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gone numb with cold. Now, he thought, do it now, or die.

source:Bright and aboveboardedit:healthtime:2023-12-07 04:10:15

II. MEDIAEVAL SCIENCE AMONG THE ARABIANS The successors of Mohammed showed themselves curiously receptive of the ideas of the western people whom they conquered. They came in contact with the Greeks in western Asia and in Egypt, and, as has been said, became their virtual successors in carrying forward the torch of learning. It must not be inferred, however, that the Arabian scholars, as a class, were comparable to their predecessors in creative genius. On the contrary, they retained much of the conservative oriental spirit. They were under the spell of tradition, and, in the main, what they accepted from the Greeks they regarded as almost final in its teaching. There were, however, a few notable exceptions among their men of science, and to these must be ascribed several discoveries of some importance. The chief subjects that excited the interest and exercised the ingenuity of the Arabian scholars were astronomy, mathematics, and medicine. The practical phases of all these subjects were given particular attention. Thus it is well known that our so-called Arabian numerals date from this period. The revolutionary effect of these characters, as applied to practical mathematics, can hardly be overestimated; but it is generally considered, and in fact was admitted by the Arabs themselves, that these numerals were really borrowed from the Hindoos, with whom the Arabs came in contact on the east. Certain of the Hindoo alphabets, notably that of the Battaks of Sumatra, give us clews to the originals of the numerals. It does not seem certain, however, that the Hindoos employed these characters according to the decimal system, which is the prime element of their importance. Knowledge is not forthcoming as to just when or by whom such application was made. If this was an Arabic innovation, it was perhaps the most important one with which that nation is to be credited. Another mathematical improvement was the introduction into trigonometry of the sine--the half-chord of the double arc--instead of the chord of the arc itself which the Greek astronomers had employed. This improvement was due to the famous Albategnius, whose work in other fields we shall examine in a moment. Another evidence of practicality was shown in the Arabian method of attempting to advance upon Eratosthenes' measurement of the earth. Instead of trusting to the measurement of angles, the Arabs decided to measure directly a degree of the earth's surface--or rather two degrees. Selecting a level plain in Mesopotamia for the experiment, one party of the surveyors progressed northward, another party southward, from a given point to the distance of one degree of arc, as determined by astronomical observations. The result found was fifty-six miles for the northern degree, and fifty-six and two-third miles for the southern. Unfortunately, we do not know the precise length of the mile in question, and therefore cannot be assured as to the accuracy of the measurement. It is interesting to note, however, that the two degrees were found of unequal lengths, suggesting that the earth is not a perfect sphere--a suggestion the validity of which was not to be put to the test of conclusive measurements until about the close of the eighteenth century. The Arab measurement was made in the time of Caliph Abdallah al-Mamun, the son of the famous Harun-al-Rashid. Both father and son were famous for their interest in science. Harun-al-Rashid was, it will be recalled, the friend of Charlemagne. It is said that he sent that ruler, as a token of friendship, a marvellous clock which let fall a metal ball to mark the hours. This mechanism, which is alleged to have excited great wonder in the West, furnishes yet another instance of Arabian practicality. Perhaps the greatest of the Arabian astronomers was Mohammed ben Jabir Albategnius, or El-batani, who was born at Batan, in Mesopotamia, about the year 850 A.D., and died in 929. Albategnius was a student of the Ptolemaic astronomy, but he was also a practical observer. He made the important discovery of the motion of the solar apogee. That is to say, he found that the position of the sun among the stars, at the time of its greatest distance from the earth, was not what it had been in the time of Ptolemy. The Greek astronomer placed the sun in longitude 65 degrees, but Albategnius found it in longitude 82 degrees, a distance too great to be accounted for by inaccuracy of measurement. The modern inference from this observation is that the solar system is moving through space; but of course this inference could not well be drawn while the earth was regarded as the fixed centre of the universe. In the eleventh century another Arabian discoverer, Arzachel, observing the sun to be less advanced than Albategnius had found it, inferred incorrectly that the sun had receded in the mean time. The modern explanation of this observation is that the measurement of Albategnius was somewhat in error, since we know that the sun's motion is steadily progressive. Arzachel, however, accepting the measurement of his predecessor, drew the false inference of an oscillatory motion of the stars, the idea of the motion of the solar system not being permissible. This assumed phenomenon, which really has no existence in point of fact, was named the "trepidation of the fixed stars," and was for centuries accepted as an actual phenomenon. Arzachel explained this supposed phenomenon by assuming that the equinoctial points, or the points of intersection of the equator and the ecliptic, revolve in circles of eight degrees' radius. The first points of Aries and Libra were supposed to describe the circumference of these circles in about eight hundred years. All of which illustrates how a difficult and false explanation may take the place of a simple and correct one. The observations of later generations have shown conclusively that the sun's shift of position is regularly progressive, hence that there is no "trepidation" of the stars and no revolution of the equinoctial points. If the Arabs were wrong as regards this supposed motion of the fixed stars, they made at least one correct observation as to the inequality of motion of the moon. Two inequalities of the motion of this body were already known. A third, called the moon's variation, was discovered by an Arabian astronomer who lived at Cairo and observed at Bagdad in 975, and who bore the formidable name of Mohammed Aboul Wefaal-Bouzdjani. The inequality of motion in question, in virtue of which the moon moves quickest when she is at new or full, and slowest at the first and third quarter, was rediscovered by Tycho Brahe six centuries later; a fact which in itself evidences the neglect of the Arabian astronomer's discovery by his immediate successors. In the ninth and tenth centuries the Arabian city of Cordova, in Spain, was another important centre of scientific influence. There was a library of several hundred thousand volumes here, and a college where mathematics and astronomy were taught. Granada, Toledo, and Salamanca were also important centres, to which students flocked from western Europe. It was the proximity of these Arabian centres that stimulated the scientific interests of Alfonso X. of Castile, at whose instance the celebrated Alfonsine tables were constructed. A familiar story records that Alfonso, pondering the complications of the Ptolemaic cycles and epicycles, was led to remark that, had he been consulted at the time of creation, he could have suggested a much better and simpler plan for the universe. Some centuries were to elapse before Copernicus was to show that it was not the plan of the universe, but man's interpretation of it, that was at fault. Another royal personage who came under Arabian influence was Frederick II. of Sicily--the "Wonder of the World," as he was called by his contemporaries. The Almagest of Ptolemy was translated into Latin at his instance, being introduced to the Western world through this curious channel. At this time it became quite usual for the Italian and Spanish scholars to understand Arabic although they were totally ignorant of Greek. In the field of physical science one of the most important of the Arabian scientists was Alhazen. His work, published about the year 1100 A.D., had great celebrity throughout the mediaeval period. The original investigations of Alhazen had to do largely with optics. He made particular studies of the eye itself, and the names given by him to various parts of the eye, as the vitreous humor, the cornea, and the retina, are still retained by anatomists. It is known that Ptolemy had studied the refraction of light, and that he, in common with his immediate predecessors, was aware that atmospheric refraction affects the apparent position of stars near the horizon. Alhazen carried forward these studies, and was led through them to make the first recorded scientific estimate of the phenomena of twilight and of the height of the atmosphere. The persistence of a glow in the atmosphere after the sun has disappeared beneath the horizon is so familiar a phenomenon that the ancient philosophers seem not to have thought of it as requiring an explanation. Yet a moment's consideration makes it clear that, if light travels in straight lines and the rays of the sun were in no wise deflected, the complete darkness of night should instantly succeed to day when the sun passes below the horizon. That this sudden change does not occur, Alhazen explained as due to the reflection of light by the earth's atmosphere. Alhazen appears to have conceived the atmosphere as a sharply defined layer, and, assuming that twilight continues only so long as rays of the sun reflected from the outer surface of this layer can reach the spectator at any given point, he hit upon a means of measurement that seemed to solve the hitherto inscrutable problem as to the atmospheric depth. Like the measurements of Aristarchus and Eratosthenes, this calculation of Alhazen is simple enough in theory. Its defect consists largely in the difficulty of fixing its terms with precision, combined with the further fact that the rays of the sun, in taking the slanting course through the earth's atmosphere, are really deflected from a straight line in virtue of the constantly increasing density of the air near the earth's surface. Alhazen must have been aware of this latter fact, since it was known to the later Alexandrian astronomers, but he takes no account of it in the present measurement. The diagram will make the method of Alhazen clear. His important premises are two: first, the well-recognized fact that, when light is reflected from any surface, the angle of incidence is equal to the angle of reflection; and, second, the much more doubtful observation that twilight continues until such time as the sun, according to a simple calculation, is nineteen degrees below the horizon. Referring to the diagram, let the inner circle represent the earth's surface, the outer circle the limits of the atmosphere, C being the earth's centre, and RR radii of the earth. Then the observer at the point A will continue to receive the reflected rays of the sun until that body reaches the point S, which is, according to the hypothesis, nineteen degrees below the horizon line of the observer at A. This horizon line, being represented by AH, and the sun's ray by SM, the angle HMS is an angle of nineteen degrees. The complementary angle SMA is, obviously, an angle of (180-19) one hundred and sixty-one degrees. But since M is the reflecting surface and the angle of incidence equals the angle of reflection, the angle AMC is an angle of one-half of one hundred and sixty-one degrees, or eighty degrees and thirty minutes. Now this angle AMC, being known, the right-angled triangle MAC is easily resolved, since the side AC of that triangle, being the radius of the earth, is a known dimension. Resolution of this triangle gives us the length of the hypotenuse MC, and the difference between this and the radius (AC), or CD, is obviously the height of the atmosphere (h), which was the measurement desired. According to the calculation of Alhazen, this h, or the height of the atmosphere, represents from twenty to thirty miles. The modern computation extends this to about fifty miles. But, considering the various ambiguities that necessarily attended the experiment, the result was a remarkably close approximation to the truth. Turning from physics to chemistry, we find as perhaps the greatest Arabian name that of Geber, who taught in the College of Seville in the first half of the eighth century. The most important researches of this really remarkable experimenter had to do with the acids. The ancient world had had no knowledge of any acid more powerful than acetic. Geber, however, vastly increased the possibilities of chemical experiment by the discovery of sulphuric, nitric, and nitromuriatic acids. He made use also of the processes of sublimation and filtration, and his works describe the water bath and the chemical oven. Among the important chemicals which he first differentiated is oxide of mercury, and his studies of sulphur in its various compounds have peculiar interest. In particular is this true of his observation that, tinder certain conditions of oxidation, the weight of a metal was lessened. From the record of these studies in the fields of astronomy, physics, and chemistry, we turn to a somewhat extended survey of the Arabian advances in the field of medicine.

gone numb with cold. Now, he thought, do it now, or die.

ARABIAN MEDICINE The influence of Arabian physicians rested chiefly upon their use of drugs rather than upon anatomical knowledge. Like the mediaeval Christians, they looked with horror on dissection of the human body; yet there were always among them investigators who turned constantly to nature herself for hidden truths, and were ready to uphold the superiority of actual observation to mere reading. Thus the physician Abd el-Letif, while in Egypt, made careful studies of a mound of bones containing more than twenty thousand skeletons. While examining these bones he discovered that the lower jaw consists of a single bone, not of two, as had been taught by Galen. He also discovered several other important mistakes in Galenic anatomy, and was so impressed with his discoveries that he contemplated writing a work on anatomy which should correct the great classical authority's mistakes. It was the Arabs who invented the apothecary, and their pharmacopoeia, issued from the hospital at Gondisapor, and elaborated from time to time, formed the basis for Western pharmacopoeias. Just how many drugs originated with them, and how many were borrowed from the Hindoos, Jews, Syrians, and Persians, cannot be determined. It is certain, however, that through them various new and useful drugs, such as senna, aconite, rhubarb, camphor, and mercury, were handed down through the Middle Ages, and that they are responsible for the introduction of alcohol in the field of therapeutics. In mediaeval Europe, Arabian science came to be regarded with superstitious awe, and the works of certain Arabian physicians were exalted to a position above all the ancient writers. In modern times, however, there has been a reaction and a tendency to depreciation of their work. By some they are held to be mere copyists or translators of Greek books, and in no sense original investigators in medicine. Yet there can be little doubt that while the Arabians did copy and translate freely, they also originated and added considerably to medical knowledge. It is certain that in the time when Christian monarchs in western Europe were paying little attention to science or education, the caliphs and vizirs were encouraging physicians and philosophers, building schools, and erecting libraries and hospitals. They made at least a creditable effort to uphold and advance upon the scientific standards of an earlier age. The first distinguished Arabian physician was Harets ben Kaladah, who received his education in the Nestonian school at Gondisapor, about the beginning of the seventh century. Notwithstanding the fact that Harets was a Christian, he was chosen by Mohammed as his chief medical adviser, and recommended as such to his successor, the Caliph Abu Bekr. Thus, at the very outset, the science of medicine was divorced from religion among the Arabians; for if the prophet himself could employ the services of an unbeliever, surely others might follow his example. And that this example was followed is shown in the fact that many Christian physicians were raised to honorable positions by succeeding generations of Arabian monarchs. This broad-minded view of medicine taken by the Arabs undoubtedly assisted as much as any one single factor in upbuilding the science, just as the narrow and superstitious view taken by Western nations helped to destroy it. The education of the Arabians made it natural for them to associate medicine with the natural sciences, rather than with religion. An Arabian savant was supposed to be equally well educated in philosophy, jurisprudence, theology, mathematics, and medicine, and to practise law, theology, and medicine with equal skill upon occasion. It is easy to understand, therefore, why these religious fanatics were willing to employ unbelieving physicians, and their physicians themselves to turn to the scientific works of Hippocrates and Galen for medical instruction, rather than to religious works. Even Mohammed himself professed some knowledge of medicine, and often relied upon this knowledge in treating ailments rather than upon prayers or incantations. He is said, for example, to have recommended and applied the cautery in the case of a friend who, when suffering from angina, had sought his aid. The list of eminent Arabian physicians is too long to be given here, but some of them are of such importance in their influence upon later medicine that they cannot be entirely ignored. One of the first of these was Honain ben Isaac (809-873 A.D.), a Christian Arab of Bagdad. He made translations of the works of Hippocrates, and practised the art along the lines indicated by his teachings and those of Galen. He is considered the greatest translator of the ninth century and one of the greatest philosophers of that period. Another great Arabian physician, whose work was just beginning as Honain's was drawing to a close, was Rhazes (850-923 A.D.), who during his life was no less noted as a philosopher and musician than as a physician. He continued the work of Honain, and advanced therapeutics by introducing more extensive use of chemical remedies, such as mercurial ointments, sulphuric acid, and aqua vitae. He is also credited with being the first physician to describe small-pox and measles accurately. While Rhazes was still alive another Arabian, Haly Abbas (died about 994), was writing his famous encyclopaedia of medicine, called The Royal Book. But the names of all these great physicians have been considerably obscured by the reputation of Avicenna (980-1037), the Arabian "Prince of Physicians," the greatest name in Arabic medicine, and one of the most remarkable men in history. Leclerc says that "he was perhaps never surpassed by any man in brilliancy of intellect and indefatigable activity." His career was a most varied one. He was at all times a boisterous reveller, but whether flaunting gayly among the guests of an emir or biding in some obscure apothecary cellar, his work of philosophical writing was carried on steadily. When a friendly emir was in power, he taught and wrote and caroused at court; but between times, when some unfriendly ruler was supreme, he was hiding away obscurely, still pouring out his great mass of manuscripts. In this way his entire life was spent. By his extensive writings he revived and kept alive the best of the teachings of the Greek physicians, adding to them such observations as he had made in anatomy, physiology, and materia medica. Among his discoveries is that of the contagiousness of pulmonary tuberculosis. His works for several centuries continued to be looked upon as the highest standard by physicians, and he should undoubtedly be credited with having at least retarded the decline of mediaeval medicine. But it was not the Eastern Arabs alone who were active in the field of medicine. Cordova, the capital of the western caliphate, became also a great centre of learning and produced several great physicians. One of these, Albucasis (died in 1013 A.D.), is credited with having published the first illustrated work on surgery, this book being remarkable in still another way, in that it was also the first book, since classical times, written from the practical experience of the physician, and not a mere compilation of ancient authors. A century after Albucasis came the great physician Avenzoar (1113-1196), with whom he divides about equally the medical honors of the western caliphate. Among Avenzoar's discoveries was that of the cause of "itch"--a little parasite, "so small that he is hardly visible." The discovery of the cause of this common disease seems of minor importance now, but it is of interest in medical history because, had Avenzoar's discovery been remembered a hundred years ago, "itch struck in" could hardly have been considered the cause of three-fourths of all diseases, as it was by the famous Hahnemann. The illustrious pupil of Avenzoar, Averrhoes, who died in 1198 A.D., was the last of the great Arabian physicians who, by rational conception of medicine, attempted to stem the flood of superstition that was overwhelming medicine. For a time he succeeded; but at last the Moslem theologians prevailed, and he was degraded and banished to a town inhabited only by the despised Jews.

gone numb with cold. Now, he thought, do it now, or die.

ARABIAN HOSPITALS To early Christians belong the credit of having established the first charitable institutions for caring for the sick; but their efforts were soon eclipsed by both Eastern and Western Mohammedans. As early as the eighth century the Arabs had begun building hospitals, but the flourishing time of hospital building seems to have begun early in the tenth century. Lady Seidel, in 918 A.D., opened a hospital at Bagdad, endowed with an amount corresponding to about three hundred pounds sterling a month. Other similar hospitals were erected in the years immediately following, and in 977 the Emir Adad-adaula established an enormous institution with a staff of twenty-four medical officers. The great physician Rhazes is said to have selected the site for one of these hospitals by hanging pieces of meat in various places about the city, selecting the site near the place at which putrefaction was slowest in making its appearance. By the middle of the twelfth century there were something like sixty medical institutions in Bagdad alone, and these institutions were free to all patients and supported by official charity. The Emir Nureddin, about the year 1160, founded a great hospital at Damascus, as a thank-offering for his victories over the Crusaders. This great institution completely overshadowed all the earlier Moslem hospitals in size and in the completeness of its equipment. It was furnished with facilities for teaching, and was conducted for several centuries in a lavish manner, regardless of expense. But little over a century after its foundation the fame of its methods of treatment led to the establishment of a larger and still more luxurious institution--the Mansuri hospital at Cairo. It seems that a certain sultan, having been cured by medicines from the Damascene hospital, determined to build one of his own at Cairo which should eclipse even the great Damascene institution. In a single year (1283-1284) this hospital was begun and completed. No efforts were spared in hurrying on the good work, and no one was exempt from performing labor on the building if he chanced to pass one of the adjoining streets. It was the order of the sultan that any person passing near could be impressed into the work, and this order was carried out to the letter, noblemen and beggars alike being forced to lend a hand. Very naturally, the adjacent thoroughfares became unpopular and practically deserted, but still the holy work progressed rapidly and was shortly completed. This immense structure is said to have contained four courts, each having a fountain in the centre; lecture-halls, wards for isolating certain diseases, and a department that corresponded to the modern hospital's "out-patient" department. The yearly endowment amounted to something like the equivalent of one hundred and twenty-five thousand dollars. A novel feature was a hall where musicians played day and night, and another where story-tellers were employed, so that persons troubled with insomnia were amused and melancholiacs cheered. Those of a religious turn of mind could listen to readings of the Koran, conducted continuously by a staff of some fifty chaplains. Each patient on leaving the hospital received some gold pieces, that he need not be obliged to attempt hard labor at once. In considering the astonishing tales of these sumptuous Arabian institutions, it should be borne in mind that our accounts of them are, for the most part, from Mohammedan sources. Nevertheless, there can be little question that they were enormous institutions, far surpassing any similar institutions in western Europe. The so-called hospitals in the West were, at this time, branches of monasteries under supervision of the monks, and did not compare favorably with the Arabian hospitals. But while the medical science of the Mohammedans greatly overshadowed that of the Christians during this period, it did not completely obliterate it. About the year 1000 A.D. came into prominence the Christian medical school at Salerno, situated on the Italian coast, some thirty miles southeast of Naples. Just how long this school had been in existence, or by whom it was founded, cannot be determined, but its period of greatest influence was the eleventh, twelfth, and thirteenth centuries. The members of this school gradually adopted Arabic medicine, making use of many drugs from the Arabic pharmacopoeia, and this formed one of the stepping-stones to the introduction of Arabian medicine all through western Europe. It was not the adoption of Arabian medicines, however, that has made the school at Salerno famous both in rhyme and prose, but rather the fact that women there practised the healing art. Greatest among them was Trotula, who lived in the eleventh century, and whose learning is reputed to have equalled that of the greatest physicians of the day. She is accredited with a work on Diseases of Women, still extant, and many of her writings on general medical subjects were quoted through two succeeding centuries. If we may judge from these writings, she seemed to have had many excellent ideas as to the proper methods of treating diseases, but it is difficult to determine just which of the writings credited to her are in reality hers. Indeed, the uncertainty is even greater than this implies, for, according to some writers, "Trotula" is merely the title of a book. Such an authority as Malgaigne, however, believed that such a woman existed, and that the works accredited to her are authentic. The truth of the matter may perhaps never be fully established, but this at least is certain--the tradition in regard to Trotula could never have arisen had not women held a far different position among the Arabians of this period from that accorded them in contemporary Christendom.

gone numb with cold. Now, he thought, do it now, or die.

III. MEDIAEVAL SCIENCE IN THE WEST We have previously referred to the influence of the Byzantine civilization in transmitting the learning of antiquity across the abysm of the dark age. It must be admitted, however, that the importance of that civilization did not extend much beyond the task of the common carrier. There were no great creative scientists in the later Roman empire of the East any more than in the corresponding empire of the West. There was, however, one field in which the Byzantine made respectable progress and regarding which their efforts require a few words of special comment. This was the field of medicine. The Byzantines of this time could boast of two great medical men, Aetius of Amida (about 502-575 A.D.) and Paul of Aegina (about 620-690). The works of Aetius were of value largely because they recorded the teachings of many of his eminent predecessors, but he was not entirely lacking in originality, and was perhaps the first physician to mention diphtheria, with an allusion to some observations of the paralysis of the palate which sometimes follows this disease. Paul of Aegina, who came from the Alexandrian school about a century later, was one of those remarkable men whose ideas are centuries ahead of their time. This was particularly true of Paul in regard to surgery, and his attitude towards the supernatural in the causation and treatment of diseases. He was essentially a surgeon, being particularly familiar with military surgery, and some of his descriptions of complicated and difficult operations have been little improved upon even in modern times. In his books he describes such operations as the removal of foreign bodies from the nose, ear, and esophagus; and he recognizes foreign growths such as polypi in the air-passages, and gives the method of their removal. Such operations as tracheotomy, tonsellotomy, bronchotomy, staphylotomy, etc., were performed by him, and he even advocated and described puncture of the abdominal cavity, giving careful directions as to the location in which such punctures should be made. He advocated amputation of the breast for the cure of cancer, and described extirpation of the uterus. Just how successful this last operation may have been as performed by him does not appear; but he would hardly have recommended it if it had not been sometimes, at least, successful. That he mentions it at all, however, is significant, as this difficult operation is considered one of the great triumphs of modern surgery. But Paul of Aegina is a striking exception to the rule among Byzantine surgeons, and as he was their greatest, so he was also their last important surgeon. The energies of all Byzantium were so expended in religious controversies that medicine, like the other sciences, was soon relegated to a place among the other superstitions, and the influence of the Byzantine school was presently replaced by that of the conquering Arabians.

THIRTEENTH-CENTURY MEDICINE The thirteenth century marks the beginning of a gradual change in medicine, and a tendency to leave the time-worn rut of superstitious dogmas that so long retarded the progress of science. It is thought that the great epidemics which raged during the Middle Ages acted powerfully in diverting the medical thought of the times into new and entirely different channels. It will be remembered that the teachings of Galen were handed through mediaeval times as the highest and best authority on the subject of all diseases. When, however, the great epidemics made their appearance, the medical men appealed to the works of Galen in vain for enlightenment, as these works, having been written several centuries before the time of the plagues, naturally contained no information concerning them. It was evident, therefore, that on this subject, at least, Galen was not infallible; and it would naturally follow that, one fallible point having been revealed, others would be sought for. In other words, scepticism in regard to accepted methods would be aroused, and would lead naturally, as such scepticism usually does, to progress. The devastating effects of these plagues, despite prayers and incantations, would arouse doubt in the minds of many as to the efficacy of superstitious rites and ceremonies in curing diseases. They had seen thousands and tens of thousands of their fellow-beings swept away by these awful scourges. They had seen the ravages of these epidemics continue for months or even years, notwithstanding the fact that multitudes of God-fearing people prayed hourly that such ravages might be checked. And they must have observed also that when even very simple rules of cleanliness and hygiene were followed there was a diminution in the ravages of the plague, even without the aid of incantations. Such observations as these would have a tendency to awaken a suspicion in the minds of many of the physicians that disease was not a manifestation of the supernatural, but a natural phenomenon, to be treated by natural methods. But, be the causes what they may, it is a fact that the thirteenth century marks a turning-point, or the beginning of an attitude of mind which resulted in bringing medicine to a much more rational position. Among the thirteenth-century physicians, two men are deserving of special mention. These are Arnald of Villanova (1235-1312) and Peter of Abano (1250-1315). Both these men suffered persecution for expressing their belief in natural, as against the supernatural, causes of disease, and at one time Arnald was obliged to flee from Barcelona for declaring that the "bulls" of popes were human works, and that "acts of charity were dearer to God than hecatombs." He was also accused of alchemy. Fleeing from persecution, he finally perished by shipwreck. Arnald was the first great representative of the school of Montpellier. He devoted much time to the study of chemicals, and was active in attempting to re-establish the teachings of Hippocrates and Galen. He was one of the first of a long line of alchemists who, for several succeeding centuries, expended so much time and energy in attempting to find the "elixir of life." The Arab discovery of alcohol first deluded him into the belief that the "elixir" had at last been found; but later he discarded it and made extensive experiments with brandy, employing it in the treatment of certain diseases--the first record of the administration of this liquor as a medicine. Arnald also revived the search for some anaesthetic that would produce insensibility to pain in surgical operations. This idea was not original with him, for since very early times physicians had attempted to discover such an anaesthetic, and even so early a writer as Herodotus tells how the Scythians, by inhalation of the vapors of some kind of hemp, produced complete insensibility. It may have been these writings that stimulated Arnald to search for such an anaesthetic. In a book usually credited to him, medicines are named and methods of administration described which will make the patient insensible to pain, so that "he may be cut and feel nothing, as though he were dead." For this purpose a mixture of opium, mandragora, and henbane is to be used. This mixture was held at the patient's nostrils much as ether and chloroform are administered by the modern surgeon. The method was modified by Hugo of Lucca (died in 1252 or 1268), who added certain other narcotics, such as hemlock, to the mixture, and boiled a new sponge in this decoction. After boiling for a certain time, this sponge was dried, and when wanted for use was dipped in hot water and applied to the nostrils. Just how frequently patients recovered from the administration of such a combination of powerful poisons does not appear, but the percentage of deaths must have been very high, as the practice was generally condemned. Insensibility could have been produced only by swallowing large quantities of the liquid, which dripped into the nose and mouth when the sponge was applied, and a lethal quantity might thus be swallowed. The method was revived, with various modifications, from time to time, but as often fell into disuse. As late as 1782 it was sometimes attempted, and in that year the King of Poland is said to have been completely anaesthetized and to have recovered, after a painless amputation had been performed by the surgeons. Peter of Abano was one of the first great men produced by the University of Padua. His fate would have been even more tragic than that of the shipwrecked Arnald had he not cheated the purifying fagots of the church by dying opportunely on the eve of his execution for heresy. But if his spirit had cheated the fanatics, his body could not, and his bones were burned for his heresy. He had dared to deny the existence of a devil, and had suggested that the case of a patient who lay in a trance for three days might help to explain some miracles, like the raising of Lazarus. His great work was Conciliator Differentiarum, an attempt to reconcile physicians and philosophers. But his researches were not confined to medicine, for he seems to have had an inkling of the hitherto unknown fact that air possesses weight, and his calculation of the length of the year at three hundred and sixty-five days, six hours, and four minutes, is exceptionally accurate for the age in which he lived. He was probably the first of the Western writers to teach that the brain is the source of the nerves, and the heart the source of the vessels. From this it is seen that he was groping in the direction of an explanation of the circulation of the blood, as demonstrated by Harvey three centuries later. The work of Arnald and Peter of Abano in "reviving" medicine was continued actively by Mondino (1276-1326) of Bologna, the "restorer of anatomy," and by Guy of Chauliac: (born about 1300), the "restorer of surgery." All through the early Middle Ages dissections of human bodies had been forbidden, and even dissection of the lower animals gradually fell into disrepute because physicians detected in such practices were sometimes accused of sorcery. Before the close of the thirteenth century, however, a reaction had begun, physicians were protected, and dissections were occasionally sanctioned by the ruling monarch. Thus Emperor Frederick H. (1194-1250 A.D.)--whose services to science we have already had occasion to mention--ordered that at least one human body should be dissected by physicians in his kingdom every five years. By the time of Mondino dissections were becoming more frequent, and he himself is known to have dissected and demonstrated several bodies. His writings on anatomy have been called merely plagiarisms of Galen, but in all probability be made many discoveries independently, and on the whole, his work may be taken as more advanced than Galen's. His description of the heart is particularly accurate, and he seems to have come nearer to determining the course of the blood in its circulation than any of his predecessors. In this quest he was greatly handicapped by the prevailing belief in the idea that blood-vessels must contain air as well as blood, and this led him to assume that one of the cavities of the heart contained "spirits," or air. It is probable, however, that his accurate observations, so far as they went, were helpful stepping-stones to Harvey in his discovery of the circulation. Guy of Chauliac, whose innovations in surgery reestablished that science on a firm basis, was not only one of the most cultured, but also the most practical surgeon of his time. He had great reverence for the works of Galen, Albucasis, and others of his noted predecessors; but this reverence did not blind him to their mistakes nor prevent him from using rational methods of treatment far in advance of theirs. His practicality is shown in some of his simple but useful inventions for the sick-room, such as the device of a rope, suspended from the ceiling over the bed, by which a patient may move himself about more easily; and in some of his improvements in surgical dressings, such as stiffening bandages by dipping them in the white of an egg so that they are held firmly. He treated broken limbs in the suspended cradle still in use, and introduced the method of making "traction" on a broken limb by means of a weight and pulley, to prevent deformity through shortening of the member. He was one of the first physicians to recognize the utility of spectacles, and recommended them in cases not amenable to treatment with lotions and eye-waters. In some of his surgical operations, such as trephining for fracture of the skull, his technique has been little improved upon even in modern times. In one of these operations he successfully removed a portion of a man's brain.

Surgery was undoubtedly stimulated greatly at this period by the constant wars. Lay physicians, as a class, had been looked down upon during the Dark Ages; but with the beginning of the return to rationalism, the services of surgeons on the battle-field, to remove missiles from wounds, and to care for wounds and apply dressings, came to be more fully appreciated. In return for his labors the surgeon was thus afforded better opportunities for observing wounds and diseases, which led naturally to a gradual improvement in surgical methods.

FIFTEENTH-CENTURY MEDICINE The thirteenth and fourteenth centuries had seen some slight advancement in the science of medicine; at least, certain surgeons and physicians, if not the generality, had made advances; but it was not until the fifteenth century that the general revival of medical learning became assured. In this movement, naturally, the printing-press played an all-important part. Medical books, hitherto practically inaccessible to the great mass of physicians, now became common, and this output of reprints of Greek and Arabic treatises revealed the fact that many of the supposed true copies were spurious. These discoveries very naturally aroused all manner of doubt and criticism, which in turn helped in the development of independent thought. A certain manuscript of the great Cornelius Celsus, the De Medicine, which had been lost for many centuries, was found in the church of St. Ambrose, at Milan, in 1443, and was at once put into print. The effect of the publication of this book, which had lain in hiding for so many centuries, was a revelation, showing the medical profession how far most of their supposed true copies of Celsus had drifted away from the original. The indisputable authenticity of this manuscript, discovered and vouched for by the man who shortly after became Pope Nicholas V., made its publication the more impressive. The output in book form of other authorities followed rapidly, and the manifest discrepancies between such teachers as Celsus, Hippocrates, Galen, and Pliny heightened still more the growing spirit of criticism. These doubts resulted in great controversies as to the proper treatment of certain diseases, some physicians following Hippocrates, others Galen or Celsus, still others the Arabian masters. One of the most bitter of these contests was over the question of "revulsion," and "derivation"--that is, whether in cases of pleurisy treated by bleeding, the venesection should be made at a point distant from the seat of the disease, as held by the "revulsionists," or at a point nearer and on the same side of the body, as practised by the "derivationists." That any great point for discussion could be raised in the fifteenth or sixteenth centuries on so simple a matter as it seems to-day shows how necessary to the progress of medicine was the discovery of the circulation of the blood made by Harvey two centuries later. After Harvey's discovery no such discussion could have been possible, because this discovery made it evident that as far as the general effect upon the circulation is concerned, it made little difference whether the bleeding was done near a diseased part or remote from it. But in the sixteenth century this question was the all-absorbing one among the doctors. At one time the faculty of Paris condemned "derivation"; but the supporters of this method carried the war still higher, and Emperor Charles V. himself was appealed to. He reversed the decision of the Paris faculty, and decided in favor of "derivation." His decision was further supported by Pope Clement VII., although the discussion dragged on until cut short by Harvey's discovery. But a new form of injury now claimed the attention of the surgeons, something that could be decided by neither Greek nor Arabian authors, as the treatment of gun-shot wounds was, for obvious reasons, not given in their writings. About this time, also, came the great epidemics, "the sweating sickness" and scurvy; and upon these subjects, also, the Greeks and Arabians were silent. John of Vigo, in his book, the Practica Copiosa, published in 1514, and repeated in many editions, became the standard authority on all these subjects, and thus supplanted the works of the ancient writers. According to Vigo, gun-shot wounds differed from the wounds made by ordinary weapons--that is, spear, arrow, sword, or axe--in that the bullet, being round, bruised rather than cut its way through the tissues; it burned the flesh; and, worst of all, it poisoned it. Vigo laid especial stress upon treating this last condition, recommending the use of the cautery or the oil of elder, boiling hot. It is little wonder that gun-shot wounds were so likely to prove fatal. Yet, after all, here was the germ of the idea of antisepsis.

NEW BEGINNINGS IN GENERAL SCIENCE We have dwelt thus at length on the subject of medical science, because it was chiefly in this field that progress was made in the Western world during the mediaeval period, and because these studies furnished the point of departure for the revival all along the line. It will be understood, however, from what was stated in the preceding chapter, that the Arabian influences in particular were to some extent making themselves felt along other lines. The opportunity afforded a portion of the Western world--notably Spain and Sicily --to gain access to the scientific ideas of antiquity through Arabic translations could not fail of influence. Of like character, and perhaps even more pronounced in degree, was the influence wrought by the Byzantine refugees, who, when Constantinople began to be threatened by the Turks, migrated to the West in considerable numbers, bringing with them a knowledge of Greek literature and a large number of precious works which for centuries had been quite forgotten or absolutely ignored in Italy. Now Western scholars began to take an interest in the Greek language, which had been utterly neglected since the beginning of the Middle Ages. Interesting stories are told of the efforts made by such men as Cosmo de' Medici to gain possession of classical manuscripts. The revival of learning thus brought about had its first permanent influence in the fields of literature and art, but its effect on science could not be long delayed. Quite independently of the Byzantine influence, however, the striving for better intellectual things had manifested itself in many ways before the close of the thirteenth century. An illustration of this is found in the almost simultaneous development of centres of teaching, which developed into the universities of Italy, France, England, and, a little later, of Germany. The regular list of studies that came to be adopted everywhere comprised seven nominal branches, divided into two groups--the so-called quadrivium, comprising music, arithmetic, geometry, and astronomy; and the trivium comprising grammar, rhetoric, and logic. The vagueness of implication of some of these branches gave opportunity to the teacher for the promulgation of almost any knowledge of which he might be possessed, but there can be no doubt that, in general, science had but meagre share in the curriculum. In so far as it was given representation, its chief field must have been Ptolemaic astronomy. The utter lack of scientific thought and scientific method is illustrated most vividly in the works of the greatest men of that period--such men as Albertus Magnus, Thomas Aquinas, Bonaventura, and the hosts of other scholastics of lesser rank. Yet the mental awakening implied in their efforts was sure to extend to other fields, and in point of fact there was at least one contemporary of these great scholastics whose mind was intended towards scientific subjects, and who produced writings strangely at variance in tone and in content with the others. This anachronistic thinker was the English monk, Roger Bacon.

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