according to my ability and judgment I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to man, woman, or child born or unborn. With purity and with holiness I will pass my life and practise my art. Whatever in connection with my professional practice, or not in connection with it, I see or hear in the life of men which ought not to be spoken of abroad, I shall not divulge, as reckoning that all such should be kept secret. While I continue to keep this oath inviolate may it be granted to me to enjoy life and the practice of my art respected by all men in all times; but should I trespass and violate this oath may the reverse be my lot."

It is sometimes thought that after the Roman medicine, which was an imitation of the Greek (though Galen well deserves a place by himself, and Galen is usually thought of as a Roman though he wrote in Greek and had obtained his education at Pergamos in Asia Minor), there was an interregnum in medicine until our own time. This is, however, quite as much of an assumption as to suppose that the Egyptians had no medicine-as we used to until we knew more about them or that old-time medicine is quite negligible because we were ignorant of its value. The Middle Ages had much more of medicine than we are likely to think, and just as soon as the great universities arose at the end of the

twelfth and the beginning of the thirteenth centuries, medicine gained a new impetus and flourished marvellously. These university medical schools of the later Middle Ages are models in their way, and put us to shame in many things. According to a law of the Emperor Frederick II issued for the Two Sicilies in 1241,* three years of preliminary study were required at the university before a student might take up the medical course, and then he had to spend four years at medicine, and practise for a year under the supervision of a physician of experience before he was allowed to practise for himself. The story of the medicine of this time is all the more wonderful because subsequent generations forgot about it until recent years, and supposed that all of this period was shrouded in darkness. It was probably one of the most brilliant periods in medical history. Some of the men who worked and taught in medicine at this time will never be forgotten.

Probably the greatest of them was Guy de Chauliac, a Papal chamberlain, whom succeeding generations have honored with the title of Father of Surgery. His great text-book, the

Chirurgia Magna," was in common use for several centuries after his death, and is full of surgical teaching that we are prone to think much

* For the complete text of this law, the first regulating the practice of medicine in modern times, also the first pure drug law, see Walsh's The Popes and Science. New York, Fordham University Press, 1908.

more modern. He trephined the skull, opened the thorax, operated within the abdomen, declared that patients suffering from wounds of the intestines would die unless these were sewed up, operated often for hernia in an exaggerated Trendelenberg position, with the patient's head down on a board, but said that many more patients were operated upon for hernia "for the benefit of the surgeon's purse than for the good of the patient." His directions for the treatment of fractures and for taxis in hernia were followed for full four centuries after his time. No wonder that Pagel, the great German historian, declared that "Chauliac laid the foundation of that primacy in surgery which the French maintained down to the nineteenth century." Portal, in his "History of Surgery," declares that " Guy de Chauliac said nearly everything which modern surgeons say, and his work is of infinite price, but unfortunately too little read, too little pondered." Malgaigne declared "the 'Chirurgia Magna' a masterpiece of learned and luminous writing."

*

Chauliac's personal character, however, is even more admirable than his surgical knowledge. He was at Avignon when the black death occurred and carried away one-half the population. He was one of the few physicians who had the cour

* For sketch of Chauliac see Johns Hopkins Hospital Bulletin, 1909, or Catholic Churchmen in Science, second series. Dolphin Press, Philadelphia, 1909.

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age to stay. He tells us very simply that he did stay not because he had no fear, for he was dreadfully afraid, but he thought it his duty to stay. Toward the end of the epidemic, he caught the fever but survived it and has written a fine description of it. He was looked upon as the leader of surgery in his time, and this is his advice as to what the surgeon should be as given in the introductory chapter of his Chirurgia Magna": "The surgeon should be learned, skilled, ingenious and of good morals; be bold in things that are sure, cautious in dangers; avoid evil cures and practices; be gracious to the sick, obliging to his colleagues, wise in his predictions; be chaste, sober, pitiful and merciful; not covetous nor extortionate of money; but let the recompense be moderate, according to the work, the means of the sick, the character of the issue or event and its dignity." No wonder that Malgaigne says of him: "Never since Hippocrates has medicine heard such language filled with so much nobility and so full of matter in so few words."

The old-time medical traditions of education which in the mediæval universities produced such men as William of Salicet and Lanfranc and Mondeville and Guy de Chauliac, persisted during the next two centuries in the southern countries of Europe, and then were transferred to America through Spain. The first American medical school was not, as has so often been said, at my own Alma Mater, the University of

Pennsylvania, which had its first lectures in 1767, while the Physicians and Surgeons of New York did not come for some ten years later and Harvard only in the following decade, but in the medical school of the University of Mexico, where the first lectures were held in 1578, and where a full medical school was organized before the end of the sixteenth century. In this medical school, which during the seventeenth century came to have several hundred students, the university tradition of the olden time was well preserved. Three years of preliminary study at the university were required before a student could take up the course in medicine, and four years of medical study were required before graduation. We have some of the text-books, and know much about the curriculum of this old medical school, and in every way it is worthy of the old university traditions.

Unfortunately our universities in what is now the United States developed very slowly. King's College (Columbia) did not become a university in the sense of having law and medical schools as well as an undergraduate department until the nineteenth century had almost begun. Harvard did not have a law school affiliated with it until the first quarter of the nineteenth century had almost run its course. The affiliations between the medical schools and the universities in these cases was only very slight, and the medical schools were entirely in the hands of the medi