A History of Science, vol 2 by Henry Smith Williams (most recommended books .txt) 📕

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.

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.

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