introduction of Arabic medicine to the western world.

[Sidenote: Instances of early medieval additions to ancient medicine.] A good instance of the working over by men of the early medieval period of the medical writings of the late Roman period is provided by a manuscript of the ninth or tenth century at Berlin.[2869] It now consists of a number of fragments whose original order can no longer be determined. These are made up of extracts from different sources or from other collections, but the collection also bears the mark of its last compiler who has introduced new remedies of his own and words derived from the vernacular of his day. Even extracts on fevers taken from the old Latin adaptation of Galen[2870] are added to by some Christian physician, who introduces among other things some incantations, such as, “I adjure you, spots, that you go away and recede from and be destroyed from the eye of the servant of God.”[2871] The manuscript also comprises more than one tract on how dreams or the fate of the patient or child born can be foretold from the day of the moon.[2872] Another tract[2873] tells how God made the first man out of eight parts, of which the first was the mud of the earth and the last the light of the world. This would seem to be rather a novel departure from the usual four element theory but perhaps involves ancient Gnostic error. The author further argues that individual divergences of character depend upon the preponderance of one or another of the eight constituents of the body. [Sidenote: _Leech-Book of Bald and Cild._] The Anglo-Saxon _Leech-Book of Bald and Cild_[2874] has been called “the first medical treatise written in western Europe which can be said to belong to modern history.”[2875] It was produced in the tenth century. However, it extracts a good deal from late Greek medical writers, such as Paul of Aegina and Alexander of Tralles, and cites Pliny, “the mickle leech,” for the cure of baldness by application of dead bees burnt to ashes,[2876] a remedy also found in the _Euporista_ ascribed to Galen. On the whole, however, it uses parts of animals somewhat less than Pliny, although sometimes a powdered earthworm is recommended, or a man stung by an adder is to drink holy water in which a black snail has been washed, or the bite of a viper is to be smeared with ear-wax while thrice repeating “the prayer of Saint John.”[2877] And a man about to engage in combat is advised to eat swallow nestlings boiled in wine.[2878] Herbs are as useful against a woman’s tongue as birds against a foeman’s steel, for we are told: “Against a woman’s chatter; taste at night fasting a root of radish; that day the chatter cannot harm thee.”[2879] There are directions for plucking herbs similar to those in Pliny,[2880] and the significance which he ascribed to cart ruts is paralleled by the injunction, after one has treated a venomous bite by striking five scarifications, one on the bite and four around it, to “throw the blood with a spoon silently over a wagon way.”[2881] Eight virtues of the stone agate are enumerated.[2882] [Sidenote: Magical procedure and incantations.] Not only such occult virtues of animals, vegetables, and minerals, but also magical procedure and incantations abound in the work. In a prescription “for flying venom and every venomous swelling” butter is to be churned on a Friday from the milk of a “neat or hind all of one color,” and a litany, paternoster, and incantation of strange words are to be repeated nine times each.[2883] A great deal of superstitious use is made of such Christian symbols, names, and forms of prayer as the sign of the cross, the names of the four evangelists, and masses, psalms, and exorcisms. Fear of witchcraft and enchantment is manifested, and the ills both of man and beast are frequently attributed to evil spirits. “A drink for a fiend-sick man” is on one occasion “to be drunk out of a church bell,” with the accompaniment of much additional ecclesiastical hocus-pocus.[2884] “If a horse is elf-shot, then take the knife of which the haft is horn of a fallow ox, and on which are three brass nails. Then write upon the horse’s forehead Christ’s mark, and on each of the limbs which thou may feel at. Then take the left ear; prick a hole in it in silence. This thou shalt do; then take a yerd, strike the horse on the back, then it will be whole. And write upon the horn of the knife these words, _Benedicite omnia opera domini dominum_. Be the elf what it may, this is mighty for him to amends.”[2885] [Sidenote: A superstitious compound.] Neither Bald and Cild nor their continuator shared Pliny’s prejudice against compound medicines. In the third book by the continuator is described “a salve against the elfin race and nocturnal visitors, and for women with whom the devil hath carnal commerce.” One takes the ewe hop plant, wormwood, bishopwort, lupin, ashthroat, henbane, harewort, viper’s bugloss, heatherberry plants, cropleek, garlic, grains of hedgerife, githrife, and fennel. These herbs are put in a vessel and placed beneath the altar where nine masses are sung over them. They are then boiled in butter and mutton fat; much holy salt is added; the salve is strained through a cloth; and what remains of the worts is thrown into running water. The patient’s forehead and eyes are to be smeared with this ointment and he is further to be censed with incense and signed often with the sign of the cross.[2886] [Sidenote: Summary.] The “modern” character of Bald’s and Cild’s book cannot be said to have produced any diminution of superstition as against the writings of antiquity. But we do find native herbs introduced, also popular medicine, and probably a considerable amount of Teutonic and perhaps also Celtic folk-lore, which, however, has been more or less Christianized. Indeed the connection between medicine and religion is remarkably close. [Sidenote: Cauterization.] The medicine of this period may be further illustrated by two Latin manuscripts of the eleventh century in the Sloane collection of the British Museum.[2887] One contains a brief treatise which illustrates the common tendency at that time to employ cauterization not only for surgical purposes in connection with wounds, but as a medical means of giving relief to internal diseases and trivial complaints with which cauterization could have no connection. That the practice was very largely a superstition is further evident from the fact that one part of the body often was cauterized for a complaint in another or opposite portion or member. In the present example, under the alluring names of Apollonius and Galen as professed authors,[2888] are presented a series of human figures showing where the cautery should be applied. These pictures of naked patients marked all over their anatomy with spots where the red-hot iron should be applied, or submitting with smiling or wry faces to its actual administration in the most tender places, are both amusing and, when we reflect that this useless pain was actually repeatedly inflicted through long centuries, pathetic.[2889] [Sidenote: Treatment of demoniacs.] In a general and much longer work on diseases and their remedies which follows in the same manuscript and which is professedly compiled from Hippocrates, Galen, and Apollonius, the treatment prescribed for demoniacs,[2890] who, it states, are in Greek called _epilemptici_ (epileptics), includes among other things vaporization between the shoulder blades with various mixtures, scarification and bleeding, application of leeches to the “stomach where you ought not to operate with iron,”[2891] shaving and “imbrocating”[2892] the scalp, and anointing the hands and feet with oil. Both our manuscripts contain recipes for expelling or routing demons.[2893] For this purpose such substances are employed as the stone _gagates_ and holy water, and elsewhere the usual confidence is reposed in the virtues of herbs and such parts of animals as the liver of a vulture. [Sidenote: Incantations and characters.] In one of the manuscripts is a treatise in which much use is made of incantations and characters. There are prayers to “Lord Jesus and Holy Mary” to heal the sick, while characters, sometimes engraved upon lead plates, are employed not only for medical purposes, but to prevent women from conceiving, to make fruit trees bear well, and against enemies.[2894] Later on in the manuscript instructions for plucking a medicinal herb include facing east and reciting a paternoster.[2895] [Sidenote: In a twelfth century manuscript.] The twelfth century portion of this same manuscript consists mainly of a long medical medley with no definitely marked beginning or ending but apparently originally in five books.[2896] Towards its close occur a number of incantations and characters quite in the style of Marcellus Empiricus.[2897] Indeed, “a marvelous charm” for toothache is an exact copy of his instructions to repeat seven times in a waning moon on Tuesday or Thursday an incantation beginning, “Aridam, margidam, sturgidam.”[2898] To make all his enemies fear him a man should gather the herb verbena on a Thursday, repeating seven times a formula in which the plant is personally addressed and the desire expressed to triumph over all foes as the verbena conquers winds and rains, hail and storms.[2899] If here the influence of pagan religion is still present, many of the incantations are in Christian form and expressed in the name of God or the Father. To find a thief characters are employed together with the incantation, “Abraham bound, Isaac held, Jacob brought back to the house.”[2900] A charm against fever opens, “Christ was born and suffered; Christ Jesus rose from the dead and ascended unto heaven; Christ will come at the day of judgment. Christ says, According to your faith it shall be done.” Then the sign of the cross is employed and “sacred words,” which seem, however, to include not only Matthew, Mark, Luke, and John, but Maximianus, Dionysius, John, Serapion, and Constantinus. As we have to do with a twelfth century manuscript the last two names might be presumed to have reference to the medical writers of the eleventh century, but another manuscript which contains a similar incantation states that they are the names of the seven sleepers.[2901] Our charm then continues “In the name of Christ” and with a prayer to God to free from sickness anyone who “bears this writing in Thy name.”[2902] [Sidenote: Magic with a split hazel rod.] In the same work occurs the earliest instance of which I am aware of the magical “experiment” with a split rod and an incantation, to which we shall hear William of Auvergne, Albertus Magnus, John of St. Amand, and Roger Bacon refer in the thirteenth century. A rod of four cubits length is to be cut with repetition of the Lord’s Prayer. It is to be split, and the two halves are to be held apart at the ends by two men. Then, making the sign of the cross, one should repeat the following incantation, “Ellum sat upon ella and held a green rod in his hand and said, Rod of green reunite again,”[2903] together with the Lord’s Prayer until the two split halves bend together in the middle. One then seizes them in one’s fist at the junction point, cuts off the rest of the rods, and makes magic use of the section remaining in one’s grasp.[2904] [Sidenote: More incantations and the virtues of a vulture.] Another manuscript of the twelfth century[2905] contains many similar charms, incantations, prayers, and characters for healing purposes. One formula employed is, “Christ conquers, Christ reigns, Christ commands.” In cases of miscarriage a drink of verbena is recommended and repetition of the following incantation with three Paternosters, “Saisa, laisa, relaisa, because so Saint Mary did when she bore the Son of God.” Presently a paragraph opens with the assertion that the human race does not know how great virtue the vulture[2906] possesses and how much it improves health. But certain ceremonial directions must be observed in making use of it. The bird should be killed in the very hour in which it is caught and with a sharp reed rather than a sword. Before beheading it, one should utter an incantation containing such names as Adonai and Abraam. Various healing virtues appertain to the different parts of its carcass, although here again there are instructions to be observed. The bones of its head should be bound in hyena skin; its eyes should be suspended from the neck in wolf’s skin. Binding its wings on the left foot of a woman struggling in child-birth produces a quick delivery. One who wears its tongue will receive the adoration of all his enemies; if one has its heart bound in the skin of a lion or wolf, all demons will avoid one and robbers will only worship one. Its gall taken in quite a mixture cures epileptics and lunatics; its lung in another compound cures fevers; and so on. [Sidenote: _Lots of the saints._] There follow _Sortes sanctorum_, introduced by a page and a half of prayers of this tenor, “In the name of our Lord Jesus Christ, we ask Father and Son and Holy Ghost, Three and One; we ask Saint Mary, the mother of our Lord Jesus Christ; we ask the nine orders of angels; we ask the whole chorus of patriarchs; we ask the whole chorus of apostles, martyrs, confessors, and virgins, and the whole chorus of God’s faithful that they deign to reveal to us these lots which we seek, and that no seduction of the devil may deceive us.” The treatise closes, “These are the lots of the saints which never fail; so ask God and obtain what you desire.” [Sidenote: Superstitious veterinary and medical practice.] The next items in the manuscript are some cases of superstitious veterinary practice, with such pious incantations as “May God who saved the thief on the cross save this beast!”[2907] and with instructions concerning the religious invocations and written characters to be employed in blessing the food and salt to be given to domestic animals in order to keep them in good health. Characters are also mentioned which will prevent the blood of a pig from flowing when it is slaughtered, provided they are bound upon the breast or are written on the knife with which the pig is to be stuck.[2908] Holy water and bread that has been blessed are used for medical purposes and instructions are given on what days medicinal herbs should be gathered. The prayers employed are usually put in Christian form, but one for the cure of toothache has slipped by at least partially uncensored. It opens with the words “O lady Moon, free me....”[2909] [Sidenote: Two Paris manuscripts.] If we turn from medical manuscripts of the eleventh and twelfth centuries in the British Museum to those of the Bibliothèque Nationale, we find the same occurrence of superstitious passages. In an eleventh century codex which contains parts of the medical work of Celsus and the _De dinamidis_ of Galen are also found prayers to God for the medicinal aid of the angel Raphael against the treacherous attacks of the demons, a work on the virtues of stones which has much to say of their marvelous properties, and figures and text concerning the twelve signs of the zodiac and twelve winds.[2910] Much more superstitious, however, is an anonymous treatise occupying the first ten leaves of a twelfth century manuscript[2911] which is apparently of German origin from the number of German words and phrases introduced near its close. This treatise is followed in the manuscript by the works of Notker, Hermann the Lame, and others on _computus_ and the astrolabe. [Sidenote: Blood-letting.] After discussing the effect of food upon health, listing potions of herbs to be drunk in each month of the year,[2912] treating of the veins and of the four winds, four seasons, and four humors, and the relations existing between the two last-named, the author enumerates the many advantages of blood-letting in a long passage which is worth quoting in part. “It contains the beginning of health, it makes the mind sincere, it aids the memory, it purges the brain, it reforms the bladder, it warms the marrow, it opens the hearing, it checks tears, it removes nausea, it benefits the stomach, it invites digestion, it evokes the voice, it builds up the sense, it moves the bowels, it enriches sleep, it removes anxiety, it nourishes good health ...”: and so on. The operation of bleeding should not be performed on the tenth, fifteenth, twenty-fifth, or thirtieth day of the moon, nor should a potion be taken then. The Egyptian days and dog-days are to be similarly observed. The hours of the day when each humor predominates are then given. [Sidenote: Resemblances to Egerton 821.] There then is introduced rather abruptly an account of the medicinal virtues of the vulture almost identical with that in the British Museum manuscript. Once again, too, herbs are to be plucked with repetition of the Lord’s Prayer.[2913] The use of characters to prevent a slaughtered pig from bleeding is introduced somewhat otherwise than in the other manuscript. Having first recommended as a cure for human sufferers from flux of blood the binding about the abdomen of a parchment inscribed with the characters in question, the author adds, “And if you don’t believe it, write them on a knife and kill a pig with it, and you will see no blood flow from the wound.”[2914] [Sidenote: Virtues of blood.] Considerable medicinal use is made of blood in this treatise. For cataract is recommended instilling in the eye the blood which flows from a certain worm (_oudehsam?_) when “you cut it in two near the tail.”[2915] To break the stone one employs goat’s blood caught in a glass vessel in a waning moon and dried eight days in the sun together with the pulverized skin of a rabbit caught in a waning moon and roasted over marble. These are to be mixed in wine and given in the name of the Lord to the patient to drink while he is in the bath.[2916] Another remedy consists of three drops of the milk of a woman nursing a male child given in a raw egg to the patient without his knowledge.[2917] [Sidenote: Pious incantations and magical procedure.] The work abounds in characters and in incantations which consist either of seemingly meaningless words or of Biblical phrases and allusions. These are very much like those in the manuscripts already considered and are often accompanied by elaborate procedure. For example, the prayer, “O Lord, spare your servant N., so that chastised with deserved stripes he may rest in your mercy,” is to be written on five holy wafers which are then to be placed on the five wounds of a figure of Christ on a crucifix. The patient is to approach barefoot, eat the wafers, and say: “Almighty God, who saved all the human race, save me and free me from these fevers and from all my languors. By God Christ was announced, and Christ was born, and Christ was wrapped in swaddling clothes, and Christ was placed in a manger, and Christ was circumcised, and Christ was adored by the Magi, and Christ was baptized, and Christ was tempted, and Christ was betrayed, and Christ was flogged, and Christ was spat upon, and Christ was given gall and vinegar to drink, and Christ was pierced with a lance, and Christ was crucified, and Christ died, and Christ was buried, and Christ rose again, and Christ ascended unto heaven. In the name of the Father and of the Son and of the Holy Ghost, Jesus, rising from the synagogue, entered the house of Simon. Moreover, Simon’s daughter was sick with a high fever. And they entreated Him on her behalf. And standing over her He commanded the fever and it departed.”[2918] To cure epilepsy an interesting combination of scriptural incantation and rather unusual magic procedure is recommended. Before the attack comes on, the words of the Gospel of Matthew, “Jesus was led by the spirit into the desert; and angels came and ministered unto Him,” are to be written on a wooden tablet with some black substance which will wash off readily. Then, when the fit comes on, this writing is to be washed off into a vessel with still water and given to the patient to drink in the name of Father, Son, and Holy Ghost. “If you do this three times, God helping the patient will be cured.”[2919] [Sidenote: More superstitious veterinary practice.] Our manuscript further resembles Egerton 821 of the British Museum in containing remedies for beast as well as man. If a horse suffers from over-eating, one should learn his name and procure some hazel rods. Then one is to whisper in his right ear an incantation consisting of outlandish words accompanied by the Lord’s Prayer, and is to bind his thighs and feet with the rods. This ceremony, too, is to be repeated thrice.[2920] [Sidenote: The School of Salerno.] We now come to the consideration of treatises supposed to have been produced by the school of medicine at Salerno. But not only are the origins of the so-called School of Salerno “veiled in impenetrable obscurity,”[2921] much of its later history is scarcely less uncertain, and it is no easy matter to say what men and what writings may be properly called Salernitan, or when they lived or were composed. The manuscripts of Salernitan writings seem to have been found more frequently north of the Alps than in Italian libraries. It would perhaps be carrying scepticism too far to doubt if medicine developed much earlier or more rapidly at Salerno than elsewhere, since it seems certain that the town was famous for its physicians at an early date, and that we have medical writings of Salernitans produced in the early eleventh century. But one is inclined to view with some scepticism the assumption of historians of medicine[2922] that the word Salernitan represents a separate body of doctrine, or of method in practice, which may be sharply distinguished from Arabic medicine or from later medieval medicine as affected by Arabic influence. Rather the medical literature and practice of Salerno is an integral and scarcely distinguishable part of medieval medicine as a whole. Many Salernitan treatises themselves belong to the later medieval period, and very few of them can be shown to antedate Constantinus Africanus, whose translations seem to mark the beginning of Arabic influence. And on the other hand there are equally early medieval medical treatises, such as those we have hitherto been considering, which are not Salernitan and yet show no sign of Arabic influence. Thus the word Salernitan cannot accurately be identified with a first period of medieval Latin medicine based upon early or Neo-Latin translations of Greek medical authors and upon independent medical practice. Such activity was not confined to Salerno. But if we so employ the word Salernitan for a moment, there seems no reason for thinking that such a development would be very different from the Arabic and Byzantine continuations of Greek medicine. A place so open to Saracen and Byzantine influence as the coast of southern Italy is hardly the spot where we should look for a totally distinct medical development, and the influence of Celtic and Teutonic folk-lore upon medical practice would presumably be more felt north of the Alps. And it is to Salerno that Constantinus Africanus, the earliest known importer of Arabic medicine, comes. [Sidenote: Was Salernitan medicine free from superstition?] The notion, too, that the Salernitan or early medieval Latin medical practice was sound and straightforward and sensible and free from the superstition with which the holders of this opinion represent Arabic and later medieval medicine as overburdened, is also probably illusory. We have already seen evidence of rather extreme superstition in early medieval Latin medicine which shows no trace of Arabic influence, and the medical practitioners of Salerno are sometimes represented in the sources as empiricists or old-wives. The place was peculiarly noted for its female practitioners, of whom more anon; and one of the earliest mentions of a physician of Salerno is the account in Richer’s chronicle[2923] of the mutual poisoning of two rival physicians in 946 A. D. Here the Salernitan is described as lacking in Latin book-knowledge and skilful from natural talent and much experience. He was the queen’s favorite physician, but was worsted by another royal physician, Bishop Deroldus, in a debate which the king, Louis IV, instituted in order to find out “which of them knew more of the natures of things.” The defeated Salernitan then “prepared sorcery” and tried to poison the bishop, who cured himself with theriac and secretly poisoned his rival in turn. The Salernitan was then reduced to the humiliating position of being forced to beseech the prelate to cure him, but in his case the theriac only drove the poison into his foot, which had to be amputated by a surgeon. This tale, be it true or not, suggests that there were good Latin physicians and surgeons outside of Salerno at an early date as well as that Salernitan medicine was far from being free from magic and empiricism. [Sidenote: The _Practica_ of Petrocellus.] It is fairer, however, to judge Salerno by its own best written productions rather than by the stories of perhaps jealous northerners, and we may note Payne’s comparison of the _Practica_ of Petrocellus,[2924] written probably in the early eleventh century, with the earlier _Leech-Book of Bald and Cild_. Selected recipes, it may first be said, were translated from the _Practica_ into Anglo-Saxon.[2925] Dr. Payne was impressed by “the complete freedom of the former from the magic and superstition which tainted the Anglo-Saxon and all other European medicine of the time.” Payne noted that the compounds of Petrocellus contained fewer ingredients, and regarded the Salernitan selection of drugs as “more intelligent.” The Salernitan formulae are “clear, simple, and written on a uniform system which implies traditional skill and culture.”[2926] “The pharmacy is generally very simple; and, as might be expected, there is an entire absence of charms and superstitious rites.”[2927] Such simplicity, however, is at best a negative sort of virtue; and we wonder if this early specimen of the School of Salerno is free from elaborate superstition for the very reason that the work is simple and elementary. The less medicine, the less superstition perhaps. Moreover, superstition is not quite absent, since Payne himself quotes the following recipe: “For those who cannot see from sunrise to sunset.... This is the leechcraft which thereto belongeth. Take a kneecap of a buck[2928] and roast it, and, when the roast sweats, then take the sweat and therewith smear the eyes, and after that let him eat the same roast; and then take fresh asses’ dung and squeeze it, and smear the eyes therewith, and it will soon be better with them.”[2929] [Sidenote: Its sources.] Petrocellus is thought to have used Greek writings directly without the intermediary of Arabic versions.[2930] He says in the introductory letter which opens the _Practica_ that he reduces to brief form in the Latin language those “authors who have culled the dogmas of all cases from Greek places.”[2931] But these words might be taken to indicate that he has used Greek sources only indirectly, while the fact that the person to whom the work is addressed is called “dearest son” and “sweetest son” is rather in the style of Arabian and Hebrew medieval writers. He goes on to assure this person that everything in the work has been tested by experience and that nothing should be added to or subtracted from it. [Sidenote: Fourfold origin of medicine.] This introductory epistle also embodies an account of the origin of medicine which, while not exactly superstitious, is quite in the usual naïve and uncritical style so often employed by both ancient and medieval writers in treating of a distant past. Apollo and his son Esculapius, Asclepius and “Ypocras” are named as the four founders of the medical art. Apollo discovered _methoyca_, which presumably means methodism, but which Petrocellus proceeds to identify with surgery. Esculapius invented _empirica_, which is described as pharmacy rather than empiricism, although perhaps the distinction _is_ slight. Asclepius founded _loyca_, which is probably meant for the dogmatic school. Hippocrates’ contribution was _theoperica_, which may mean therapeutics but is further described as the prognostication or “prevision of diseases.” It is in this same introductory epistle that Petrocellus makes the division of the brain into three cells of which we spoke in the chapter on Arabic occult science. Besides distinguishing the three cells as phantastic, logical, and mnemonic, he adds that good and evil are distinguished in the middle cell and that the soul is in the posterior one. [Sidenote: Therapeutics of Petrocellus.] In the _Practica_ proper the method of Petrocellus is to take up one disease at a time, tell what the Greeks call it, and briefly describe it, sometimes listing its symptoms or causes, but devoting most of his space to such methods of curing it as diet and bleeding, simples and compounds. I saw no instance of astrological medicine nor of resort to amulets and incantations in the version published by Renzi from a twelfth century manuscript at Paris. But in a fragment of the work from a Milan manuscript where twenty-six lines are devoted to the treatment of epilepsy instead of but seven as in the other text,[2932] one is advised to use antimony in the holy water “which the Greeks bless on Epiphany” and to chant the Lord’s Prayer three times. If this passage be a later addition, it shows that Petrocellus was less inclined to superstitious methods than others and that his injunction that nothing should be subtracted from or added to his work was not well observed. But in any case it illustrates my previous point that the more medicine, the more superstition. In twenty-six lines on epilepsy one is much more likely to find something superstitious than in seven. Indeed, the treatment of epilepsy was so generally superstitious that my recollection is that any account of it of any considerable length which I have seen in medieval writings contained some superstition. In fact, even if Petrocellus wrote the longer passage, he could be praised for having resorted to charms and formulae only in the case of that mysterious disease. [Sidenote: The _Regimen Salernitanum_.] The work most generally known as a characteristic product of the School of Salerno is the Latin poem[2933] which opens with the line, “To the King of the English writes the whole School of Salerno.”[2934] This poem has been variously entitled _Schola Salernitana_, _Regimen Salernitanum_, and _Flos medicinae_. How much more influential and widespread it was than the _Practica_ of Petrocellus may be seen from the fact that manuscripts of the text of the latter are rare, though the introductory letter is more common, and that it was first published by Renzi in the nineteenth century, whereas about one hundred manuscripts and two hundred and fifty printed editions of the poem have been found. It was known chiefly through the brief version of 362 verses, upon which Arnald of Villanova commented at the close of the thirteenth century, until as a result of the researches of Baudry de Balzac, Renzi, and Daremberg the number of lines was increased to 3526. This patchwork from many manuscripts can scarcely be regarded as the work of any one author, time, or even school, and it may be seriously questioned how many of the verses really emanated from Salerno. Certainly it is not free from Arabic influence, since it cites Alfraganus as well as Ptolemy.[2935] Pliny is used a great deal for the virtues of herbs. Much of it sounds like a late versification of commonplaces for mnemonic purposes. Sudhoff has recently pointed out that it was not generally known until the middle of the thirteenth century, before which time Frederick II, the cultured monarch, and Giles de Corbeil, the medical poet, appear unaware of its existence.[2936] [Sidenote: Its superstition.] The brief version of the poem commented upon by Arnald of Villanova naturally contains only one-tenth of the superstition found in the fuller text which is ten times longer. In some respects this brief version might pass as a restrained, though quaint, early set of directions how to preserve health, to which later writers have added superstitious recipes. But as a matter of fact it is too superstitious for even one as hospitable to theories of occult influence as Arnald, who rejects as false and worthless[2937] its assertion that the months of April, May, and September are lunar and that in them consequently fall the days upon which bleeding is prohibited. In the lines upon which Arnald comments marvelous properties are mentioned in the case of the plant rue, but the fuller text has many mentions of the occult virtues of herbs, stones, and animals. Almost at a glance we read that the urine of a dog or the blood of a mouse cures warts; that juice of betony should be gathered on the eve of St. John the Baptist, that rubbing the soles of the feet cures a stiff neck, and that pearls or the stone found in a crab’s head are of equal virtue for heart trouble.[2938] And not far away is a passage[2939] on the virtue of the _Agnus Dei_, made of balsam, pure wax, and the Chrism. It protects against lightning and the waves of the sea, aids women in child-birth, saves from sudden death, and in short from “every kind of evil.” Astrology is by no means omitted from the _Regimen Salernitanum_; in fact Balzac seems to have taken the fact that verses were astrological in character as a sign that they belonged in the Salernitan collection. [Sidenote: The _Practica_ of Archimatthaeus.] A third work which may be considered as an example of the medicine of Salerno is the _Practica_ of Archimatthaeus which Renzi placed in the twelfth century and conjectured to be the work of Matthaeus Platearius the Elder.[2940] One or two expressions, however, might be taken as indications that the writer is neither of early date nor himself a Salernitan. He speaks of curing pleurisy in a different way from the treatment recommended in the _Practica’s_ and tells how the Salernitans try to prevent their hair from falling out by reason of their pores opening too wide when they frequent the bath.[2941] Renzi hailed this treatise with delight as “a true medical clinic,”[2942] since the author describes some twenty-two specific cases. He states at the beginning that he does not propose to write a systematic treatise or to deal with every variety of disease, but only with those in which he has learned new and better methods by experience, “and in which God has put the desired effect in my hand.”[2943] Through the work we encounter such phrases as _expertum est, aliud probatissimum_, “I tell you what I have proved,” “We have tested this by experience and rejoiced at the result.” These utterances seem really to refer to the writer’s own experience and not to be copied from previous authors. The following is an example of his cases. “A certain lady incurred paralysis of the face during sleep after the bath,” which he attributes to dissolution of humors which affected the muscles. First he bled the cephalic vein, hoping thereby to draw off somewhat the humors from the afflicted place. Then for three successive days he gave her “the potion of St. Paul with wine of a decoction of salvia and castoria which in part prevent dissolution, in part consume it.” He also had her hold that wine in her mouth for a long time before swallowing it. At length he gave her a purgative with pills of yerapiga (_sacrum amarum_), mixed with golden pills. “Afterwards we injected pills of diacastoria into her nostrils and placed her near the fire. Finally we gave _opopira_ (bread free from furfure) with the aforesaid wine, and so she was cured, only a certain tumor remained in her face and made her eye water. We anointed her face with golden unguent and the potion of St. Paul mixed together and the tumor disappeared; for the tears we gave golden Alexandrina and they were checked; and thus it was that this year in your presence we cured a certain paralytic.”[2944] Like Galen’s accounts of his actual cases this makes us realize that all the gruesome mixtures of which we read in the books were actually forced upon patients, often several of them upon one poor sick person, and that medical practice was rather worse than medical theory. An interesting observation concerning the lot of the lower classes is let fall by our author when, in discussing involuntary emission of urine, he states that serfs and handmaids are especially subject to this ailment, since they go about ill-clad and with bare feet and become thoroughly chilled.[2945] [Sidenote: A Salernitan treatise of about 1200.] Giacosa classed one of the treatises which he published as Salernitan because it was written in a Lombard or Monte Cassino hand of about 1200.[2946] He described its contents as purely therapeutical and regarded its author as showing “a certain repugnance” to the popular remedies and superstitions recommended by other contemporary treatises. For this conclusion the chief evidence seems to be a passage where the author, after listing such means to prevent a woman from conceiving as binding her head with a red ribbon or holding the stone found in the head of an ass, says that he thinks that such remedies “operate more by faith than reason.”[2947] But he makes much use of parts of animals and of suffumigations, advising for example on the same page that after conception there should be fumigation with a root of mandragora or peony or the excrement of an ass mixed with flour, an operation which he characterizes as _expertissimum_. And on the preceding page, as Giacosa has noted, he recommends a procedure which is even more improbable than it is immoral, whereby patients who show themselves ungrateful to the physician after they have been cured may be made to suffer again.[2948] [Sidenote: The wives of Salerno.] We promised to say something of the female practitioners of Salerno. Trotula is no longer believed to be a woman and we have to judge the women of Salerno mainly by what others say of them. In a commentary of a Master Bernard of Provence, who I suspect may be Bernard Gordon, the medical writer at Montpellier of the closing thirteenth century, are a number of practices attributed to the women of Salerno which Renzi has already brought together.[2949] In these cases the practices are chiefly those employed by the women themselves in child-birth. We may note three from the list that savor strongly of magic. “The women of Salerno cook doves with the acorns which the doves eat; then they remove the acorns from the gizzard and eat them, whence the retentive virtue is much comforted.” “When the women of Salerno fear abortion, they carry with them the pregnant stone,” which our author explains is not the magnet. The other recipe had perhaps better remain untranslated: _Stercus asini comedunt mulieres Salernitanae in crispellis et dant viris suis ut melius retineant sperma et sic concipiant_. As we shall see in our chapter on Arnald of Villanova, another medical writer of the late thirteenth and early fourteenth century, he condemned the use of incantations in cases of child-birth by old-wives of Salerno but approved of a very similar procedure by which a priest had cured him of warts, and also mentioned favorably the cures wrought by female practitioners at Rome and Montpellier.