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Medical schools are founded

In Christian Europe, there was little scientific progress during the Middle Ages. Disease was once again attributed to divine causes, and miraculous cures were sought at healing shrines dedicated to a variety of saints. Some groups of Christian monks, however, provided practical care for the sick. Eventually this led to the founding of hospitals. The oldest surviving hospital in England is London’s St. Bartholomew’s, which was founded in 1123 by a courtier who became a monk after a "miraculous" recovery from malaria. The hospital was intended for the "recreacion of poure men." St. Thomas’s Hospital was founded slightly later, in a similar manner. When the English monasteries were dissolved by King Henry VIII in the 16th century, both hospitals became secular institutions and eventually the home of distinguished medical schools.

The first European medical school was established at Salerno, in southern Italy. According to legend, the school was founded by an Italian, an Arab, a Jew, and a Greek who brought with him the writings of Hippocrates. The story reflects the cosmopolitan nature of the region, where Greek and Middle Eastern influences were strong. The school actually started in the 9th century as a place for monks to dispense medicines. In the 11th century, however, scholars at the school began translating Greek and, later, Arabic medical texts into Latin. In this way they reintroduced Hippocratic learning as funneled through Galen and Islamic scholarship.

Medical schools were also founded at Montpellier, in southern France, and Bologna and Padua, in Italy. At Bologna the 13th-century physician Taddeo Alderotti (1223-95) reintroduced the Hippocratic practice of teaching medicine at the patient’s bedside. He also kept clinical case studies. Also at Bologna, in 1315, the first recorded European human dissection was conducted by Mondino de’ Luzzi (1275-1326). He apparently didn’t learn much from it. Instead he demonstrated the common propensity of humans to see what they expect to see. He published an anatomy text that perpetuated errors such as the three-chambered heart and the five-lobed liver.

The most eminent surgeon of the European Middle Ages was Guy de Chauliac (1298-1368), who was associated with Montpellier in the 14th century. He wrote a medical and surgical text, the Chirurgia magna (Great Surgery), which served as standard reference for several centuries. He challenged the Greek notion that suppuration (pus) was a sign of healing.

De Chauliac survived the Black Death (approximately 1347-51), which he described in his work. The Black Death, which killed many millions at this time, was almost certainly bubonic plague. However no one knew what it was or what caused it. Most people saw it as divine punishment. Some Christians said that the Jews had poisoned the wells, and this led to massacres of Jews. Some attributed the plague to different natural causes, among them miasmas—poisons that were thought to exist in the air coming from rotting animal and vegetable matter. There were some people who believed that the plague was caused by contagion—that is, that it was passed from person to person by close contact—but they had few ideas of what might actually carry the disease.

The Black Death led to significant public health measures. The city of Venice appointed a sort of public health committee, which issued burial regulations and banned the sick from entering the city. Public processions were prohibited. In the city of Florence a similar committee required the killing of dogs and cats. The reasons for this are unclear. The people of this time certainly did not know that the bubonic plague is actually spread by fleas from rats to humans; this was not learned until centuries later. However, dogs and cats carry fleas. Whether killing the animals helped is a good question. On the one hand, it probably got rid of quite a few fleas in residence on the animals. On the other, cats are good rat-catchers.

The field of medicine was clearly becoming organized around the idea of a scientific approach by the end of the Middle Ages. But when did science really take over medicine?