Prologue: the two worlds of Christendom
[From, Byzantine East & Latin West: Two Worlds in Middle Ages and Renaissance, Harper Torch books, New York 1966]
In the early medieval period the only medical knowledge available to Western Europe consisted of scattered fragments, in Latin translation, of the ancient Greeks Hippocrates, Galen, Soranus and Dioscorides. The revival of western medicine began in the late tenth or early eleventh century at the medical school of Salerno in southern Italy, where the traditions of Latin, Greco Byzantine, Arabic, and Jewish medicine met and were blended. Half-legendary tradition has it that the founders of the Salerno school were Salernus who taught in Latin, a certain Pontos who taught in Greek, Adela who instructed in Arabic, and Helinus who taught in Hebrew. Of the several elements represented here it is generally believed that the Byzantine, aside from the ancient Greek proper, was rather negligible. But further research on the neglected field of Byzantine medicine may reveal that this view may have to be qualified. It is already known for example that a late twelfth century Latin physician at the same medical school, Roger of Salerno, was influenced by the treatises of the Byzantine doctors Aetius and Alexander of Tralles of the sixth century, and Paul of Aegina of the seventh.(41)
Arabic medicine was based largely on the ancient Greek, though in several areas, such as the science of vision, symptomatology and pharmacology the Arabs were able to make a few original contributions. In Byzantium the tradition of the ancients of course also obtained, and though the Byzantines seem to have made few if any important advances (our knowledge of Byzantine medicine is, however, still extremely scanty), they achieved in certain respects a rather high state of practical application. Thus, we know that in the twelfth century the capital city Constantinople had two well organized hospitals staffed by medical specialists (including women doctors), with special wards for various types of diseases and systematic methods of treatment.(42) This situation of course was not typical of the entire Empire, nor of all classes. Yet it is to be contrasted sharply with conditions in the West where, in the early period in general, apart from Salerno; gross superstition was rife.(43)
Arabic, and to a lesser extent, Byzantine medical practice was accordingly far advanced over the contemporary western. Eastern physicians had learned to recognize the decay of tissues and in the case of dentistry to treat and fill decayed teeth and do extractions.(44) With the transmission to western Europe in the twelfth and thirteenth centuries of much ancient medical learning from the Arabs of Spain, Sicily, and North Africa, and to some extent also from the medieval Greeks, the body of western medical knowledge began to increase. It was the ancient medical and anatomical texts of Hippocrates and Galen, gradually in more complete form, both in Arabic and Greek versions, that in the fourteenth century were used in the rising medical schools of the West -at Bologna, Padua, Paris and Montpellier. Thus the most influential anatomical textbook in the fourteenth century in the West-indeed it was to remain the most popular until Vesalius in the sixteenth century -was the Anatomia of Mondino di Luzzi, a work based largely on Galen, the Byzantine Theophilus, and Arabic authorities.
Much used in the examination of the pulse and the urine, the commonest method of diagnosis in the medieval period, was the treatise of the above-mentioned Theophilus of seventh century Byzantium. But the principal medical work of the Byzantine era was that of the seventh century Paul of Aegina. Emphasizing the practical aspects of medicine, its surgical section was celebrated for its excellence and had considerable influence on the medical science of the West as well as of the Arabs. Another Byzantine treatise, that of the thirteenth century Nicholas Myrepsos, remained the principal pharmaceutical code of the Parisian medical faculty until 1651, while the Byzantine tract of Demetrios Pepagomenos (thirteenth century) on gout was translated and published in Latin by the great post-Byzantine humanist, Marcus Musurus, in Venice in 1517.(45)
41. - On Salerno's origins see History of Science Ancient and Medieval ed. R. Taton, English transl. (New York, 1963), article by G. Beaujouan, 476. On Roger see Α. Crombie, Medieval and Early Modern Science (New York, 1959) Ι, 232-36. Also see Ρ. Kristeller, 'Ancient Philosophy at Salerno in the Twelfth Century' (unpublished paper) where it is shown that in the eleventh century a certain Bartholomaeus knew Greek there. See also his 'Beitrag der Schule von Salerno zur Entwicklung der scholastischen Wissenschaft im 12. Jahrhundert', Artes Liberales, ed. J. Koch (Leiden, 1959) 84-90, and his 'Nuove fonti per la medicina salernitana del secolo ΧlI, Rassegna storica.salernitana, XVIII (1957) 61-75. On early western medicine see L. MacKinney 'tenth Century Medicine', in 'Symposium in the Tenth Century', Medievalia et Humanistica, IΧ (1955) 10-13. On Soranus (Galen's predecessor) see Ο. Temkin, Soranus' Gynecology (Baltimore, 1956).
42. - Ch. Diehl, La société byzantine a l'époque des Comnenes (Paris, 1929) 51-56 and G.Schreiber, 'Byzantinisches und abendlandisches Hospital, Gemeinschaften des Mittelalters, Ι (1948), esp. 42 ff. Also G. Sarton, Introduction to History of Science, Ι (Baltimore, 1927) 372 ff.
43. - Exceptions earlier in the West can be seen in medical practice at Theodoric's Ostrogothic court and Charlemagne's court: Ε. Campbell and J. Cotton, the Surgery of Theodoric (New York, 1960) and L. MacKinney, 'An Unpublished Treatise on Medicine and Magic from the Age of Charlemagne', Speculum (1943) 494-96.
44. - Crombie, Medieval and Early Modern Science Ι, 234. The work was of course elementary.
45. - See J.Theodorides 'Byzantine Science', History of Science Ancient and Medieval, ed. R. Taton, transl. Α. Pomerans (New York, 1957) 440 ff. Crombie, op. cit., Ι, 220. MacKinney, loc. cit., 12. Ε. Nordenskold, History of Biology (New York, 1942). On, Musurus see D. Geanakoplos, Greek Scholars in Venice, 162. Most recent for Byzantine Medicine is Ο. Temkin, 'Byzantine Medicine: Tradition and Empiricism', Dumbarton Oaks papers XVI (1962) 96-115.