THE STORY OF ANATOMY DOWN TO THE RENAISSANCE
We have seen that the supposed prohibition of anatomy by the Popes has no existence in reality. In spite of this fact, which it was easy for anyone to ascertain who wished to consult the documents asserted to forbid, a number of historical writers have insisted on finding religious or ecclesiastical, or theological, opposition to anatomical studies. Professor White has been most emphatic in his assertions in this regard. He admits that the supposed bull of prohibition had quite a different purport, yet he still continued to assert its connection with the failure of anatomy to develop during the Middle Ages. This presumed failure of anatomy during the Middle Ages is a myth. It continues to secure credence only in the minds of those who know nothing of the history of medical science during the thirteenth, fourteenth, and fifteenth centuries and who have not consulted the serious histories of medicine that treat of this time, but flourishes vigorously in the minds of those who have a definite purpose in making out a story of theological or Church opposition to science in general.
To counteract the false impression that has gained such wide acceptance in this matter, it has seemed advisable, in order to settle the question definitely once and for all, to trace the history of anatomical science from its beginning in the Middle Ages down to modern times. It will not be hard to show that there was a constant development and an unfailing interest in this subject. This can be understood even more clearly from the story of the development of surgery in the Middle Ages and its relations to anatomy than from the history of anatomy itself. As is well known, materials with regard to practical and applied science interest men more at all times, and documents with regard to them are more likely to be preserved, and so the history of surgery is very full, while the history of anatomy may prove not quite so satisfactory. It is true of all sciences, that there are periods when they have much less attraction than at other times, and the success of investigators and original workers is not always the same. As in nearly everything else, the real advances in all science come when genius makes its mark, and not merely because a large number of men happen to be interested in the subject. This will be found as true in anatomy as in other sciences, and so there are periods when not much is doing, but nowhere is there a trace of ecclesiastical opposition to account for these variations of interest.
There is no doubt at all that there was much popular opposition to the practice of dissection in the Middle Ages; that has existed at all times in the world's history. It was very pronounced among the old Pagans in Rome as well as in Greece, and it prevented anatomical study to a very great degree. It continued to exist in modern times until almost the present generation. Indeed, it has not yet entirely disappeared, as any physician who has tried to secure autopsies on interesting cases knows very well. The New York Academy of Medicine is only a little over a half century old, and yet nearly every one of its early presidents had thrilling experiences in body-snatching as a young man, because no proper provision for the supplying of anatomical material had as yet been made by law, and bodies had to be obtained. The feeling of objection to having the bodies of friends anatomized is natural and not due to religion. It exists quite as strongly among the ignorant who have no religion as among the religiously inclined. It has not disappeared among the educated classes of our own time, religious or irreligious. If this is borne in mind, the history of the development of anatomy will be easier to understand.
The first definite evidence in modern history for the existence of the practice of dissection is a famous law of the German Emperor, Frederick II., from the first half of the thirteenth century. This law was promulgated for the two Sicilies, that is, for Southern Italy and Sicily proper, very probably in the year 1240. It has often been vaguely referred to, but its actual significance can only be understood from the terms of the law itself, which has been literally translated by Von Töply in his Studien Zur Geschichte der Anatomie in Im Mittelalter. [Footnote 5]
[Footnote 5: Deuticke Leipzig und Wien, 1893]
The paragraph with regard to dissection runs as follows:
"As an enactment that will surely prove beneficial to health, we decree that no surgeon will be allowed to practice, in case he has not a written testimonial, which he must present to the teachers in the medical faculty, that he has for at least a year applied himself to that department of medicine which is concerned with the teaching and practice of surgery, and that he has, above all, learned the anatomy of the human body in this manner, and that he is fully competent in this department of medicine, without which neither surgery can be undertaken with success nor sufferers cured." [Footnote 6]
[Footnote 6: The complete text of this law, which is a marvelous anticipation of all our efforts for the regulation of the practice of medicine down even to the present day, will be found in the appendix.]
Such a regulation, as pointed out by Professor Pilcher in an article on the early history of dissection, [Footnote 7] and as we know by modern experience, does not come into force as a rule before the actual practice of what is prescribed, has been for some time the custom and its usefulness proved by the results attained. It seems very probable, then, that even at this early day the Emperor Frederick was only making into a law what had been at least a custom before this time. Lest anyone should think that this is a far-fetched assumption, certain other paragraphs of this law, which show very definitely the high degree to which the development of medical teaching had reached, must be recalled. Frederick declared that medicine could only be learned if there was a proper groundwork of logic. Only after three years devoted to logic, then, under which term is included the grammar and philosophy of an ordinary undergraduate course, could a man take up the study of medicine. After three years devoted to medicine, to which it is again specifically declared another year must be added if surgery were to be practiced, a man might be given his degree in medicine, but must spend a subsequent full year in the practical study of medicine under the supervision of an experienced physician.
[Footnote 7: The Mondino Myth, Medical Library and Historical Journal, 1906]
The law further decreed definite punishments for the practice of medicine without due warrant and violation of its regulations, and also regulated the practice of apothecaries. It is rather interesting to find that these were forbidden to share their profits with physicians, and the physicians themselves were not allowed to distribute their own medicines. In a word, practically every one of the problems in the practice of medicine which medical societies are trying to solve at the present moment, were also occupying the attention of the civil authorities about seven centuries ago. Anyone who reads this law will not be loath to believe that it represents the culmination of a series of efforts to regulate medical practice, and especially medical education, and that it was not merely a chance legal utterance that happened to touch a single important question for the first time. One of the paragraphs of the law even contains some clauses that would prevent fake medical schools and that establishes a board of medical examiners. This consisted of certain state officials and some professors of the art of medicine. In a word, medical education had reached a high grade of development, and medical practice was legally established on a high plane of professional dignity.
Salerno had already enjoyed a high reputation as a medical school for more than two centuries when Frederick's law was promulgated. It is true that we have no definite records of dissections done in the school. If these were not an uncommon occurrence, however, but came as did dissections later on, quite as a matter of course, the absence of such records, when we recall how liable to destruction were the meagre accounts of the university transactions of the time during the long period that has intervened and because of the many vicissitudes they were liable to, is not surprising. During the century following this decree there seems to be no doubt that dissections were done regularly, though perhaps not very frequently from our modern standpoint, at Salerno. Salerno, as we shall see in the chapter on The Papal Medical School, was always closely in touch with the ecclesiastical authorities, and especially with the Papacy. There was no hint of friction of any kind, either before or after this law of Frederick's. The question of ecclesiastical interference with dissection does not seem to have arisen at all, much less to have proved an obstacle to the development of medical science.
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