After Constantine's time the principal textbooks of the school became, according to De Renzi, Hippocrates, Galen, and Avicenna. To these ! were added the Antidotarium of Mesue, and there were various compendiums of medical knowledge, quite as in our own time—one well known under the name of Articella. In surgery the principal textbook was the surgical works of the Four Masters of Salerno, which interestingly enough was the sort of combination work gathered from a series of masters that we are accustomed to see so frequently at the present day. De Renzi insists that there was much less Arabic influence at Salerno than is usually thought; and Gurlt more recently has emphasized, as we have said, the fact that the great textbooks of surgery which we have from Salerno contain not Arabisms, as might be expected from the traditions of Arabic influence that we hear so much of, but Graecisms, which show that here at Salerno there was a very early Renaissance, and the influence of Greek writers was felt even in the twelfth century.
Probably the best way to convey in brief form a good idea of the teaching in medicine at Salerno is to quote the Regimen Sanitatis Salernitanum, the Code of Health of the School of Salernum, which for many centuries was popular in Europe, and was issued in many editions even after the invention of printing. Professor Ordronaux, Professor of Medical Jurisprudence in the law school of Columbia College (now Columbia University, New York), issued a translation of it in verse,* which gives a very good notion of the contents and the spirit and the mode of expression of the little volume.
The Regimen was written in the rhymed verses which were so familiar at this time. Many writers on the history of medicine have marvelled at this use of verse, but anyone who knows how many verse-makers there were in the twelfth and thirteenth centuries all over Europe will not be surprised. It used to be the custom to make little of these rhymed Latin verses of the Middle Ages, but it may be well to recall that in recent years a great change has come over the appreciation of the world of literature in their regard. The rhymed Latin hymns of the Church, especially the Dies Irse, the Stabat Mater, and others, are now looked upon as representing some of the greatest poetry that ever was written. Professor Saintsbury of the University of Edinburgh has declared them the most wondrous wedding of sense and sound that the world has ever known. The Regimen Sanitatis of Salerno is of course no such poetry, mainly because its subject was commonplace and it could not rise to poetic heights. A good deal of the deprecation of its Latinity might well be spared, for most of the mistakes are undoubtedly due to copyists and interpolation. The verses not only rhyme at the end, but often there are internal sub-rhyrnes. This too was a very common custom among the hymn-writers, as the great sequence of Bernard of Morlaix, so well known through its translations in our time, as " Jerusalem the Golden " attests.
* Philadelphia: Lippincott, 1871.
The Regimen was not written for physicians, but for popular information. It seems to have been a compilation of maxims of health from various professors of the Salernitan School. Nothing that I know shows more clearly the genuine knowledge of medicine, and the careful following of the first rule of medical practice non nocere to which Salerno had reached at this time, than the fact that this popular volume contained no recommendation of specific remedies, but only health rules for diet, air, exercise, and the like, many of which are as valuable in our time as they were in that, and very few of which have been entirely superseded—together with some general information as to simples, and a few details of medical knowledge that would give a convincing air to the compilation.
The book was dedicated to the King of the English, Anglorum regi scribit sclioh tola Salerni, and in the translation made by Professor Ordonaux begins as follows : flf thou to health and vigour wouldst attain, Shun weighty cares—all anger deem profane, From heavy suppers and much wine abstain. Nor trivial count it, after pompous fare, To rise from table and to take the air. Shun idle, noonday slumber, nor delay The urgent calls of Nature to obey. These rules if thou wilt follow to the end, Thy life to greater length thou mayst extend.*
Evidently it was rather easy to commit such rhymes to memory, and this accounts for the fact that we have many different versions of the Regimen and disputed readings of all kinds. These medieval hygienists believed very much in early rising, cold water, thorough cleansing, exercise in the open air, yet without sudden cooling afterwards. The lines on morning hygiene seem worth while giving in Ordonaux's translation.
At early dawn, when first from bed you rise, Wash, in cold water, both your hands and eyes. With brush and comb then cleanse your teeth and hair, And thus refreshed, your limbs outstretch with care.
* The Latin lines run thus :
Si vis incolumem, si vis te reddere sanum, Cures tolle graves, iras crede profanum. Parce mero—ccenato parum, non sit tibi van urn Surgere post epulas; somnum fuge meridianum ; Ne mictum retine, nec compiime fortiter anum ; Haec bene si serves, tu longo tempore vives.
Such things restore the weary, o'ertasked brain ; And to all parts ensure a wholesome gain. Fresh from the bath, get warm. Rest after food, Or walk, as seems most suited to your mood. But in whatever engaged, or sport, or feat, V Cool not too soon the body when in heat.
The Salernitari writers were not believers in noonday sleep, though one might have expected that the tradition of the siesta in Italy had been already established. They insist that it makes one feel worse rather than better to break the day by a sleep at noonday.
Let noontide sleep be brief, or none at all; Else stupor, headache, fever, rheums, will fall On him who yields to noontide's drowsy call.