April i, 1920] 



NATURE 



27 



Science, and Scholasticism. 



Medieval Medicine. By Prof. James J. Walsh. 

 (Medical History Manuals.) Pp. xii + 221. 

 (London: A. and C, Black, Ltd., 1920.) Price 

 75. 6d. net. 



PROF. WALSH has written an attractive and 

 most readable account of the course of 

 medieval medicine. He has painted a good, even 

 a speaking, picture, but it is not a likeness which 

 most first-hand investigators of his material will 

 easily recognise, nor is the voice with which it 

 speaks that which is familiar to them. As to his 

 learning and competence for his task, no question 

 can be raised, but the method he elects to adopt 

 is one which has brought much work on the 

 history of science into not unjustified contempt. 

 There are authors, less well equipped than Prof. 

 Walsh, who occupy their time in ransacking the 

 printed masses of ancient literature and abstract- 

 ing passages which seem to show traces of prac- 

 tices similar to, yet quaintly different from, those 

 of our own time. This of itself, though neither 

 history nor science, is an entertaining and harm- 

 less antiquarian diversion. But it is a different 

 matter when such extracts, riven from their con- 

 text, are gravely pieced together and presented 

 as an account of medieval science to a public 

 necessarily ignorant both of the original material 

 and of the method of research. If an expert, such 

 as Prof. Walsh undoubtedly is, adopts this 

 method, he leaves no alternative but protest to a 

 reviewer with first-hand knowledge. 



Prof. Walsh's attitude towards the medieval 

 past may perhaps be illustrated by a single critical 

 sentence: "We have come," he says, "to know 

 more about Aristotle in our own time, and as a 

 <'onsequence have learned to appreciate better 

 medieval respect for him." This, we submit, is 

 not an attitude with which many Aristotelian 

 scholars or many men of science will be found in 

 agreement. It is undoubtedly a fact that at the 

 present time the reputation of Aristotle stands 

 very high indeed as an observer of animal life; 

 but that was not the cause of his appreciation in 

 the Middle Ages. In the scholastic centuries his 

 reputation in physical science, — we omit discussion 

 of his position in other departments, — was based 

 chiefly on his view of the form of the universe 

 and of the nature of matter and of man. His 

 first-hand and very valuable observations on the 

 habits, structure, and development of animals 

 were either neglected or they were misunderstood 

 and placed in series with his oracular utterances 

 on the circular motions of the heavenly bodies, the 

 sub-celestial character of comets, the existence of 

 NO. 2631, VOL. 105] 



the outer aether and of the primum mobile, the in- 

 telligences of the stars, and the continuous nature 

 of matter. It was these conceptions that earned 

 for Aristotle his position in medieval science, and 

 on the errors involved in them Prof. Walsh is con- 

 tent to be silent. 



Prof. Walsh similarly places in the forefront of 

 his argument that "the most interesting feature 

 of the work of the North Italian surgeons of the 

 later Middle Ages is their discovery and develop- 

 ment of two specific advances of our modern 

 surgery . . . union by first intention and anaes- 

 thesia." Now, since the days of Hippocrates, 

 and doubtless before, the medical attendant, both 

 for his patients' sake and for his own, has never 

 been reluctant to prescribe narcotic drugs to 

 those in acute pain. The medieval physician was 

 accustomed to use far more drugs than are con- 

 tained in the modern pharmacopoeia, and he in- 

 cluded in his long list many sedative and narcotic 

 substances. The very vices of the nations will 

 tell of this, for there was never a time when men 

 did not seek oblivion fronj care and pain in that 

 form of unconsciousness which is brought by 

 poppy and mandragora and all the drowsy per- 

 fumes of the East. Such devices were as 

 freely used by medical men in medieval i as in 

 pre-medieval or in post-medieval times ; in 

 the nineteenth century they were partly super- 

 seded by the advent of chloroform and ether, 

 though many surgeons even yet give a dose of 

 belladonna or opium in addition to the inhaled 

 anaesthetic as a routine in major operations. Prof. 

 Walsh, however, seizes on the practice of nar- 

 cotisation before operation in medieval times, and, 

 directing attention to a few references to the 

 administration of anodyne drugs by inhalation, — 

 a generally unsatisfactory procedure with such 

 substances, — he boldly writes : 



" Hugh [of Lucca] seems to have been deeply 

 intent on chemical experiments, and especially 

 anodyne and anaesthetic drugs. ... A great many 

 of these surgeons of the time seem to have experi- 

 mented with substances that might produce anaes- 

 thesia. . . . With anaesthesia combined with anti- 

 sepsis, it is easy to understand how well equipped 

 the surgeons of this time were for the develop- 

 ment of their speciality." 



The facts are that Hugh wrote nothing on 

 surgery, or if he did his work is lost ; that the 

 evidence, such as it is, of his use of anaesthetics 

 is at best but second-hand ; that among all the tens 

 of thousands of medieval medical MSS. — there 

 are some fifteen thousand in this country alone — 

 perhaps some dozen have a single sentence re- 

 ferring to this process of inhalation ; that inhala- 

 tion is a measure ill-adapted to the drugs said to 



