Compayre"s discussion of the "Causes of the Ignorance" of the Middle Ages in the next paragraph, is one of the most curious bits of special pleading by a man who holds a brief for one side of the question, that I think has ever been seen in what was to be considered serious history. He first makes it clear how much opposed the Christian Church was to education, then he admits that she did some things which cannot be denied, but minimizes their significance. Then he concludes that it was not {70} the fault of the Church, but in this there is a precious bit of d.a.m.ning by faint praise. It would be impossible for any ordinary person who had only Compayre for authority to feel anything after reading the paragraph, but that Christianity was a serious detriment and surely not a help to the cause of progress in education.
I quote part of the paragraph:
"What were the permanent causes of that situation which lasted for ten centuries? The Catholic Church has sometimes been held responsible for this. Doubtless the Christian doctors did not always profess a very warm sympathy for intellectual culture. Saint Augustine has said: It is the ignorant who gain possession of heaven (indocti coelum rapiunt.) Saint Gregory the Great, a Pope of the Sixth Century, declared that he would blush to have the holy word conform to the rules of grammar. Too many Christians, in a word, confounded ignorance with holiness. Doubtless, towards the Seventh Century, the darkness still hung thick over the Christian Church. Barbarians invaded the Episcopate, and carried with them their rude manners. Doubtless, also, during the feudal period the priest often became a soldier, and remained ignorant. It would, however, be unjust to bring a constructive charge against the Church of the Middle Age, and to represent it as systematically hostile to instruction. Directly to the contrary, it is the clergy who, in the midst of the general barbarism, preserved some vestiges of the ancient culture. The only schools of that period are the Episcopal and claustral schools, the first annexed to the Bishops" palaces, the second to the monasteries. The religious orders voluntarily a.s.sociated manual labor with mental labor. As far back as 530, St. Benedict founded the Convent of Monte Ca.s.sino, and drew up statutes which made reading and intellectual labor a part of the daily life of the monks." When this d.a.m.ning by faint praise is taken in connection with the paragraph in which only a single monk at the Monastery of St. Gall is declared to have been able to read and write, the utterly false impression that is sure to result, can be readily understood even by those who are not sympathetic students of the Middle Ages. This is how our histories of education have been written as a rule, and as a consequence the most precious period in modern education, its great origin, has been ignored even by professional scholars, to the great detriment not only of historical knowledge but also of any proper appreciation of the evolution of education.
Portraits Bennozo Gozzoli
[Ill.u.s.tration]
PETRARCA OMNIUM VIRTUTUM MONARCA
[Ill.u.s.tration]
GIOTTO, PICTOR EXIMIUS
[Ill.u.s.tration]
DANTE THEOLOGUS NULLIUS DOGMATIS EXPERS
{71}
It will be said by those who do not appreciate the conditions that existed in the Middle Ages, that these numbers at the universities seeking the higher education, mean very little for the culture of the people, since practically all of those in attendance at the universities belonged to the clerical order. There is no doubt that most students were clerics in the Thirteenth Century. This did not mean, however, that they had taken major orders or had in any way bound themselves irrevocably to continue in the clerical vocation. The most surprising thing about the spread of culture and the desire for the higher education during the Thirteenth Century, is that they developed in spite of the fact that the rulers of the time were all during the century, embroiled in war either with their neighbors or with the n.o.bility. Anyone who wanted to live a quiet, intellectual life turned naturally to the clerical state, which enabled him to escape military duties and gave him opportunities for study, as well as protection from many exactions that might otherwise be levied upon him. The church not only encouraged education, but supplied the peaceful asylums in which it might be cultivated to the heart"s content of the student.
While this clerical state was a necessity during the whole time of residence at the university, it was not necessarily maintained afterward. Many of the clerics did not even have minor orders--orders which it is well understood carry with them no absolute obligation of continuing in the clerical state. s.e.xtons and their a.s.sistants were clerics. When the word canon originally came into use it meant nothing more than that the man was entered on the rolls of a church and received some form of wages therefrom. Students at the universities were by ecclesiastical courtesy then, clerics (from which comes the word clerk, one who can read and write) though not in orders, and it was because of this that the university was able to maintain the rights of students. It was well understood that after graduation men might take up the secular life and indeed most of them did. In succeeding chapters we shall see examples of this and discuss the question further. Professors at the {72} universities had to maintain their clerical condition so that even professors of law and of medicine were not allowed to marry. This law continued long beyond the Thirteenth Century, however. Professors of medicine were the first to be freed from the obligation of celibacy, but not until the middle of the Fifteenth Century at Paris, while other professors were bound thus for a full century later. Certain minor teaching positions at Oxford are still under this law, which evidently has seemed to have some advantage or it would not have been maintained.
It might perhaps be thought that only the wealthier cla.s.s, the sons of the n.o.bility and of the wealthy merchants of the cities had opportunities at the universities. As a matter of fact, however, the vast majority of the students was drawn from the great middle cla.s.s.
The n.o.bility were nearly always too occupied with their pleasures and their martial duties to have time for the higher education. The tradition that a n.o.bleman should be an educated gentleman had not yet come in. Indeed many of the n.o.bility during the Thirteenth Century rather prided themselves on the fact that they not only had no higher education, but that they did not know even how to read and write. When we reflect, then, on the large numbers who went to the universities, it adds to our surprise to realize that they were drawn from the burgher cla.s.s. It is evident that many of the sons even of the poor were afforded opportunities in different ways at the universities of the time.
Tradition shows that from the earliest time there were foundations on which poor students could live, and various arrangements were made by which, aside from these, they might make their living while continuing their studies. Working one"s way through the university was more common in the Thirteenth Century than it is at the present day, though we are proud of the large numbers who now succeed in the double task of supporting and educating themselves, with excellent success in both enterprises. There are many stories of poor students who found themselves about to be obliged to give up their studies, encountering patrons of various kinds who enabled them to go on with their education.
There is a very pretty set of legends with regard to St. Edmund of Canterbury in this matter. He bears this name {73} because he was afterward the sainted primate of England. For many years he taught at the University of Oxford. The story is told of a clerical friend sending him up a student to Oxford and asking that his bills be sent to him. St. Edmund"s answer was that he would not be robbed of an opportunity of doing good like this, and he took upon himself the burden of caring for the student. At the time there were many others dependent on his bounty and his reputation was such that he was enabled to help a great many through the benefactions of friends, who found no higher pleasure in life than being able to come generously to Edmund"s a.s.sistance in his charities.
Those who know the difficulty of managing very large bodies of students will wonder inevitably, how the medieval universities, with their less formal and less complete organizations, succeeded in maintaining discipline for all these thousands of students. Most people will remember at once all the stories of roughness, of horse play, of drinking and gaming or worse that they have heard of the medieval students and will be apt to conclude that they are not to be wondered at after all, since it must have been practically impossible for the faculties of universities to keep order among such vast numbers. As a matter of fact, however, the story of the origin and maintenance of discipline in these universities is one of the most interesting features of university life. The process of discipline became in itself a very precious part of education, as it should be of course in any well regulated inst.i.tution of learning. The very fact, moreover, that in spite of these large numbers and other factors that we shall call attention to in a moment, comparatively so few disgraceful stories of university life have come down to us, and the other and still more important fact that the universities could be kept so constantly at the attainment of their great purpose for such numbers, is itself a magnificent tribute to those who succeeded in doing it, and to the system which was gradually evolved, not by the faculty alone but by teachers and students for university government.
With regard to the discipline of the medieval universities not much is known and considerable of what has been written on this obscure subject wears an unfavorable tinge, because it is unfortunately true that "the good men do is oft interred with {74} their bones" while the evil has an immortality all its own. The student escapades of the universities, the quarrels between town and gown, the stories of the evils apparently inevitable, where many young men are congregated--the hazing, the rough horse play, the carousing, the immoralities--have all come down to us, while it is easy to miss the supreme significance of the enthusiasm for learning that in these difficult times gathered so many students together from distant parts of the world, when traveling was so difficult and dangerous, and kept them at the universities for long years in spite of the hardships and inconveniences of the life. With regard to our modern universities the same thing is true, and the outside world knows much more of the escapades of the few, the little scandals of college life, that scarcely make a ripple but are so easily exaggerated, and so frequently repeated and lose nothing by repet.i.tion, the waste of time in athletics, in gambling, in social things, than of the earnest work and the successful intellectual progress and interests of the many.
This should be quite enough to make the modern university man very slow to accept the supposed pictures of medieval student life, which are founded mainly on the worse side of it. Goodness is proverbially uninteresting, a happy people has no history and the ordinary life of the university student needs a patient sympathetic chronicler; and such the medieval universities have not found as yet. But they do not need many allowances, if it will only be remembered under what discouragements they labored and how much they accomplished.
The reputation of the medieval universities has suffered from this very human tendency to be interested in what is evil and to neglect the good. Even as it is, however, a good deal with regard to the discipline of the universities in the early times is known and does not lose in interest from the fact, that the main factor in it was a committee of the students themselves working in conjunction with the faculty, and thus antic.i.p.ating what is most modern in the development of the disciplinary regime of our up-to-date universities. At first apparently, in the schools from which the universities originated there was no thought of the necessity for discipline. The desire for education was considered to be sufficient to keep men occupied in {75} such a way that further discipline would not be necessary. It can readily be understood that the crowds that flocked to hear Abelard in Paris, and who were sufficiently interested to follow him out to the Desert of the Paraclete when he was no longer allowed to continue his lectures in connection with the school at Paris, would have quite enough of ruling from the internal forum of their supreme interest, not to need any discipline in the external forum.
In the course of time, however, with the coming of even greater numbers to the University of Paris, and especially when the attendance ran up into many thousands, some form of school discipline became an absolute necessity. This developed of itself and in a very practical way. The masters seem to have had very little to do with it at the beginning since they occupied themselves entirely with their teaching and preparation for lectures. What was to become later one of the princ.i.p.al instruments of discipline was at first scarcely more than a social organization among the students. Those who came from different countries were naturally attracted to one another, and were more ready to help each other. When students first came they were welcomed by their compatriots who took care to keep them from being imposed upon, enabled them to secure suitable quarters and introduced them to university customs generally, so that they might be able to take advantage, as soon as possible, of the educational opportunities.
The friendships thus fostered gradually grew into formal organizations, the so-called "nations." These began to take form just before the beginning of the Thirteenth Century. They made it their duty to find lodgings for their student compatriots, and evidently also to supply food on some cooperative plan for at least the poorer students. Whenever students of a particular nationality were injured in any way, their "nation" as a formal organization took up their cause and maintained their rights, even to the extent of an appeal to formal process of law before the magistrates, if necessary. The nations were organized before the faculties in the universities were formally recognized as independent divisions of the inst.i.tution, and they acted as intermediaries between the university head and the students, making themselves responsible for discipline to no slight {76} degree. At the beginning of the Thirteenth Century in Paris all the students belonged to one or other of four nations, the Picard, the Norman, the French, which embraced Italians, Spaniards, Greeks and Orientals, and the English which embraced the English, Irish, Germans, Poles (heterogeneous collection we would consider it in these modern days) and in addition all other students from the North of Europe.
Professor Laurie, of the University of Edinburgh, in his Rise and Early Const.i.tution of Universities in the International Educational Series [Footnote 8] says:
[Footnote 8: The Rise and Early Const.i.tution of Universities, with a survey of Medieval Education, by S. S. Laurie, LL.D., Professor of the Inst.i.tutes and History of Education in the University of Edinburgh. New York, D. Appleton & Company, 1901.]
"The subdivisions of the nations were determined by the localities from which the students and masters came. Each subdivision elected its own dean and kept its own matriculation-book and money-chest. The whole "nation" was represented, it is true, by the elected procurators; but the deans of the subdivisions were regarded as important officials, and were frequently, if not always, a.s.sessors of the procurators. The procurators, four in number, were elected, not by the students as in Bologna and Padua, but by the students and masters.
Each nation with its procurator and deans was an independent body, pa.s.sing its own statutes and rules, and exercising supervision over the lodging-houses of the students. They had each a seal as distinguished from the university seal, and each procurator stood to his "nation" in the same relation as the Rector did to the whole university. The Rector, again, was elected by the procurators, who sat as his a.s.sessors, and together they const.i.tuted the governing body; but this for purposes of discipline, protection and defense of privileges chiefly, the _consortium magistrorum_ regulating the schools. But so independent were the nations that the question whether each had power to make statutes that overrode those of the _universitas_, was still a question so late as the beginning of the Seventeenth Century."
It is typical of the times that the governing system should thus have grown up of itself and from amongst the students, rather than that it should have been organized by the teachers {77} and imposed upon the university. The nations represented the rise of that democratic spirit, which was to make itself felt in the claims for the recognition of rights for all the people in most of the countries during the Thirteenth Century, and undoubtedly the character of the government of the student body at the universities fostered this spirit and is therefore to a noteworthy degree, responsible for the advances in the direction of liberty which are chronicled during this great century. This was a form of unconscious education but none the less significant for that, and eminently practical in its results. At this time in Europe there was no place where the members of the community who flocked in largest numbers to the universities, the sons of the middle cla.s.ses, could have any opportunities to share in government or learn the precious lessons of such partic.i.p.ation, except at the universities. There gradually came an effort on the part of the faculties to lessen many of the rights of the nations of the universities, but the very struggle to maintain these on the part of the student body, was of itself a precious training against the usurpation of privileges that was to be of great service later in the larger arena of national politics, and the effects of which can be noted in every country in Europe, nowhere more than in England, where the development of law and liberty was to give rise to a supreme heritage of democratic jurisprudence for the English speaking peoples of all succeeding generations.
{78}
V
POST-GRADUATE WORK AT THE UNIVERSITIES.
In modern times it has often been said that no university can be considered to be doing its proper work unless, besides teaching, it is also adding to the existing body of knowledge by original research.
Because of unfortunate educational traditions, probably the last thing in the world that would enter into the minds of most people to conceive as likely to be found in the history of the universities of the Thirteenth Century, would be original research in any form. In spite of this almost universal false impression, original work of the most valuable kind, for much of which workers would be considered as amply deserving of their doctorates in the various faculties of the post-graduate departments of the most up-to-date of modern universities, was constantly being accomplished during this wonderful century. It is, as a matter of fact, with this phase of university activity that the modern educator is sure to have more sympathy than with any other, once the significant details of the work become clear.
All surprise that surpa.s.sing original work was accomplished will cease when it is recalled that, besides creating the universities themselves, this century gave us the great Cathedrals--a well-spring of originality, and a literature in every civilized country of Europe that has been an inspiration to many subsequent generations. At last men had the time to devote to the things of the mind. During what are called the Dark Ages, a term that must ever be used with the realization that there are many bright points of light in them, men had been occupied with wars and civic and political dissensions of all kinds, and had been gradually climbing back to the heights of interest in intellectual matters which had been theirs before the invasion of the barbarians and the migration of nations. With the rebirth of intellectual interests there came an intense curiosity to know everything and to investigate every manifestation. {79} Everything that men touched was novel, and the wonderful advances they made can only be realized from actual consultation of their works, while the reader puts himself as far as possible at the same mental point of view from which they surveyed the world and their relations to it.
The modern university prides itself on the number of volumes written by its professors and makes it a special feature of its announcements to call attention to its at least supposed additions to knowledge in this mode. It must have been immensely more difficult to preserve the writings of the professors of the medieval universities for they had to be copied out laboriously by hand, yet we have an enormous number of large volumes of their works, on nearly every intellectual topic, that have been carefully preserved. There are some twenty closely printed large folio volumes of the writings of Albertus Magnus that have come down to us. For two centuries, until the time of printing, ardent students must have been satisfied to spend much time in preserving these. While mainly devoted to theology, they treat of nearly everything else, and at least one of the folio volumes is taken up almost exclusively with physical science. St. Thomas Aquinas has as many volumes to his credit and his work is even of more importance.
Duns Scotus died at a very early age, scarcely more than forty, yet his writings are voluminously extensive and have been carefully preserved, for few men had as enthusiastic students as he. Alas! that his name should be preserved for most people only in the familiar satiric appellation "dunce." The modern educator will most rejoice at the fact that the students of the time must have indeed been devoted to their masters to set themselves to the task of copying out their work so faithfully for, as Cardinal Newman has pointed out, it is the personal influence of the master, rather than the greatness of the inst.i.tution, that makes education effective.
First with regard to philosophy, the mistress of all studies, whose throne has been shaken but not shattered in these ultimate times.
After all it must not be forgotten that this was the great century of the development of scholastic philosophy. While this scholastic philosophy is supposed by many students of modern philosophy to be a thing of the past, it still continues {80} to be the basis of the philosophical teaching in the Catholic seminaries and universities throughout the world. Catholic philosophers are well known as conservative thinkers and writers, and yet are perfectly free to confess that they consider themselves the nearer to truth the nearer they are to the great scholastic thinkers of the Thirteenth Century.
Even in the circle of students of philosophy who are outside the influence of scholasticism, there is no doubt that in recent years an opinion much more favorable to the Schoolmen has gradually arisen.
This has been due to a study of scholastic sources. Only those despise and talk slightingly of scholasticism who either do not know it at all or know it only at second hand. With regard to the system of thought, as such, ever is it true, that the more close the acquaintanceship the more respect there is for it.
With regard to theology the case is even stronger than with regard to philosophy. Practically all of the great authorities in theology belong to the Thirteenth Century. It is true that men like Saint Anselm lived before this time and were leaders in the great movement that culminated in our century. Saint Anselm"s book, _Cur Deus h.o.m.o_, is indeed one of the best examples of the combination of scholastic philosophy and theology that could well be cited. It is a triumph of logical reasoning, applied to religious belief. Besides, it is a great cla.s.sic and any one who can read it unmoved by admiration for the thinker who, so many centuries ago, could so trenchantly lay down his thesis and develop it, must be lacking in some of the qualities of human admiration. The writers of the Thirteenth Century in theology are beyond even Anselm in their marvelous powers of systematizing thought. One need only mention such names as Albertus Magnus, Thomas Aquinas, Bonaventure. Duns Scotus, and Raymond Lully to make those who are at all acquainted with the history of the time realize, that this is not an idle expression of the enthusiasm of a special votary of the Thirteenth Century.
As we shall see in discussing the career of Saint Thomas Aquinas, the Catholic Church still continues to teach scholastic theology on exactly the same lines as were laid down by this great doctor of the church in his teaching at the University of Paris. Amid the crumbling of many Christian systems of {81} thought, as upheld by the various protestant sects, there has been a very general realization that the Catholic Church has built up the only edifice of Christian apologetics, which will stand the storms of time and the development of human knowledge. Confessedly this edifice is founded on Thirteenth Century scholasticism. Pope Leo XIII., than whom, even in the estimation of those who are least sympathetic toward his high office, there was no man of more supremely practical intelligence in our generation, insisted that St. Thomas Aquinas must in general principle at least, be the groundwork of the teaching of philosophy and theology as they are to form the minds of future Catholic apologists.
The scholastic theology and philosophy of the Thirteenth Century have come to us in absolute purity. The huge tomes which represent the indefatigable labors of these ardent scholars were well preserved by the subsequent generation which thought so much of them, and in spite of the absence of printing have come down to us in perfectly clear texts. It is easy to neglect them and to say that a study of them is not worth while. They represent, however, the post-graduate work and the research in the department of philosophy and theology of these days, and any university of modern time would consider itself honored by having their authors among its professors and alumni. Any one who does not think so need only turn to the volumes themselves and read them with understanding and sympathy, and there will be another convert to the ranks of that growing mult.i.tude of scholars, who have learned to appreciate the marvelous works of our university colleagues of the Thirteenth Century.
With regard to law, not much need be said here, since it is well understood that the foundations of our modern jurisprudence (see chapters on Legal Origins), as well as the methods of teaching law, were laid in the Thirteenth Century and the universities were the most active factors, direct and indirect, in this work. The University of Bologna developed from a law school. Toward the end of the Twelfth Century Irnerius revived the study of the old Roman law and put the curriculum of modern Civil Law on a firm basis. A little later Gratian made his famous collection of decretals, which are the basis of Canon {82} Law. Great popes, during the Thirteenth Century, beginning with Innocent III., and continuing through such worthy emulators as Gregory IX. and Boniface VIII., made it the special glory of their pontificates to collect the decrees of their predecessors and arrange and publish them, so that they might be readily available for consultation.
French law a.s.sumed its modern form, and the basis of French jurisprudence was laid, under Louis IX., who called to his a.s.sistance, in this matter, the Professors of Law at the University of Paris, with many of whom he was on the most intimate terms. His cousin, Ferdinand of Castile, laid the foundation of the Spanish law about the same time under almost similar circ.u.mstances, and with corresponding help. The study of law in the English universities helped to the formulation of the principles of the English Common Law in such simple connected form as made them readily accessible for consultation. Just before the beginning of the last quarter of the Thirteenth Century, Bracton, of whose work much more will be said in a subsequent chapter, drew up the digest of the English Common Law, which has been the basis of English jurisprudence ever since. It took just about a century for these countries, previously without proper codification of the principles of their laws, to complete the fundamental work to such a degree, that it is still the firm substructure on which rests all our modern laws.
Legal origins, in our modern sense, came not long before the Thirteenth Century; at its end the work was finished, to all intents and purposes. Of the influence of the universities and of the university law departments, in all this there can be no doubt. The incentive, undoubtedly, came from their teachings. The men who did so much for legal origins of such far-reaching importance, were mainly students of the universities of the time, whose enthusiasm for work had not subsided with the obtaining of their degrees.
It is in medicine, however, much more than in law or theology, that the eminently practical character of university teaching during the Thirteenth Century can be seen, at least in the form in which it will appeal to a scientific generation. We are so accustomed to think that anything like real progress in medicine, and especially in surgery, has only come in very {83} recent years, that it is a source of great surprise to find how much these earnest students of a long distant century antic.i.p.ated the answers to problems, the solutions of which are usually supposed to be among the most modern advances. Professor Allb.u.t.t, the Regius professor of Physic in the University of Cambridge, a position, the occupant of which is always a leader in English medical thought, the present professor being one of the world"s best authorities in the history of medicine, recently pointed out some of these marvels of old-time medicine and surgery. In an address On the Historical Relations of Medicine and Surgery to the end of the Sixteenth Century, delivered at the Congress of Arts and Sciences at the St. Louis Exposition in 1904, he (Prof. Allb.u.t.t) spoke with regard to one of the great university medical teachers of the Thirteenth Century as follows:
"Both for his own great merits, as an original and independent observer, and as the master of Lanfranc, William Salicet (Guglielmo Salicetti of Piacenza, in Latin G. Placentinus de Saliceto--now Cadeo), was eminent among the great Italian physicians of the latter half of the Thirteenth Century. Now these great Italians were as distinguished in surgery as in medicine, and William was one of the protestants of the period against the division of surgery from inner medicine; a division which he regarded as a separation of medicine from intimate touch with nature. Like Lanfranc and the other great surgeons of the Italian tradition, and unlike Franco and Ambroise Pare, he had the advantage of the liberal university education of Italy; but, like Pare and Wurtz, he had large practical experience in hospital and on the battlefield. He practised first at Bologna, afterward in Verona. William fully recognised that surgery cannot be learned from books only. His Surgery contains many case histories, for he rightly opined that good notes of cases are the soundest foundation of good practice; and in this opinion and method Lanfranc followed him. William discovered that dropsy may be due to a "_durities renum_"; he subst.i.tuted the knife for the Arabist abuse of the cautery; he investigated the causes of the failure of healing by first intention; he described the danger of wounds of the neck; he sutured divided nerves; he forwarded the diagnosis of {84} suppurative disease of the hip, and he referred chancre and phagedaena to their real causes."
This paragraph sets forth some almost incredible antic.i.p.ations of what are usually considered among the most modern phases of medicine and surgery. Perhaps the most surprising thing is the simple statement that Salicet recognized that surgery cannot be learned from books alone. His case histories are instructive even to the modern surgeon who reads them. His insistence on his students making careful notes of their cases as the soundest foundation of progress in surgery, is a direct contradiction of nearly everything that has been said in recent years about medieval medicine and especially the teaching of medicine.
(See Appendix.)
William"s great pupil, Lanfranc, followed him in this, and Lanfranc encouraged the practise at the University of Paris. There is a note-book of a student at the University of Paris, made toward the end of the Thirteenth Century, carefully preserved in the Museum of the University of Berlin. This notebook was kept during Lanfranc"s teaching and contains some sketches of dissections, as well as some ill.u.s.trations of operative procedures, as studied with that celebrated surgeon. The tradition of case histories continued at the University of Paris down to the beginning of modern surgery.
Some of the doctrines in medicine that William of Salicet stated so clearly, sound surprisingly modern. The connection, for instance, between dropsy and _durities renum_ (hardening of the kidneys) shows how wonderfully observant the old master was. At the present time we know very little more about the dropsical condition a.s.sociated with chronic Bright"s disease than the fact that it constantly occurs where there is a sclerosis or contraction of the kidney. Bright in his study of alb.u.minuria and contracted kidney practically taught us no more than this, except that he added the further symptom of the presence of alb.u.min in the urine. It must have been only as the result of many carefully studied cases, followed by autopsies, that any such doctrine could have come into existence. There is a dropsy that occurs with heart disease; there is also a dropsy in connection with certain affections of the liver, and yet the most frequent cause is just this hardening of the kidneys {85} spoken of by this middle-of-the-Thirteenth Century Italian professor of medicine, who, if we would believe so many of the historians of medicine, was not supposed to occupy himself at all with ante and post-mortem studies of patients, but with the old-time medical authorities.
Almost more surprising than the question of dropsy is the investigation as to the causes of the failure of healing by first intention. The modern surgeon is very apt to think that he is the only one who ever occupied himself with the thought, that wounds might be made to heal by first intention and without the occurrence of suppuration or granulation. Certainly no one would suspect any interest in the matter as far back as the Thirteenth Century. William of Salicet, however, and Lanfranc, both of them occupied themselves much with this question and evidently looked at it from a very practical standpoint. Many careful observations must have been made and many sources of observational error eliminated to enable these men to realize the possibilities of primary union, especially, knowing as they did, nothing at all about the external causes of suppuration and considering, as did surgeons for nearly seven centuries afterward, that it was because of something within the patient"s tissues that the cases of suppuration had their rise.
Unfortunately, the pioneer work done by William and his great disciple did not have that effect upon succeeding generations which it should have had. There was a question in men"s minds as to whether nature worked better by primary union or by means of the suppurative process.
In the next century surgeons took the wrong horn of the dilemma and even so distinguished a surgeon as Guy de Chauliac, who has been called, not without good cause, the father of surgery, came to the conclusion that suppuration was practically a necessary process in the healing of large wounds at least, and that it must be encouraged rather than discouraged. This doctrine did not have its first set-back until the famous incident in Ambroise Pare"s career, when one morning after a battle, coming to his patients expecting to find many of them very severely ill, he found them on the contrary in better condition than the others for whom he had no forebodings. In accord with old custom {86} he poured boiling oil into the wounds of all patients, but the great surgeon"s supply of oil had failed the day before and he used plain water to cleanse the wounds of a number, fearing the worst for them, however, because of the poison that must necessarily stay in their wounds and then had the agreeable disappointment of finding these patients in much better condition than those whom he had treated with all the rules of his art, as they then were. Even this incident, however, did not serve to correct entirely the old idea as to the value of suppuration and down to Lister"s time, that is almost the last quarter of the Nineteenth Century, there is still question of the value of suppuration in expediting the healing of wounds, and we hear of laudable pus and of the proper inflammatory reaction that is expected to bring about wound repair.