III

TEACHERS, SCHOOLS, AND STUDENTS OF MEDICINE

Medical teachers in ancient times-The temple schools-The Crotona, Alexandria, and Salernum schools-The French schools monastic from the tenth to the fifteenth century— The Italian, French, Dutch, Austrian, and German Universities-Desault and his colleagues the beginners of the modern Parisian school of medicine-American teachers and schools-The American medical student-The students in the twentieth century.

In

THE aspirant having gathered from his sponsor the information which he had sought regarding the mission and the characteristics of the true physician, and the aims of the profession of medicine, would be likely to make special inquiries concerning the medical teachers, the schools, and the students of the past and present. that case the sponsor would probably begin by suggesting that a rapid glance be cast at some of the medical myths of remote antiquity; at the temple schools under priestly conduct; at the Crotona school of philosophy and medicine; at the Hippocratic school whence began the evolution of the medical student; at the Alexandrian school; and at the Salernian and other schools of the middle ages, as a preliminary step to the inquiry respecting the teachers, the schools, and the students of the

eighteenth, nineteenth, and twentieth centuries. In all likelihood his discourse would be substantially as follows:

1. The medical myths of the Egyptians or of other ancient nations scarcely need any notice, since they give very little more information than those of the Greeks who borrowed nearly all of them and added to the list their own domestic legends; the earliest of which being about Melampus (1526 B.C.). This first medicine man, mentioned in medical biography, does not appear to have instructed others than members of his own family, nor to have left any trace of the source whence he had obtained his knowledge of the art to which he united vaticination. He was supposed to have won high repute in Argos by curing of madness the daughters of King Proetus, by means of hellebore purgatives, warm baths and incantations.

The fable then tells of Chiron the Centaur (1270, B.C.), and celebrates him as horse-doctor, medicine-man, teacher of bits of surgery, and instructor of Theseus, Amphiaraus, Castor, Achilles, and the renowned Esculapius father of Machaon and Podalyrius the fighting physicians at the siege of Troy.

2. The ancient temples, serving in part for the reception and treatment of the sick but not for their prolonged lodgement as in modern hospitals, were the primitive schools of medicine in which the chief priests obtained some crude notions of disease which they imparted to other priests or let them gather what they could from the "sacred book." None but the full-fledged priests were

practisers in these temples, these real dispensaries, outside of which they saw no patients.

3. The Crotona school of philosophy and medicine, founded about 529 B.C. by Pythagoras, took the first departure from the custom of combining priestly and medical offices by admitting laymen to be instructed in medicine as well as in philosophy. From this school went forth men of much ability tinctured, however, with the master's fanciful notions. Empedocles (504, B.C.), and Alemæon (500, B.C.), were among the votaries of the medical doctrines of that school, which afterward turned loose upon the world hosts of itinerant speculative philosophers, essaying to be physicians but burdened with nice hypotheses and lacking in practical skill for the treatment of disease.

4. Prior to the Hippocratic era (460, B.C.), it is clear from the foregoing, that there were no medical students properly so called; that is to say, men devoted to the study of the art of medicine with the fixed purpose of making its practice their sole occupation. That great reformer, who had obtained the rudiments of his vast medical knowledge in the Æsculapian temple of Cos, that true founder of rational medicine, had divorced the noble art from speculative philosophy and from priestly offices by taking as pupils young men who, under oath and stipulation, agreed to make the study and practice of medical art their profession and to engage in no other work. From this began the real evolution of the medical student. But the pupil had a single instructor, for there

was not then what is now called a faculty composed of professors in the several branches of medicine, the one master teaching his disciples the whole art of physic. This sort of teaching was not uncommon even as lately as the first half of the nineteenth century.

5. The Alexandrian school of medicine, established through Ptolemyan munificence, and equipped with a regular corps of able professors engaged in teaching great numbers of domestic and foreign students, produced the accomplished, masterly Herophilus, Erasistratus and Galen, besides many other learned physicians who went forth into the world promulgating sound doctrines, doing good, and honoring their alma mater. The glorious school continued to flourish long after the fall of Alexandria in 640, A.D.

6. The Salernian school, founded in the eighth and closed early in the nineteenth century, also had a regular corps of professors, ten in number. The studies comprised the therapeutics of Galen, the beginning of the first canon of Avicenna, and the aphorisms of Hippocrates. The candidates for the degree of Doctor of Medicine were required to be at least twenty-one years of age and to have studied medicine under the guidance of learned professors for seven years. But to be received as surgeons they were obliged to spend an additional year in the study of anatomy. Another exaction was that each candidate should, on admission, take an oath of conformity to the laws of the school. A book was then handed to him, a ring placed on his left annular finger, and a crown

of laurel on his head. He was then wished God speed with a kiss of peace.

Many of the students of that famous school attained great renown as physicians. Among them were Constantine of Carthage, better known as the African; Theodore, Archbishop of Canterbury; Wigart, Bishop of Hildesheim; Cuthbert, the English monk; John of Ravenna; Gerbert, afterward Pope Sylvester II.; John the Milanese, author of the Regimen Sanitatis Salerni; Gilles de Corbeil; and hosts of other clerico-medical celebrities. One of Gerbert's most distinguished students was Fulbert who became Bishop of Chartres and died in 1028. He practised and taught medicine with great success, and had among his pupils Peter of Chartres, Hildier, Goisbert, and John of Chartres physician to Henry I. of France; all attaining celebrity in the medical art.

7. From the tenth to the fifteenth century, the union of priestly and medical offices was invariably exacted by the French schools all of which were episcopal or monastic; and for a very long time after laymen had been admitted as students of medicine, the priests continued to practice the art despite four forbidding decrees of church councils. The fifth and final decree, prohibiting them from entering upon the study or practice of medicine, did not take effect until about the middle of the eighteenth century. It was then that great teachers began to attract crowds of laymen as medical students, and that the continental schools offered the most abundant advantages to their pupils.