The first medical school of modern history, and the institution which more than any other has helped us to understand the Middle Ages, is that of Salerno. Indeed, the accumulation of information with regard to this medical school, formally organized in the tenth century but founded a century earlier, and reaching a magnificent climax of development at the end of the twelfth century, has done more than anything else to revolutionize our ideas with regard to medieval education and the scientific interests of the Middle Ages. We owe this development of knowledge to De Renzi, whose researches with regard to matters Salernitan, and medical education generally in Italy in the Middle Ages, are well deserving of the prestige that has been at length accorded them.

In his " Storia della Medicina in Italia," published so modestly at Naples, the patient Italian student of medical history made an epoch-making contribution to the history of medicine. Unless one has actually read his book, it is difficult to 37 understand how deep our obligations to him are. Anyone who might be tempted to think that medicine was not taken seriously, or that careful clinical observations and serious experiments for the cure of disease were not made at Salerno, will be amply undeceived by a reading of De Renzi. Above all, he makes it very clear that medical education was taken up with rigorous attention to details and high standards maintained. Three years of college work were demanded in preparation for medical studies, and then four years at medicine, followed by a year of practice with a physician, and even an additional year of special study in anatomy, had to be taken, if surgery were to be practised. All this before the licence to practise medicine was given; though the degree of doctor, granting the privilege of teaching as the word indicates, was conferred apparently after the completion of the four years at the medical school. We have had to climb back to these medieval standards of medical education in many countries in recent years, after a period of deterioration in which often the requirements for the physician's training for practice were ever so much lower.

It may seem surprising that the first medical school should have arisen in the southern part of Italy, but for those who know the historical conditions it will seem the most natural thing in the world that this development should have come in this region. As we have said, touch with Greek has always been the most important factor for modern educational and intellectual development. Salerno was situated in the heart of that Greek colony in the southern part of Italy which came to be known as Magna Grsecia. Apparently at no time during the Middle Ages was Greek entirely a dead language in this part of Italy, and there were Greek travellers, Greek sailors, and many other wanderers, who made their way along the shores of the Mediterranean at this time, and carried with them everywhere the stimulus that always came from association with the Greeks of Asia Minor and of the Grecian Islands and peninsula.

There were two other factors that made for the development of the medical school at Salerno. The first of these seems undoubtedly to have been the presence of the Benedictines, who had a rather important school at Salerno, and who were closely in touch with their great mother-house at Monte Cassino not far away. It was they who imparted the academic atmosphere to the town, and made it possible to gather together the elements for the university which gradually came into existence around the medical school, after that began to attract European attention.

The actual foundation of the medical school, however, seems to have been due to the fortunate accident that Salerno became a health resort, a place to which invalids were attracted from many parts of Europe because the climate was salubrious, and opportunities for obtaining the medical advice of men of many different schools of thought from all over the Mediterranean, and securing the Oriental drugs which were so much valued — as drugs from a distance always are—were there afforded. It is easy to understand that, especially in the winter-time, better-class patients from all over Europe would be glad to go down to the mild temperate climate of Salerno and spend their time there.

It has been pointed out that the first modern university, that of Salerno, had for a nucleus a medical school, representing man's interest in his body as his primary intellectual purpose in modern history. The second modern university, that of Bologna, gathered around a law school representing man's interest in his property—his second formal purpose in life. And the third, that of Paris, developed around a school of theology and philosophy, demonstrating that man's intellectual interests rise finally to the consideration of his relations to his fellow-man and to God.

The first that we know definitely about the medical school of Salerno, the origin of which is difficult to trace, is concerned with Alphanus, usually designated 4 4 the First," because there are several of the name. He was a Benedictine monk, distinguished as a literary man and known by his contemporaries as both poet and physician, who was afterwards raised to the Bishopric of Salerno. He had taught at Salerno in the Benedictine school there before becoming Bishop, and when exercising the highest ecclesiastical authority did much to encourage the development of Salerno. He states that medicine nourished in the town even in the ninth century, and there is an old chronicle published by De Renzi in his 44 Collectio Salernitana " in which it is said that the medical school was founded by four doctors—a Jewish Rabbi, Elinus; a Greek, Pontus; a Saracen, Adale; and the fourth a native of Salerno—each of whom lectured in his native language. This reads like a mythical legend that has formed around some real tradition of the coming of physicians from many countries. Puschmann in his 44 History of Medical Education " has suggested that the names are probably as much varied as the absolute truth of the facts. Elinus, the Jew, is probably Elias or Eliseus, Adale is probably a corruption of Abdallah, and Pontus should be probably Gariopontus.