Читать книгу Medicine in the Middle Ages - Edmond Dupouy - Страница 4

“Balnea si calidis queras sudantia thermis,

In claris intrabis aqua, ubi corpus inungit,

Callidus, et multo medicamine spargit aliptes’,

Mox ubi membra satis geminis mundata lacertis

Laverit et sparsos crines siccaverit, albo

Marcida subridens componit corpora lecto.”

Already, in the time of Saint Louis, the number of bath-keepers was so great that they had a trades union; they were almost all barbers, too; they washed the body, cut hair, trimmed corns and nails, shaved and leeched.

Bath houses more than multiplied from the twelfth century, imitations of Oriental customs, due to the crusaders. Baths were run not only by men, but by old harridans and fast girls. No respectable woman ever entered a public bath-house; Christine de Pisan bears witness to that fact in the following lines: “As to public baths and vapor baths, they should be avoided by honest women except for good cause; they are expensive and no good comes out of them, for many obvious reasons; no woman, if she be wise, would trust her honor therein, if she desire to keep it.”

The establishments known as vapor baths, as early as the time of Saint Louis, had already degenerated into houses of prostitution. The police, in defense of public morality, were finally obliged to forbid fast women and diseased men from frequenting such places.

In Italy, vapor baths were recognized officially and tolerated as places of public debauchery; this was also the case in Avignon. The Synodal statutes of the Church of Avignon, in the year 1441, bear an ordinance drawn by the civil magistrates and applicable to married men and also to priests and clergy, forbidding access to the vapor baths on the Troucat Bridge, which were set apart as a place of tolerated debauchery by the municipal authorities. This ordinance contained a provision that was very uncommon in the Middle Ages, i.e., a fine of ten marks for a violation of the law during day time and twenty marks fine for a violation occurring under cover of night.

In 1448 the city council of Avignon again tried its hand at regulating the vapor baths at the bridge; but the golden days of debauched women had long before passed away, and the previous century had witnessed the acme of the courtesans’ fortunes. The sojourn of the Popes at Avignon had gathered together from all over the Globe a motley collection of pilgrims and begotten a frightful condition of libertinage; we have the authority of Petrarch in saying that it even surpassed that of the Eternal City, and Bishop Guillaume Durand presented the Council of Vienna with a graphic picture of this social evil.

According to the proclamation of Etienne Boileau, Mayor of Paris in the reign of Louis IX., barber bath keepers were forbidden to employ women of bad reputation in their shops in order to carry on under cover, as in the massage shops of the present day, an infamous commerce, on penalty of losing their outfit—seats, basins, razors, etc.,—which were to be sold at public auction for the profit of the public treasury and the Crown. But we know full well that the Royal Ordinance of 1254, which had for its object the reformation of public debauchery, was only applied for the space of two years, and that the new law of 1256 re-established and legalized public prostitution which offered less objectionable features than clandestine prostitution.

The use of public baths and hydrotherapy lasted until the sixteenth century. At this epoch, and without any known reason, the public suddenly discontinued all balneary practices, and this was noticeable among the aristocratic class as among the common people. A contrary evil was developed. “Honest women,” says Vernille, “took a pride in claiming that they never permitted themselves certain ablutions.” Nevertheless, Marie de Romien, (Instruction pour les Jeunes Dames) in her classical work for the instruction of young women, remarks: “They should keep clean, if it be only for the satisfaction of their husbands; it is not necessary to do as some women of my acquaintance, who have no care to wash until they be foul under their linen. But to be a beautiful damoyselle one may wash reasonably often in water which has been previously boiled and scented with fragrants, for nothing is more certain than that beauty flourishes best in that young woman who not only looks but smells clean.”

In an opuscle published in 1530, by one called De Drusæ, we observe that “notwithstanding the natural laws of propriety, women use scents more than clean water; and they thus only increase the bad smells they endeavor to disguise. Some use greasy perfumed ointments, others sponges saturated in fragrants”

“Entre leur cuisses et dessoubz les aisselles,

Pour ne sentir l’espaulle de mouton.”

This horror of water did not last long, however, and at the commencement of the seventeenth century the false modesty of women ended with the creation of river baths, such as exist to-day along the banks of the Seine.

Was this restoration of cleanly habits due to medical advice? This question cannot be answered, but it may not be out of place to cite that remarkable passage from the “Essays of Montaigne” on the hygiene of bathing, which he recommends in certain maladies:

“It is good to bathe in warm water, it softens and relaxes in ports where it stagnates over sands and stones. Such application of external heat, however, makes the kidneys leathery and hard and petrifies the matter within. To those who bathe: it is best to eat little at night to the end that the waters drank the next morning operate more easily, meeting with an empty stomach. On the other hand, it is best to eat a little dinner, in order not to trouble the action of the water, which is not in perfect accord; nor should the stomach be filled too suddenly after its other labor; leave the work of digestion to the night, which is better than the day, when the body and mind are in perpetual movement and activity.

“I have noted, on the occasion of my voyages, all the famous baths of Christendom, and for some years past have made use of waters, for as a general rule I consider bathing healthy and deem it no risk to one’s physical condition. The custom of ablution, so generally observed at times past in all nations, is now only practiced in a few as a daily habit. I cannot imagine why civilized people ever allow their bodies to become encrusted with dirt and their pores filled with filth.”[9]

If Montaigne made great use of mineral waters, he had in revenge a formidable dread of physicians and their medicines, a sentiment he inherited from his father, “who died,” says he, “at the age of seventy-four years,” and his “grandfather and great-grandfather died at eighty years without tasting a drop of physic.”

Montaigne has justly criticized medicine in several essays on the healing art. He knew well the intividia medicorum, and it was for this reason that he remarked that a physician should always treat a case without a consultant. “There never was a doctor,” says Montaigne, “who, on accepting the services of a consultant, did not discontinue or readjust something.” Is not the same criticism deserved at the present day? How absurd are our medical consultations. The examples Montaigne gives of disagreements of doctors in consultation as to doctrines are equally applicable to modern times. The differences of Herophilus, Erasistratus, and the Æsclepiadæ as to the original causation of disease were no greater than those of the schools of Broussais and Pasteur, which have both acquired a universal celebrity in less than half a century.

Montaigne insisted that medicine owed its existence only to mankind’s fear of death and pain, an impatience at poor health and a furious and indiscreet thirst for a speedy cure, but the author of the “Essays” adds in concluding: “I honor physicians, not following the feeling of necessity, but for the love of themselves, having seen many honest doctors who were honorable and well worthy of being loved.”

The reputation for disagreement among doctors so much insisted on by Montaigne has served as a well-worn text for many other critics.

In Les Serres of Guillaume Bouchet, a contemporary of the author, we find the same shaft of sarcasm directed at physicians. Where will you find men in any other profession save that of medicine who envy and hate each other so heartily? What other profession on earth is given over to such bitter disagreements? How can common people be expected to honor and respect experts and savants so-called when the professors call each other ignoramusses and asses? Call these doctors into a case and one after the other they will disagree as to the diagnosis as well as to the method of cure. As Pellisson wrote:

“When an enemy you wish to kill

Don’t call assasins full of vice,

But call two doctors of great skill

To give contrary advice.”

Or in the verses of the original:

“D’un ennemi voulez vous defaire?

Ne cherchez pas d’assasins

Donnez lui deux medecins,

Et qui’ils soient d’avis contrarie.”

This professional jealousy is always more apparent than real. Aside from the rivalry for public patronage physicians are a very social class of men, as witness their many festive meetings. We banquet in honor of St. Luke the physician, and St. Come, after each thesis, at anniversaries, at the election of the Dean, and on many other occasions. It is these co-fraternal meetings at which are reinagurated the old feelings of good-fellowship; our little quarrels only serve to discipline the medical body and to increase the grandeur of the Faculty. It is the constant rubbing of surfaces that makes the true professional metal glitter.

When we hear new doctors, young graduates, swear the Hippocratic oath, we do not forget that the principal articles of the statute prescribe the cultivation of friendships, respect for the older members of the profession, benevolence to the young beginners, and the preservation of professional decency and kindness. It may be insisted that banquets are not to be considered as medical assemblages, for there they laugh long and loud, and drink many a bumper of rich Burgundy; making joyous discourse; holding to the famous compliment of Moliere:

Salus, honor et argentum

Atque bonum appetitum.

We know to-day many of the truthful precepts of the School of Salerno and their bearing on the medical records of the middle ages. Then as now the doctor had the ever increasing ingratitude of the patient (ad proccarendam oegrorum ingratitudinem).

“The disciple of Hippocrates meeteth often treatment rude,

The payment of his trouble is base ingratitude.

When the patient is in grievous pain the time is opportune

For a keen, sharp-witted doctor to make a good fortune.

Let him profit by the sufferer’s aches and gather in the money,

For the ant gets winter provender and the summer bee its honey.”

Our ancient friends had no pity for charlatans, however. They rightfully abused all medical impostors, as we read in the precepts of Salerno’s school:

“Il n’est par d’ignorant, de chartatan stupide,

D’histron imposteur, ou de Juif fourbe avide,

De sorciere crasseuse ou de barbier bavard,

De faussiare inpudent, ou de moine cafard,

De marchand de savon, ou de avengle oculiste,

De baigneur imbecile, ou d’absurde alchimiste,

Pas d’heretique impur qui ne se targue, enfin,

Du beau titre, du nom sacre de medecin.”

The investigation of medical science was far from being an honor to the middle ages. The best of the profession was hidden in the doctoral sanctuary, enveloped in those mysteries which are never penetrated by the profane and only known to the initiated.

The recommendations as to the secrets of our art are addressed to all young doctors in that famous epilogue commencing:

“Gardez surtout, gardez qui’un profane vulgaire

De votre art respecte ne perce le mystere;

Son eclat devoile perdrait sa dignite

D’un mystere connu decroit la majeste,”

Let us invoke God, the Supreme physician, let us demand the professional banishment of every doctor who reveals a professional secret.

“Exsul sit medicus physicius secreta revelans.”—Amen!