Читать книгу The Greatest Benefit to Mankind: A Medical History of Humanity - Roy Porter - Страница 35

The Salerno medical school was supposedly founded by four scholars – a Latin teacher, a Jew, an Arab and a Greek who had brought to the West the writings of Hippocrates. This legend carries a figurative truth. Sited in mid-Mediterranean and protected by the modernizing Norman dukes of Sicily, Salerno lay at a crossroads – cultural, economic and ethnic. In 1063, Alphanus (d. 1085), a Benedictine monk of Monte Cassino who had become archbishop of Salerno, travelled to Constanti nople where he became acquainted with Greek medical texts. His Premnon Physicon introduced into the Latin-speaking world a Christianized Galenism, while his writings on the humours and the pulse reflected Byzantine medicine. Together Alphanus’s works amount to a more philosophical approach to medicine than that hitherto available in the West, hellenizing it and enabling the physician to set himself above the workaday healer.

Later Salernitan teaching texts continued the latinization of Greek writings, and Salerno channelled Arabic medicine into the West, under the stimulus of Constantinus Africanus (c. 1020–87). A native of Carthage (in modern Tunisia) who became a monk of Monte Cassino, Constantine relayed texts of Arabic and Greek medicine, the most important of his translations being the Pantegni [The Whole Art] of Haly Abbas (d. 994). Many Greek texts which had been translated into Arabic were now latinized by Constantine, notably Galen’s Method of Healing, his commentaries on Hippocrates’ Aphorisms, his Regimen in Acute Diseases, Prognostic and the Art of Medicine. Constantine also made a version of Hunayn’s (Johannitius’) Medical Questions, known as the Liber Ysagogarum [Isagogue or Introduction]. By the mid-twelfth century these texts were seeping beyond Italy.

Constantinc’s translations were crucial, providing as they did the means whereby Latin Christendom gained access to the tradition of Hippocratic learning rationalized by Galen and digested by the Arabs. For the first time since the sixth century, Latin speakers could share in contemporary medical thinking. Providing a framework for medical teaching on diagnosis and therapy, the Liber Ysagogarum became a foundation text in the medical schools which sprang up in Italy and France, forming the basis of the Articella (see below).

The Liber Ysagogarum also broadened and gave greater prominence to the Galenic idea of the ‘six non-naturals’ – food and drink, environment, sleep, exercise, evacuations (including sexual) and state of mind; by regulating these, natural body balance could be preserved in the medical analogue to monastic rule. Stressing regimen, the non-naturals set the mould for medieval therapeutics, particularly in popular health books emanating from Salerno. The Regimen sanitatis salernitanum [Salernitan Regime of Health], a book of verses probably compiled in the thirteenth century and sometimes credited to Arnald of Villanova (1240–1311), supplied tips for healthy living from youth to old age, highlighting hygiene, exercise, diet and temperance. The first of the home health manuals, its enduring popularity is shown by the number of later printed editions: some 240 versions in Latin and other European languages, as well as Hebrew and Persian. And no wonder, since it was simple and even entertaining in its advocacy, alongside Galenic venesection, of Drs Quiet, Diet and Merryman.^*

Salernitan translations and teachings created a new canon of medical authority known as the Articella [Little Art of Medicine], which included the Liber Ysagogarum and Hippocrates’ Aphorisms and Prognostic, supplemented by Galen’s Tegni and the Hippocratic On Regimen in Acute Diseases in a translation by Gerard of Cremona (fl. 1150–87). Rapidly becoming canonical, the Articella or Ars medicinae marked a turning point in the revival of medicine in the West. It combined translations from Greek and Arabic; it was concerned with theory, providing a basis of philosophical knowledge organized around key themes; its discussions set medicine within a wider conception of nature; and its Aristotelian orientation appealed to university scholastics. Not least, the Articella gave medicine a distinctly Galenic complexion. Pre-Salernitan compendia had included texts drawn from the Methodist as well as the Hippocratic tradition; Galen had not eclipsed all others. But the Articella texts were wholly Galenic: a proper doctor could thenceforth be defined as a man who knew his Galen.

Learned medicine continued to develop, thanks to the rise of universities (discussed below) and further access to scholarship via translation. The business of Latin translation proceeded through several stages. The first, the Salernitan, involved both Greek and Arabic texts. From the 1140s, there was a great outpouring of Latin translations from Arabic made in Muslim Spain, sometimes by way of Hebrew intermediaries. This development, which included philosophical texts, especially Aristotle, as well as medical, was led by Gerard of Cremona. Settling in Toledo, he translated an incredible quantity of material from Arabic – twenty-four works on medicine alone, including the Qanun of Avicenna, the Liber Almansorius of Rhazes (al-Razi), the last part of Albucasis’ De cirurgia, the Ars parva and other works of Galen, and the Commentary on Galen’s Art of Medicine by Haly Rodoan (Ali-ibn Ridwan). The Qanun or Canon of Medicine became the cornerstone of the medical curriculum at the University of Montpellier, remaining a textbook there until 1650! These translations created a richer terminology for learned medicine in Latin and provided Galenic medicine with a logical backbone. Medicine could now speak the language of scholasticism.

A century later there came a further burst of translations, mainly in Spain and Italy, latinizing other major works of Arabic science. These included the Continens [All-Embracing Book] of al-Razi (trans. 1282); and the Colliget [The Book of Universals] of Ibn Rushd, translated in Padua in 1283. The key figure in this drive was Arnald of Villanova. After studying medicine at Montpellier, he became a teacher and a polymath. Not only a translator of medical works, he was physician to the popes and the Aragonese royal family in Spain; later in life, he pored over theology, propounding heterodox ideas – his astrological computations predicted the world would end in 1378. As a theoretician, Arnaud aspired to rationalize Galenic medical theory with mathematical precision, by drawing on Arabic writers, notably al-Kindi and Averroës.

His Italian contemporary Pietro d’Abano (1257-c. 1315) made versions directly from Greek manuscripts he had carried back from Constantinople, including the beginning of a translation of Galen’s On the Use of the Parts of the Body. Niccolò da Reggio (fl. 1315–48) translated over fifty Galenic writings, many for the first time, including the entire text of that work. There was also translation from Latin into the vernacular, in growing demand when town life was reviving and courts and burghers were hungry for knowledge. The Surgery of John of Arderne (c. 1307–70), discussed below, exists in both Latin and English versions, and Bartholomew the Englishman’s (d. 1260) De proprietatibus rerum (1246) [On the Properties of Things] also enjoyed wide circulation in both tongues. Parts of the Articella were made available in French and English, and even in Welsh and Gaelic. For a couple of centuries, the translation movement had no less momentous consequences in Europe than in Islam, bolstering the prestige of antiquity and canonizing a Galenic medicine set in an arabized Aristotelian framework. Medical knowledge was buttressed not just by its classical heritage but by its place within the divine scheme of Christianity.