In spite of the fact that books were only written by hand, the teaching of distinguished professors had a wide diffusion, and students were quite ready to go through the drudgery of making these handwritten copies of a favourite master's work. They had plenty of common sense as well as powers of observation, and some of their writing is still of great practical value.
A number of men who are famous in the history of medicine made their medical studies at Mont-pellier in the twelfth and thirteenth centuries. Among them are Mondeville, who afterwards taught surgery at Paris; and Guy de Chauliac, who was a Papal Physician at Avignon and at the same time a professor at Montpellier, probably spending a certain number of weeks, or perhaps months, each year in the university town. Sketches of these men, and of other students and teachers at Montpellier who reached distinction in surgery, will be found in the chapter on Surgeons of the West of Europe. Some other distinguished Montpellierians deserve brief mention.
One of the distinguished professors at Montpellier was the well-known Arnold de Villanova, of whose name there are a number of variants, including even Rainaldus and Reginaldus. In 1285 he was already a famous physician, and was sent for to treat Peter III., King of Aragon, who was severely ill. In 1299 he was summoned on a consultation to the bedside of King Philip the Handsome (le Bel) at Paris. After this we hear of him in many places, as at the Court of Pope Benedict XL at Rome, and in 1308 as the physician and friend of Pope Clement V. at Avignon. His writings were printed in a number of editions in the Renaissance time, Venice 1505, Lyons 1509, 1520, 1532, Basel 1585, and his medical and astronomical and chemical works in separate volumes at Lyons in 1586.
His aphorisms are well known, and used to be frequently quoted during the Middle Ages and afterwards, and some of them deserve to be remembered even at the present time. For instance, he said : ' * Where the veins and arteries are notably large, incision and deep cauterization should be avoided." " When cauterization is to be done the direct cautery should be used; caustic applications are only suitable for very timid patients." " The lips of a wound will glue together of themselves if there is no foreign substance between them, and in this way the natural appearance of the part will be preserved." " In large wounds sutures should be used, and silk thread tied at short distances makes the best sutures." " The infection of the dura mater is followed in most cases by death." 44 A collection of pus is best dissolved by incision and cleaning out of the purulent material." " To put off the opening of an abscess brings many dangers with it." " In most cases of scrofula external applications are better than the use of the knife. Scrofulous patients always have other sources of infection within them, and so it does them no good to operate externally." " Tranquil and pure air is the best friend for convalescents".
Villanova advised that the bite of a mad dog should not be permitted to heal at once, but the wound should be enlarged and allowed to bleed freely, leeches and cups being used to encourage bleeding, and healing should not be permitted for forty days. He believed very thoroughly in drainage, and in the dilation of narrow fistulous openings. He describes anthrax or carbuncle, and has chapters on various painful conditions for which he employs the terms arthritis, sciatica, chiragra, podagra, and gonagra.
Villanova's treatment of the subject of hernia shows how thoroughly conservative he was, and how careful were his observations. In young persons in recent hernias he advised immediate complete reposition of the contents of the sac, the bringing together of the hernial opening by means of adhesive plaster, above which a bandage was placed, and the patient should be put to bed with the feet and legs elevated and the head depressed for ten to fifteen days or more if necessary. He says that there are seme—especially surgeons—who claim that they can cure hernia by incision, and some others by means of a purse-string ligature, and still others by the cautery or by some cauterizing material [they manifestly had our complete catalogue of 4 fakes ' in the matter] ; but I prefer not to mention these procedures, since I have seen many patients perish under them, and others brought into serious danger of death, and I do not think that the surgeon will acquire glory or an increase of his friends from such perilous procedures, and I do not approve their use".
One of the important writers of Montpellier was Gilbertus Anglicus (Gilbert the Englishman), who is called in one of the old translations of Mesue Doctor Desideratissivius, which I suppose might be Anglicized 44 loveliest of doctors." After his studies in England he went for graduate work to some of the famous foreign universities, and is named as a chancellor of Montpellier. His best-known work is his 44 Compendium Medicinal," which bore as its full title 44 The Compendium of Medicine of Gilbert the Englishman; useful not only to physicians, but to clergymen for the treatment of all and every disease." Gurlt says that it contains little that is original, being a copy of Roger of Parma and Theodorie of Lucca, with a number of quotations from the Arabs, nearly all of whom Gilbert seems to have read with considerable attention. It is interesting to find that Gilbert was definitely of the opinion that cancer is incurable except by incision or cauterization. He declares that it yields to no medicine except surgery.
Another of the men whose names are connected with Montpellier was John of Gaddesden, often called Joannes Anglicus. lie was a student of Merton College, and received his degree of doctor of medicine at Oxford. He studied afterwards at Montpellier and also at Paris, and settled down to practise in London. He treated the son of King Edward II. for smallpox, and having wrapped him in red cloth and made all the hangings of his bed red, so that the patient was completely surrounded by this colour, he declared that he made " a good cure, and I cured him without any vestiges of the pocks." The treatment is interesting, as an anticipation in a certain way of Finsen's red light treatment for smallpox in our own time. Hanging the room, and especially the doors and the windows, with red when smallpox was to be treated was a favourite treatment down at Montpellier. Gaddesden's book is called by the somewhat fanciful name " Rosa Anglica." Bernard Gordon of Montpellier had written a " Lilium Medicine," and we have a 44 Flos Medicinae " from Salerno, so that flower names for medical textbooks were evidently the fashion of the time.
Gaddesden's book is almost entirely a compilation, and except in the relation of his surgical experience, contains little that is new. Guy de Chauliac was quite impatient with it, and declared that " lately there had arisen a foolish Anglican rose which was sent to me and I looked it over. I expected to find the odour of sweetness in it, but I found only some old fables." The criticism is, however, as Gurlt remarks, too severe and not quite justified, representing rather Guy's high ideal of the originality that a new textbook should possess, than a legitimate critical opinion. If our own textbooks were to be judged by any such lofty standard, most of them would suffer rather severely.
Another of the well-known teachers at Montpellier was Valesco de Taranta. There are the usual variants of his name, his first name being written also Balesco, and his last name sometimes Tharanta. He was a Portuguese who studied in Lisbon, and later in Montpellier, where he taught afterwards and was considered one of the distinguished professors of his day, being for a time chancellor. He became so well known that he was summoned in consultation to the French King Charles VI., and there is some doubt as to whether he did not become his regular physician. One of his works, the " Philonium Pharmaceuticum et Chirurgicum de medendis omnibus, cum internis turn externis, humani corporis affectionibus," had the honour of being printed at Lyons in two editions in 1490, and one at Venice the same year, at Lyons 1500, Venice 1502, Lyons 1516, 1521, 1532, 1535, Venice 1589, and Lyons 1599. It has also been reprinted subsequently in a number of editions, so that it must have been a much-read book. Valesco had two favourite authors, Galen and Guy de Chauliac. The fact that he should have appreciated two such great men so thoroughly is of itself the best evidence of his own ability and critical judgment. His book, from the number of printed editions, must have been in the hands of practically all the progressive physicians of the southern part of France, at least during the fifteenth, sixteenth, and part of the seventeenth centuries.
A very well-known teacher of Montpellier, who has had a reputation in English-speaking countries because his name was supposed to indicate that he was a Scotchman, was Bernard Gordon or de Gordon, whose name is, however, also written Gourdon. He was a teacher at Montpellier at the end of the thirteenth and the beginning of the fourteenth century. His textbook of medicine, in accordance with the custom of the time, is called by the flowery title 6' Lilium Medicinse," the Lily of Medicine. While much of his information was derived from the Arabs, some of his teaching was an advance on theirs, and he described the acute fevers, leprosy, scabies, anthrax, as well as erysipelas, and still more strangely phthisis, as contagious. Dr. Garrison has called attention in his " History of Medicine " to the fact that the book is notable as containing the first description of a modern truss, and a very early mention of spectacles under the Latin name oculus berellinus. In recent years it has come to be the custom to think of Gordon or Gourdon as probably not of Scotch but of French origin—that is, born somewhere in the confines of what we now call France. There are a number of French places of the name of Gourdon from any of which he might have come.
Montpellier represented for the West of Europe then very nearly what Salerno did for Italy and Eastern Europe. It very probably attracted many of the English and Scotch students of medicine, though not all the names supposed to be of British origin have proved to be so with the development of our knowledge. Montpellier has survived, however, while Salerno disappeared as a force in medical education. Its story would well deserve telling in detail, and doubtless the new national spirit of the French after the war will prove an incentive to the writing of it.