge, however, of the history of surgery has given a serious set-back to this self-complacency, and now we know that the later medieval surgeons understood practical antisepsis very well, and applied it successfully. They used strong wine as a dressing for their wounds, insisted on keeping them clean, and not allowing any extraneous material of any kind, ointments or the like, to be used on them. As a consequence they were able to secure excellent results in the healing of wounds, and they were inclined to boast of the fact that their incisions healed by first intention and that, indeed, the scar left after them was scarcely noticeable. We know that wine would make a good antiseptic dressing, but until we actually read the reports of the results obtained by these old surgeons, we had no idea that it could be used to such excellent purpose. Antisepsis, like anæsthesia, was marvellously anticipated by the surgical forefathers of the medieval period.
It has always seemed to me that the story of Medieval Dentistry presented an even better illustration of a great anticipatory development of surgery. This department represents only a small surgical specialty, but one which even at that period was given over to specialists, who were called dentatores. Guy de Chauliac's review of the dentistry of his time and the state of the specialty, as pictured by John of Arcoli, is likely to be particularly interesting, because if there is any department of medical practice that we are sure is comparatively recent in origin, it is dentistry. Here, however, we find that practically all our dental manipulations,