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Rh writers of this century need not be mentioned here; but the next, the 11th century, is given as the probable though uncertain date of a writer who had a great influence on European medicine, Mesua the younger of Damascus, whose personality is obscure, and of whose very existence some historians have doubted, thinking that the name was assumed by some medieval Latin writer. The work De simplicibus, which bears his name, was for centuries a standard authority on what would now be called materia medica, was printed in twenty-six editions in the 15th century and later, and was used in the formation of the first London pharmacopoeia, issued by the College of Physicians in the reign of James I. Either to the 10th or the 11th century must be referred the name of another Arabian physician who has also attained the position of a classic, Abu’l Qāsim or Abulcasis, of El-Zahra, near Cordova, in Spain. His great work, Altaṣrif, a medical encyclopaedia, is chiefly valued for its surgical portion (already mentioned), which was translated into Latin in the 16th century, and was for some centuries a standard if not the standard authority on surgery in Europe. Among his own countrymen the fame and position of Abulcasis were soon eclipsed by the greater name of Avicenna.

Avicenna has always been regarded as the chief representative of Arabian medicine. He wrote on philosophy also, and in both subjects acquired the highest reputation through the whole of eastern Islam. In Mahommedan Spain he was less regarded, but in Europe his works even eclipsed and superseded those of Hippocrates and Galen. His style and expository power are highly praised, but the subject-matter shows little originality. The work by which he is chiefly known, the celebrated “canon,” is an encyclopaedia of medical and surgical knowledge, founded upon Galen, Aristotle, the later Greek physicians, and the earlier Arabian writers, singularly complete and systematic, but is thought not to show the practical experience of its author. As in the case of Galen, the formal and encyclopaedic character of Avicenna’s works was the chief cause of his popularity and ascendancy, though in modern times these very qualities in a scientific or medical writer would rather cause him to become more speedily antiquated.

In the long list of Arabian medical writers none can here be mentioned except the great names of the Hispano-Moorish school, a school both philosophically and medically antagonistic to that of Avicenna. Of these the earliest is or Abumeron, that is, Abū Merwān ʽAbd al-Malik Ibn Zuhr (beginning of 12th century), a member of a family which gave several distinguished members to the medical profession. His chief work, Al-Teysīr (facilitatio), is thought to show more practical experience than the writings of Avicenna, and to be less based upon dialectical subtleties. It was translated into Latin, and more than once printed, as were some of his lesser works, which thus formed a part of the contribution made by the Arabians to European medicine. His friend and pupil of Cordova (q.v.), so well known for his philosophical writings, was also an author in medical subjects, and as such widely read in Latin. The famous Rabbi ( 1135–1204) (q.v.) closes for us the roll of medical writers of the Arabian school. His works exist chiefly in the original Arabic or in Hebrew translations; only some smaller treatises have been translated into Latin, so that no definite opinion can be formed as to their medical value. But, so far as is known, the independent and rationalistic spirit which the two last-named writers showed in philosophy did not lead them to take any original point of view in medicine.

The works of the Arabian medical writers who have now been mentioned form a very small fraction of the existing literature. Three hundred medical writers in Arabic are enumerated by Ferdinand Wüstenfeld (1808–1899), and other historians have enlarged the list (Häser), but only three have been printed in the original; a certain number more are known through old Latin translations, and the great majority still exist in manuscript. It is thus evident that the circumstance of having been translated (which may have been in some cases almost an accident) is what has chiefly determined the influence of particular writers on Western medicine. But it is improbable that further research will alter the general estimate of the value of Arabian medicine. There can be no doubt that it was in the main Greek medicine, modified to suit other climates, habits and national tastes, and with some important additions from Oriental sources. The greater part is taken from Hippocrates, Galen, Dioscorides and later Greek writers. The Latin medical writers were necessarily unknown to the Arabs; and this was partly the cause that even in Europe Galenic medicine assumed such a preponderance, the methodic school and Celsus being forgotten or neglected. In anatomy and physiology the Arabians distinctly went back; in surgery they showed no advance upon the Greeks; in practical medicine nothing new can be traced, except the description of certain diseases (e.g. small-pox and measles) unknown or imperfectly known to the Greeks; the only real advance was in pharmacy and the therapeutical use of drugs. By their relations with the farther East, the Arabs became acquainted with valuable new remedies which have held their ground till modern times; and their skill in chemistry enabled them to prepare new chemical remedies, and form many combinations of those already in use. They produced the first pharmacopoeia, and established the first apothecaries’ shops. Many of the names and many forms of medicines now used, and in fact the general outline of modern pharmacy, except so far as modified by modern chemistry, started with the Arabs. Thus does Arabian medicine appear as judged from a modern standpoint; but to medieval Europe, when little but a tradition remained of the great ancient schools, it was invested with a far higher degree of originality and importance.

It is now necessary to consider what was the state of medicine in Europe after the fall of the Western Empire and before the influence of Arabian science and literature began to be felt. This we may call the pre-Arabian or Salernitan period.

Medicine in the Early Middle Ages: School of Salerno.—In medical as in civil history there is no real break. A continuous thread of learning and practice must have connected the last period of Roman medicine already mentioned with the dawn of science in the middle ages. But the intellectual thread is naturally traced with greater difficulty than that which is the theme of civil history; and in periods such as that from the 5th to the 10th century in Europe it is almost lost. The chief homes of medical as of other learning in these disturbed times were the monasteries. Though the science was certainly not advanced by their labours, it was saved from total oblivion, and many ancient medical works were preserved either in Latin or vernacular versions. The Anglo-Saxon Leechdoms of the 11th century, published in the Rolls series of medieval chronicles and memorials, admirably illustrate the mixture of magic and superstition with the relics of ancient science which constituted monastic medicine. Similar works, in Latin or other languages, exist in manuscript in all the great European libraries. It was among the Benedictines that the monastic study of medicine first received a new direction, and aimed at a higher standard. The study of Hippocrates, Galen, and other classics was recommended by Cassiodorus (6th century), and in the original mother-abbey of Monte Cassino medicine was studied; but there was not there what could be called a medical school; nor had this foundation any connexion (as has been supposed) with the famous school of Salerno.

The origin of this, the most important source of medical knowledge in Europe in the early middle ages, is involved in obscurity. It is known that Salerno, a Roman colony, in a situation noted in ancient times for its salubrity, was in the 6th century at least the seat of a bishopric, and at the end of the 7th century of a Benedictine monastery, and that some of the prelates and higher clergy were distinguished for learning, and even for medical acquirements. But it has by recent researches been clearly established that the celebrated Schola salernitana was a purely secular institution. All that can with certainty be said is that a school or collection of schools gradually grew up in which especially medicine, but also, in a subordinate degree, law and philosophy were taught. In the 9th century Salernitan physicians were already spoken of, and the city was known as Civitas hippocratica. A little later we find great and royal personages resorting to Salerno for the restoration of their health, among whom was William of Normandy, afterwards the Conqueror. The number of students of medicine must at one time have been considerable, and in a corresponding degree the number of teachers. Among the latter many were married, and their wives and daughters appear also in the lists of professors. The most noted female professor was the celebrated Trotula in the 11th century. The Jewish element appears to have been important among the students, and possibly among the professors. The reputation of the school was great till the 12th or 13th century, when the introduction of the Arab medicine was gradually fatal to it. The foundation of the university of Naples, and the rise of Montpellier, also contributed to its decline.

The teachings of the Salernitan doctors are pretty well known through existing works, some of which have only recently been discovered and published. The best-known is the rhyming Latin poem on health by Joannes de Meditano, Regimen sanitatis Salerni, professedly written for the use of the “king of England,” supposed to mean William the Conqueror; it had an immense reputation in the middle ages, and was afterwards many times printed, and translated into most European languages. This was a popular work intended for the laity; but there are others strictly professional.