History of Medicine

Havingvoluntarilyundertaken theeducationof the young in all branches of learning, themonasterieswere aided in their endeavours by bothChurch and State. The foundation of stateschoolsis the work ofCharlemagne(768-814), whose activity, especially in the Germanic countries, was stimulated by thedecreeof the Synod ofAachen(789), that eachmonasteryand eachcathedralchapter should institute aschool. According to the Capitulary ofCharlemagneat Diedenhofen (Thionville) in 806, medicine was commonly taught in theseschools. At theinReims, we find Gerbert dAurillac, laterPope Sylvester II(999-1003), long active as a teacher of medicine. Simultaneously with the rise of the cities there sprang up higher municipalschools, as for instance theBurgerschuleat St. Stephans inVienna(about 1237). Out of the secular and religiousschools, the curriculum of which institutions comprised the entire learning of the times, the firstuniversitiesdeveloped themselves partly under imperial and partly underpapalprotection, according as they sprang from the lay and thecathedralor.School of Salerno

One of the opponents of humoral pathology was Asclepiades of Prusa in Bithynia (born about 124 B.C.). He tried to use in medicine theatomistic theoryofEpicurusand Heracleides ofPontus. He taught that health and disease depend upon the motion of theatomsin the fine capillaries or pores, which, endowed with sensation, pass through the entire body. With Themison as their leader, the followers of Asclepiades simplified hisdoctrineby supposing disease to be only a contraction or relaxation, and later only a mixed condition (partly contracted, partly relaxed) of the pores. This simple and convenient explanation of all diseases without regard toanatomyand physiology, taken in conjunction with its allied system of physical dietetic therapeutics, explains why thisdoctrineenjoyed so long a life, and why the works of the methodist, Caelius Aurelianus of Sicca in Numidia (beginning of fifth century A.D.), were diligently studied down to the seventh century.Galen

In their endeavour to complete thedoctrineof their great master, the successors of the Hippocratics fell victims to the snares of speculation. In spite of this, we owe to this so-called dogmaticschoolsome fruitful investigation. Diocles Carystius advanced theknowledgeofanatomy, and tried to fathom the causal connection between symptom and disease, in which endeavours he was imitated by Praxagoras of Cos, who established the diagnostic importance of the pulse.

Departure from the Hippocratic observation of nature led physicians to form numerous mutually opposingsects. A man of great industry and comprehensiveknowledge, Galen ofPergamum(about A.D. 130-201), tried to rescue medicalsciencefrom thislabyrinth. He chose the path ofeclecticism, on which he built his (as he thought) infallible system. Whatever sense-perception and clinical observation left obscure, he tried to explain in a speculative manner. That this system of teaching could hold medicine in bondage until modern times shows the genius of the master, who understood how to cover up the gaps by brilliancy of style. Galen took the entire anatomicalknowledgeof his time, and out of it produced a work the substance of which was for centuries regarded as inviolable. Hisanatomywas to a large extent based upon the dissection of mammals, especially of monkeys, and, like his physiology, was underteleologicalinfluence. His presentation of things lacks dispassionateness. Instead of explaining the functions of organs on the basis of their structure, Galen chose this reverse method. Hisanatomyand physiology were the most vulnerable part of his system, and an earnest re-examination of these fields must necessarily have shaken his entire scheme of teaching. Galen expressed the greatest respect for Hippocrates, published his most important works with explanatory notes, but never entered into the spirit of theschoolof Cos, although he adopted many of its doctrines. Galen is the culminating point and end of ancient Greek medicalscience. In his vanity he thought he had completed all investigation, and that his successors had only to accept without effort what he had discovered. As will be shown in the following paragraph, his advice was, unfortunately forscience, followed literally.Pedanius Dioscurides

The history of medicalscience, considered as a part of the general history of civilization, shouldlogicallybegin in Mesopotamia, where tradition and philological investigation placed the cradle of thehuman race. But, in a condensed article such as this, there are important reasons which dictate the choice of another starting point. Modern medicalsciencerests upon a Greek foundation, and whatever other civilized peoples may have accomplished in this field lies outside our inquiry. It iscertainthat the Greeks brought much with them from their original home, and also that they learned a great deal from their intercourse with other civilized countries, especiallyEgyptandIndia; but the Greek mind assimilatedknowledgein such a fashion that its origin can rarely be recognized.Mythical, Homeric, and pre-Hippocratic times

In Byzantine times medicine shows but little originality, and is of small importance in the history of medical development. The work handed down to us are all compilations, but as they frequently contain excerpts from lost works they are of some historical value. The notable writers of this period are: Oreibasios (325-403), physician in ordinary toJulian the Apostate; and Atius ofAmida, aChristianphysician underJustinian(597-66). A little more originality than these men exhibited was shown by Alexander ofTralles(525-605), and Paulus gineta of the first half of the seventh century, of whose seven books, the sixth, dealing with surgery, was greatly valued inArabianmedicine. Paulus lived at Alexandria, and was one of the last to come from its once famousschool, which became extinct after the capture of the city by Omar in 640. At the end of the thirteenth century Nicolaus Myrepsus, living at the court inNicaea, made a collection of prescriptions which was extensively used. In the time of Emperor Andronicus III (1328-42) lived a highly gifted physician, Joannes Actuarius, and the mention of his writings closes the account of this period.Arabian medicine

The desire to give to medicine ascientificbasis found rich nourishment in the ancient civilized soil ofEgyptunder the Ptolemies. Herophilus of Chalcedon (about 300 B.C.) and Erasistratus of Iulis (about 330-240 B.C.) are mentioned in this connection. Asanatomists, they were the first systematic investigators, and, following Hippocrates, they tried to complete clinical experience by exact methods. This tendency was opposed by the empires, whose services lay solely in the field of drugs and toxicology. Erasistratus as well as Philinus, the empiric, attacked thedoctrineof humors (humoral pathology), which developed out of the Hippocratic tendency. The former alone was a serious opponent since, as an anatomist, he looked for the seat of the disease in the solid parts, rather than in the four fundamental humors (blood, mucus, black and yellow gall) and their different mixtures.The methodizers

Pedanus Dioscurides, who was from Anazarbe and lived in the time ofNeroandVespasian, may be mentioned here as the most important pharmaceutical writer of ancient times. He simplified greatly the pharmacopoeia, which had then assumed unwieldy dimensions, and freed it from ridiculous,superstitiousremedies. Our modern pharmacology is based on his work,Ta ton tylikon biblia.Cornelius Celsus

How diligently medicine was studied in themonasteriesis shown by the numerousmanuscripts(many still unedited) in the oldand by those which were taken from the suppressedmonasteriesand are now to be found in the nationallibrariesof various countries.Priestswho possessed aknowledgeof medicine served as physicians-in-ordinary to princes as late as the fifteenth century, although they were forbidden to practice surgery by theFourth Synod of the Lateran(1213). Thus, Master Gerhard,in Felling, who founded theHospitalof the Holy Ghost atVienna(1211), was physician-in-ordinary to Duke Leopold VI ofAustria, andSigismund Albicus, who afterward becameArchbishopofPrague(1411), held the same office at the court of King Wenzel ofBohemia(1391-1411). From this time, we constantly meet withpriestspossessing aknowledgeof medicine and writing on medical subjects. Thepopes, the most important patrons of all thesciences, were friendly also to the development of medicine. That they ever at any time forbade the practice of anatomical investigation is a fable.Pope Boniface VIIIin 1299-1300 forbade the practice then prevalent of boiling the corpses of noblepersonswho had died abroad, in order that their bones might be more conveniently transported to the distant ancestraltomb. This prohibitory rule had reference only to cases of death inChristiancountries, while in the Orient (e.g. during theCrusades) the usage seems to have been tacitly allowed to continue.First universities in the west

Of the surgical authors, Abul Kasim Chalaf ben Abbas el-Zahrewi of el-Zahra near Cordova (Abulkasem, about 912-1013) alone deserves mention, and he depends absolutely on Paulus gineta. While he received scant attention at home, since surgery was little cultivated by theArabs, his work, written in a clear and perspicuous style, became known in the West through the Latin translation byGerardus of Cremona(1187), and was extensively used even in later days. Arabian medicine reached its culmination with thePersianAbu Ali el-Hosein ben Abdallah Ibn Sina (Avicenna, 980-1037), who based his system entirely upon the teaching of Galen and tried in various ways to supplement the latter. His chief work, El-Kann (Canon Medicinae), written in a brilliant style and treating all branches of medicalscience, soon supplanted in the West the works of the Greeks and, until the time of theHumanists, served as the most important textbook for physicians, but in ArabianSpainhis fame was small. One of his chief rivals was Abu-Merwan Abd el-Malik ben Abul-Ala Zohr ben Abd el-Malik Ibn Zohr (Avenzoar, 1113-62) from the neighbourhood of Seville. His friend, thephilosopherand physician Abul-Welid Muhammed ben-Ahmed Ibn Roshd el-Maliki (Averros, 1126 -98), ofCordova, is regarded as the complement ofAvicenna. His book was also popular in the West and bears the title Kitbel-Kolijjat (Colliget). With the decline ofArabianrule began the decay of medicine. In the Orient this decline began after the capture ofCordovain 1236, decay becoming complete after the loss ofGranadain 1492. The predominance ofArabianmedicine, which lasted scarcely three centuries, seriously delayed the development of ourscience. A brief survey of this period shows that theArabsbent in slavish reverence before the works ofAristotleand Galen without examining them critically. No other Greek physician obtained such a hold on theArabsas Galen, whose system, perfect in form, pleased them inphilosophy. Nowhere did dialectics play a greater part in medicine than among theArabsand their later followers in the West. Independent investigation in the fields of exactscienceanatomy, and physiology was forbidden by thelawsof theKoran. Symptomatology (semiotics) at the bedside, especially prognosis, based on the pulse and the of the urine, were developed by them with an equally exaggerated and fruitless subtlety. Much, and perhaps the only credit due to them is in the field of pharmaceutics. We are indebted to them for a series of simple and compound drugs of oriental and Indian origin, previously unknown, and also for the polypharmacy of later times. Until the discovery of America theVenetiandrug-trade was controlled by Arabian dealers.Christianitys share in the development of medical science

Tradition knows seven physicians named Hippocrates, of whom the second is regarded as the most famous. Of his life weknowbut little. He was born at Cos in 460 or 459 B.C., and died atLarissaabout 379. How great his fame was during his lifetime is shown by the fact thatPlatocompares him with theartistsPolycletus and Phidias. Later he was called the Great or the Divine. The historical kernel is probably as follows: a famous physician of this name from Cos flourished in the days of Pericles, and subsequently many things, which his ancestors or his descendants or hisschoolaccomplished, were attributed to him as the hero of medicalscience. The same wastrueof his writings. What is now known under the title of Hippocratis Opera represents the work, not of anindividual, but of severalpersonsof different periods and of differentschools. It has thus become customary to designate the writings ascribed to Hippocrates by the general title of the Hippocratic Collection (Corpus Hippocraticum), and to divide them according to their origin into the works of theschoolsof Cnidus and of Cos, and of theSophists. How difficult it is, however, to determine theirgenuinenessis shown that even in the third century before Christ the Alexandrian librarians, who for the first time collected the anonymous scrolls scattered through Hellas, could not reach a definite conclusion. For the development of medicalscienceit is of little consequence who composed the works of theschoolof Cos for they are more or less permeated by the spirit of one great master. The secret of hisimmortalityrests on the fact that he pointed out the means whereby medicine became ascience. His first rule was the observation of individual patients, individualizing in contradistinction to the schematizing of theschoolof Cnidus. By the observation of all the principles were gradually derived from experience, and these, uniformly arranged, led byinductionto aknowledgeof thenatureof the disease, its course, and its treatment. This is the origin of the famous Aphorismi, short rules which contain at times principles derived from experience and at times conclusions drawn from the same source. They form the valuable part of the collection. Theschoolof Cos and its adherents, the Hippocratics, looked upon medicalsciencefrom a purely practical standpoint; they regarded it as the art of healing the sick, and therefore laid most stress on prognosis and treatment by aiding the powers of nature through dietetic means, while the wholeschoolof Cnidus prided itself upon its scientific diagnosis and, in harmony with money with the East, adopted a varied medicinal treatment. The method which theschoolof Cos established more than 2000 years ago has proved to be the only one, and thus Hippocratic medialsciencecelebrated its renascence in the eighteenth century with Boerhaave at Leyden and subsequently with Gerhard van Swieten atVienna. In his endeavour to thetruththe earnest investigation often reaches an impassable barrier. There is nothing more tempting than to seek an outlet by means of reflection anddeduction. Such a delusive course may easily become fatal to thephysicist; but a medical system, erected upon the results of speculative investigation, carries the germ of death within itself.The dogmatic school

Cornelius Celsus (about 25-30 B.C. to A.D. 45-50) is the only Roman who worked with distinction in the medical field, but it isdoubtfulwhether he was a physician. His work, De re medica libri viii, which is written in classical Latin, and for which he used seventy-two works lost to posterity, gives a survey of medicalsciencefrom Hippocrates to imperial times. Very famous is his description lithotomy. Celsus was altogether forgotten until the fifteenth century, whenPope Nicholas V(1447-55) is said to have discovered amanuscriptof his works.Byzantine period

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This is regarded as the oldest medicalschoolof the West.Salernoon the Tyrrhenian Sea, originally probably a Doric colony, was from the sixth to the eleventh century under the rule of theLombards, and from 1075 to 1130 under that of the Normans. In 1130 it became a part of theKingdom of NaplesandSicily. The origin of theschoolis obscure, but, contrary to formerbelief, it was not a religious foundation, though very manypriestswere engaged there as teachers of medicine.Womenand evenJewswere admitted to these studies.Salernowas destined to cultivate for a long time Greek medicalsciencein undimmed purity, until the twelfth century saw theschoolfall a victim to the all-powerfulArabinfluence. One of its oldest physicians was Alpuhans, later (1058-85)ArchbishopofSalerno. With him worked the Lombard Gariopontus (d. 1050), whose Passionarius is based upon Hippocrates, Galen, and Caelius Aurelianus. Contemporary with him was thefemalephysician Trotula who worked also in the literary field, and who is said to have been the wife of the physician Joannes Platearius. Perhaps the best known literary work of thisschoolis the anonymous Regimen sanitatis Salernitanum a didactic poem consisting of 364 stanzas, which has been translated into all modern languages. It is said to have been dedicated to Prince Robert, son ofWilliam the Conqueror, upon his departure from S.Salernoin 1101. An important change in theintellectualtendency of the Civitas Hippocratica, as thisschoolcalled itself, was brought about by the physician Constantine of Carthage (Constantinus Africanus), a man learned in the Oriental languages and a teacher of medicine atSalerno, who died in 1087 amonkofMonte Cassino. While hitherto the best works of Greek antiquity had been known only in mediocre Latin translations, Constantine in the solitude ofMonte Cassinobegan to translate to translate from the Arabic, Greek authors (e.g. the Aphorisms of Hippocrates and the Ars parva of Galen), as well as such Arabic writer as were accessible to him (Isaak, Ali Abbas). As he brought to theknowledgeof his contemporaries first-class Greek authors, but only secondaryArabwriters, the study of the former became more profound, while on the other hand an interest was awakened in the hitherto unknown Arabic literature. His pupils were Bartholomaeus, whose Practica was translated into German as early as the thirteenth century, and Johannes Afflacius (De febribus et urinis). To the twelfth century, when Arabian polypharmacy was introduced, belong Nicolaus Praepositus (about 1140), whose Antidotarium, a collection of compounded pharmaceutical formulae, became a model for later works of this kind, and Matthaeus Platearius, who, towards the end of the century, wrote a commentary on the above-named Antidotarium (Glossae) and a work about simple drugs (Circa instans). Similar productions appeared from the hand of an otherwise unknownMagister Solernitanus. Maurus, following Arabian sources, wrote on uroscopy. Here must be also mentioned Petrus Musandinus (De cibis et potibus febricitantium), the teacher of Pierre Giles of Corbeil (gidius Corboliensis), who later became a canon and the physician-in-ordinary toPhilip Augustus of France(1180-1223), and who even at this day began to complain about the decay of theschool.

Greek medicalscience, like that of all civilized peoples, shows in the beginning a purely theurgical character. Apollo is regarded as the founder of medicalscience, and, in post-Homeric times, his son sculapius (in Homer, a Thessalian prince) is represented, as the deity whose office it is to bring about mans restoration to health by means of healing oracles. His oldest place of worship was atTriccain Thessaly. Thetemplesof sculapius, of which those at Epidaurus and Cos are the best known, were situated in a healthy neighbourhood. The sickpilgrimswent thither that, after a long preparation ofprayerfastingand ablutions, they might, through of mediation of thepriests, receive in their dreams the healing oracles. This kind of medicalsciencealready shows a rational basis, for thepriestsinterpreted the dreams and prescribed a suitable treatment, in most cases purely dietetic. Important records of sicknesses were made and left as votive-tablets in thetemples. Side by side with thepriestlycaste, and perhaps out of it there arose the order of temple physicians, who, as supposed descendants of the god sculapius, were known as theAsclepiadae, and formed a kind of guild or corporation. This separation of offices must have occurred at an early time, for even in Homer we find lay physicians mentioned, especially the sons of seulapius, Machaon and Podalirius. In the vegetable drugs ofEgyptianorigin mentioned in Homer we recognize the early influence of the country of thePharaohsupon Greek medicalscience. Theschoolsof thephilosopherslikewise exerted no small influence upon development, medical problems being studied by Pythagoras ofSamos, Alcmaeon of Crotona, Parmenides of Elea, Heraclitus of Ephesus (sixth century B.C.), Empedocles of Agrigentum, and Anaxagoras ofClazomenae(fifth century B.C.). The earliest medicalschoolswere atCyrenein Northern Africa, Crotona, Cnidus and Cos. From Cnidus came Euryphon and also Ctesias the geographer, who was at first physician in the army of Cyrus and, after the battle of Cunaxa (401 B.C.), to Artaxerxes Memnon. Of greater interest is the medicalschooladjoining the shrine of seulapius at Cos, for from it arose the man who first placed medicine upon a scientific basis, and whose name is even today well known to all physicians, Hippocrates.Hippocrates and the so-calledCorpus Hippocraticum

Its focus was the city of Toledo, which was taken from theMoorsin 1085 by Alfonso VI ofCastileandLeon. Here Archbishop Raimund (1130-50) founded an institution for translations, in which Jewish scholars were the chief workers. Here livedGerard of Cremona(1114-87, properly Carmo

Its first misfortune dates from the death of King Roger III (1193), when the army ofKing Henry VIcaptured the city. The establishment of the University ofNaplesbyFrederick IIin 1224, the preponderance ofArabianinfluence, and the rise of the Montpellierschool, all exerted so unfavourable an influence that by the fourteenth centurySalernowas well-nigh forgotten.Salernois the oldestschoolhaving a curriculum prescribed by the state. In 1140 King Roger II ordered a state examination to test the proficiency of prospective physicians, andFrederick IIin 1240 prescribed five years of study besides a year of practical experience. When we consider the proximity of Northern Africa, that the neighbouringSicilyhad been underSaracenicrule from the ninth to the eleventh century, and that the Norman kings, and to a far greater degreeFrederick II, gave powerful protection to Arabian art andscience, it seems wonderful that this oasis of Graeco-Roman culture endured so long. Down to the twelfth century thisschoolwas ruled by a purely Hippocratic spirit, especially in practical medicine, by its diagnosis and by the treatment of acute diseases dietetically. Arabian influence makes itself felt first of all in therapeutics, a fact which is easily explained by the proximity ofAmalfi, where the Arabian drug-dealers used to land. Local conditions (resulting from theCrusades) explain how surgery, especially the treatment of wounds received inwar, was diligently cultivated. In Rogerius we find a Salernitan surgeon armed with independent experience, but showing, nevertheless, reminiscences of Abulhasem. His Practica Chirurgiae dates from the year 1180. AlthoughSalernofinally succumbed to Arabian influences, thisschooldid not hand down to us aknowledgeof the best Arabian authors.Spain as the transmitter of Arabian medicine

Unfortunately, there already began withAristotle(38-22 B.C.) that tendency later rendered so fatal through Galens teaching to regard organic structure and function not in accordance with facts but from theteleologicalstandpoint.The Alexandrian period

Arabian medicalscienceforms an important chapter in the history of the development of medicine, not because it was especially productive but because it preserved Greek medicalsciencewith that of its most important representative Galen. It was, however, strongly influenced by oriental elements of later times. The adherents of the, who in 431 settled inEdessa, were the teachers of theArabs. After the expulsion theseNestorianssettled in Dschondisapor in 489, and there founded a medicalschool. After the conquest ofPersiaby theArabsin 650, Greek culture was held in great esteem, and learnedNestorianJewish, and even Indian physicians worked diligently as translators of the Greek writings. In ArabianSpainconditions similarly developed from the seventh century. Among important physicians in the first period of Greek-Arabic medicine the period of dependence and of translations come first theBachtischua ofSyria, which flourished until the eleventh century; Abu Zakerijja Jahja ben Maseweih (d. 875), known as Joannes Damascenus, Mesue the Elder, aChristianwho was a director of thehospitalatBagdad, did independent work, and supervised the translation of Greek authors, Abu Jusuf Jacub ben Ishak ben el-Subbah el-Kindi (Alkindus, 813-73), who wrote a work about compound drugs, and theNestorianAbu Zeid Honein ben Ishak ben Soliman ben Ejjub el Ibadi (Joannitius, 809-about 873), a teacher in Baghdad who translated Hippocrates and Dioscurides, and whose work Isagoge in artem parvam Galeni, early translated into Latin, was much read in theMiddle Ages. Wide activity and independent observation based, however, wholly upon thedoctrineof Galen were shown by Abu Bekr Muhammed ben Zakarijia er-Razi (Rhazes, about 850-923), whose chief work, however, El-Hawi fil Tib (Continens) is a rather unsystematic compilation. In theMiddle Ageshis Ketaab altib Almansuri (Liber medicinalis Almansoris) was well known and had many commentators. The most valuable of the thirty-six productions of Rhazes which have come down to us is De variolis et morbillis, a book based upon personal experience. We ought also to mention the dietetic writer Abu Jakub Ishak ben Soleiman el-Israili (Isaac Judaeus, 830-about 932), an; the Persian, Ali ben el Abbas Ala ed-Din el-Madschhusi (Ali Abbas, d. 994) author of El-Maliki (Regalis dispositio, Pantegnum). Abu Dshafer Ahmed ben Ibrahim ben Abu Chalid Ihn el-Dshezzar (d. 1009) wrote about the causes of the plague inEgypt. A work on pharmaceutics was written by the physician in ordinary to the Spanish Caliph Hisham II (976-1013), Abu Daut Soleiman ben Hassan Ibn Dsholdschholl.

As long as the cruelpersecutiontheChurchlasted throughout the Roman Empire, it was impossible forChristiansto take direct part in the development of medicalscience. But provision had been made for medical aid within the community, because thepriest, like therabbiof small Jewish communities in the lateMiddle Ages, was also a physician. This is clear from the story of the two brothers, Sts. Cosmas and Damian, who studied medicine inSyriaand weremartyredunderDiocletian. The exercise of practical charity under the direction ofdeaconsof the churches gave rise to systematic nursing andhospitals. In recent times it has, indeed been alleged that the existence ofhospitalsamong theBuddhists, even in the third century before Christ, and their existence in ancient Mexico at the time of its discovery is demonstrable, and thathospitalshad their origin in general philanthropy; but nobody denies that the nursing of the sick, especially during epidemics, had never before been so widespread, so well organized, so self-sacrificing as in the earlyChristiancommunities.Christianitytended the sick and devised and executed extensive schemes for the care of deserted children (foundling,orphans), of the feeble and infirm, of those out of work and ofpilgrims. The era ofpersecutionended, we find large alms-houses andhospitalslike that ofSt. Basilius in Caesarea(370), those of the Roman Lady Fabiola inRomeandOstia(400), that ofSt. Samsonadjoining thechurchof St. Sofia in Constantinople in the sixth century, thefoundling asylumof Archbishop Datheus ofMilanin 787, and many others. In 1198Pope Innocent IIIrebuilt thepilgrimsshelter, which had been founded in 726 by aBritishking, but had been repeatedly destroyed by fire. He turned it into a refuge for travellers and ahospital, and entrusted it to the Brothers of the Holy Ghost established by Guy de Montpellier. Mention must also be made here of thereligiousorders ofknightsand the houses forlepersof later times. The greathospitalsof theArabsin Dschondisapor and Bagdad were built afterChristianmodels. The celebratedecclesiasticalwriterTertullian(born A.D. 160) possessed a wideknowledgeof medicine, which, following the custom of his time, he calls a sister ofphilosophyClement of Alexandria, about the middle of the century, lays down valuable hygieniclawsin hisPaedagogusLactantiusin the fourth century speaks in his work De Opificio Dei about the structure of the human body. One of the most learnedpriestsof his time,St. Isidore of Seville(d. 636), treats of medicine in the fourth book of his Origines S. Etymologiae.St. Benedict of Nursia(480) made it adutyfor thesciences, and among them medicine, as aids to the exercise ofhospitalityCassiodorusgave hismonksdirect instructions in the study in medicine. Bertharius,AbbotofMonte Cassinoin the ninth century, was famous as a physician. Walafrid Strabo (d. 849),AbbotofReichenauthe oldest medical writer on German soil, describes in a poem (Hortulus) the value of native medicinal plants, and also the method of teaching medicine inmonasteries. We must mention, furthermore, the Physica, a description of drugs from the three kingdoms of nature, written bySt. Hildegarde(1099-1179),abbessof amonasterynear Bingen-on-the-Rhine. The curative properties of minerals are described byMarbodus of AngersBishopofRennes(d. 1123), in his Lapidarius.

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