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Full text of "The history of the study of medicine in the British Isles"

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THE ^HISTORY 

OF THE 

STUDY OF MEDICINE IN 
THE BRITISH ISLES// 



THE FITZ-PATRICK LECTURES FOR 1905-6 

DELIVERED BEFORE THE ROYAL COLLEGE OF 

PHYSICIANS OF LONDON 



BY 

NORMAN ^IOORE/ M.D., Cantab. 

Fellow of the Royal College of Physicians 
Physician to St. Bartholom&io's Hospital 



OXFORD — Ti 

AT THE CLARENDON PRESS 
1908 



HENRY PROWDE, M.A. 

PUBLISHER TO THE UNIVERSITY OF OXFORD 

LONDON, EDINBURGH 

NEW YORK AND TORONTO 



/>17 



PREFACE 

The first of these lectures treats of Medical Study 
in London during the Middle Ages, and of John 
Mirfeld, a physician, who lived in London in the 
reign of Eichard II. 

The second lecture treats of the reading and 
general attainments of physicians from the founda- 
tion of our CoUege, in 1518, to the beginning of the 
eighteenth century. I have described, as an example 
of what the course of education and the learning of 
a physician were at the end of this period, the studies 
and attainments of Dr. Edward Browne, who lived 
from 1644 to 1708, and was physician to St. Bar- 
tholomew's Hospital. 

In the third and fourth lectures I have tried 
to show how that part of medicine which consists 
in the precise observation of patients grew up in 
England, Scotland, and Ireland ; and I have particu- 
larly considered the effect of the works of Mayerne, 
Glisson, and Sydenham upon this study in England, 
and the influence of Boerhaave upon it in Scotland 
and Ireland. 

In the Appendix I have printed from the 
manuscript in Mayerne's hand in the British 
Museum his notes on the health of James I, and 
the report on Queen Henrietta Maria which he 
drew up when she thought of going abroad in 1641. 



IV 



PREFACE 



From the original cartulary of Abingdon Abbey in 
the British Museum I have printed seven short 
charters and the termination of a lengthy one, all 
witnessed by Grimbald the physician, and from the 
original at St. Bartholomew's a charter of Gilbert, 
Prior of Buttley, witnessed by John of London, the 
physician. 

The Treasurer and Almoners have been so good 
as to allow me to print this document here as well 
as in a History of St. Bartholomew's Hospital, on 
which I have been long engaged, and which will 
appear during the coming year. 

I have reprinted my account of Harvey's manu- 
script notes on the Opuscula of Galen, published in 
the Athenceum for October 6, 1888. 

I have to thank Mr. J. H. Herbert for making 
a copy for me of Mayerne's note on James I, and 
Mr. J. P. Gilson for most generously allowing me 
to study his notes on the Florarium of Mirfeld and 
on the manuscripts of the Schola Sakrnitana in the 
British Museum. 

Finally, I have to thank the President, the 
Censors, and the Fellows of the Koyal College 
of Physicians of London for the honour which 
they conferred upon me by appointing me to deliver 
these lectures before them. 



CONTENTS 



LECTUEE I 

PAGE 

Medical Study in London duking the Middle Ages . 1 — 49 



Dr. Thomas Fitz-Patrick 

Dr. Barklot 

Dr. Baldwin Hamey . 

Dr. William Munk . 

Dr. Mac Michael 

Dr. John Freind 

Grimbald the Physician 

Physicians known to Matthew Paris 

Eobert Grosseteste 

Medical Books in Monastic Libraries 

Hospitals in the Middle Ages . 

JohnMirfeld .... 



1 

2 

2 

3 

3 

3 

8 

16 

18 

19 

21 

25 



LECTUEE II 

The Education of Physicians in London in the 

Seventeenth Century ..... 50 — 83 

Attainments of Mirfeld 50 

Nicholas of Cusa . . . . . . . 53 

Dr. Thomas Linacre 55 

Dr. John Clement 57 

Dr. Edward Wotton 57 

Dr. John Caius 60 

Dr. Thomas Doyley 62 

Sir Theodore Turquet de May erne .... 65 

Dr. William Gilbert 65 

Dr. Theodore Goulston 65 

Dr. Edward Browne 69 



vi CONTENTS 

LECTURE III 

PAGE 

The History of the Study of Clinical Medicine in 

THE British Islands 84 — 122 

Dr. John Caius 90 

Dr. William Gilbert 92 

Dr. William Harvey 92 

Sir Theodore Turquet de Mayerne . . . • 93 

Dr. Francis Glisson Ill 

Dr. Christopher Benet 113 

Dr. Walter Charleton 114 

Dr. Thomas Sydenham 116 

Dr. Thomas Willis 119 

Dr. Richard Morton 120 

LECTURE IV 

The History of the Study of Clinical Medicine in 

the British Islands (continued) . . . 123 — 157 

Dr. John Freind 124 

Sir John Floyer 125 

Dr. William Heberden 125 

Dr. James Douglas 128 

Dr. Edward Tyson 130 

Sir Hans Sloane 130 

Sir Thomas Molyneux 134 

The Irish Mediaeval Physicians .... 139 

Dr. David Betthun 149 

University of Edinburgh 153 

Influence of Boerhaave 154 



APPENDIX 

PAGE 

I. Charters Witnessed by Grimbald . . .158 

II. Charter Witnessed by John of London, the 

Physician 160 

III. Mayerne's Note on the Health of James I . 162 

IV. Mayerne's Note on the Health of Queen 

Henrietta Maria 176 

V. Harvey's Notes on Galen 181 

Index . . 187 



LIST OF ILLUSTRATIONS 

PLATE PAGE 

Grant by Gilbert, Prior of Buttley, to St. Bar- 
tholomew's Hospital, 1186-1189. (Actual 
size) Frontispiece 

I. Breviarium Bartholomei. Introduction. (12|: in. 

x3|:in.) To face page 31 

II. Breviarium Bartholomei. Verses indicating the 

author's name. (12^ in. x 8J in.) To face page 33 

III. Breviarium Bartholomei. On Materia Medica. 

(12iin. x3iin.) . . . To face page 36 

IV. Florarium Bartholomei. Introduction. (12^ in. 

xOJin.) To face page 44 

V. Florarium Bartholomei. Chapter on Physicians. 

(12^in. xOJin.) . . . To face page 46 

VI. Liber Serapionis. Initial showing a lecture 
on Medical Plants. (Actual size of column) 

To face page 52 

VII. Liber Serapionis. Note in the hand of Nicholas 

ofCusa. (Actual size of column) To face page 53 

VIII. Treatise on Materia Medica, in the hand of 
Cormac MacDuinntsleibhe, written in 1459. 
(8|in. x5|in.) .... To face page 143 

IX. Manuscript of Cormac MacDuinntsleibhe. 

Chapter on Gout. (8| in. x 5 J in.) To face page 144 

X. Manuscript of Cormac MacDuinntsleibhe. 
Chapter on Epilepsy. (8| in. x 5| in.) . 

To face page 145 



LECTURE I 

MEDICAL STUDY IN LONDON DUEING 
THE MIDDLE AGES 

Me. President, Censors, and FeUows of the Col- 
lege, — It is right that these lectures should begin 
with a commemoration of Dr. Thomas Fitz-Patrick, 
the Member of this College in whose honour they 
were founded by Mrs. Fitz-Patrick. He was born 
in 1832 at Virginia in Cavan, received his school 
education at Carlow, and graduated in the University 
of Dublin. His medical career at Trinity College 
was distinguished, and is fitly commemorated there 
by a scholarship bearing his name. He had an 
inborn love of learning which was, of course, in- 
creased in the college of Burke and Swift and 
Goldsmith, and which continued without abatement 
to the end of his life. I had the advantage of know- 
ing him and of enjoying his conversation, which was 
that of a man who had read and re-read the great 
books of Greek and Latin, of English, French, Ger- 
man, Italian, and Spanish literature till they had 
become part of his mind. He was devoid alike of 
love of display and of pedantry, and his one desire 
in knowing much was that what he knew might 
help him to know more. 

The history of medicine is a subject which has 
never been neglected in this College. Dr. Kichard 

MOOB£ B 



2 LECTURE I 

Bartlot of All Souls College, Oxford, our President 
in 1527, was learned in the particular part of it on 
which I propose to lecture to-day. It was included 
in the profound and varied attainments of Dr. John 
Caius, President in 1555. Sir Hans Sloane, our 
President from 1719 to 1735, made collections of 
materials for medical history which begin with 
twelfth-century manuscripts of Hippocrates and 
Galen and extend to the letters of the physicians 
of his own time. Dr. Baldwin Hamey, a Censor 
in 1640 and for forty-two years a Fellow of this 
College, wrote in Latin a biographical history of the 
physicians of his time from the year 1628, entitled 
Bustorum Aliquot Beliquiae, He endeavours to give 
the character of each physician in a few sentences, 
and though he never sacrifices truth to brevity he 
is not always free from the conceits which were in 
fashion when he was young. His account of Harvey 
is an example : 

Of William Harvey, the most fortunate anatomist, 
the blood ceased to move on the third day of the 
Ides of June in the year 1657, the continuous move- 
ment of which in all men, moreover, he had most 
truly asserted. What more: His statue in his robes, 
and the marble carved with his epitaph in his 
museum in our college as well as his annual celebra- 
tion will easily atone to Harvey for this my brevity. 
Unless, perhaps, it may be pleasing to add an epi- 
gram I made: That according to the opinion of 
Copernicus as to the motion of the earth and of 
Harvey as to the movement of the blood we are 
here — 

"Ep t€ Tpox^ irdvT^s /cat ivl iracri rpo^oi. 



STUDY IN LONDON 3 

In Latin — 

Tunc agit atque agimus nos rota nosque rotam ; 
or in English — 
Then are we all in a wheel and a wheel in us all. 

Books, like living teachers, besides giving instruc- 
tion in their subject, stimulate future workers, and 
the modest little book of Hamey, which only exists 
in manuscript, was probably the origin of Dr. William 
Munk's Roll of the Boyal College of Physicians of London, 
a well-arranged collection of medical biography. 
Dr. MacMichael, Censor in 1820, wrote part of the 
Lives of British Physicians in which Dr. Munk also 
had a share, and which is a piece of good literature 
containing much information. The light and enter- 
taining style of MacMichael's Gold-headed Cane must 
not exclude it from consideration as a contribution 
to medical history. 

Dr. John Freind of Christ Church, Oxford, was 
elected a Fellow of our College in 1716. He was 
already known for his classical learning and soon 
became eminent in the practice of his profession. 
In 1725 and 1726 he published The History of 
Physick from the time of Galen to the beginning of the 
Sixteenth Century, which begins with Oribasius and 
Aetius and ends with Linacre, our founder. Freind 
had studied every author whose works he describes, 
and was as learned in the mediaeval writers as in 
the Greeks. He is always interesting, even in his 
accounts of the most prolix writers of the least 
brilliant periods, and his book is valuable because 

b2 



4 LECTURE I 

he was skilled in the practice of medicine as well 
as deeply read in the medical treatises of classical, 
mediaeval, and modern times. His history is one 
of those few writings on the subject of a particular 
profession which, like Sir Wilham Blackstone's 
Commentaries on the Laws of England, deserves a 
permanent place in general literature. I need only 
remind you of the works of our Harveian librarian, 
Dr. J. F. Payne, of his Fitz-Patrick lectures, of his 
introduction to the reprint of the Cambridge edition 
of Linacre's Latin version of the *De Temperamentis' 
of Galen, of his numerous contributions to the 
history of epidemics, of his admirable biography of 
Linacre, and of his many medical lives in the 
Dictionary of National Biography, to convince you 
that the history of medicine is not neglected 
among the present Fellows of this College. 

A few months ago, while watching the excavations 
necessary for the foundations of the new out-patient 
rooms of St. Bartholomew's Hospital, I saw dug up 
from many feet below the surface a piece of Samian 
ware and a coin of the Emperor Nero. Some few 
days later another coin of the same emperor was 
found. These bronze dupondii had been used in 
that commerce of which their contemporary, Tacitus, 
speaks in the first passage in literature which con- 
tains the name of the famous city in which we live. 
*At Suetonius mira constantia medios inter hostes 
Londinium perrexit, cognomento quidem coloniae 
non insigne, sed copia negotiatorum et commeatuum 
maxime celebre.' Such relics of the business trans- 



STUDY IN LONDON 5 

actions of the empire and the numerous examples 
of mosaic pavements, of Koman inscriptions, pottery, 
glass and coins discovered at various times through- 
out the city, as well as the fragments of Eoman 
walls and roads, help us to realize that in the time 
of Galen London was within the sphere of influence 
of Koman civilization. 

London had some share, however small, in the 
intellectual life of Eome, and through Eome felt 
the influence of ancient Greece in literature and 
in science. There is nothing improbable in the 
supposition that men who had consulted Galen as 
to their health may have walked along the Roman 
causeway in Cheapside on which, fifteen hundred 
years later. Wren placed the foundations of the 
present tower of the church of St. Mary-le-Bow, or 
may have watched the Britons bringing products 
of fishing or of the chase up Walbrook from the 
Thames in skin-covered wicker boats. The tides of 
the world's mind ebb and flow, but however great 
the ebb some tide-marks generally remain showing 
where the waves of intellect have been. Among 
the few traces left of the intellectual life of the 
Eomano-British period are the Confession of Patrick 
and the Epistle against Coroticus. The ' imperitia ' 
and * rusticitas ' of which the writer complains take 
nothing from the interest of these compositions as 
the authentic literary remains of Britain in the fifth 
century. The letter in which Quintus Cicero, writing 
from the camp of Julius Caesar, mentions Lucretius, 
is the first indication of the spread of the literature 



6 LECTURE I 

of the civilized world to our island, while the Con- 
fession of Patrick and his Epistle to the Christian 
subjects of Coroticus seem the last remains of living 
literature of the classical period in Britain. When 
the son of Calpurnius set forth on his missionary 
travels the legions had already been withdrawn, and 
the tribes from whose union the English nation is 
mainly derived were pouring into Britain, making 
settlements after their own manner and destroying 
the Eomano-British civilization. 

Kent and Sussex, Essex and East Anglia, Wessex, 
Mercia, and Northumbria were carved out of Britain, 
kingdoms still marked in the vowel sounds and 
accents of their natives, as we may observe them 
in the out-patient rooms or wards of our hospitals. 
After constant wars a Eex Anglorum arose strong 
enough to maintain his supremacy, and an Anglo- 
Saxon nation was formed and grew in strength. 
My learned predecessor in this lectureship has 
shown what progress was made in science, and has 
maintained that the medicine of the Anglo-Saxons 
was not unworthy of the countrymen of Csedmon, of 
Bede, and of Alcuin. The Norman Conquest placed 
England once more in direct and constant relation 
with the rest of the Western world, and for more 
than a century London was a city in which foreign 
influence predominated. Though the Conqueror 
granted a charter, still preserved in the custody of 
the City at Guildhall, to Doorman, a prominent 
Saxon of London, and though the districts which 
ultimately made up the City and which were very 



STUDY IN LONDON 7 

early called wards were presided over by men with 
the Saxon style of Alderman, it is nevertheless clear 
that soon after the Conquest the chief influence in 
London was not that of the Saxons. The bishops of 
the see, the deans of St. Paul's, the canons of that 
cathedral, the deans of the College of St. Martin-le- 
Grand, many of the secular clergy, the magnates of 
London, the officials of the Exchequer, and the 
justiciars were almost all of Norman, or French, or 
Breton, or Italian birth or descent. The charters of 
the time show the predominance of foreigners by 
the way in which the preambles often mention the 
French first. A grant to St. Bartholomew's Hos- 
pital, made in London by John, Earl of Moreton, 
afterwards King John, on the eve of All Saints, 
1193, begins : * Johannes comes Moretonie omnibus 
hominibus et amicis suis Francis et Anglis presenti- 
bus et futuris salutem.' Another somewhat earlier 
charter of a great landowner in Essex begins: *Serlo 
de Marci omnibus hominibus suis Francis et Anglis 
presentibus et futuris salutem.' And another, written 
in London and copied into the cartulary of St. Mary 
of Dunmow,^ uses a similar form : * Walterus filius 
Eoberti omnibus sancte matris ecclesie filiis et 
omnibus hominibus suis Francis et Anglis salutem.' 
The civil institutions of London assumed a French 
complexion, and the terms * Communa ' and ' Mayor ' 
were introduced from France. 

I have dwelt upon this close relationship with 
France because it has an important bearing on the 
1 Harley 662, f. 12 b. 



8 LECTURE 1 

nature of our early hospitals. In this time when 
foreign influence was predominant in London, while 
the great English nation of the future was slowly 
being formed, physicians are now and then men- 
tioned in records still extant. King Henry I had 
a physician named Grimbald, who appears as a wit- 
ness in a very solemn charter of 1105/ in which 
Henry, King of the English, with the consent of 
Matilda his wife, grants ten hides of land in 
Lifesholt to the abbey of Abingdon. The witnesses' 
names succeed their crosses or marks, and begin with 
* Ego Henricus rex redicionem et donacionem hanc 
signavi ', Eanulf, Bishop of Durham ; John, Bishop 
of Bath and Wells ; Hervey, Bishop of Bangor ; 
Kobert, Bishop of Lincoln; Eoger, Bishop-elect of 
Salisbury. William de Werelwast, Waldric the 
king's chancellor, are witnesses, and their names 
are followed by the physician's attestation : * Ego 
Grimbaldus medicus interfui.' Three seneschals 
or dapifers, important officers in the royal court, 
come next — Eudo, Koger Bigod, and Haimo. Three 
other witnesses follow, Urs de Abetot, Walter, son 
of Richard, and Eoger de Oilei, the constable. 
Another grant of the same king to the same abbey, 
giving a hospice in Westminster Street, London, to 
the abbot, has as its witnesses Grimbald the physician 
and Nigell de Albini. It was made at Windsor.^ 

The next charter in the beautiful register of the 
abbey of Abingdon ^ is addressed to Eichard, Bishop 

^ Claudius C. ix, f. 159 a (British Museum). 
* f. 150 a. » ib. 



STUDY IN LONDON 9 

of London, and grants land to the abbey. Its first 
witness is that Eoger, Bishop of Sarum, who after- 
wards took so active a part in the early wars of 
King Stephen, and the fourth is Grimbald the 
physician. It was witnessed at Westminster. An- 
other charter of Henry I ^ to the same abbey, ad- 
dressed to the sheriff of Oxfordshire and executed 
at Eomsey, is witnessed by the chancellor and by 
Grimbald. Yet another charter addressed by the 
king from Woodstock to Herbert, Bishop of Nor- 
wich, the builder of the present choir and transepts 
of Norwich Cathedral, has for its first two witnesses 
Ranulf the chancellor and Grimbald the physician. ^ 
A grant of Queen Matilda ^ to Faritius the abbot 
and the abbey of Abingdon is witnessed by Roger 
the chancellor (afterwards Bishop of Salisbury) and 
Grimbald the physician. An ordinance* of King 
Henry I issued from Oxford, addressed * Omnibus 
constabulariis et omnibus fidelibus suis de curia', 
orders that no one shall stay at Abingdon without 
the abbot's leave, and its sole witness is Grimbald 
the physician. A charter of Henry I ^ about land 
at Wincfeld belonging to the abbot of Abingdon 
is witnessed at Northampton by Eoger Bigot and 
Grimbald the physician. Another deed addressed 
to Nigel de Oilley is witnessed by Grimbald. Thus 
it is clear that Grimbald Hved in the royal court 
and travelled about with the king. Two charters of 
the reign of Henry I, now at St. Paul's Cathedral, 

» Claudius C. ix, f. 149 a. ' f. 147 b. 

M. 145 b. *f. 151a. ''f. 152 a. 



10 LECTURE I 

mention other physicians of the time. William, 
Dean of St. Paul's, granted to John, the physician, 
and his heirs some land in Aldermanesburi at a rent 
of three shillings a year, eighteen-pence at Easter 
and eighteen-pence at Michaelmas. The last wit- 
ness is Gilbert the physician. William was Dean 
of St. Paul's from 1111 to about 1136,^ so that 
Aldermanbury may be regarded as the earliest re- 
corded residence of a physician in London. It is 
clear by the position of the physician among the 
witnesses and by the absence of any indication of 
clerical office that Gilbert was a layman. 

Another charter, also at St. Paul's, mentions a 
physician who, like our founder Linacre and our 
original Fellow Dr. Chambre, was in holy orders. 
It is an agreement made about 1127 between 
William the Dean and the Canons of St. Paul's, 
and William de Marci. After Otuel, son of the 
earl, Hugh de Eedvers, Aldewin the queen's 
chamberlain, and Giifard the chaplain, Clarumbald,^ 
physician and chaplain, occurs as a witness, followed 
by nineteen other witnesses. The first large 
monastic foundation in London was the Augustinian 
Priory of Holy Trinity, Aldgate, and its cartulary 
is preserved in the varied collection of books and 
antiquities which William Hunter bequeathed to 
the University of Glasgow. It contains a copy of 
a charter addressed to the Bishop of London by 
Geoffrey de Mandeville, the Earl of Essex, who 
died in 1144, the remains of whose castle of Pleshy 

' Hist. MSS. Com,, Ninth Keport, p. 67. ' lb. p. 66. 



STUDY IN LONDON 11 

may still be seen in Essex. He was chief constable 
of the Tower, and in this charter he restores to the 
Priory of Holy Trinity a mill and some land next 
the Tower which he had taken from them. The first 
witness of this charter is his wife, Eohaisia, and the 
last two are Ernulf the physician and Iwod the 
physician. Mr. J. H. Eound in his Geoffrey de 
Mandeville conjectures that the presence of these 
two physicians and of a Templar indicates that 
the restoration was made when this earl, who 
was one of the great lords who made the state of 
England intolerable in the reign of Stephen, was on 
his deathbed, slowly dying from an arrow wound in 
the head. This document, though connected with 
London by its address to the bishop, was probably 
attested near Burwell where the earl lay.^ A 
charter written later in the same century was 
undoubtedly attested in London and by a London 
physician. It chances to be the earliest document 
relating to St. Bartholomew's Hospital in which a 
physician is mentioned, and is a grant of some land 
on the south side of Newgate Street in London from 
Gilbert, prior of the Augustinian canons of Butley 
in Suffolk, to the brethren of the hospital, written 
between 1186 and 1189. The physician is the last 
of nineteen witnesses to this charter. Hubert 
Walter, Dean of York, is the first witness, who, 
though not a physician, was a man of science. 
This great man was a baron of the Exchequer in 

^ J. H. Round, Geoffrey de Mandeville, p. 101, where the 
charter is printed from the transcript in the Guildhall. 



12 LECTURE I 

1184, became Dean of York in 1186, and in 1189 
Bishop of Salisbury. He went to the Holy Land 
with Eichard Coeur de Lion and was one of 
the first band of pilgrims admitted by the Mussul- 
mans to the Holy Sepulchre. In 1193 he became 
Archbishop of Canterbury and Chief Justiciar of 
England. In May, 1194, when Richard, after his 
release, left England, Hubert Walter was left as 
chief governor of the country. Having thus risen 
to the highest rank as an ecclesiastic, a statesman, 
and a lawyer, in November, 1197, he appears in the 
chronicles as a man of science, the first reformer of 
the standards of England. He engaged in the 
difficult task of making uniform throughout the 
realm all weights and measures, whether of capacity 
or of length, every measure of wine and of cloth. ^ 
His ordinance, like many similar enactments of later 
times, failed to produce the uniformity intended, 
owing to the tenacity with which men adhere to 
the familiar things of the household, the farm, and 
the market. 

A charter in the British Museum relating to the 
hospital of St. Cross at Winchester, ^ dated April 10, 

1185, of which the first witness is King Henry II 
himself, * Henrico illustri rege Anglorum,' and 
which is also witnessed by Hubert Walter, has two 
physicians among its witnesses, * Magistris Hamone 

' Matthew Paris (Rolls Series), ed. Luard, vol. ii, p. 442 ; 
Hoveden (Rolls Series), ed. Stubbs, vol. iv, p. 433. 

^ Printed with facsimile in Warner and Ellis, Facsimiles of 
Charters. 



STUDY IN LONDON 18 

et Eicardo medicis.' King Henry was going abroad 
with Heraclius, the patriarch of Jerusalem, and 
Koger de Molins, Master of the Hospitallers, and 
these physicians were accompanying him, and were 
not the attendants of the Hospital of St. Cross ; that 
hospital, indeed, was from the first intended as a 
refuge for the relief of poverty and not of sickness. 
Its inmates are called not infirmi but pauperes. 
In this charter Kichard, formerly Archdeacon of 
Poictiers and a distinguished official of the Court 
of Exchequer, but then Bishop of Winchester, in- 
creases the number of the poor to be relieved from 
one hundred and thirteen to two hundred and 
thirteen. The seals attached to this fine specimen of 
the penmanship of its period are perfect, and on one 
of them is a figure in a canopied bed with a large 
bolster, a representation of a twelfth-century bed 
such as the poor of that hospital and the patients 
of other hospitals of that time may have occupied. 

Master Kanulphus Besace, a contemporary of 
Dr. John of London, who was physician to King 
Eichard I in Palestine and afterwards lived 
to old age in London, related to Matthew Paris 
how when Saladin took the Prince of Antioch 
prisoner 1 he was sent to try to arrange his 
release. Saladin was sitting in his court, and the 
captive Christian knight was led in with his arms 
bound. *What,' said Saladin, * would you do to 
me were I your prisoner as you now are mine?' 

^ Luard (Matthew Paris: Eolls Series) conjectures that 
Keginald de Chatillon was the prisoner. 



14 LECTURE I 

* I would cut off your head and do it myself, because, 
though an infidel, you are some kind of king,' said 
the Christian knight. Saladin said, *And I will 
decapitate thee, intemperate fellow,' rose, and asked 
for his sword. *Take, dog, this my head, thou 
shameful hairy-bearded, lean-faced, and vile-eared 
Pagan ; for myself, I have no more to say than that 
I commend my soul to God.' Saladin said, * Oh ! 
obstinate, not even in dying shalt thou prevail,' and 
with a light blow cut off his head. Dr. Eanulphus 
Besace, who witnessed this terrible scene, lived to 
the middle of the reign of Henry III, and filled 
the stall of Newington in St. Paul's Cathedral. 
Matthew Paris also knew a Dr. Eeginald at St. 
Albans. 

John of Hertford was elected abbot of St. Albans 
on March 27, 1235, and Matthew Paris, then 
himself a monk of that abbey, records that two 
monks, both in priests' orders, were sent to Rome 
to obtain confirmation of the election. One of these 
was Magister Reginaldus Physicus. They took 
formal letters with them, and later in the year 
came back with the document they sought from 
Pope Gregory IX. In the obituary of the abbey of 
1212-53 it is noted that this Reginald, physician 
and priest (physicus, sacerdos), died on Sept. 21, 
1251. Matthew Paris in 1255 records the death of 
three trusted officials of the queen of King Henry 
III ^ — Robert Muscegros, her seneschal ; Walter de 

* Matthew Paris (Rolls Series), ed. H. R. Luard, vol. iii, 
pp. 407 et seq., and vol. vi, p. 269. 



STUDY IN LONDON 15 

Bradele, her treasurer ; and Master Alexander, her 
physician, * three men worthy of the highest praise/ 
Queen Eleanor had also another physician, Magister 
Keginaldus de Bathonia.^ She sent him to see her 
daughter, the Queen of Scotland, and when he came 
* ad castrum puellarum quod vulgariter dicitur 
Edenburc', he showed his letters to the Scottish 
court and was well received. He asked the young 
Queen, when he had a private audience, why she 
was so pale and depressed, and she admitted that 
the Scots did not treat her kindly. He reproved 
them for their treatment of her. After a few days 
he fell ill and took to his bed, so that some said he 
was poisoned. When he knew he was dying he 
wrote to the King and Queen of England, and said 
that he had come to Scotland on an unhappy day, 
and that the queen was inhumanly treated by the 
Scots. Matthew Paris evidently did not admire the 
physician, for he says : * Magister autem physicus 
cum virus discordie et magni venturi mali et 
dampni irrestaurabilis evomuisset animam miseram 
exhalavit.' 

In a charter belonging to St. Albans Abbey and 
of about the year 1259 of John, son of Alexander 
the carpenter of Walthamstede, the seventeenth of 
nineteen witnesses is Adam the physician, and he is 
followed by William, his son. Another charter of 
the same period in the same register is that of John, 
son of Walter, granting a rent of six shillings to St. 
Albans Abbey. William the physician is the sixth 
^ Luard : Matthew Paris (Rolls Series), vol. v, p. 501. 



16 LECTURE I 

of the twelve witnesses, and it seems possible that 
this is the son of Adam the physician. 

Matthew Paris, friend of King Henry III and of 
many magnates of the realm in church and state, 
and living in the greatest abbey of England in the 
midst of the intellectual life of the time, knew 
personally five physicians, and may have seen two 
more. From the writings of this historian we can 
draw up a sort of Medical Kegister of the time of 
King Henry III. 

Adam, physician practising at St. Albans. 
Alexander, physician to Queen Eleanor of 

Provence. 
Bathonia, Eeginald de, physician to Queen Eleanor 

of Provence ; sent on a mission to the court of 

Scotland. 
Besace, Kanulphus, Canon of St. Paul's (1217-43). 

Served in the crusade with King Kichard I, 

and sent as envoy to Saladin. 
John de Sancto Egidio, doctor of medicine, doctor 

of laws, doctor of theology, a Dominican, 

studied at Paris and at Montpellier, professor 

at Paris and at Oxford ; sometime physician to 

the King of France; physician to the Bishop 

of Lincoln. 
Eeginald, physician ; a priest resident in St. 

Albans Abbey, sent on a mission from the 

abbey to Kome (1235-51). 
Richard de Wendover, physician, Canon of 

St. Paul's. 
William, physician at St. Albans, son of Adam 

the physician. 

That physicians were not numerous in London is 
suggested by the rarity with which they occur as 
witnesses in London charters in the long reign of 



STUDY IN LONDON 17 

Henry III. It is clear that considerable attain- 
ments were necessary before a man was styled 
medicus or physicus. His study chiefly consisted 
in reading books and hearing lectures on books in 
the university. Most learned men had read some 
medicine, or knew something about it ; and some 
ecclesiastics had specially devoted themselves to a 
study the use of which was so suitable to their 
profession. Of this kind was the abbot of Croke- 
stone *in arte medicina erudito', who attended 
John in 1216 at Newark. The king had been 
marching through Suffolk and Norfolk, ravaging the 
districts which had shortly before yielded to Lewis 
of France, and reached the abbey of Swinestead in 
Lincolnshire, where he slept. He was deeply de- 
jected by the loss of his baggage and treasure in 
quicksands. He had severe rigors, ' acutis correptus 
febribus,' yet, hungry after the march, ate a large 
meal and drank much new beer. His temperature 
continued to rise, 'febrilem in se calorem acuit 
fortiter et accendii' Next day, nevertheless, he 
went on to the castle of Sleaford. After a night 
there he was drawn in a horse litter to Newark. 
He took to bed and was conscious enough to 
receive the Holy Eucharist and afterwards to 
nominate his son Henry as his heir, and to order 
the Great Seal to be affixed to letters patent ad- 
dressed to the sheriffs and castellans of the realm 
commanding them to be ' ei intendentes '. He was 
obviously getting worse, and the abbot of Croke- 
stone in guarded terms asked him where he wished 



i 



18 LECTURE 1 

to be buried should he die. The king, speaking no 
doubt in French, said, * To God and St. Wulstan I 
recommend my body and soul.' This seems to have 
been on St. Luke's day, and he died the night follow- 
ing. His illness, thus terminating within a week and 
beginning with a violent rigor and aggravated by his 
moving on from Swinestead instead of staying in 
bed, may have been acute pneumonia or an acute 
gastro-enteritis, aggravated by exhaustion, mental 
and physical. The abbot of Crokestone, ^ qui Medi- 
cus regis tunc temporis extiterat,' made a necropsy, 
* facta anatomia de corpore regio,' not for patho- 
logical purposes but * ut honestius portaretur'. He 
carried the viscera to his own religious house, and 
there honourably buried them. The body with its 
proper ornam^ents was borne to Worcester, where 
the royal tomb may be seen to this day. 

Eobert Grosseteste, Bishop of Lincoln from 1235 
to 1253, knew Greek as well as Latin, and in his 
extensive reading he had not neglected medical 
books and was able to apply his knowledge. To 
a preaching friar whose health was imperfect he 
recommended sufficient food, proper sleep, and 
good humour, clearly having in his mind the 
lines of the School of Salernum : 

Si tibi deficiant Medici, Medici tibi fiant 

Haec tria : mens hilaris, requies, moderata dieta. 

He advised another friar, who had a tendency to 

melancholia, to take a cup of good wine ; and his 

insistence on its quality, when his own ascetic life 

and the context are considered, shows that he had 



STUDY IN LONDON ig 

another verse of the ^ Kegimen Sanitatis Salerni ' 
in his thoughts : 

Gignit et humores melius vinum meliores. 

After a prescription in a fourteenth-century manu- 
script (Mirfield) is written : * Et dicitur hoc esse 
per Kobertum Grosseteste Episcopum Lincolni- 
ensem.' We may be certain that Grosseteste 
had read the chapter on medicine in the Liber 
Etymologiarum of Isidore of Seville. His chief 
friend was a physician, Dr. John of St. Giles (de 
Sancto Egidio), sometimes called John of St. Albans. 
The libraries of monasteries and cathedrals always 
contained books on medicine, and as reading was 
thought the chief source of medical knowledge 
books were even more important to a physician in 
the Middle Ages than they are at the present day. 
The catalogue of the library of Chaucer's physician 
is familiar to every one : 

Well knew he the olde Aesculapius, 
And Deiscorides and eek Rufus, 
Old Ypocras, Haly and Galien ; 
Serapyon, Razis and Avycen ; 
Averrois, Damascien and Constantyn ; 
Bernard and Gatesden and Gilbertyn. 

Some such book as Trismegistus ad Asclepium^ one 
leaf of which begins with the words ^ Asclepius iste 
pro sole ', was perhaps in Chaucer's mind when he 
placed Aesculapius in the list. A copy of Trisme- 
gistus was in the library of Dover Priory, and the 
same library, which had in it some one hundred and 
eighteen medical treatises, contained amongst them 

c2 



20 LECTURE I 

works of Hippocrates, Galen, Ehazes, Bernard, and 
Gilbert, as is shown by the catalogue of the library 
written in 1389 and thus almost exactly contemporary 
with the Canterbury Tales, The library of St. Augus- 
tine's Abbey at Canterbury contained ten of the 
fifteen authors mentioned by Chaucer in its collection 
of two hundred and thirty or more medical works. 
Aesculapius, Kufus, Averrois, Damascien, and Gates- 
den are the writers who were not in the library. 
The catalogue was written towards the end of the 
fifteenth century. The catalogue of the library of 
Christ Church, Canterbury, contains over two 
hundred and eighty medical treatises, including 
nine of those of Chaucer. The catalogue was 
written in the time of Prior Henry de Estria, whose 
name is familiar to every visitor to Canterbury at 
the present day from the beautiful stone screen with 
finely proportioned geometrical tracery with which 
he enclosed the choir of that noble church. De 
Estria ruled from 1284 to 1331, so that he had been 
prior for twenty years before two of the authors in 
Chaucer's list had risen to fame. Bernard and 
Gatesden, Aesculapius, Serapion, Eufus, and Gilbert 
are the others absent in the Christ Church library. 
These three catalogues have been printed by 
Dr. Montague Bhodes James, whose learning may, 
we hope, long continue to produce works which add 
so much to the fame of the University of Cambridge, 
and of the ancient foundation of which he has 
recently been elected the head — a foundation of one 
member of which, Henry Bradshaw, I should indeed 



STUDY IN LONDON 21 

be forgetful if I did not express my gratitude when 
lecturing on my subject of to-day, since he first 
opened to me the stores of mediaeval literature. 

At St. Paul's Cathedral a solitary manuscript of 
Avicenna remains, given to it in May, 1451, by John 
Somerset, Master of Arts and Doctor of Law, 
Chancellor of the Exchequer of England. Eeading 
and hearing lectures were the chief means used to 
acquire medical knowledge, but hospitals existed 
which contained patients with various diseases and 
so gave opportunities for observation. 

Jacobus de Vitry, Bishop of Acre in Palestine 
and a cardinal, in his Historia Occidentalism'^ written 
about 1220, shows the nature of the hospitals of his 
time in France and consequently of similar institu- 
tions in England. He is giving an account of the 
state of society in the West of Europe : * There are, 
moreover, very many associations of men and of 
women renouncing the world and living by rule in 
houses of lepers or hospitals of the poor, humbly 
and devotedly ministering to the poor and the sick. 
They live according to the rule of St. Augustine. 
. . . These servants of Christ, sober and sparing 
towards themselves, and rigid towards their own 
bodies, abound in compassion towards the poor and 
sick, and at once minister to them all necessaries to 
the best of their ability. For Christ's sake they 
bear the filth and impurities of the patients and the 

^ lacobi de Vitriaco, Primum Acconensis deinde Tusculani 
Episcopi : libri duo quorum prior Orientalis sive Hierosolymitanae, 
alter Occidentalis Historiae nomine inscrihitur. Duaci, 1597. 



22 LECTURE I 

annoyance of almost unbearable smells.' He ends 
with a eulogium of several good hospitals and says 
that they are * a refuge to the poor, an asylum for 
the wretched, consolations for the mourning, 
nourishment for the starving, a kindness and 
diminution of suffering for the sick '. The societies 
following the rule of St. Augustine were often 
devoted to the care of the poor, the sick, and the 
leprous. The frequent contrast in their statutes ^ 
between sani and infirmi shows that the sick, and not 
merely, as has sometimes been supposed, the poor 
were their care. The statutes of the hospital of 
Angers (Hotel Dieu), founded in 1175, ordain that 
messengers shall be sent twice a week through the 
town seeking sick persons to be admitted. If it 
chances that at the gate any sick man be found 
desiring admission the porter, if a brother (as we 
should say, one of the staff), shall admit him. If 
not, he shall send word to the prioress and she shall 
come at once or send another sister, one not hard or 
rough but kindly, and she, if the patient ought to 
be received, shall admit him. After he has con- 
fessed his sins and received the Holy Communion, 
if with due devotion he desires it, he shall be carried 
to bed. The brethren and sisters and the poor are 
to have the same bread and the same wine, unless 
the weakness of the sick should require better bread 
and better wine. The following persons are not to 
be admitted to the hospital : lepers, permanent 
cripples, blind, thieves whose hands and feet have 
* Le Grand, Statuts. Paris, 1901. 



STUDY IN LONDON 2a 

been lately cut off, or foundling children. Lying-in 
women are to be received and cared for till well. 
The statutes of the Hotel Dieu of Amiens of the 
year 1230 mention that the patients may stay in the 
hospital seven days after they are convalescent if 
they wish. These passages are sufficient to prove 
that in France, including the French dominions of 
the English kings, there were hospitals containing 
such patients as are to be found in our hospital 
wards at the present day. 

In England it is clear that many hospitals were 
from the first intended for the care of the sick and 
maimed as well as of the poor. A few were 
restricted to some particular kind of poor person, 
just as the leper hospitals were restricted to a 
particular kind of patient. Several ancient records 
indicate that St. Bartholomew's in London was 
arranged on the same plan as the French hospitals. 
A husband and wife, for example, might be received 
as a brother and a sister of the hospital. Ralph de 
Quatremares and Albreda his wife in the reign of 
John gave to St. Bartholomew's Hospital a holding 
which they held of Westminster Abbey, next the 
church of All Hallows in Bread Street, with the 
house on it and all its contents, as well as an 
orchard which they held of the church of St. Paul, 
in free and perpetual alms, ' And if poverty should 
come upon us the brethren of the aforesaid hospital 
shall minister to us all necessary things as if we 
were a brother and sister of the hospital in our own 
house, and further when it pleases us they shall 



24 LECTURE I 

receive us into their society/ This last clause may 
be compared with a statute of the Hotel Dieu of 
Troyes (domus Dei comitis trecensis) drawn up in 
1263. * Nullus recipiatur cum uxore sua nisi per 
dispensationem.' This statute shows that in earlier 
times it had been customary to receive a husband 
and wife as stipulated by Ealph and Albreda de 
Quatremares in London, and with other resem- 
blances in organization justifies the view that the 
hospitals under the care of the Augustinian order in 
France and England were foundations identical in 
function. Some hospitals in England before the 
dissolution had become simply homes for poor men 
and women who had no other infirmity than that 
of age, but many continued to treat the sick. A 
passage in the Close Kolls of Edward III (March 5, 
1341) shows that St. Bartholomew's Hospital was one 
of these. It was, * Ad omnes pauperes infirmos ad 
idem hospitale confluentes quousque de infirmita- 
tibus suis convaluerint ac mulieres pregnantes 
quousque de puerperio surrexerint, necnon ad 
omnes pueros de eisdem muheribus genitos usque 
septennium, si dicte mulieres infra hospitale pre- 
dictum decesserint.' The last part of this extract 
from the Close Eolls shows that in the Middle Ages 
the benefits of the revenues of a hospital were not 
always restricted to the sustenance and treatment 
of patients, but were sometimes extended to the 
support of orphans whose mothers had not survived 
their birth. This was naturally done ^ caritatis 
intuitu \ as the old charters say, just as equally at 



STUDY m LONDON 25 

the prompting of charity we add museums and 
other means of increasing knowledge, and so re- 
lieving not only the patients of our own hospital, 
but sick men all over the world in ages to come as 
well as in our own time. A passage in the will of 
the charitable Gilbert Chaumpneys,^ dated 1375 and 
preserved at St. Paul's Cathedral, suggests that there 
were patients, in our sense, in the hospital of St. 
Thomas the Martyr in Southwark, which now 
flourishes in Lambeth under the tutelage of St. 
Thomas the Apostle. Chaumpneys left a shilling to 
every leper in London, three beds with linen to the 
hospital of St. Mary without Bishopsgate, and three 
to St. Thomas's, and sixpence to every sick person 
(infirmus) in each of these hospitals. This charitable 
man also left sixpence to every prisoner in Newgate, 
and twenty pounds to get debtors out of Newgate, 
twenty shilHngs to the prisoners in the Marshalsea 
and the same to those in the King's Bench, twenty 
shillings to every nun in the convent of Sopwell, 
with gifts to other nuns and to St. Paul's Cathedral, 
to fifteen parish churches, and to the fabric of a 
bridge in the country. 

The writings of John Mirfeld, the author of 
the treatise on medicine entitled Breviarium Bar- 
tholomeiy show the nature and extent of the studies 
of a physician of the fourteenth century. 

Mirfeld belonged to the period when the practice 
of medicine was sometimes exercised by a layman, 
sometimes by an ecclesiastic ; when medical books 
^ Ninth BepoH on Historical MSS., 1883, p. 47. 



26 LECTURE I 

were to be found in most libraries, and when in 
London there were some hospitals in which diseases 
were treated and might be observed. He was a 
resident in the convent of St. Bartholomew in 
Smithfield. This priory was founded in the reign 
of Henry I, shortly after the hospital of St. Bartho- 
lomew, by Eahere, the founder of both. The priory 
had certain relations to the hospital, of which the 
most important were that the brethren of the 
hospital had to present their master on his election 
to the prior and canons for confirmation, and must 
obtain the same consent for the admission of 
members into their society, and that a certain 
share of the food and drink left by the canons must 
be given to the hospital. In his medical writings 
Mirfeld speaks of * magister mens ', his instructor 
in the practice of medicine. His master operated, 
he says, in an original way in a case of hydrocephalus 
in a girl. He rubbed in sulphur ointment twice a 
day and then bound a bandage of warm wool on the 
girl's head, and kept it there a month or more. 
Then he tapped by a cautery in front ; water came 
out slowly. After a time he did the same at the 
back of the head, and more water came out. In less 
than a year the girl was well. He closed the wounds 
with tents. Mirf eld's master was called to a man 
in gaol who had stabbed himself, so that when he 
swallowed, food and drink and air came out of 
the wound. He joined the parts of the wound 
carefully, and covered the place with powders and 
bandages. The man recovered within a month. 



STUDY IN LONDON 27 

His master treated a woman who had lost her 

speech. He rubbed her palate with a preparation 

known as theodoricon emperisticon and with a little 

diacastorium. She recovered her speech and bore 

witness to his skill. Was this a case of hysterical 

aphonia ? An apothecary brought to his master a 

youth with a carbuncle on his face. His whole 

neck and throat were swelled beyond belief, and the 

sick man had already tokens of death ; he had no 

pulse and was fainting. The master said to that 

apothecary that the youth should go home because 

he was about to die in a short time. The apothecary 

said, * Is there no further remedy ? ' The physician 

replied, *I believe most truly that if thou wert to give 

tyriacum in a large dose there would be a chance that 

he might live.' Having heard this, the apothecary took 

the youth home, though barely able to get him there, 

and he gave to him about two drachms of tyriacum 

and put him to bed. The youth's head and the 

affected part broke into profuse perspiration, and after 

a little there was a general perspiration and his pulse 

returned. And the apothecary gave him the dose 

again of his own accord, and that day he was made 

whole except for a little sore place which afterwards 

healed up, ^ and my master said that he had never 

feeen anyone else who had recovered after being in a 

faint and tremor, and especially without pulse.' 

It is clear that Mirfeld's master was a physician, 
and that, like Chaucer's doctor of physic — 

Ful redy hadde he his apotecaries 

To send him dragges and his letuaries. 



28 LECTURE I 

The tyriacum which his master used was a prepara- 
tion attributed to Mithridates, King of Pontus, which 
from the Augustan age to the eighteenth century 
was used by physicians. It did not come from 
Mithridates, says Quintus Serenus Sammonicus, for 
when that king was vanquished by Pompey, the 
medicine found in his casket was worthless : 

Antidotus vero multis Mithridatia fertur 
Consociata modis, sed Magnus scrinia regis 
Quum raperet victor, vilem deprendit in illis 
Synthesin, et vulgata satis medicamina risit, ' 
Bis denum rutae foHum, salis et breve granum, 
Juglandesque duas, totidem cum corpore ficus. 

Mithridatium, afterwards called Theriaca, con- 
tained opium. It began with thirty-eight ingredients, 
then had fifty-three, and later still seventy-five, 
and continued to be made and prescribed long after 
the identity of many of its ingredients had been 
lost. Dr. William Heberden, one of the greatest of 
English physicians, wrote in 1745 an essay entitled 
Antitheriaca, relating its history and attacking its use. 

From another passage in the Breviarium it may 
be inferred that Mirfeld had studied at Oxford. One 
Master Nicholas Tyngewich, he says, related in his 
lecture theatre at Oxford that he rode forty miles 
to an old woman, who had cured innumerable men 
of jaundice, and gave her a sum of money for 
teaching him her method of treatment. This seems 
like the statement of one who had heard the 
lecture. Nicholas Tyngewich was King Edward I's 
physician, and he is mentioned in two documents 
of 1306. One is the king's request that he may bo 



STUDY IN LONDON 29 

allowed to hold the living of Reculver, and the 
other Pope Clement Vs letter confirming the 
presentation. His name also occurs in a charter 
of the same period at St. Paul's Cathedral.^ The 
late Mr. J. L. G. Mowat, who edited in the Anecdota 
Oxoniensia in 1882 the Sinonima or glossary, the 
only part of Mirfeld's works which has been printed, 
points out that John Mirfeld represented the 
convent of St. Bartholomew in 1392 and 1393. 
Mr. E. A. Webb has shown that in 1379 Mirfeld 
was taxed as a layman living in the priory. He 
was in 1390 granted a chamber on the south side of 
the church, and was a liberal benefactor of the 
priory.2 His chief medical work, as is shown by 
the calendar which is attached to it in its finest 
copy, was written before the year 1387. If Mirfeld 
was at Oxford when sixteen years old, a not uncom- 
mon age for university life at that time, and if at 
the time he appeared as one of the seniors of the 
Priory of St. Bartholomew he was about seventy 
years old, he may easily have attended the medical 
lectures of Nicholas Tyngewich between 1336 and 
1340. 

The general impression left after reading his 
medical writings is that Mirfeld's master was a 
layman, and that it was after the beginning of his 
medical studies and his university career that 

' H. 0. Maxwell Lyte, Ninth Beport on Historical MSS., 1883, 
p. 10. 

^ Information from the Clerical Subsidy Roll and the Patent 
Rolls, kindly given to me by Mr. E. A. Webb, 



30 LECTURE I 

Mirfeld entered the convent of St. Bartholomew 
of Smithfield. Yet his theological reading is so 
extensive that he must have for a long time led a 
studious and probably a monastic life. The course 
of his studies was perhaps similar to that of John 
of St. Giles, that learned Englishman of the reign 
of Henry III, who was physician to Bishop Eobert 
Grosseteste of Lincoln. John of St. Giles studied at 
Oxford, and then at Paris and at Montpelier, where 
he pursued medicine, and with such distinction that 
he became physician to Philip Augustus, Ejng of 
France. He lived in Paris in the hospital of St. 
James, which he had bought, and later gave it to 
the Dominicans, hence called in Paris Jacobins. 
It was the meetings of a section of the Eevolutionists 
there which had led to the use of the word Jacobin 
in a sense so very different from that which it had 
for several centuries. He was no doubt in holy 
orders, as he became a doctor of divinity and 
lecturer on philosophy and theology as well as on 
medicine. About 1222 he became a Dominican, 
and is said to have been the first EngHshman to 
join that order. He came back to England in 
1235, and stayed here till his death, which took 
place in or soon after 1258. He became an intimate 
friend of Eobert Grosseteste, Bishop of Lincoln. 
Their relations were chiefly ecclesiastical, but John 
was certainly Grosseteste's physician, attended 
him when he was supposed to be poisoned, and 
was sent for by the bishop in his last illness. 
Matthew Paris, who had probably known John, 



Plate I. 



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Breviarium Bartholomei of John Mirfeld. 
Introduction. 



To face page 3 1 



STUDY IN LONDON 81 

says that he was an elegant scholar and teacher, 
skilled in medicine and in theology. Mirfeld, like 
John, began life in the study of medicine, and was 
always devoted to it, but after his youth he became 
also a learned theologian and a member of a regular 
order. 

That Mirfeld knew something of the patients in 
St. Bartholomew's Hospital seems certain from 
some passages in his works. Leland (1505-52) 
in his Commentarii de Scriptorihus Britannicis men- 
tions having a conversation with * Bertholetus 
medicus ', who had certainly studied the medical 
writings of Mirfeld. This Bertholetus was 
Dr. Eichard Bartlot, an Oxford man, who was the 
first Fellow elected into our College (March 12, 1523), 
and whose learning Caius praises. He was Pre- 
sident in 1527, 1531, and 1548. He died in 1556-7, 
aged eighty-six years. The President, Dr. Caius, 
and the College attended his funeral in the church 
of St. Bartholomew the Great. This was in the 
reign of Queen Mary, when that church, from which 
the Augustinian canons had been expelled under 
Henry VIII, was in the hands of the Dominicans. 
Bartlot had read the very copy of Mirfeld's book 
now at Pembroke College, Oxford : indeed, it seems 
to have belonged to him, for on a blank leaf of it is 
written, * Kichard Bartlot in Medicinis doctor.' The 
Breviarium Bartholomei is Mirfeld's greatest work, 
and as the first book on medicine in any way 
connected with the oldest hospital in London 
deserves particular consideration. I have examined 



32 LECTURE I 

two complete copies of the work : one in the British 
Museum and one in the Hbrary of Pembroke College, 
Oxford, as well as some fragments of a third copy 
also in the British Museum. The Oxford copy is 
in its original binding. The manuscript begins 
with a calendar, which with some scattered notes 
occupies the first nineteen leaves. The Breviarium 
then has an illuminated page. At the foot of the 
page is a shield of arms : argent four martlets and 
a cross, and at the top of the page is a saint in a 
dress of camel's hair, and with a lamb in his left 
hand, obviously St. John the Baptist. These 
ornaments show to whom the manuscript originally 
belonged, for the arms are those of the abbey of 
Abingdon, and at the gate of the abbey was a 
hospital dedicated to St. John the Baptist. The 
possession of such a book by it is a sign that it was 
not, as it afterwards became, a mere almshouse, but 
was a hospital for the sick. I had the opportunity of 
examining the manuscript during several successive 
wrecks in the rooms of the late Professor Henry 
William Chandler, a Fellow of Pembroke College, 
and Waynflete Professor of Moral Philosophy at 
Oxford. 

I ought here to express my gratitude to this most 
learned man, who died in 1889, for his literary 
hospitality to me. His profound knowledge of 
Aristotle, his attainments in bibliography, and his 
untiring devotion to study were well known at 
Oxford. His stores of mediaeval learning, his 
thorough acquaintance with English literature, his 



Pi ATE II. 







/ o^ftA^rt'lp' *r*i»«t^*«a f«(h/ft^. n. 4»jHH»%. a)g^t»m«|nfttr(f4M4|»^etfBft' 




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Bkkviarium Baiitholomei of John Mirfeld. 
End of Part I and beginning of Part II, with verses indicating 
how to find the author's name. 
Ordine pretacto si connumeres capitales : 
Nomen factoris demonstrabunt tibi tales. 
page 3.S- 



STUDY IN LONDON 33 

interest in human nature, and his kindly disposition 
made his conversation as deHghtful as it was full. 
After my perusal of the Breviarium Bartholomei I 
enjoyed his friendship to the end of his life. When 
I visited Oxford I always went to see him and 
noticed on each occasion that before our conversation 
had lasted five minutes I had learned something 
hardly to be attained anywhere else, and that how- 
ever long his conversation continued it was rich in 
learning throughout. The British Museum copy of 
the Breviarium is also a fine manuscript, though not 
so large as that of Pembroke College. On folio 21 & 
is a note which has not hitherto been observed : — 

Ordine pretacto si connumeres capitales 
Nomen factoris demonstrabunt tibi tales. 

Following this injunction the capital letters from 
folio 21 h make the words : * Ora pro nobis sancte 
bartholomee ait iohannes dde Mirfeld ut digni 
efiiciamur promissionibus Cristi.' There are slight 
variations in the text of these two copies. Both 
belong to Mirfeld's lifetime. The index of the 
Oxford copy is headed with a fine illuminated ' I ' 
and the words : * Incipit tabula libri Johannis 
Mirfeld quem ipse composuit et Breviarium Bar- 
tholomei vocavit ; compilavit in monasterio sancti 
Bartholomei London eundemque divisit in partes 
quindecim.' The first of the fifteen parts is of 
fevers ; the second of affections of the whole body ; 
the third of affections of the head, neck, and throat ; 
the fourth of the chest ; the fifth of the abdomen ; 
the sixth of the pelvic organs ; the seventh of the 



34 LECTURE I 

legs ; the eighth of boils ; the ninth of wounds and 
bruises ; the tenth of fractures and dislocations ; the 
eleventh of joints ; the twelfth of simple medicines ; 
the thirteenth of compound medicines ; the four- 
teenth of purgatives ; and the fifteenth of the 
regimen of health. As in most mediaeval systems 
of medicine the part on fever follows the general 
arrangement of the subject in Galen. Mirfeld's 
chapter * De febribus pestilencialibus ' ^ begins 
with the statement that such epidemics come in 
rotten and sterile seasons when the crops are 
blighted and the air and water corrupted, so that 
they infect human bodies. The infected air goes 
to the heart and round the whole body, and to it is 
added infected food and drink. Men and vermin 
and brute animals are attacked, and sometimes 
animals only, while the epidemic avoids men. Of 
all fevers these are the worst. Signs of the approach 
of plague are comets and irregular seasons, too much 
cold in the hot season, too much heat in the cold 
season, thick and foggy air, the threatening of rain 
without rain. Also a warm and damp summer, a 
time when birds desert their nests and when many 
reptiles appear on the surface of the earth. All 
these are signs that an epidemic is about to come. 
The symptoms are that the heat of the body is 
moderate externally and great internally, with 
thirst and dry tongue and difficulty of breathing and 
praecordial pain and foetor of everything coming out 
of the body. The prognosis is bad and there are 

» f. 136. 



STUDY IN LONDON 35 

terrible and deceptive complications, and after these 
small-pox and measles may follow. Physicians are 
often deceived, and when they expect a good turn 
after the crisis then comes death. A person may 
be preserved from infection in a cold season by 
smelling and swallowing musk and aloes-wood and 
storax, calamita and amber and such-like aromatics. 
If the season is warm, sandal-wood and roses, 
camphor and ' acetositas citri,' sour milk, all kinds 
of sour herbs and vinegar. Repletion of food 
and drink is to be avoided. If the extremities 
are cold they are to be rubbed. Purging and bleed- 
ing are protective. Warm baths are to be avoided. 
Sweets made with honey, green fruits, and sweet 
fruits are to be avoided. Veal, fowls, and partridges 
may be eaten with lettuce, vinegar, and acid herbs. 
SjTup of vinegar is to be taken in the morning and 
at midday syrup of violet in cold water. 

Brother John Helme, who was probably one of 
the brethren of St. Bartholomew's Hospital, recom- 
mended against the plague a mixture of aloes and 
myrrh to be taken out of warm wine, the bulk of 
a little nut of the powder to be the dose. Water 
distilled from diptamius, pimpernel, tormentil, and 
scabious, equal parts of each, is to be drunk daily. 
* Est enim optima et nobilissima medicina.' Cam- 
phor, three or four grains, avails against pestilential 
air according to Hali Abbas. Warm bread should 
be consumed, as a few morsels of it prevail against 
pestilential air and against fetid morning vapours. 
It is also good against the foetor of the sea, and if 

D 2 # 



36 LECTURE I 

you have not warm fresh bread, says Mirfeld, * da 
tostum/ 

I may here remark that our idea that sea air is 
wholesome has not always prevailed, for in an 
account of Northamptonshire, published in 1738, 
the author remarks ' the air of Northamptonshire is 
exceedingly pleasant and wholesome, the sea being 
so remote that it is not infected with its noisome 
fumes '. Scented wine should be drunk, and on 
going out of the house an aromatic should be 
thrown on to the fire. One proceeding difficult to 
explain is recommended in cases of fever. A little 
twig of hazel, a foot long, is to be broken in the 
middle. The two parts are to be held a little way 
apart and certain words repeated, and by virtue of 
the words the twig becomes united in some place. 
Here it is to be held by finger and thumb and the 
rest cut away so that there is a little cross. This 
the feverish man is to hold above him and to say 
some words in French and five paternosters, and he 
will be healed, as has often been proved, says the 
Breviarium, This therapeutic method does not 
seem less rational than the method of discovering 
subterranean water by the movement of a hazel rod 
in the hands of a water finder, which has been 
gravely defended and widely practised in our own 
times. 

Among the medical books of Mirfeld's time were 
treatises on the diseases of horses, of cattle, and of 
hawks ^ Epidemic disease in cattle, he says, may be 

' The Hieracosophion sive Be Be Accipitraria of J. A. Thuanus 



Plate III. 




o^ 









•L, 



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BREviARum Bartholomei of John Mirfeld, 
On Materia Medica. 
Sulfuraca. Sulfur. Spinac. Talpa. Tamarindi.* Tamariscus, Tapsia. 
To face page 36 



I 



STUDY IN LONDON 37 

warded off by hay prepared in a very harmless and 
charitable way. Three poor travellers are to be 
entertained on Christmas Eve and beds of hay are 
to be made for them. This hay is to be placed daily 
between the oxen from Christmas Day till Twelfth 
Day, and by the goodness of God they will be safe 
for the whole year. To recommendations of this 
sort Mirfeld usually adds some such phrase as * so 
it is said '. Mirfeld had witnessed the long wake- 
fulness of some cases of fever. His prayer to be 
used in such cases is based upon the legend of the 
Christians of Ephesus who outslept the age of perse- 
cution. The mention of the names of the seven 
sleepers of Ephesus — Maximian, Malchus, Dionysius, 
Marcian, John, Constantino, and Serapion — in rela- 
tion to insomnia was not confined to Christendom. 
It extended to the Mohammedan nations and is still 
in use among the Arabs in Algiers. Mirfeld was 
not afraid to bend over the patient in fever, and 
recommends that the thickly furred tongue should 
be wiped with a linen rag moistened in acid juice. 
If uncertain whether the patient was alive or dead, 
he put a little burnt lard to the nostrils. If alive, 

shows how much material had accumulated two centuries later 
on this subject for his third book beginning : 

lam quibus adversus pesteis, et semina dira, 
Morborum, accipitrumque lues, atque ulcera hiulca 
Praesidiis uti consultus debeat auceps : 
Quaque etiam plagas, lethaliaque obliget arte 
Vulnera, et obducto doceat coalescere callo, 
Exsequar ; haec longi nobis meta ultima cursus 
Scilicet, et tanto finem impositura labori. 

extends to more than nine hundred lines. 



88 LECTURE I 

he found that the patient thereupon scratched his 
nose. Mirfeld's account of plague is based upon 
the chapter on the same subject in the Lilium 
Medicinae of Bernard of Gordon, written at Mont- 
peUier in 1305. On all general questions Mirfeld 
uses Bernard's words, but his numerous remarks on 
protection from infection, as well as the way in 
which he leaves the reader to infer that treatment 
is of very little use in the plague, point to actual 
experience * tempore pestilenciae '. One of the 
greatest recorded epidemics of plague occurred 
during Mirfeld's lifetime, and he was probably old 
enough in 1348-57 to have observed its phenomena 
and must have talked with many men who survived 
the epidemic. His chapter * De febribus pesti- 
lencialibus' reflects that time in the recommendations 
of numerous protective measures and in the observa- 
tion that vermin and brute beasts as well as men 
died and that the animals sometimes died when 
men did not ; but he makes no original clinical notes. 
In Part II skin diseases are described and couplets 
are often given to enable the memory to retain their 
names and symptoms. He is inclined to agree with 
Platearius of Salernum that all kinds of leprosy 
are incurable, yet in one case by very severe purga- 
tive pills he did good and the leprosy was relieved 
for almost three years, yet after that it reappeared 
distinctly. The diet, he says, must be restricted. The 
patient's bread must consist of two parts rye and 
one part barley. He must drink clear well-scented 
wine and may eat game and eggs. The flesh of 



STUDY IN LONDON 



8» 



domestic animals is to be avoided as well as putrefied 
food, cheese, salt meat, hares, and pulse. Gout 
Mirfeld treats with an ointment made from goose 
fat, for the making of which he gives a metrical 
recipe : — 



Anser sumatur 

Veteranus qui videatur 

Post deplumetur 

Intralibus evacuetur 

Intus ponatur 

Trita caro tota 

Catti mox pelle remota 

Mel sal fuligo 

Faba pondere jungitur 

aequo 
Unctum porcinum 



Thus cera sagmen ovinum 

Post hoc assatum 

Tunc assus non comme- 

datur 
Vas supponatur 
Sagmen ut accipiatur 
Istud pinguamen 
Dat gutte cuique levamen 
Anseris unguentum 
Valet hoc super onme 

talentum. 



He treated chronic rheumatism by rubbing the 
part with olive oil. This was to be put into a 
clean vessel while the pharmacist made the sign of 
the cross and said two prayers over it, and when 
the vessel was put on the fire the Psalm * Quare 
fremuerunt gentes' was to be said as far as the 
verse * Postula a me et dabo tibi gentes hereditatem 
tuam'. The Gloria and two prayers are then to 
be said and the whole repeated seven times. The 
mixture of prayers with pharmacy seems odd to 
us, but let it be remembered that Mirfeld wrote 
in a religious house, that clocks were scarce and 
watches unknown, and that in that age and place 
there was nothing inappropriate in measuring time 
by the minutes required for the repetition of so 
many verses of scripture or so many prayers. The 



40 LECTURE 1 

time occupied I have found to be a quarter of an 
hour. Scrophulus (scrofula) is, he says, according 
to Johannicius, nothing more than multipUed glands. 
If other methods of treatment fail we go to kings, 
because by touch alone kings are wont to cure that 
infirmity thence called by many morbus regius. 
^ The chapter on epilepsy and apoplexy and that 
on hemicrania are based upon the chapters on the 
same subjects in John of Gaddesden's Hosa Anglica, 
Verses are to be repeated in the ear of the epileptic 
man as he Hes on the ground. The epileptic uncon- 
sciousness lasts but a short time, and no doubt, as 
Mirfeld and other writers of his time assert, the 
patient often got up after 

Gaspar fert mirram : thus Melchior : Balthazar 

aurum. 
Hec tria qui secum portabit nomina regum, 
Solvitur a morbo Domini pietate caduco 

was repeated in his ear. To a man ignorant of the 
fact that while the anatomical change which produces 
an apoplectic fit is one involving actual destruction 
of a part of the brain, that of an epileptic fit is, for 
the most part, a transient condition, it must have 
seemed reasonable by analogy that verses should do 
good to an apoplectic patient. Mirfeld recommends 
an empiric remedy of English Gilbert. The follow- 
ing two verses are to be tied round the arm, the Lord's 
Prayer being said the while. The verses are to be 
written with crosses above and below each word : — 

Amara timi taturi : postos sigalos sicaluri : 
Ely poly carras: polyly pylini lyvarras. 




STUDY IN LONDON 41 

There are several similar medical charms in 
Marcellus Empiricus,^ and Professor Khys ^ has 
lately maintained with great ingenuity that they 
preserve sentences of one of the three chief Celtic 
dialects of Gaul. He shows how interesting such 
verses may prove on minute examination. I may 
give one example from Marcellm for purpose of 
comparison : — 

Omnia, quae haeserint faucibus, hoc carmen expellet : 
Heilen prosaggeri nome si poUa nabuliet onodieni 

iden eliton 
Hoc ter dices et ad singula expues : 
Item fauces, quibus aliquid inhaeserit, confricans 

dices : 
Xi exucricone xu crigrionaisus scrisu mi orelor 

exugri cone xu grilau. 

To trace to their origin the numerous lines of 
verse of which Mirfeld recommends the repetition 
in various emergencies would take a long time, but 
I may point out the source of one couplet.^ 

Sancte Columquille remove mala dampna faville 
Atque Columquillus salvet ab igne domus. 

The Unes were repeated as a charm to stop the burn- 
ing of a house. In the life of St. Columcille or 
Columba in the Leahhar Breac, a fifteenth-century 

^ Medici antiqui omnes (Aldus), Venice, 1547, containing 
Marcellus de Medicamentis, p. 107 b. I like to quote from this 
edition since it reminds me of the friendship of Mr. K. W. Kaper, 
of Trinity College, Oxford, who gave me a fine copy of it in a 
splendid ancient binding. 

^ Celtae and Galli : Proceedings of the British Academy, vol. ii, 
1905. 

^ Oxford MS. of Breviarium, f. 253 a, col. 1. 



42 LECTURE I 

manuscript, occurs this passage : * A great flame 
came towards him once in Hi. They asked him 
the cause of the flame. Fire of God from heaven, 
quoth he, came just now upon three cities in Italy, 
so that it slew three thousand men as well as their 
wives and sons and daughters.' ^ Mirfeld observes 
that an injury on the right side of the head is likely 
to lead to paralysis on the left side of the body and 
relates the case of one of the canons of St. Bartholo- 
mew's Priory who was treated by his master. The 
canon was about to get on his horse, and when the said 
canon wished to seat himself in the saddle the horse 
arose on his two hind legs and the canon fell head 
downwards over the crupper of the horse to earth, 
and fell so heavily upon his head that straightway he 
lost the sensation and movement of his whole body. 
Mirfeld's master having been called by the friends 
of the patient made them shave his head, and then 
rubbed in oil of roses with a quart of warm vinegar, 
and sprinkled it with a powder, and put over it 
a fine cloth soaked in the aforesaid oil and vinegar, 
and over that fastened linen stoups and bound with 
bandages his whole head, and put over all the skin 
of a lamb. And every day he visited him twice and 
rubbed in ointment into his neck and as far as the 
middle of his spine. On the second day the patient 

^ ' Laisse mor tanic dosum fechtus inhii : fiarfacht desuim 
fath na laissi. Tene De do nim olesium tanic innossa for teora 
cathracha isin, Etail coros marb tri mile fer cen mota mna ocus 
maic ocus ingena.' Lcahhar hreac : facsimile. Dublin, 1878, 
f. 33, Part I, col. a, line 67 to col. &, line 3. First edited by 
Whitley Stokes in Three Middle Irish Homilies. Calcutta, 1897. 



STUDY IN LONDON 43 

opened his mouth a Httle. Then one of his friends 
wished to try if he would eat, but the physician 
would not allow it and said, * Even if he wished to 
eat I would not let him.' On the third day, when 
a question was put to the patient, he tried to answer, 
stammering, but he could not form the word. On the 
fourth day he spoke stammeringly, and then they 
handed him a thin warm drink, which he saw and 
swallowed. The fifth day he took a thin tisane. 
On the sixth day they gave him some chicken broth. 
He then began to grow stronger, little by Httle, and 
to be able to move, but it was many days before he 
could walk. When he was able to take food Mirfeld's 
master began to prepare pills, to resolve by evacua- 
tion the residue of the material accumulated by the 
fall on his head. He recommended that the patient 
should eat the brains of birds and fowls and kids, 
and thus doing he was cured. But the poor canon 
was never quite the same man again, as Mirfeld 
says : * Nunquam tamen fuit ita subtilis ingenii et 
bone memorie sicut prius.' 

Hippocrates and Galen had observed that an 
injury to the left side of the brain may produce 
paralysis of the right side of the body, and even 
a general man of letters like Plutarch knew this. 
Mr. J. D. Duff, of Trinity College, in a letter to me 
of August 16, 1895, says : * Here is something 
I noted for you from Plutarch's Conjugalia Praecepta 
(20 E) : " atcrwep ol larpol Xeyovcn Ta9 tcov evcovvfxbyv 
irXyjya^ ttjv aicrdrjcriv iv rol^ Sefiot? ava(j)ipeiv" 
What do you suppose he means ? That an injury 



44 LECTURE I 

to the left side of the brain injured the right side of 
the body ? And is that so ? Plutarch was interested 
in medicine as in nearly everything and often quotes 
something from Hippocrates/ Dr. John Cooke, in his 
careful Treatise on Nervous Diseases, which appeared 
in 1820, tells as much, and very little more, of the 
relation of hemiplegia to destruction of part of the 
brain. When Mirfeld treats of injuries he regrets 
that medicine and surgery have become separate 
lines of practice. The well-informed, he says, are 
aware that he cannot be a good physician who 
neglects every part of surgery, and, on the other 

th^nd, a surgeon is good for nothing who is without 
knowledge of medicine. Mirfeld times with pre- 
cision the recovery of each broken bone. A rib 
will take twenty days. A humerus or a femur forty 
days. He had noticed that union is slower in the 
aged. He writes at length on materia medica, and 
I might easily give a separate lecture on this part of 
his work. He describes the drugs, names their 
common adulterations, discusses their effects, and 
gives many prescriptions. The last chapter of the 
JBreviarium, that on preserving health, is based on 
the * Eegimen Sanitatis Salerni '. 

Another work of Mirfeld's is the Florarium 
Bartholomei.^ It is to Mr. J. P. Gilson, a member 
of the learned staff in the manuscripts department 
of the library of the British Museum, that the 
discovery of the authorship of this book is due. At 
the foot of folio 3 is written : — 

^ MS. Royal 7 F. xi (British Museum). 



Plate IV. 




I 



^.,i.f>.i4 **t*«p« fiftSuT^ ^[J*'»''^4* 



'»MC»vt>tcic/»t^ C 



fW^. 



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-^A:^""^■^.^^■:av 









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(jay 



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^^|C^ 



^ J>»/rtrZ4 -^noif^ ^-^/»i<> »^ ♦»»**•»** 



<i«>trt8r w-T'to^^T^^ "-ap^^xs a/<i]«»fc^r-v^ 




<>^^c^M e.Ste/»tf*-rf: 4»«:^^||ift, 



Florarium Bartholo>[Ei of John Mirfei.d. 
Introduction, with verses at foot indicating how to find th( 
author's name. 
Ad IHS incipies capitales inde notabis 
Nunc quo vado scies : venio simul uftde probabis. 

To face jjage 44. 



STUDY IN LONDON 45 

Ad IHS incipies capitales inde notabis. 

Nunc quo vado scies venio simul unde probabis. 

Chapter Ixii begins with the word * Jesus ' and 
the initials of the following chapters make up the 
words : Johanni de Suthwelle per Johannem de 
Mirfeld : Ora pro nobis beate Bartholomee ut 
digni efficiamur promissionibus Cristi. Amen. 
Explicit. 

Mr. Gilson was so kind as to point out to me this 
discovery of his, and I wrote down the first words of 
one hundred and fourteen chapters, beginning at 
chapter Ixii. There is an erratum, which may 
perhaps point to the fact that the book is actually 
in Mirfeld's handwriting. The words, the initials 
of which ought to make up his name, are : Monachus; 
Inter ; Eaymundus ; Foemina ; Kex ; Loquens ; De. 
These initials are decorated in red. This was 
usually done by an illuminator and not by the 
original scribe. A little letter was written by the 
original scribe over which the illuminator painted 
his large red initial. The fifth word was Kex, but 
the acrostic requires an E and not an R. It is clear 
that the sentence was made before the *r' was 
illuminated, and while it was so small as to be over- 
looked, so that E and not E was used in the acrostic. 
Mr. J. P. Gilson has mentioned as indications of 
the date of composition in his catalogue of the Eoyal 
MSS. that the constitutions of Simon Islip of 1362 
are quoted,^ and that a sermon of John Grandison ^ 
(written Cronson), Bishop of Exeter, 1328-69, is 
^ f. 69. » f. 181. 



46 LECTURE 1 

also mentioned. It is clear, therefore, that the 
Florarium was composed not earlier than 1362, and 
perhaps as late as 1369. The single medical 
chapter which it contains does not allude to the 
Breviarium Bartholomew so I am inclined to believe 
that the Florarium was composed first. The 
Florarium is a theological treatise with one chapter 
on physicians and their medicines. The manu- 
script in the British Museum once belonged to 
the library of the religious house (of the order 
of the Trinity) of Ashridge in Hertfordshire, and 
had been given to Ashridge in 1518 by Richard 
Hutton.i 

The preface of the Florarium explains that the 
author has collected numerous passages from the 
Holy Scriptures and from sacred writers. A flower 
garden is a place where flowers abound and so the 
name, he says, is appropriate to a collection of 
flowers from holy and spiritual writers, from 
doctors, and wise men. *Sed quare cum hac 
addicione Bartholomei sic nominatur ad presens 
nolo declarare non expedit quidem.' The cause of 
this secrecy is no doubt that it has pleased him to 
explain his name and place of writing by the 
acrostic already mentioned. There are one hundred 
and seventy-five chapters, of which the first is on 

^ * Iste liber constat Thome Baxter vicario perpetuo ecclesie 
parochialis de Stikeford : Eicardus Hutton : Qui Kicardus con- 
tulit istum librum domui religiose de asherug ibidem in 
biblioteca permansurum. Anno domini, 1518.' Florariunif 
f. 259 



Plate V. 




ca Ixxxviii. 



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<i«:^ ^^<i fA.^ .|, »-'^.?7^^rtft 

tc«»g<t*o All*- -^fi^*^ V*<y>j^9Aai^t 
,>SUT«f»f»' hirtTT**!. ©it/^^t to„":ji^,-r 

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UfiPtflX ^* *^^ ^J^' ^0^ CT^-to^.^49 






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!/'o /ace jpa</e 46. 



PYORARIUM BaRTHOLOMEI OF JoHN MiRFELD. 

Chapter on physicians and their medicines. 



STUDY IN LONDON 47 

Abstinence and the other subjects follow in alpha- 
betical order. The one medical chapter is of great 
length, ' On Physicians and their Medicines.' / 
Mirfeld urges physicians not to think too much 
of money, and relates as a warning the case of one i 
to whom were owed thirteen pounds for his treat- \ 
ment of a patient during three years. The \ 
physician when dying and exhorted to receive the J 
Holy Eucharist could say nothing but *thirteejL — ^ 
pounds in three years '. Mirfeld advises prelates to 
have a rope in their study hanging from the ceiling 
and knotted at the end on which they may take 
exercise by swinging or raising their weight on it, 
and recommends them to carry weights in their 
hands about their rooms if they cannot take enough 
outdoor exercise. He counsels every one to bear in 
mind the verses (of the 'Kegimen Sanitatis Salerni ') : 

Sit cena levis 
Vel cena brevis 
Sit raro molesta 
Magna nocet 
Medicina docet 
Ees est manifesta. 

Gluttony slays more than the sword. Foods are 
not to be mixed, but a meal of bread to be taken in 
the morning, and of meat in the evening. * And in 
this,' he says, * all doctors of this faculty agree, but 
we English from long habit hold the reverse.' 

In the library of Lambeth Palace there is 
a manuscript which once belonged to Archbishop 
Sancroft, whose name (W. Saner.) is twice written 



48 LECTURE I 

in it. The volume contains several manuscript 
fragments, and among them four and a half pages 
on prognosis abstracted from medical authors and 
digested into a treatise called Speculum Johannis 
Mirfeld, It ends, * Explicit iste tractatulus multum 
necessarius.' In these three works Mirfeld does 
not mention any vernacular writer. The EngHsh 
men of letters with whose works he was familiar, 
Bede, John of Salisbury, John of Gaddesden, Kanulf 
Higden, all wrote in Latin. He was acquainted 
with Horace and Virgil, and Ovid. He had read 
Boethius, and knew well the Liber Etymologiarum 
of Isidore of Seville. I am not competent to speak 
of his theological reading, but it was obviously 
extensive. Mirfeld had read one . medical book of 
his own time again and again — the Lily of 
Medicine of Bernard of Gordon — and had a less 
profound acquaintance with the English Rose of 
John of Gaddesden, and with the writings of 
Gilbertus Anglicus. These were the modern books 
of his time. Of ancient authors he had studied the 
then current books attributed to Hippocrates and 
Galen. He had read a good deal in the Continent 
of Khazes, and was acquainted with some of the 
works of Serapion, of Avicenna, of Constantinus 
Africanus, and of Isaac, son of Solomon. The works 
of Eoger and Lanfranc, and Platearius of Salernum, 
and Arnaldus de Villa Nova were well known 
to him. The Antidotarium of Nicholas and Aemilius 
Macer's De Herbarum Virtutihus were his chief reading 
in pharmacology. Mirfeld had observed patients 



STUDY IN LONDON 49 

for himself both in the world, and in a hospital, 
and had formed independent opinions on the effects 
of treatment, and on general prognosis. 

In universal humanity towards the sick, and in 
the wish to alleviate pain, and to consider the 
feelings of the patient, those essential parts of our 
profession, without which the highest skill in our 
art can never be attained, he was equal to the 
physician of to-day. He was imperfectly trained 
in the art of observation, and was inclined to accept 
without examination the dicta of great teachers of 
medicine. It was for him a proof of the usefulness 
of methods of treatment that patients were said to 
have been better after employing them, and he did 
not pause to consider whether the improvement 
was a probable event of the disease, or examine 
very closely into the accuracy of the diagnosis. 
Such was John Mirfeld, a physician of wide reading, 
with a mind full of all that was known in his time, 
a laborious and high-minded man, anxious to do all 
in his power for his patients, and to instruct others 
how to relieve suffering. 



E 



LECTURE II 

THE EDUCATION OF PHYSICIANS IN 
LONDON IN THE SEVENTEENTH CENTUKY 

Mr. President, Censors, and Fellows of the Col- 
lege, — I have endeavoured in my first lecture to 
show what were the attainments and what the 
studies of a mediaeval physician in London. John 
Mirfeld knew something of the seven liberal arts, 
of grammar, of rhetoric, of logic, of arithmetic, of 
music, of geometry, and of astronomy. He had 
been influenced by the society, the traditions, and 
the architecture of a great university; had been 
trained in medicine by a master who was a physician ; 
had known the members of the staff of a hospital 
and seen cases in it ; had read materia medica, 
medical botany, and pharmacology in Nicholas 
and perhaps in Marcellus, surgery in Eoger and 
Lanfranc, medicine in some books of Galen, in 
Ehazes, in Avicenna, in Platearius of Salernum, and 
in the more modern writers Bernard de Gordon, 
John of Gaddesden, and Gilbertus Anglicus. He 
had read Ysaac on diet and knew by heart the 
precepts on regimen of the school of Salernum. He 
was familiar with the names and with parts of books 
attributed to Hippocrates and to Aristotle. He 
knew something of Horace, of Virgil, and of Ovid, 



EDUCATION IN LONDON 51 

and had read the Be Consolatione Philosophiae of 
Boethius ^ and some of the other works of that last 
of the Latin classical writers. His chief source of 
general knowledge was St. Isidore, whose Liber 
Etymologiarum is a vast collection on everything 
known to the educated world of the sixth century. 
He was thoroughly versed in the Old and the New 
Testament. He had read much in the writings of 
St. Augustine and St. Jerome and some of the works 
of St. Bernard, St. Anselm, and St. Thomas Aquinas. 
He wrote easily the Latin of his time, the living 
language of the Church and the Law. He had read 
no Greek literature, but was acquainted with the 
Greek alphabet, and knew something of Aristotle 
and of Alexander. In medicine he was capable of 
recognizing the general condition of fever and of 
distinguishing clearly a few species of disease in 
which fever occurs, the plague, for example, and 
tertian ague. He could distinguish to some extent 
the manifestations of diseases which we call pleurisy 
and bronchitis. He knew that dysenteric symptoms 
were not all due to the same cause. He had names 
for several distinct skin diseases. He had some 
knowledge of enlargement of the lymphatics. He 
was as well acquainted with epilepsy as most 
physicians up to the days of Trousseau. He had 

^ Mirfeld was neither the latest nor the most famous medical 
writer who was versed in Boethius. Sydenham , in his chapter 
De morbis acutis in genere, quotes Book II, Metrum III, of the 
Be Consolatione Philosophiae : 

Constat aeterna positumque lege est, 
Ut constet genitum nihil. 

e2 

* 



52 LECTURE II 

observed hemiplegia clinically. He could recognize 
gout. He knew something of dislocations and frac- 
tures. He understood the value of exercise and of 
rational diet for the preservation of health, and was 
certain of the ill effects of intemperance. He was 
acquainted with some of the effects of opium, of 
turpentine, of sulphur, and of some other drugs. 
He understood the necessity of attention to the 
details of nursing, and was aware of the importance 
of remembering the effect of the mind on the body. 
I need not point out the gaps in his knowledge of 
clinical medicine or of therapeutics, nor the defects 
in his whole system due to the small accumulated 
knowledge of his age in anatomy and physiology. 
Morbid anatomy was altogether unknown to him. 
Such were the attainments of John Mirfeld in the 
last quarter of the fourteenth century. A manu- 
script on pharmacology,^ which was in existence in 
his time and which is now in the British Museum, 
has at the beginning a fine illuminated initial in 
which Serapion, in a doctor's gown, is depicted 
lecturing on materia medica with a plant in his 
hand. The picture is instructive, for it shows that 
they are wrong who suppose that scientific methods 
were unknown in the Middle Ages. At the time of 
this manuscript a lecturer illustrating his teaching 
by specimens was clearly a familiar sight to students 
of medicine. While examining the manuscript I 
observed a Latin inscription in a much later hand, 
which stated that the book belonged to Nicholas de 
^ Harley, 3745. 



Plato VI. 







iter ton\ncmt]r<v 
nofntictfwnitfi^ 

c i) ngixa?itc^ fig2.K «p ticcm e tc fcii cantnt 
- mn cS^ ftiftamt^ tn tJ A qii|n cimit Or 

m 4ho/cfm*2S't«mcma5nnr ttm^qj m^ 
cu ommiftnpnSri ft^itm^tiiiumtr^^^i^ 
i^^.twiemcminr mm rt oJit r^i^wc f%to 
1 4btmc ftii ^c flm-z imtitrc am 7 tinu 
^p mtf»?inatimii l4h?2C wami • (Pmti 

ttt^r ct4(ce|n tr<f c^rliicm *t^ ncpa q;5 
amrf^lviruj ah^z^lihzcv-n^fmvainUtS 




To face page 52 



.i^xc tnmxftg^nnciteripn'l? fm rcq tfl^ 

2imtiiitf^ r4jr^^titiutmn cStf .Sctn re 
imtr^tnT!aiiir:cn5i1l4 4 timimitr-ib'tn 
tini<tmt^ipTp::iru confer nirm irrra? 

Liber Serapionis de Medicixis Si:mplicibus. 
Initial showing a lecture on medical plants. 



Plate VII. 




to 

xnV 
nftT 
ace 



tt>f 
wit ^ 



' ■*. 




fi 




LiHf:R Serai'ionis. 
Note in the hand of Nicholas of Cusa. dated 1449. 



To face page 53. 



EDUCATION IN LONDON 53 

Cusa, who had bought it and many other books on 
medicine and on the acts in 1449. 

Nicholas de Cusa, to whom in the generation 
following Mirfeld's this copy of Serapion had be- 
longed, was a man of varied learning and of a 
scientific habit of mind. He was a theological 
writer, a mathematician, and an observer of natural 
phenomena. He made an original examination of 
the Koran, and critically discussed its contents ; and 
in medicine he introduced an improvement which 
in an altered form has continued in use to this day. 
This improvement was the counting of the pulse 
which up to his time had been felt and discussed in 
many ways, but never counted. The first method 
of a new invention is often unnecessarily cumbrous, 
but this does not detract from the merit of the man 
who first discerns its principle. Nicholas of Cusa 
proposed to compare the rate of pulses by weighing 
the quantity of water run out of a water-clock while 
the pulse beat one hundred times. Thus, he said, 
you may easily prove the degree in which the pulse 
of a young man is more rapid than that of an old 
man. *The weight, therefore, of water that flows 
out in relation to the differences of pulses in the 
youth, in the aged man, in the healthy and the sick 
ought necessarily to lead to a truer knowledge of the 
disease, one weight being proper to one infirmity 
and a different weight to another.' 

The manufacture of watches with second-hands 
has since given us a simpler method of counting, 
but the merit of introducing this useful kind of 



54 LECTURE II 

observation into clinical medicine belongs to Nicholas 
of Cusa. He became a cardinal, and is buried in the 
church from which he took his title, St. Peter ad 
Vincula. Devotion attracts many people to this 
church, and a love of art, since it contains a great 
work of Michael Angelo, many others, and science 
adds a third interest in the monument of this 
improver of clinical medicine. His tomb has no 
ornament but its inscription, yet it is not improper 
to consider that he has a more lasting memorial in 
his commemoration over the whole globe, wherever 
medicine is practised, by the simple method of 
observation which he was the first to contemplate. 

Some knowledge of Greek is discoverable in 
Western Europe throughout the Middle Ages, and 
two Greek phrases at least were known by sound to 
every Christian. The Greek quotations in the Be 
Consolatione Fhilosophiae of Boethius, for many 
centuries one of the most widely read of books, 
must have made every reader familiar with the 
Greek letters, and passages of Greek are to be found 
here and there in manuscripts, as in the Schaff hausen 
copy of Adamnan's Life of Columba,^ Johannes 
Scotus Erigena, it is certain, knew Greek well 
enough to translate the Pseudo-Dionysius, and both 
Koger Bacon and Kobert Grosseteste had considerable 
attainments in it ; but it was a rare accomplishment, 
and there were very few Greek books in the libraries. 
The increased study of this great literature, which 
began in the fifteenth century, changed the attain- 

' William Keeves : Life of St Columha. Dublin, 1857. 



EDUCATION IN LONDON 55 

ments required in a learned man. The invention 
of printing gave force to the new learning, and both 
the aspect of libraries and the studies of students 
were altered. 

The founder of our College of Physicians, Thomas 
Linacre, was born about the time of the death of 
Nicholas of Cusa, a.d. 1464. A century after the 
Breviarium Bartholomei was written, Linacre was 
pursuing the study of Greek under Demetrius 
Chalcondylas in Italy. Before 1500 he had taken 
his M.D. degree at Padua and had returned to 
England. In the Eenaissance, medicine was as 
closely associated with literature and general learn- 
ing as it had been in the Middle Ages. The differ- 
ence was in the kind of Hterature and consequently 
in its effect. Linacre and his contemporaries had 
learned Greek, and the study of the books of ancient 
Greece, whether Hippocratic or philosophical, 
opened their minds to the true source of natural 
knowledge — Nature herself and not books. Our 
College was founded in 1518 and established in 
England a permanent relation between our profes- 
sion and the world of learning. 

The mediaeval physician attained nearly all his 
knowledge from books. He had read books of 
many kinds, but more on medicine than on other 
subjects. He was inclined to add little from 
observation. The physician of the Eenaissance had 
read medicine too. Both reverenced Hippocrates 
and Galen, but the later physician had seen Hippo- 
crates and Galen so near that he adopted the method 



56 LECTURE II 

by which they had attained knowledge, and followed 
their example instead of only considering their 
conclusions. The trouble the later physician had 
to take to attain a knowledge of Greek, as on the 
one side it brought him to the true sources of 
natural knowledge, so on the other, bound him to 
the other branches of human thought. The know- 
ledge required in this College was not to be attained 
but by living laborious days, yet many men attained 
it, and thus a physician in England was rightly 
thought a member of the learned world. 

Leland and Caius, his contemporaries, have both 
borne testimony to the learning of our first elected 
Fellow, Dr. Bartlot. Since his attainments were 
admired by Caius it is certain that he knew Greek 
and was well read in Galen, and we have the direct 
testimony of Leland that, unlike most of the 
physicians of the Eenaissance, he knew also the 
mediaeval writers. It was appropriate that a man 
not negligent of the old medicine and well versed 
in the new should be the first doctor to be elected 
into our College, and that the first occasion on which 
our statute book, bound in silver, was carried before 
the President in state should have been in the funeral 
procession which bore Dr. Bartlot to his grave in 
the church which had once been the daily resort of 
John Mirfeld and in which probably his bones then 
rested. A fine medal struck in honour of Dr. John 
Freind has on its reverse figures of an ancient and 
a modern physician joining hands, with the words : 
Medicina vetus et nova : Unam facimus utramque. 



EDUCATION IN LONDON 57 

The same design would have been appropriate to the 
commemoration of Eichard Bartlot. 

Linacre, our first President, and Dr. John Clement, 
president in 1544, were physicians of the Eenais- 
sance. Linacre was a priest and Clement a layman, 
but both were Greek scholars of extensive reading, 
and the practice of both was guided by what they 
had learned from many treatises of Galen and from 
parts of Hippocrates. Most of Linacre's transla- 
tions were of books of Galen, but he also translated 
the ^^aipa of Proclus, a Byzantine Greek of the fifth 
century of our era who founded a system of philo- 
sophy drawn from Plato, Pythagoras, and Aristotle. 
Clement's translations were of theological writers. 
Linacre wrote on Latin grammar and taught it to 
the Princess Mary. Clement was professor of 
Greek at Oxford, and in both classical learning was 
indissolubly bound up with their profession. Their 
Greek reading gave a precision to their medical 
thoughts and practice. Perhaps the constant desire 
to bear in mind Hippocrates and Galen in dia- 
gnosis, prognosis, and treatment may have to some 
degree caused their view of medicine to be narrow, 
yet the contact of their minds with the truly natural 
method of the Greeks must have led them some- 
times to opinions wholly based upon their own 
observations. These physicians were members of 
the learned world of their time. Sir Thomas More, 
Erasmus, and Colet were their friends. 

Edward Wotton, who was President in 1541, and 
John Caius, President in 1555, were no less Grecians 



58 LECTURE II 

than Linacre and Clement, but they were the first 
of our College who added zoology to their studies. 
Wotton was of Magdalen College, and took his first 
degree at Oxford in 1514. The College of Corpus 
Christi was founded two years later, and Wotton in 
1521 was appointed lecturer in Greek there. Bishop 
Eichard Foxe, the founder, wished to encourage the 
new learning in his college, and he gave Wotton the 
income of a Fellow with leave to travel in Italy * to 
improve his learning and chiefly to study Greek'. 
Wotton graduated M.D. at Padua, and after his 
return to Oxford, where he was incorporated M.D. 
on May 16, 1526, lectured again on Greek at 
Corpus, but two years later came to London. In 
1552 he published in Paris a folio. Be Bifferentiis 
Animalimn, the first printed book by an Englishman 
on zoology. He had read all the passages about 
natural history in the Greek and Latin classics 
because he was interested in the subject, and so 
gradually came to put together the book. Sir John 
Mason, his particular friend and patron, who was 
English Ambassador in France in 1550 and 1551,^ 
took the manuscript with him to Paris and seems to 
have arranged for the printing and publication of 
the book there. It was brought out with paper and 
type of the finest kind and dedicated to King 
Edward VI. 

The pages of Wotton contain much from Pliny 
and something from Aristotle, with many learned 

^ Edoardi Wottoni Oxoniensis De Bifferentiis Animalium 
Libri Decern : Preface. 



EDUCATION IN LONDON 59 

notes, some Greek in every chapter, and quotations 
in the text from Plautus and Virgil, Ovid, Martial, 
and Oppian. He had read Cicero and Columella, 
Theophrastus, Hermolaus, Ennius, Aelian, Ausonius, 
Suetonius, Heliodorus, Nicander, Dioscorides, Paulus 
Aegineta, and Albertus Magnus, yet very little in 
the book of nature. His chapter on thrushes is less 
abstruse than some others, and shows that his mind 
looked rather towards bookshelves than hedgerows. 
* Of the kinds of thrushes and blackbirds and of 
other birds which are more or less like them. In 
the country and among hedges and farms the 
thrushes and blackbirds have their haunts. There 
are three kinds of thrushes. One is called viscivorus 
(misselthrush) because it must have mistletoe and 
resin to feed upon, and it is of the size of a pica. 
Another kind is of the size of a blackbird. A third, 
which some call tXta? and tXXa?, and others rvXa? ; 
in Latin iliacus is of smaller size and less marked 
with spots. Thrushes make their nests from mud, 
as swallows do, alone in high trees. They make 
a covering of hair and wool and line the inside of 
the nest with the same. The thrush changes its 
colour : for in the summer the plumage about the 
neck is spotted, while in winter it is of a single 
hue : their note is the same all the year round. It 
migrates in winter in search of winter food, so 
that in Germany thrushes are most numerous in 
winter. Beech nuts are liked by thrushes. The 
flesh of thrushes is harder than that of partridges 
and that kind of birds. The juice, nevertheless, 



60 LECTURE II 

if rightly cooked, is highly nutritious. As Martial 

says : — 

Inter aves turdus, si quis me iudice certet, 
Inter quadrupedes gloria prima lepus. 

The thrush roasted with berries of myrtle is good 
for dysentery/ 

John Caius translated parts of Hippocrates and 
of Galen, and in him the study of these Greek 
physicians led to his own publication of observa- 
tions, and his two books Be Ephemera Britannica, 
one in Latin and one in the vernacular, are the 
firstfruits of clinical observation in England. His 
contributions to natural history were both addressed 
to the naturalist, Conrad Gesner, and were a treatise 
on British dogs, and one on rare animals and plants. 
His natural history has a more outdoor complexion 
than that of Wotton, with whose account of thrushes 
and blackbirds Caius's chapter De Morinello may 
be compared. * Morinellus, a bird common on our 
seashores, is foolish but good to eat and is among 
us thought one of the greatest of delicacies and 
fetches a high price. The bird is a mocker. So 
that as the owl and the bustard by imitation of 
jumping, so this by night in candle-light is captured 
by the motion of the catcher. For if he stretches 
out his arm the bird extends its wing, if he his leg 
it does the same. Thus the bird intent on the 
man's movement is taken by the fowler and is 
inclosed in the net. It is a small bird of the size 
of a starling with three front toes and no hind toe, 
with a black top of its head, white round the eye, 



EDUCATION IN LONDON 61 

and is almost of the colour of a quail if you add 
a little grey, especially round the neck. I call it 
Morinellus for two reasons : because the bird is 
commonest among the Morini and because it is a 
stupid bird, which stupidity in Greek is called 
^(op6rr)<;. For the same reason we call it Doterel, as 
if, so to speak, crazy with folly.' The description of 
the meleagris or guinea fowl, the head of which, he 
says, is so arranged * ita ut insideat capiti eo modo 
quo ducalis pileus illustrissimo duci Veneto si quod 
iam adversum est aversum fieret', seems to bring 
Caius before us in Venice looking at the Doge in 
ducal cap walking in solemn procession round the 
piazza of St. Mark, or passing by in the Bucentaur 
in gorgeous state to wed the Eepublic to the sea ; 
while the account of the Doterel shows him in the 
open country of his native Norfolk. 

I have mentioned together Wotton and Caius as 
the men who first in our College brought zoology 
into the list of subjects on which a physician should 
be informed. They had an association outside this 
College, for Sir John Mason was the patron of both. 
This statesman, the son of a cowherd at Abingdon, 
had been an undergraduate at Oxford while Wotton 
was in residence, and became a Fellow of All Souls, 
and in 1552 Chancellor of the University of Oxford. 
He was early employed in diplomatic service abroad, 
and so continued almost to the end of his life. 
In October, 1555, he was English Ambassador at 
Brussels, and witnessed the elaborate ceremony in 
which Charles V abdicated the imperial crown. 



62 LECTURE II 

Charles, moved by the stage effect which he had 
himself arranged, * broke into weeping,' says Mason, 
* whereunto, besides the dolefulness of the matter, 
I think he was moche provoked by seeing the whole 
company do the lyke before, there being in myne 
opinion not one man in the whole assembhe, 
stranger or another, that during the time of a good 
piece of his oration poured not out as abundantly 
teares, some more, some lesse.' ^ 

The study of modern languages and their litera- 
ture began in England soon after that of Greek, and 
with this part of learning our College was connected 
in several ways. Spanish was the first continental 
language in which a Fellow of this College became 
distinguished. Thomas Doyley, of Magdalen College, 
was at Oxford with Sir Philip Sidney and Lyly the 
euphuist and Hakluyt, the editor of the great series 
of voyages, all of whom were affected by the taste 
for the Spanish language and literature, which began 
in England in the reign of Philip and Mary and 
increased in the time of Queen Elizabeth. Doyley 
took his B.A. degree in 1564 and his M.A. degree 
in 1569, and after some medical reading at Oxford 
went abroad in 1571 to pursue medical studies. 
He graduated M.D. at Basle in 1581. Throughout 
these years he continued to increase his knowledge 
of Spanish and persevered in the study after his 
return to London in 1585. He was elected a 
Fellow of this College in 1588, and physician to 

^ Dispatch quoted in Motley, Bise of the Dutch EepuUiCj 
ch. i. 



EDUCATION IN LONDON 63 

St. Bartholomew's Hospital in 1590. He died 
in 1603 and was buried in the church within the 
hospital. 

The first Spanish dictionary was published in 
London in 1591 under the title of ^ Bibliotheca 
Hispanica ; by Eichard Percyvall : Gent.' The 
dedication to *Eobert Earl of Essex and Ewe, 
Viscount Hereford and Bourghchier, Lord Ferrers 
of Chartley, Baron Louvaine, Master of the Queen's 
Majestie's horse and Knight of the Garter', is followed 
by an address to the reader. In this, after describ- 
ing the aims and contents of the book, and the help 
he had received from Don Pedro de Valdes and Don 
Vasco de Sylva, Percyvall says : * In very good time 
I chaunced to be acquainted with the learned gentle- 
man Master Thomas Doyley, doctor in Physicke, who 
had begunne a Dictionary in Spanish, English and 
Latine, and seeing me to be more foreward to the 
presse than himself : very friendly gave his consent 
to the publishing of mine, wishing me to adde the 
Latin to it as hee had begunne in his, which I per- 
formed, being not a little farthered therein by his 
advice and conference.' The generosity of Doyley 
seems to have been as great as his learning, and 
having thus contributed to the dictionary he wrote 
a short Latin poem in praise of it : — 

Quas novus orbis opes, quos profert India fructus, 
Quas mare, quas tellus gemmas aurique fodinas. 
Has habet Hispanus, Jasonis vellere dives : 

Cum populo aurato coUubet ergo loqui. 
Expetit Hispanus Belgas evincere, regem 
Gallorum per vim regno depellere, regnum 



64 LECTURE II 

Diripere Anglorum, quid non ? Cupit esse monarchal 
Cum rege hoc tanto, coUubet ergo loqui. 

Cum quibus aut bellum cupimus, commercia, pacem, 

Horum sermo placet : facilemque brevemque 
loquendi 

Dat liber iste modum, dat Percyvallius author 
Cum populo Hispano quam cito posse loqui. 

Some prefixed commendatory verses by James Lea 
show that though Spanish was the first modern 
language in which our College produced a master, 
French and Italian had before received more atten- 
tion in the world of London : — 

Though Spanish speech lay long aside within our 

British He, 
Our courtiers liking nought save French or Tuscan's 

stately stile, 
Yet now at length (I know not how) steps Castile's 

language in. 
And craves for credit with the first, though latest 

she begin. 

The reading of Greek books as the only true 
method of entrance to medicine in particular and to 
learning in general lasted about a hundred years. 
Then at length the way to acquire knowledge, which 
Hippocrates and Galen made clear by example, had 
come to be thoroughly understood, and men, eager 
to acquire more knowledge of things from nature, no 
longer needed to be assured that thus only truth 
could be attained. The last words of the preface of 
the Be Magnete of William Gilbert published in 
1600, the year in which he was elected President of 
this College, show that this stage had been reached. 
* To those early forefathers of philosophy, Aristotle, 



EDUCATION IN LONDON 65 

Theophrastus, Ptolemy, Hippocrates, and Galen, let 
due honour be ever paid ; for by them wisdom hath 
been diffused to posterity ; but our age hath uncovered 
and brought to light very many facts which they, 
were they now living, would gladly have accepted.' 
The addition of such facts by Harvey, by Glisson, 
and others in this College and by many other 
observers all over Europe rapidly brought medicine 
into that state of constant growth and improvement 
in which it has ever since continued, but the change 
was gradual and not sudden. Theodore Goulston, 
a Censor in 1626 and three earlier years, made trans- 
lations of the Opuscuh of Galen published in 1640, 
eight years after his death, which were carefully read 
and annotated by Harvey. Goulston was, perhaps, 
the last physician of the Eenaissance kind who 
studied Greek and through it attained his medical 
knowledge. 

If Gilbert may be regarded as the first physicist 
of the College, the first Fellow who knew much of 
chemistry was undoubtedly Theodore Turquet de 
Mayerne, who came to settle in England from Paris 
in 1611, and was elected a Fellow of our College in 
1616. He made many chemical experiments, and 
applied his chemistry to pharmacy and to thera- 
peutics, making the lotio nigra, which has been 
valued ever since, and bringing calomel into use. 
He also carried out a long series of experiments on 
pigments. His varied attainments, his large 
practice, and consequent experience, as well as his 
upright character, caused his influence to be great. 



66 LECTURE II 

and he showed to the College the usefulness of 
knowing something of chemistry, while his habit of 
taking elaborate notes of cases gave an example which 
had a most valuable effect on the study of clinical 
medicine. Sir Theodore Mayerne died in 1655. 

Linacre, Clement, Wotton, Caius, Doyley, Gilbert, 
Harvey, Mayerne, and Glisson represent the kind 
of knowledge with which this College began, and 
that to which it gradually attained in the first 
century and a half of its existence. Latin was 
the language of composition and communication. 
Botany of some kind was an inheritance of phy- 
sicians from the Middle Ages, improved first by the 
study of the text of Dioscorides, and then by the 
observations in the field of Lobel and Gerard and 
Parkinson, and many more in other countries. 
Greek was the most important professional training, 
diminishing in importance as the effects of reading 
Greek books became more distinct. The lesson 
was at last learned and the teacher was no more 
needed. The value of a knowledge of modern 
languages had come to be understood. Anatomy 
and physiology were sufficiently known by dis- 
section and observation to make Harvey's discovery 
possible. The usefulness of physics and of chemistry 
had been demonstrated by Gilbert and by Mayerne. 
Morbid anatomy was considerably advanced, and 
its importance in its relation to clinical medicine 
made plain in the work of Harvey and Mayerne 
and Glisson. The precise study of disease during 
life was established by the copious note-taking 



EDUCATION IN LONDON 67 

of Mayerne, and the exact observations of 
Glisson. 

The pubHcation by the College of the Pharma- 
copoeia in 1618, for the first edition of which 
Mayerne wrote the dedication to the King, may be 
said to have established the study of pharmacology 
on a sound basis by providing in successive editions 
of the Pharmacopoeia a tribunal before which drugs 
might be arraigned from time to time to answer for 
their usefulness, and be retained in the public 
service, or dismissed from it according to the 
decision. The College of Physicians was the sole 
guardian of medical learning in England at this 
period, for the universities were inclined to treat 
the subject as a part of general book-learning, only 
exercising a very slight and varying control over 
men who wished to take a Bachelor of Medicine 
or Doctor of Medicine degree. Supplicats were 
occasionally refused, and it seems reasonable to 
suppose that this was sometimes on account of 
insufficient knowledge in the candidate, or unsatis- 
factory evidence of study. The College, from its 
close connexion with Oxford and Cambridge, to 
which universities all its Fellows by residence or 
incorporation belonged, and by the influence of its 
recognized supremacy in medical knowledge, was 
sometimes able to prevent persons of insufficient 
attainments from admission to degrees. Thus 
Simon Ludford, who had failed in his examination 
before the College in 1553, and tried to obtain 
a licence to practise in each university, though of 

f2 



68 LECTURE II 

most defective attainments, was for a time pre- 
vented — at Oxford by an appeal to the visitors, and 
at Cambridge by the influence of Caius — from 
receiving licence or degree. The refusal had the 
effect of leading him to improve himself, and he 
obtained an M.D. degree at Oxford about four years 
later, in 1560, and in 1563 he was elected a Fellow 
of this College. His copy of Avicenna is in our 
library, and in another book of his, Be dissectione 
partium corporis humani lihri tres a Garolo Stephana, 
Paris, 1545, he has written a copy of Latin verses 
headed by the words : — 

Simonis Ludefordi est hoc volumen' 

Corporis dissecti, anatomicarum 
Partium humani, docet hoc Volumen 
Et modum, et formam, Vtilitatem et Vsum, 

Illiteratos. 

Absolutis comprobat argumentis 
Actiones, officia, atque nexus, 
Esse quadam symmetria coacta 

Particularum. 

Cuilibet membro propriam figuram 
Et situm, cursumque notamque ponit. 
Nil inexpertum memorat nee Vllum 

Sectio fallet. 

Erutum a scitis Veterum quod prosit : 
Posteris charum, Stephanus relinquens, 
Munus inculpabile, quo perhenne 

Nomen adeptus. 

Hiisce lectis, caetera quae medendae 
Sunt facultatis, potes experiri : 
Euadas tandem Vt medicus peritus. 

Perge Galenum. 



EDUCATION IN LONDON 69 

Floccipendas pecuniam, Valebit 
Ars : thesaurus deficiet, Volumen 
Sollidis hoc Venditum habebis octo : 

Totque ego solvi. 

Whether these verses are sufficiently bad to have 

required his continued exclusion from the College 

I must leave to the distinguished Latin poets whom 

we have among our Fellows at the present day — 

to Dr. Eobert Bridges and Dr. J. A. Ormerod. 

I suppose that Ludford did not obtain the purchaser 

who would pay the eight shillings he asked, as the 

book is in our library, to which, with the Avicenna, 

he probably gave it when, his early want of education 

having been repaired, he was honoured as a Censor. 

Edward Browne was admitted a Fellow on 

July 29, 1675, when Sir George Ent was President, 

who had known Harvey well, and is honourably 

mentioned by Dryden in his Epistle to Br, Charleton, 

The circling streams once thought but pools of blood — 
(Whether life's fuel or the body's food). 
From dark oblivion Harvey's name shall save 
While Ent keeps all the honour that he gave. 

Edward, the eldest son of the celebrated Sir 
Thomas Browne, was thirty-three years of age when 
he pledged his faith to the President and to the 
College on his admission to the Fellowship, and 
the silver sceptre which you, Mr. President, carried 
in your hand when you took the chair to-day, was 
on that day in the hands of Sir George Ent. 

Edward Browne was already known as a man of 
letters, for he had published a volume of travels 
and a translation of a Discourse of the Cossacks, The 



70 LECTURE II 

travels had been widely read, and the Duke of Queens- 
bury and Dover, the Scottish statesman, some years 
later, thought the translation of the Discourse of the 
Cossacks entertaining enough to take with him in his 
coach when travelHng. Edward Browne had had all 
the advantages of education which a kind and learned 
father could give him. He was born at Norwich, pro- 
bably in 1642, and received his school education at 
the Grammar School in the Close, just within the 
gate, over which Sir Thomas Erpingham, a hero of 
Agincourt, was then kneeling in his niche as he is 
at this day. As the author of the JReligio Medici 
took his boy to school I can imagine that he 
pleasantly pointed to the figure and quoted the 
words of King Henry V in Shakespeare : 

Good morrow, old Sir Thomas Erpingham. 
The conversation of his home was an important 
part of the education of Edward Browne. There 
must have been much delight to him in his boyhood 
in being told the nature and history of the many 
curious objects in his father's museum, of the 
narwhal's tooth, then called a unicorn's horn, of the 
birds' eggs, and of the funeral urns. 

Sir Thomas Browne in his writings now and then 
is as sententious as Mr. Shandy, but his letters to 
his sons and theirs to him show that his nature had 
little in common with the selfishness of the Squire 
of Shandy Hall, who forgot every human feeling in 
his eagerness to establish the truth of his theories. 
On one occasion, that of the witch trial, Sir Thomas 
Browne allowed theories, drawn from ancient 



EDUCATION IN LONDON 71 

reading, to pervert his natural humanity, but in his 
family affection, and his kindness to the poor, and 
in a certain simplicity which shines through his 
fondness for recondite fragments of knowledge and 
paradoxical antitheses, he shows a resemblance to 
that immortal example of goodness of heart, Captain 
Toby Shandy. A visitor in the household of the 
Brownes has in his writings a passage which 
represents the spirit which pervaded it. *I can 
wonder at nothing more than how a man can be 
idle ; but of all others, a scholar ; in so many 
improvements of reason, in such sweetness of 
knowledge, in such variety of thoughts : other 
artisans do but practise, we still learn ; others run 
still in the same gyre to weariness, to satiety ; our 
choice is infinite; others' labours require recrea- 
tions ; our very labour recreates our sports ; we can 
never want either somewhat to do, or somewhat 
that we would do.' ^ In such a home Edward 
Browne was soon ripe for the university, and he 
entered at Trinity College, Cambridge, in October, 
1657, which makes it probable that 1642 is the true 
date of his birth and not 1644 as commonly stated, for 
thirteen years was then an unusual age, but fifteen 
years a common one at which to enter the university. 
In 1663, Browne applied for admission to the 
degree of M.B. He preserved a copy of the sup- 
plicat 2 which he wrote on the occasion in one of 
liis notebooks. It states that he had studied 

* Bishop Hall : Epistle to Mr. Milward. 
' MS. in British Museum, Sloane, 1797. 



72 LECTURE II 

medicine for six years, and had heard the usual 
lectures, and passed through the required opposi- 
tions, responsions, and other exercises of the kind. 
He asks that these may be sufficient to allow him 
to enter into the faculty. He has also preserved 
a copy of the grace for his admission to the degree 
of Bachelor of Medicine at the congregation at 
which the grace is read or at the next. The 
exercises were matter of reading and of argument, 
but Dr. Francis Glisson, then Kegius Professor of 
Physic, was careful that these should be duly per- 
formed, and it must have been an advantage to 
Browne to know something of a professor so deep 
in anatomy and morbid anatomy, and at the same 
time so exact in clinical observation. Browne 
seems to have had the opportunity of seeing two 
bodies dissected probably at the demonstrations 
founded by Dr. Caius. 

After taking his degree Browne returned to 
Norwich, and continued his studies amid a good 
deal of enjoyment suitable to his years. The Duke 
of Norfolk was at that time the greatest person in 
Norwich, and his palace was in 1663-4 occupied 
by his brother Henry, and contained a part of 
their grandfather's wonderful collection of works 
of art — the Earl of Arundel, with whom Harvey 
visited Eome. Edward Browne was one of the 
guests of New Year's Day at this great house. He 
dissected a bull's heart on January 2, and danced 
at the Duke's palace on the 4th. He dined there 
on the 5th, and danced again in the evening, and 



EDUCATION IN LONDON 73 

again on Twelfth Night. Next day he dissected 
a dog, and on the 9th the knee-joint of a calf, and 
another bull's heart, and the larynx of a bullock. 
On January 11 he danced at the palace till two 
o'clock in the morning to celebrate his host's birth- 
day. Next day he dissected a turkey's heart, and 
examined the dentition of a monkey. Two days 
later he went over the monkey's skeleton, and on 
January 22 studied the anatomy of a sheep, and the 
next day prepared the right forefoot of a monkey. 
At the palace he met Dr. De Veau, a godson of 
Sir Theodore Mayerne, and then or later physician 
to Charles II. De Veau had with him a febrifuge 
powder, probably of cinchona bark, which he 
wished to try on a well-marked case of ague. On 
January 28, Browne studied the anatomy of oxen, 
and the next day dissected a hare, and further studied 
the monkey's skeleton. In February he prepared 
the skull and bones of the foot of a hare, dissected 
another hare, a hedgehog, and a badger. He paid 
at the same time some attention to botany, noting 
the flowering Aconitum hyemale and Helleboraster, 
and gathered many seaside plants. He examined 
a nasal polypus, and saw two patients, a man with 
consumption, and an old man with a fever. He 
went to London, arriving on February 24, and next 
day went to hear an anatomy lecture at Chirurgeon's 
Hall,^ and saw a human body dissected — the third 
he had seen. In the morning Dr. Christopher 

^ The hall was in Monkwell Street : more anciently known 
as Muggewelle Street. 



74 LECTURE II 

Terne, assistant physician to St. Bartholomew's 
Hospital, gave a general introduction to the course 
in Latin, and then lectured on the skin. There was 
a second lecture in the afternoon on the stomach, 
intestines, and mesentery, and before the lecture 
Browne was allowed to examine the dissected body 
in the * anatomizing room'. He no doubt needed 
a little fresh air after this well-occupied day, and 
took a walk in St. James's Park, where he saw the 
king's zoological collection, * divers sorts of out- 
landish deer, guiny-sheep, a white raven, a great 
parrot, a storke which, having broken its own leg, 
had a wooden leg set on, which it doth use very 
dexterously. Here are very stately walkes set out 
with lime trees on both sides and a fine Pall Mall.' 
Next day he heard the third lecture, which was on 
the suprarenals, the kidneys, and their related parts. 
He dined with his sister, who lived in Clerkenwell, 
and attended the fourth lecture in the afternoon. 
It was on the pleura, mediastinum, and lungs, which 
he went to see dissected before the lecture. His 
record of the fifth lecture has not been preserved. 
The sixth and last was given on the afternoon of 
the third day, and its subject was the anatomy of 
the eye. Dr. Terne concluded the course with 
a Latin speech. These six lectures given on 
Thursday, Friday, and Saturday were a course of 
anatomy of that time. The lecturer was a phy- 
sician, the dissections were made under his 
direction by surgeons, the teaching was conducted 
in their hall, and was chiefly for the benefit of the 



EDUCATION IN LONDON 75 

members of their company, though friends of the 
lecturer and others, if properly introduced, some- 
times attended.^ Dr. Terne, the lecturer, was a 
well-read physician who had studied at Leyden. 
He delivered the Harveian oration, and wrote 
a thoughtful paper discussing the question, *An 
respiratio inserviat nutritioni ? ' but the only part of 
his writings which has been printed is an in- 
scription in Latin verse under the engraved 
portrait of Dr. Christopher Bennet. This portrait 
is the frontispiece of Bonnet's TaUdorum Theatrum, 
which is the fuller edition of the first treatise on 
tuberculosis published in England. 

Hospitii quicumque petis quis incola tanti 
Spiritus, egregia hunc consule scripta dabunt. 

Browne married Terne's daughter, Henrietta, in 
1672. 

Dr. Windet, with whom Browne dined on the 

first lecture day, had practised in Yarmouth, and 

was a correspondent of Sir Thomas Browne. They 

agreed in a taste for out-of-the-way subjects, and for 

verbal conceits. Windet at the Kestoration brought 

out two Latin poems. One is a condemnation of 

the execution of Charles I, and begins with the 

word * Occidimus '. The other is on * His Majesty's 

Happy Eestoration ', and begins with the word 

* Vivimus '. A Latin letter De vita functorum statu, 

of which young Browne probably thought fit to 

mention his father's admiration, when on the first 

^ Edward Browne's notes are printed in Wilkin, Works of 
Sir Thomas Broume, 



76 LECTURE II 

day of his anatomy lectures he dined with 
Dr. Windet, is a production containing much 
reading, Latin, Greek, Hebrew, and Arabic, and 
showing a turn of thought not unUke that often 
displayed by Sir Thomas Browne. The writer 
discusses the meaning of the word Tartarus, and 
debates the precise sense of various Hebrew and 
Greek words and sentences used in describing the 
state of man after death as well as all the opinions 
expressed by Hebrews and Greeks on the same 
subject. Windet was evidently a vast reader, but 
of the same kind as that Bishop, of whom Bentley, 
when asked whether he was not a very learned 
man, remarked, *Dr. Warburton has a large 
appetite but a bad digestion.' Sir Thomas Browne 
and Windet had minds filled with the same kind 
of learning, but while the works of Browne continue 
to appear in new editions, and to form part of 
general reading, those of Windet are never opened. 
The difference consists in something difficult to 
express but easy to feel. Dryden has considered 
such distinctions, and has expressed his conclusion 
with his usual felicity, *A happy genius is the 
gift of Nature : it depends on the influence of the 
stars say the astrologers, on the organs of the body, 
say the naturalists ; 'tis the particular gift of 
Heaven say the divines, both Christians and 
heathens. How to improve it many books can 
teach us ; how to obtain it none ; that nothing can 
be done without it all agree.' ^ 
* Preface to Translation of Du Fresnoy, Art of Painting, 1695. 



EDUCATION IN LONDON 77 

On March 1, Browne called on Dr. Joseph Dey, 
a Norwich man who practised in Crutched Friars, 
and as he was out, walked on to * Mr. King's, living 
in Little Britain, an ingenious chirurgeon', who 
showed him various anatomical preparations. *I 
being desirous to see the inside of a man's stomacke 
hee cut up one for me which he had by him.' In 
the afternoon he went to see a private museum 
near St. Paul's, where he was shown a sea 
elephant's head, a sloth, and an Indian serpent, and 
then walked on to Arundel House in the Strand, 
which contained the famous Arundel marbles. Mr. 
King, the surgeon, afterwards gave up surgery and 
took to medicine, and was made Sir Edmund King, 
and physician to Charles II in 1676. He became 
a Fellow of this College in 1687, and his picture 
by Lely is in our dining-room. His papers in 
the Philosophical Transactions show that he was a 
desirable man for a student to know. He was one 
of the first persons in London to use a microscope, 
and to pursue histological studies. He also worked 
at chemistry and entomology, and wrote creditable 
papers on the habits of ants and on leaf-cutter bees. 
He had dissected one hundred human brains, and 
Dr. Thomas Willis, the author of the Anatomy 
of the Brain, praises his anatomical skill. 

More than twenty years later King took part in 
the first scene of a memorable tragedy. ' On the 
first of February,' says Burnet in his history of his 
own time, * the King eat little aU day, and came to 
Lady Portsmouth at night, and called for a por- 



78 LECTURE II 

ringer of spoon meat. It was made too strong for 
his stomach. So he eat Httle of it : And he had 
an unquiet night. In the morning one Dr. King, 
a Physician, and a Chymist, came, as he had been 
ordered, to wait on him. All the King's discourse 
to him was so broken, that he could not understand 
what he meant. And the Doctor concluded, he 
was under some great disorder, either in his mind, 
or in his body. The Doctor amazed at this, went 
out, and meeting Lord Peterborough, he said, the 
King was in a strange humour, for he did not speak 
one word of sense. Lord Peterborough desired he 
would go in again to the bed-chamber, which he did. 
And he was scarce come in, when the King, who 
seemed all the while to be in great confusion, fell 
down all of a sudden in a fit like an apoplexy. He 
looked back, and his eyes turned in his head. The 
physician, who had been formerly an eminent 
surgeon, said, it was impossible to save the King's 
life if one minute was lost : He would rather 
venture on the rigour of the law, than leave the 
King to perish. And so he let him blood. The 
King came out of that fit : And the physicians 
approved what Dr. King had done.' 

Three days after his visit to Edmund King, 
Browne returned to Norwich, and for the rest of 
the month worked at botany, dissected a frog, a rat, 
and a polecat, did a little chemistry, and was con- 
sulted in a case of scurvy. Having filled his mind 
with information at home, at Cambridge, and in 
London, Browne was well prepared for the further 



EDUCATION IN LONDON 79 

education of travel. He left home on March 28,. 
1664, reached London at midday on the 30th, went 
by boat to Gravesend, and rode thence through 
Kochester, Sittingbourne, and Canterbury to Dover, 
whence he sailed to Calais, and thence went by 
Beauvais to Paris. In Paris he lived in a room in 
the Eue St. Zacharie for seven livres a month, and 
began regular studies at once. He went to four 
courses of lectures : Dr. Maureau on hernia. Dr. 
Dyneau on fevers. Dr. Le Bell on surgical operations, 
and that of Dr. Guy Patin who answered * all doubts 
and questions proposed ', and was a staunch Galenist 
who laughed at the chemists. Browne also went 
round the Hotel Dieu and La Charite. In Septem- 
ber he left Paris, and went to Montpellier and 
studied there for about a month, and then went on 
to Italy, visiting many cities, and staying for some 
time in Eome. He travelled north again with 
Dr. Paman, a physician and Fellow of St. John's 
College, Cambridge, who must have been a man 
of a full mind since Sydenham valued his friend- 
ship. Some of Paman's books are in our library. 

Browne went to Venice, and then spent some 
weeks at Padua studying anatomy. The dissection 
was admirably done by a demonstrator named 
Marchetti who had been instructed by Sir John 
Finch, *one that in anatomy hath taken as much 
pains as most now living.' This was Dr. Finch 
of Christ's College, Cambridge,^ a connexion by 

^ His rooms in Christ's College, finely panelled in oak and 
with his armorial bearings over one of the doors, are occupied 



80 LECTURE II 

marriage of Harvey. Browne left Padua in April, 
1665, and went to Montpellier again, thence pro- 
ceeding to Paris, which he reached in the middle 
of June, and attended lectures on botany and 
chemistry, short courses of about a month's 
duration. In July he caught small-pox, an event 
which happened in the life of very many students 
at universities of that period. Some months later 
he returned home. He had learned French and 
Italian. In August, 1668, he went abroad again 
to Holland, where he visited universities, their 
libraries, and museums, and attended lectures. He 
went on to Vienna, and there learned much from 
Lambecius, the librarian, and seems to have 
acquired colloquial Greek. From Vienna he went 
into Thessaly and visited Larissa in order to know 
the air and place in which Hippocrates practised. 
He also made a tour in Hungary and one in Styria 
and Carinthia, and came home in 1669. He went 
abroad once more in 1673, visiting Cologne and the 
Low Countries. He was admitted Fellow of this 
College in 1675, and elected physician to St. 
Bartholomew's Hospital in 1682, and was our 
President 1704-8. He died in 1708. 

I have chosen to consider Dr. Edward Browne as 
an example of the education of physicians in 
London in his time, because while his opportunities 
of learning were excellent they were yet such as 
physicians often enjoyed. He began life in a 

at the present day by that distinguished biologist, Mr. Arthur 
Everitt Shipley, F.R.S. 



EDUCATION IN LONDON 81 

learned home, going to the grammar school of his 
native city, and at the age of fifteen years entered 
the university, where after six years he took the 
degree of M.B. He had seen some human dis- 
section, but had not done any with his own hands, 
and had attended some university exercises, pro- 
bably both lectures and disputations, conducted by 
Glisson. He had probably read the Aphorisms of 
Hippocrates, of which Kalph Winterton, Glisson's 
predecessor as professor of physic, had edited 
a convenient edition with translations of each 
aphorism into Greek and Latin verse, and from 
some passages in Browne's writings he seems to have 
also read the Hippocratic treatises on air, water, and 
situation, as well as the Epidemics. He had also 
read pai-ts of Galen. He could write and speak 
Latin. After taking his M.B. degree he continued 
his anatomical studies, and worked practically at 
zoology, botany, chemistry, and pharmacology, and 
at medicine, parts of surgery, and morbid anatomy. 
He learned French and Italian, and could speak 
a little Greek. He used every opportunity of con- 
versing with learned men, such as Swammerdam 
the zoologist, Glauber the chemist, and Lambecius 
the bibliographer. He had read widely — Purchas, 
his Pilgrims^ the travels of de la Martiniere in the 
Arctic regions, Ealeigh's History of the World, 
Ashmole's Order of the Garter, and the Duchess of 
Newcastle's New Blazing World, His father advised 
him to study Cicero, and not to read much of 
Lucretius. * Quotations may be taken from it,' says 



82 LECTURE II 

Sir Thomas Browne, but ^ otherwise I do not much 
recommend the reading or studying of it, there 
being divers impieties in it, and 'tis no credit to be 
punctually versed in it ; it containeth the Epicurean 
natural philosophy '. Besides his university exami- 
nation, which was a kind of disputation, Edward 
Browne was no doubt examined in this College for 
admission as a candidate in 1668, after he had been 
engaged in medical studies for about ten years. He 
took his M.D. degree at Oxford in 1667, when he 
had studied nine years, and in his own university 
in 1670. This degree was probably given on proof 
of study in the faculty. The studies were less 
regulated, and the practical work less precise than 
those of a physician in our time. There were as 
yet no organized schools of medicine in England, 
and except in this College there was no thorough 
examination of candidates. 

The study of history is most worth pursuing when 
the consideration of the past can be made useful 
to us in the present. The lesson, ' Ars longa, vita 
brevis,' is plain enough wherever we contemplate 
the attempts of men to learn and to teach medicine. 
Further than this, we may learn that only those 
subjects become really valuable to the student, in 
which he has sought out things for himself, so that 
his knowledge does not rest on the dicta of a 
teacher. 

Last, we may conclude that medicine in itself, 
with its essential preliminary, anatomy, contains 
sufficient opportunities of training in every form of 



EDUCATION IN LONDON 83 

observation and of logical deduction from what is 
observed, and that, for the rest, a mind which has 
been opened by a sound literary education is that 
best adapted to follow the lifelong study of medicine 
which is the duty of every physician. These are 
the conclusions to which I have been led by a study 
of the history of the education of physicians in 
London from the time of John Mirfeld to that of 
Edward Browne, from the Middle Ages to the time 
when the methods of study which we now follow 
began to be used. 



g2 



LECTURE III 

THE HISTOEY OF THE STUDY OF CLINICAL 
MEDICINE IN THE BKITISH ISLANDS 

Mr. President, Censors, and Fellows of the 
College, — To us who have spent the greater part 
of our lives in the observation of patients, and in 
teaching in the wards of hospitals, the study of 
medicine appears to be essentially clinical. We 
know that reading, meditation, laboratory work, 
even investigations in the post-mortem room, are 
insufficient to make a physician without prolonged 
observation of patients in every condition of disease. 
Sydenham's firm conviction of the importance of 
spending as much time as possible in observation 
at the bedside and in meditation makes him, in his 
writings, appear negligent of the opinions of the 
men who before his day had given their lives to the 
study of medicine. He mentions Hippocrates about 
a dozen times and Galen once, Diemerbroek and 
Botallus, and twelve other writers on the plague, 
and hardly any other authors except some of those 
whose living conversation he had enjoyed. Dr. 
Robert Brady, the Master of Caius from 1660 to 
1700; Dr. Henry Paman, Public Orator at Cam- 
bridge; Dr. Charles Goodall, afterwards President 
of this College ; and one Oxonian, Dr. WiUiam Cole, 



STUDY OF CLINICAL MEDICINE 85 

— these, and Dr. Thomas Short, are addressed as 
men who understood his aims and appreciated his 
work, and show that, original as he was, he hked to 
feel that he had brothers in the world of learning 
in his day. Brady was a man both of active hfe 
and continuous study. He was head of his college 
and a Fellow of this College, and in practice, and 
he was for a time keeper of the records in the 
Tower, and wrote a careful history of England and 
a treatise on cities and boroughs. He was Kegius 
Professor of Physic at Cambridge, and member for 
the University in two Parliaments. Paman was 
a pupil of Sancroft at Emmanuel College, Cambridge, 
for whom in good and bad fortune he retained a 
friendship throughout life. He kept a medical act 
for his degree before Glisson at Cambridge, on the 
subject that a very light diet is suitable in acute 
diseases. It is proof of his scrupulous character 
that he gave up a valuable post rather than take the 
oath of allegiance to King William III. Goodall 
was a Cambridge man who was Gulstonian lecturer, 
Harveian orator, and President here. His works 
on this College show his minute acquaintance with 
its history and his own letters his general learning. 
Cole wrote on intermittent fever, a treatise which 
is praised by Blackmore in a long Latin poem in the 
form of a dialogue between Jupiter and Apollo. 
Cole admired Ghsson, but resembles him in a turn 
for scholastic argument without having Glisson's 
talent for original observations. He was a copious 
writer, profoundly interested in medicine, but adding 



86 LECTURE III 

nothing to it. Short is the physician to whom 
Sydenham's famous passage on posthumous fame 
is addressed. 

For I do not much esteem public applause, and 
truly what matter is it, if performing carefully the 
duty of a good citizen and serving the public to my 
own prejudice, I have no thanks for my labour ? For 
if the thing be rightly weighed, the providing for 
esteem, I being now an old man, will be in a short 
time the same as to provide for that which is not. 
For what advantage will it be for me, after I am 
dead, that eight alphabetical elements, reduced into 
that order that will compose my name, shall be 
pronounced by those who can no more frame an 
idea of me in their minds, than I can now conceive 
what those are to be ; who will not know such as 
were dead in the foregoing age ; and perhaps will 
have another language and other manners according 
to the inconstancy and vicissitude of all human 
affairs ? 

Among the mental associates of Sydenham must 
also be mentioned Locke, whose relations with him 
are well known, though none of the writers on the 
subject have, I think, compared their mutual esteem 
with that of Harvey and Hobbes. The study of both 
the political philosophers was the human race, and 
both desired from it to ascertain the principles 
applicable to their own age and country. The 
Leviathan and the Two Treatises on Civil Government 
were both scientific treatises in which the attempt 
was made to deduce the rules of government from 
observations of what had happened in past times 
and in their own. 

The medical mind, which is perpetually engaged 



STUDY OF CLINICAL MEDICINE 87 

in the observation and consideration of man in 
every aspect of his individual life, naturally inter- 
ested such philosophers, whether considering political 
problems or the special questions of metaphysics. 
The mental relation was the closer in each case 
because both Hobbes and Locke felt the charm of 
natural science, and admired the weighing and 
measuring and other considerations of the observa- 
tions of the senses which directed the habitual 
frame of mind of Harvey and of Sydenham. 

When Paracelsus began his lectures at Basle by 
flinging into a burning brazier the works of previous 
famous teachers of medicine, he must be considered 
as desiring to exalt his own teaching at the expense 
of theirs, but this was not the feeling which pre- 
vented Sydenham from mentioning other opinions 
than his own. He did not undervalue his pre- 
decessors. His care for some of those who had 
thought much on his subject in his own time 
shows the contrary, but he was impressed with the 
shortness of life, as every man must be who has 
tried to become deep in any subject. One of the 
greatest of modern men of learning at Cambridge 
migrated from this life as he was sitting at night 
by the fire in his rooms in King's College. On a 
table in the room was a series of fifty learned notes 
which he had just completed, and round the border 
of the title he had written : ^ Whatsoever thy hand 
findeth to do, do it with thy might ; for there is no 
work, nor device, nor knowledge, nor wisdom, in 
the grave, whither thou goest.' On the manuscript 



88 LECTURE III 

of Sydenham's notes, which is in the possession of 
the College, the author has written the same sentence 
from Ecclesiastes. It was a thought constantly in 
his mind, as is shown by several passages in his 
writings. 

In his practice of omitting any discussion of the 
opinions of others Sydenham makes one exception, 

* the divine old man,' Hippocrates, whom he never 
mentions without respect. He recognized that in 
the Hippocratic writings medicine rested upon the 
observation of patients, and that thence must be 
drawn all those conclusions as to the preservation 
of health and the prevention or the treatment of 
disease which are the ultimate objects of our 
study and practice. * Hippocrates,' says Sydenham, 

* better understood and more accurately described 
the History of Diseases than any one that came 
after him.' ^ Yet the true spirit of observation is 
obvious in Galen, and was not extinguished in the 
Middle Ages. We cannot read Avicenna or Khazes 
without feeling that, however different the hypo- 
theses on which they worked from those of to-day, 
they were nevertheless men who wished to find 
out the origins of diseases, and who were fitted by 
their habits of thought to add to knowledge. 

While the great physicians of those ages differed 
less in their mode of thought from modern men of 
science than is supposed by those who have not 
read their works, this was not the frame of mind 
of all who practised the medical art, or even of most 
* Of the Irregular Smallpox, p. 172. 



STUDY OF CLINICAL MEDICINE 89 



of those who wrote on medicine. For all but a 
few, medical study was to read the works of authority 
and to fit cases under the headings given in such 
treatises, while medical writing consisted in pro- 
ducing fresh books by extract and abstract from 
previous books. Quotation marks were not in 
use, and every one who has perused many of the 
writers on medicine of the Middle Ages knows how 
difficult it is to isolate any original remarks of the 
actual writer. Though in one page of a manuscript 
you may find statements made with the authority 
of Ehazes, Avicenna, Isaac, Constantin, the Philo- 
sopher (as Aristotle is generally called), Dioscorides, 
or Galen, this is no proof that other statements on 
the same page may not also be the author's version 
of what he has read, and not his original observa- 
tions. It is only a very few of the scientific writers 
of the Middle Ages who, like Eoger Bacon, are 
mainly original ; the books of a few more contain 
some little original matter, * thin in their authors,' 
as Dry den says, and the majority are commentators 
and compilers only. The immediate effect of the 
revival of learning was to introduce the age to the 
great teachers of the past, and men had to go to 
school to them for some time before they were by 
them brought back to nature. 

Greek literature, including, of course, the medical 
writers, was the influence which predominated in 
this College at its foundation. To it the greater 
part of the hours of study of Linacre and Clement 
and Wotton was devoted. The illustrious Bentley 



90 LECTURE III 

in his old age, when Mrs. Bentley lamented that he 
had bestowed so great a portion of his time and 
talents upon criticism instead of employing them in 
original composition, acknowledged the justice of 
her regret with extreme sensibility, and remained 
for a considerable time thoughtful and seemingly 
embarrassed by the nature of her remark. At last 
recollecting himself he said : * Child, I am sensible 
that I have not always turned my talents to the 
proper use for which I should presume they were 
given to me : yet I have done something for the 
honour of my God and the edification of my fellow 
creatures. But the wit and genius of those old 
Heathens beguiled me, and as I despaired of raising 
up myself to their standard upon fair ground I thought 
the only chance I had of looking over their heads 
was to get upon their shoulders.' ^ I can imagine 
that some of the physicians of the Eenaissance may 
at the end of their lives have had feelings like those 
of Bentley. 

Caius was the first to write an original description 
of disease as observed in his own time, yet his Liber 
de Ephemera Britannica contains no series of clinical 
observations, and he is content to give a general 
account of the epidemic, of its prognosis, and of the 
treatment adopted. 

The description of the symptoms of the sweating 
sickness is not connected with any particular cases, 
and is mixed up with pathological hypotheses con- 

^ Wrangham, British Plutarch, where Cumberland seems the 
authority for the statement. 



STUDY OF CLINICAL MEDICINE 91 

cerning them ; yet it was the first description of a 
disease from nature which had been written in Eng- 
land. The preface is dated at London, January 12, 
1555, and as Caius was then living in St. Bartholo- 
mew's Hospital, the book was probably written 
within its walls. Caius was satisfied that no account 
of the disease was to be found in Hippocrates or 
Galen, and he made his description from what he 
had seen. The substance of what he says about the 
sweating sickness is — at the onset the disease attacks 
in some patients the neck or shoulder, in others the 
thigh or the arm ; in some there is a feeling as if a 
breath of warmth swept down those members. At 
the same time a sudden and copious sweat takes place 
without obvious cause. First the inner parts grow 
warm, then burn, and thence the heat is diffused 
to the outer parts. There is great thirst and restless 
tossing about. The disease attacks the heart, liver, 
and stomach. A severe headache follows all these 
symptoms, then rambling and talkative delirium, 
then faintness and almost irresistible inclination to 
sleep. For the disease has a kind of sharper 
poison which moves the mind with madness and 
oppresses it with heavy sleep. Again, in other 
cases sweat is repressed at the beginning, the limbs 
are more lightly chilled, but afterwards the same 
sweat bursts out, but heavy in odour, of another 
colour by reason of the humour, in quantity imme- 
diately after diminished, then again increased, in 
substance dense. In some there is nausea, in 
others vomiting, but this in very few and almost 



92 LECTURE III 

entirely in those filled with food. All have heavy 
and frequent breathing and deeply groaning voice. 
The urine is lighter in colour, thicker in substance, 
uncertain in relief, otherwise natural. The pulse 
excited, rapid. These were the sure signs of the 
sickness.^ — The defects of Caius's book are the 
absence of a discussion of the morbid anatomy in 
explanation of the phenomena and the compara- 
tively small space given to the description of the 
symptoms in proportion to the many pages of 
hypotheses on the relation of the disease to the 
general scheme of fevers and on its origins. Yet it 
was the first step in clinical medicine in England. 

Gilbert was aware of the importance of applying 
in medicine precise scientific methods of observation 
such as led to his great discovery in physics, but 
while it is certain that his acute and observing mind 
must have had but one method in all its proceedings, 
he has left us no records of observations in clinical 
medicine. 

Harvey had made some notes of patients, as is 
shown in the manuscript of his lectures on the 
circulation. He had watched the progress of a 
suppurating hydatid of the liver in a patient at St. 
Bartholomew's, ' Apostema ingens per multos menses 
ex pure foetidissimo 2 or 3 gallons et aqua cum 
viscosis panniculis convolutis as glew stepened 
in water or Isonglass : regressum Hospitali,' ^ and 

^ .Tohannis Caii, Liher de Ephemera Britannica, Ed. S. Jebb, 
M.D. London, 1721. 
" PrelecUones Anatomiae Universalis (1886), Autotype f. 39 h. 



STUDY OF CLINICAL MEDICINE 93 

had also observed the increase of the liver in a man 
with caries of the spine accompanied by long- 
lasting abscesses— as we should say, a case of 
amyloid disease, * sic magnitudo Jon Bracey Ingen- 
tem as bigg as an ox liver : liver grown : macilen- 
tissimus curvatus pro Imbecillitate morions ex 
fistulis/ There were probably many clinical notes 
among those papers of his, the loss of which has so 
often been deplored, for almost every man who has 
devoted himself to morbid anatomy has also made 
observations in clinical medicine. Is not this plain 
in the writings of Morgagni, of Matthew Baillie, of 
Louis, of William Jenner, and of Wilks. 

Besides the traces of clinical observation in Caius 
and in Harvey other fragmentary proofs of its use 
may be collected. The works, for example, of 
William Clowes, surgeon to St. Bartholomew's 
Hospital in the reign of Elizabeth, contain many 
passages which show how carefully he observed his 
patients, though he evidently writes down the 
general result in his memory rather than anything 
noted day by day. He was good at telling a story 
rather than at recording an observation. 

The first physician in England whose writings 
«how him to have devoted himself to minute clinical 
observation is Sir Theodore Turquet de Mayerne, 
who was elected a Fellow of this College on 
June 25, 1616. He was the first person in 
England learned in all medicine, and himself a part 
of the learned world of his time, who made many 
elaborate clinical studies. This great man was born 



94 LECTURE III 

at Mayerne, near Geneva, on September 28, 1573, 
of a learned family, and you cannot go into the Uni- 
versity library at Cambridge without being reminded 
of the godfather whose name he bore, the great 
scholar Theodore Beza, who gave to the University 
the ancient codex of the New Testament called 
after him. A notebook of Mayerne's, when in the 
second class at school at Geneva in 1585, is among 
the Sloane manuscripts,^ and shows that the variety 
of tastes and assiduity of study which his mature 
writings display were already to be observed in 
him at the age of twelve years. The book begins 
with many pages of notes * de dialectica ', on logic. 
These are followed by notes on processes of distilla- 
tion with well-executed drawings of stills and other 
apparatus. At the end he has written out a French 
pastoral play. The scenes and dialogues in which 
Tonion bergere and Lysette, Clovis, Florus, and 
Daphnis take part, contain nothing which might 
not have been written by an ingenious boy, but 
Mayerne does not state that he composed it. He 
clearly was interested in it. It is probable that the 
drawings and the play may have been written 
rather later than the logic. After his school educa- 
tion he studied at the University of Heidelberg for 
four years and then at Montpelier, where he gradu- 
ated M.B. in 1596 and M.D. in 1597. He settled 
in Paris, and early in his career had some medical 
controversies with the physicians there out of which 
he emerged with credit to himself. He had been 

' Sloane MS. 2013. 



STUDY OF CLINICAL MEDICINE 95 

attacked for using chemical remedies to which the 
Galenists of the time objected, and in a well- 
expressed reply he showed that his prescriptions 
were both useful and in accordance with the prin- 
ciples and practice of Hippocrates and Galen. 
Mayerne went on with his work in spite of much 
opposition from his seniors. He felt some scorn of 
his opponents, since in one of his notebooks begun 
at Paris in October, 1602,^ he has written a list of 
fourteen patients who had been left to die by the 
physicians of Paris or by others, but were restored 
to health by him and by Kiverius, the King's 
physician. Sixteen long notes of this period of 
his practice have been printed.^ Before he left 
Paris opposition seems to have ceased, and he had 
become physician in ordinary to the King of France. 
In 1606 he was taken to England by a patient whom 
he had cured, and received the degree of M.D. at 
Oxford. He did not, however, settle in London till 
1611, when he was desired to come by letters 
patent under the Great Seal and was appointed 
first physician to James I. His profound know- 
ledge of his profession and great ability and general 
learning at once secured for him the friendship of 
this College. The first case after he came to 
England of which he has preserved a note is that 
of Sir Kobert Cecil, the Earl of Salisbury, who, 
like his descendant in our time, was first Minister 
of the Crown. Mayerne saw Cecil at Salisbury on 

1 Sloane MS. 2089, f. 23 a. 

^ Opera (ed. Browne). London, 1701. 



96 LECTURE III 

August 1, 1611, and evidently thought ill of his 
case. He describes a large hard abdominal tumour 
occupying nearly the whole hypogastrium on the 
right side and associated with prolonged diarrhoea — 
.probably a new growth of the caecum. The symptoms 
and their meaning are discussed in six folio pages of 
print of two columns each and the treatment in 
twelve and a half columns, and it is evident that 
while Mayerne expresses the wish that careful 
management may do something for the patient he 
was not hopeful of recovery. The earl died on 
May 24, 1612. 

Mayerne was consulted during the fatal illness of 
Henry Prince of Wales in 1612, and drew up an 
excellent account of the symptoms, treatment, and 
post-mortem appearances, from which, as I have 
elsewhere shown, it is easy to establish that the 
Prince died from enteric fever, of which there was 
an epidemic in London at the time of year at which 
at the present day enteric fever is almost invariably 
present in this city. So excellent are the notes of 
Mayerne that it is fair to say that nothing but the 
pathology of his time prevented him from being the 
first recognizer of enteric fever. Many, he says, 
had a similar fever in the summer of 1612. It 
usually began like a tertian, but soon became a con- 
tinued fever. In those who recovered it lasted 
a long time. Delirium, stupor, and convulsions 
often occurred. Haemorrhage sometimes ended the 
case. There were spots like flea-bites in many 
cases. The disease was not contagious, nor did one 



STUDY OF CLINICAL MEDICINE 97 



infect another, but sometimes many were sick at 
the same time in one house. 

The memoir which he drew up in December, 1623, 
on the health of James I is a good example of 
Mayerne's method. It exists in his own character- 
istic handwriting in the British Museum ^, and is 
in Latin. I may give sufficient of its substance to 
show its nature without fatiguing you by a literal 
translation of the whole. 

James the First, King of Great Britain, was born 
at Edinburgh in the year 1566, on June 19th, at 
half-past eleven in the morning, and is now aged 
over 57 years. He had a drunken wet-nurse and 
was suckled for about a year. He has a very stead- 
fast brain, which was never disturbed by the sea, by 
drinking wine, or by driving in a coach. 

(The badness of the roads and the rude construc- 
tion of vehicles must have at that time often caused 
sickness from oscillation in travellers.) 

He is easily affected by cold and suffers in cold 
and damp weather. His chest is broad and well 
formed, and the vital parts contained therein have 
strong and lively warmth and never are afflicted 
unless as a result of morbid conditions elsewhere. 
In this way it happens that his lungs are often 
attacked by fluxion, the material of which is swiftly 
thoroughly matured by the power of a very warm 
heart. The liver naturally good, large, of much 
blood, warm, liable to obstructions, and inclined to 

^ Sloane MS. 1679. I have given the original in the 
Appendix, as it has not been printed before. 

MOOKK H 



98 LECTURE III 

generate much bile. The spleen now easily heaps 
up melancholic juice, the presence of which is indi- 
cated by various symptoms. There is no swelling 
in either of these viscera and no hardness. Each 
hypochondrium is soft and never distended, except 
with wind. The stomach is always ready for the 
burden of a large quantity of food and is prompt to 
get rid of any hurtful excess, chiefly by the bowel. 
He has naturally a good appetite and duly digests 
a sufficient quantity. He very often thirsts and 
often swells out with wind, of which imperfect 
digestion or fermeatation is the origin. Bowels 
uncertain ; the discharge soft and fluid. The 
mesentery is apt to be obstructed in the wanderings 
of its vessels. Kidneys warm, disposed to generate 
sand and gravel. His legs seem not strong enough 
to sustain the weight of the body. His habit loose 
and of pervious texture, and he readily heats with 
dry heat. Skin thin and delicate, so that it itches 
easily. Fauces narrow, causing difficulty in swallow- 
ing, which defect is hereditary from his mother and 
grandfather, James V of Scotland. Animal and 
vital faculties blameless. All functions naturally 
good, but perverted on occasion and most from 
disturbance of mind. As to non-naturals : 

Air, — His Majesty bears all changes of air fairly 
well ; in damp weather with a south wind he is 
attacked by catarrh. 

Food. — As regards food he does not much amiss 
except that he eats no bread. He generally takes 
roast meats. Owing to want of teeth he does not 



STUDY OF CLINICAL MEDICINE 99 

chew his food but bolts it. Fruit he eats at all 
hours of day and night. 

Drink. — In drink he errs as to quality, quantity, 
frequency, time, and order. He promiscuously 
drinks beer, ale, Spanish wine, sweet French wine, 
white wine (his normal drink), and Muscatelle wine 
(whence he has diarrhoea), and sometimes Alicant 
wine. Nevertheless, he does not mind whether 
wine be strong or no so it be sweet. He has the 
strongest antipathy to water and all watery drinks. 

Exercise and rest — The King used to be given up 
to most violent exercise in hunting. Now he is 
quieter and lies or sits more, but that is due to the 
weakness of his knee-joints. 

Sleep and waking, — He naturally sleeps iU and 
restlessly, and often at night he is roused and calls 
the valets, and sleep does not return unless, as often, 
it takes him by surprise while the reader is reading 
aloud to him. 

Affections of the mind. — His mind is easily moved 
suddenly. He is very wrothful, but the fit soon 
passes off. Sometimes he is melancholy from the 
spleen in the left hypochondrium exciting disorders. 

Excreta. — He often blows his nose, sneezes very 
often. Does not spit much unless from catarrh. 
Stomach easily made sick if he retains undigested 
food or bile. Vomits with great effort, so that after 
being sick his face appears for a day or two spotted 
with red spots. Much wind. Vapours from his 
stomach precede illness. The alvine discharge is 
uncertain and depends on the nature of his food, 

h2 



100 LECTURE III 

which often produces morbid changes. A tendency 
to looseness gets rid of a burden produced by what 
he has eaten. 

Urine generally normal and sufficient. Often 
sandy sediment after a time. Sometimes friable 
calculi or rather agglutinated grains of sand are 
sifted out. He sweats easily owing to the thinness 
of his skin, especially at night, after exercise, after 
copious meals. He is impatient of sweat as of all 
things. From the year 1619, after a severe illness, 
in which leeches were applied, has had a copious 
haemorrhoidal flow almost daily. If this does not 
occur the King becomes very irascible, melancholy, 
jaundiced, glows with heat, and his appetite falls 
off. When the flow returns all things are changed 
for the better. 

Former illnesses and present aptitude to various morbid 
dispositions. — The King to the sixth year of his age 
was not able to walk, but was carried about, so 
weak was he from the bad milk of his drunken 
nurse. Between the second and fifth year he had 
small-pox and measles. In his fifth year for twenty- 
four hours he had suppression of urine, nevertheless 
no sand or slime was ejected. 

Colic. — He often has colic ; this was worse before 
he was twenty-four ; it afterwards became milder. 
Fasting, sadness, cold at night produced it. It is 
relieved by the converse. Cholera often, and when 
young almost every year he was seized with cholera 
morbus, with shivering preceding sickness and 
bilious diarrhoea. 



STUDY OF CLINICAL MEDICINE 101 

Diarrhoea. — He has been liable to diarrhoea all 
his life ; most in spring and autumn, most of all 
from about the end of August or beginning of 
September, after eating fruit, sometimes with fever, 
sometimes without. Before this diarrhoea he almost 
always has depression of mind, sighing, dread of 
all things, and other melancholic symptoms. In 
1610, at the end of ParHament,^ after great sadness, 
diarrhoea for eight days, with watery bilious, very 
fetid, and at last black excreta. Cardialgia, palpi- 
tation, sighing, sadness, &c. Vomiting recurring 
twice or thrice a day. The King regained his health 
after proper remedies. 

In 1612, December 4, after the death of his son, 
a paroxysm of melancholy — an attack of illness 
ending in diarrhoea lasting a few days. 1619, after 
the Queen's death, pain in joints and nephritis with 
thick sand. At Eoyston continued fever, bilious 
diarrhoea, watery and profuse throughout the illness. 
Hiccough for some days. Aphthae all over mouth 
and fauces, and even the oesophagus. Fermentation 
of bitter humours boiling in his stomach which, 
effervescing by froth out of his mouth, led to 
ulceration of his lips and chin. Fainting, sighing, 
dread, incredible sadness, intermittent pulse. Never- 
theless, it is to be noted as to this intermission of 
pulse in the King that it was frequent. Nephritis, 

* Parliament was dissolved Feb. 11, 16 ^f, after much 
sharp discussion about the King's favourites and without 
making the pecuniary arrangements he desired. James was 
highly irritated. 



102 LECTURE III 

from which, without any remedy having been 
administered, he excreted a friable calculus, as was 
his wont. The force of this, the most dangerous 
illness which the King ever had, lasted for eight 
days. Kemedies were used with success. After 
that illness for two years the King was fairly well 
and free from other, even his usual affections ; after- 
wards, as was his wont, diarrhoea recurred, but was 
less severe. 

This year 1623, at the end of autumn, it lasted 
for two or three days, and was excessive. After 
this arthritis, and after this, after an interval of 
three weeks, he was able to walk without help, while 
before for months he had had to sit in a chair and 
be carried or be helped along by the support of 
others. The happy effect of the spontaneous 
evacuation is to be noted. 

Our King is easily attacked by catarrh descending 
from the brain and producing coryza. Most often 
it attacks the lungs, and a most violent cough 
follows, but within two or three days maturation 
occurs and the cough ceases, and the humour thick 
and black is rejected from the bronchi. 

Fever. — He rarely has fever, and if any it is short 
and ephemeral. 

Jaundice. — Easily comes on if he is in any way 
out of sorts, whether in mind or body. Often his 
eyes grow yellow, but it soon passes off. 

Haemorrhoids. — Some loss of blood nearly every 
day, with sometimes prolapse and tenesmus. 

Nephritis, — Many years ago, after hunting and 



STUDY OF CLINICAL MEDICINE 103 

long riding, he often had turbid urine and red like 
Alicant wine (which are His Majesty's words), but 
without pain. 

July 12, 1613, bloody urine, with red sand, soon 
faeculent, and with thick sediment. Ardor urinae, 
pain in the left kidney ; frequent vomiting and 
other nephritic symptoms. 

The same, but worse, August 17. In 1615, 
October, the same symptoms. His accustomed flux 
relieved all these paroxysms. Afterwards the evil 
often renewed, and in some of the accessions calculi 
or rather concoctions were ejected, and soft sand 
adhering together with imperfect cohesion, and then 
the attack came to an end. 

Arthritis. — Pains many years since invaded first 
the right foot, which had an odd twist when walking, 
and from a wrong habit of steps had a less right 
position than the other, and grew weaker as he grew 
older. Afterwards occurred various bruises from 
knocking against timber, from frequent falls from 
horseback, from the rubbing of greaves and stirrups 
and other external causes which the King ingeniously 
discovered, and exactly noted, that he might baffle 
the accusation of internal disorder on the part of 
his physicians. 

Pain of his right foot used to afflict him most 
often ; not the toes, not the joint of the foot with 
tibia, but underneath the external malleolus. All 
the same, I have observed that the whole foot has 
more often swelled, and so much weakness from 
pain remained, that for several weeks he had to 



104 LECTURE III 

give up usual exercise, and was compelled to stay in 
bed or in a chair. At last, in the year 1616, this 
weakness continued for more than four months, 
with oedematous swelling of the whole skin and of 
both feet. In following years it happened that the 
pain went on to joints of other parts, the great 
toe of the left foot and the malleoli to both knees 
and shoulders and hands, sometimes not always 
with redness, more often with swelling. The pain 
is acute for the first two or three days. By night it 
rages now worse, now milder ; weakness succeeds, 
which is neither subdued nor disappears till after 
a long course of days. In winter time the arthritis 
is much worse, nor are the joints free till the return 
of the sun and summer warmth restores health to 
his Majesty. 

Thrice in his life he was seized with most severe 
pains of the thigh, very recently on October 28, 
1623, as if by a spasm of the muscles and tendons 
bending the left leg by a vaporous influence most 
pertinaciously twitching those parts in the hours of 
the night. The leanness, and so to speak atrophy, 
of his legs were to be noted as due to the inter- 
mission of exercise not calling the spirits and 
nourishment to the lower parts which from child- 
hood were slender and weak. 

The King when coming into England from Scot- 
land, falling from his horse, broke his right collar- 
bone. Another time, from a fall, he suffered from 
a bruise of the left scapula. He was completely 
cured. From that time nevertheless, there was 



STUDY OF CLINICAL MEDICINE 105 

descent of humours into his right arm, whence arose 
swollen glands like the phlegmatic excrescences of 
scrofula, which first swelled with redness and pain, 
then subsided, and at length suppurating, formed 
ulcers that were healed after a long time. 

It is to be noted that from the same humours, or 
perhaps from arthritic juice descending, a tumour 
appeared two years later on his right olecranon, 
distended with wind and serum, which happily 
ceased after proper remedies without breaking the 
skin. Once having bruised and almost broken his 
ribs on a fall from his horse, for three days he had 
slight fever. He recovered without blood-letting. 

Another time the fibula of the other leg was 
squeezed by the weight of a horse, with most 
dangerous bruising and blackening of the whole 
leg. He was cured without fever. He is of extreme 
sensitiveness, most impatient of pains ; and while 
they torture him with most violent movements his 
mind is tossed, and bile flows around his praecordia, 
whence the evil is not relieved, but made worse. 

He demands relief and freedom from pain, little 
considering about the causes of his illness. 

As to remedies. — The King laughs at medicine, and 
holds it so cheap that he declares physicians to be 
of very little use and hardly necessary. He asserts 
the art of medicine to be supported by mere con- 
jectures, and useless because uncertain. 

Mayerne mentions other royal opinions and the 
King's fancies about various drugs. He would 
never allow himself to be bled. He then goes on 



106 LECTURE III 

to say what should be done, and what is chiefly to 
be remembered in treatment of the King in every 
circumstance likely to arise. This excellent account 
shows how Mayerne behaved as a clinical observer 
— noting everything ; considering no point of the 
patient's history unworthy consideration ; weighing 
the whole in relation to treatment and to prognosis. 
It was his invariable method. He began by a 
minute series of observations of the symptoms ; 
then mentioned in succession the remedies which 
had been tried ; then discussed and determined the 
diagnosis and the several parts of the prognosis ; 
and concluded by an elaborate statement of the 
treatment to be adopted. That he felt the spleen 
is shown in his notes on Lord Salisbury, and that 
he examined by palpation the liver is shown by 
the case of M. le Natier Greffier, in which he says/ 
^Hepatis qualitas non potuit explorari ob muscu- 
lorum et cutis diductionem.' 

Anne of Denmark, Queen of James I, was also 
a patient of Mayerne's, and some of his notes on 
her illnesses, from February 28, 1612, when she 
had an ulcer on her left leg, to her death on March 
20, 1619, with cough and general dropsy, are to 
be found among the many pages headed ^Variae 
Medicamentorum Formulae' printed in Joseph 
Browne's edition of Mayerne's writings. The Queen 
had an attack of gout at Christmas, 1612. She had 
swelled feet and an ulcer on the left ankle when 
Mayerne saw her at Lay cock Abbey on May 11, 
1 Opera, p. 216. 



STUDY OF CLINICAL MEDICINE 107 

1613. In a note which he then drew up on her 
state, he mentions that she was easily made angry 
and easily grew red in the face, that she slept ill 
and that her joints were feeble. She went to Bath 
in that year for the swelling of her feet. 

May erne's notes on Queen Henrietta Maria, ^ 
contained in the same manuscript book, show equal 
care. They were written out in July, 1641, when 
the Queen was about to cross the sea ' to cure her 
mind no less than her body ', says the note. Some 
swelling of liver and spleen, frequent swelling of 
the gums and painful teeth, several renal calculi, 
frequent cough, sleepless nights only soothed by 
syrup of poppy (never by laudanum), herpes of the 
upper lip, occasional inflammation of the right eye, 
and of the eyehds, recurring headaches, curvature 
of the spine, the arm and hand of the right side 
thinner than those of the left, extreme general 
wasting and, as regards affections of the mind 
(animi pathemata), anger violent but brief, long 
sadness, frequent tears. 

The details of all these are carefully recorded, and 
besides showing the excellence of Mayerne's clinical 
observation present to us a picture of the Queen of 
Charles I, which placed beside the lady so thin and 
pale, with some grace, but no cheerfulness, in the 
pictures of Vandyke, enables us to understand how 
her troubles in the world must have affected her, 
and leads us to judge leniently any defects of manner 
or disposition in her, and to attribute them not to 
^ Appendix. 



108 LECTURE III 

a fiendish nature, as did her political opponents 
when they applied to her the words in which Aeneas 
denounces Helen as he describes how he found her 
hiding on the night of the taking of Troy — 
Troiae et patriae communis Erinys, 
but in great part at least to a physical condition 
which must have greatly detracted from her enjoy- 
ment of life. 

In Mayerne's notebook there is a blank page 
with a heading which shows that it was intended 
for notes on the health of Charles I. A friendly 
letter, dated February 3, 1636, to Harvey, then at 
Newmarket, is printed in May erne's works ^ on the 
illness and best method of treatment of the Elector 
Palatine. The confidence which Charles I and his 
Queen felt in Mayerne is shown by two letters 
which he has copied into his notebook. The 
heading is 

wavTa (Tvv OeS, afjLujv 
— the history of a journey to Exeter ^ undertaken to 
restore the health of the Queen, then seriously ill. 
He left London on May 21, 164:4, with another 
physician. Sir Matthew Lister, and carried in the 
Queen's coach, they reached Her Majesty at Exeter, 
on May 28. These royal letters are so little known 

^ Opera, p. 361. 

* * Accersitus per Eegis et Reginae literas Londino Excetriam 
unacum muneris in Aula socio, et viae comite, Equite Matthaeo 
Lister, itineri me commisi 21 Maii 1644 cum ductore a Regina 
misso qui sumptus omnes faceret et ministraret omnia 
necessaria Archibaldo Hay. Ita Reginae rheda vecti pervenimus 
ad E. M. die mensis 28.* 



STUDY OF CLINICAL MEDICINE 109 

that I may add their words. The Queen's has, I 
think, not been printed before. 

Exeter ce 3 May, 

Monsieur de Mayerne, mon indisposition ne me 
permet pas d'escrire beaucoup, pour vous prier de 
venir si vostre sante vous le permet, mais mon mal 
vous y conuie plus comme j'espere que ne feroit 
beaucoup de lignes. C'est pourquoy je ne diray que 
cela, ay ant tousjours dans ma memoire les soings 
que vous aues eu de moy dans mes besoings, qui 
faict que je crois que si vous pouues, vous viendres 
et que je suis et seray tousjours 

Vostre bien bonne mestresse 
et amie, 

Henriette Marie K. 

The letter of the King was sent from Oxford by 
William Muray to London. 

Mayerne — Pour L'amour de moy alle trouuer ma 
Femme. C. E. 

Many other of Mayerne's clinical descriptions of 
patients are as good as those of these royal persons. 
That on the first Earl of Abercorn, made on 
September 26, 1616, when the Earl was aged forty- 
one years, gives an admirable account of his history 
and of the physical and mental phases of his life. 

Mayerne left his library to this College from 
loose papers in which some fragments of his works 
were published, but it was not till 1700 that a 
volume in folio of his notes was printed by Dr. 
Joseph Browne. He selected such parts as he 
thought Mayerne would have wished to print, or 
Bonetus of Geneva, to whom Mayerne had sent the 
first fasciculus to get it printed. The printing was 



no LECTURE III 

delayed, and Bonetus sent the book back to the 
author, and urged that he should publish all he 
had written, and not only selections. A great part 
of the College agreed with Bonetus when, long after 
Mayerne's death, the question of printing arose. 
The Censors referred the matter to Dr. Charleton, 
who took a different view, and wanted to recast the 
whole. Browne wisely decided to issue the papers 
unaltered. His book contained full notes of more 
than forty cases observed by Mayerne, with letters 
about seven more, the report and papers about the 
case of Henry Prince of Wales, a letter to the 
King's physicians about the health of James I and 
Charles I, then Prince of Wales, the letter to 
Harvey at Newmarket on the health of the Elector 
Palatine, and a long series of notes on the illness of 
Isaac Casaubon, in which are incorporated the notes 
of Eaphael Thorius, the author of the poem on 
tobacco, who attended him. Notes on pharmacology 
and a long series of prescriptions for King James, 
King Charles, and Queen Henrietta Maria are also 
printed and some notes on her health. 

Mayerne seems not to have been unwilling to treat 
any symptom, however slight, and this arose not 
from any mere complaisance to the King and Queen, 
but from the fact that to his keen observation 
nothing seemed trivial. If he sometimes humoured 
his patients, he never allowed their high station to 
obscure his thorough investigation of their symptoms 
or view of their characters in relation to their 
physical frames. It was surely harmless when 



I 



STUDY OF CLINICAL MEDICINE 111 

King James swore he hated to be anthropophagous 
— to give him powdered ox bones instead of cranium 
humanum, a remedy then highly estimated.^ 

A great part of Mayeme's papers became the 
property of Sir Hans Sloane, and are now in the 
Sloane Collection in the British Museum. They 
show not only Mayerne's industry as a clinical 
observer, but his extensive learning and constantly 
studious mind. Twenty-three volumes of his 
notes of varied kinds have been preserved, and 
these, together with those printed by Dr. Joseph 
Browne, are the material for our estimate of him as 
an observer. His general plan was to divide the 
notes into two parts ; the first, called Theoria, gives 
an account of the history and symptoms, and the 
conclusions drawn from them ; the second, headed 
Curatio, deals with the treatment in great detail, and 
to increase the clearness of this he sometimes adds 
a recapitulatio ordinis agendorum. 

Sir T. Mayerne's portrait hangs on our staircase 2. 
In the dining-room is that of Francis Glisson, 
President in 1667. He is the first English writer 
of a complete account — that is, an account, both 
anatomical and clinical, of a particular disease. 
Tractatus de Bachitide appeared in 1650. It deserves 
high praise as an example of clinical observation as 

^ In rege qui avOpwirocjiayia odit, Cranium humanum in ossium 
Bubulorum Easuram poterit permutari. 

^ In the British Museum there is a magnificent drawing of 
him by Kubens, probably done between 1630 and 1640. The 
head is in oils and finished with extraordinary vigour and 
perfection. The rest of the portrait is in crayon. 



112 LECTURE III 

well as of pathological anatomy. Glisson's method 
consisted in placing side by side all the facts relating 
to the disease he was studying. He does not allude 
by name or number to particular patients, yet shows 
by the precision of his statements that each rests 
upon many carefully noted observations. He collects 
the symptoms of rickets under three heads : dia- 
gnostica, which demonstrate its presence ; diacritica, 
which distinguished the varieties ; and prognostica, 
which presage the issue of the disease. The thorough 
discussions of terms, and the minute and precise 
arrangement which he follows, give a scholastic 
appearance to his pages which is apt to make any 
one who merely glances at his book think that 
Glisson is less an observer of nature than he really 
is. When he discusses the diagnostic signs he 
does so under five heads : (1) symptoms which have 
to do with the animal functions ; (2) those which 
have to do with irregular nutrition ; (3) those which 
have to do with respiration ; (4) those which belong 
to the vital influx, as we should say, to the circula- 
tion ; and (5) certain indefinite symptoms not 
belonging to the above classes. Under the first head 
he places flabbiness of the muscles, weakness, and 
sluggishness, and describes each with admirable 
clearness and entirely from clinical notes. * If,' he 
says in the section on debility, ' children are affected 
within the first year or thereabouts, they stand on 
their feet later than usual owing to that debility, 
and often speak before they walk, which is generally 
thought by the English to be of evil omen. If 



STUDY OF CLINICAL MEDICINE 11$ 

children are attacked by this disease after they have 
learned to walk, they stand on their feet more feebly 
by degrees, and when walking often hesitate, stagger 
from a slight cause, or even fall, nor are they 
able to stand long without sitting down, or to 
quicken their movements. At last, as the disease 
increases, they are deprived of the use of their 
feet ; indeed, they can scarcely sit upright, and 
the weak neck sustains the weight of the head 
imperfectly or not at all.' Under the heading 
* Symptoms due to malnutrition ', he describes the 
large head, the feeble muscles, the enlarged wrists, 
the bent bones, the retarded dentition, and the 
pigeon breast. 

Professor Virchow, in his Croonian lecture of 
1893, praised Glisson as the discoverer of muscular 
irritability. Sir Michael Foster,^ in his interesting 
lectures on the History of Physiology, has shown 
that in his Be Ventriculo Glisson * was the first to 
give the exact proof that when a muscle contracts 
it does not increase in bulk'. He is perpetually 
commemorated as an anatomist. Whoever studies 
his Tractatus de Rachitide will be convinced that he 
also deserves recollection as one of the founders of 
thorough clinical study in England. 

The method of Christopher Benet in his Tahi^ 
dorum Theatrum sive Fhthisios Atrophiae et Hedicae 
Xenodochium, published in 1656, is similar to that 
of Glisson, and Benet seems to have lost his life by 
infection during his experiments in relation to the 

^ Lecture X : The Old Doctrines of the Nervous System. 



114 LECTURE III 

sputum of phthisis, which he carefully collected and 
examined. 

The excellent clinical method of Mayerne, in 
which all the facts about each patient were carefully 
collected, and that of Glisson, in which all the facts 
relating to a particular morbid condition were placed 
side by side and a conclusion drawn from them, 
were not adopted by all physicians. 

A prominent example of another school is Walter 
Charleton, physician to Charles I, and President 
of this College from 1689 to 1691. His Spiritus 
Gorgonicus published in 1650, in which he treats of 
the causes and symptoms and cure of calculi 
wherever formed, is altogether different from the 
writings of Glisson or of Benet. He begins by 
discussing petrifaction in the outside world, and 
thence goes on to the efficient causes of petrifaction 
in the human body, and in the chapter on dia- 
gnosis the nearest approach to the report of a case is 
the mention of a Mr. Pinckay, commissary of the 
Eoyal Army, who had shown him fifty renal calculi 
which he had passed, and afterwards carried about 
in an ivory box. Charleton's Exercitationes Patho- 
hgicae, which discusses the nature, generation, and 
causes of almost all diseases, and was written in 
1661, is in part occupied by the discussion of 
questions of medical expression, such as when a 
disease may be spoken of as malignant, or incurable, 
or hereditary, and how the common qualities of the 
tissues of the body may be defined * Crassities, 
Tenuitas, Densitas, Karitas, Consistentia, Fluiditas, 



STUDY OF CLINICAL MEDICINE 115 

Tenacitas, Friabilitas, Tensitas, Laxitas, Eigiditas, 
Flacciditas, Durities, Mollities, Laevor, Asperitas'. 
Except a case of very hard tumour of the pancreas 
in a woman which was accompanied by anaemia, or, 
as he calls it, chlorosis, he scarcely mentions any 
case which he had himself seen, nor is his account 
of even this sufficiently definite to make one sure 
whether the tumour was a dense new growth or 
a pancreatic calculus of uncommon size. How long 
the patient was ill is not stated, nor are the incidents 
of the illness. Such was the method of medicine 
of Dr. Walter Charleton. Dryden praised Charleton 
profusely, yet with some discrimination : — 

Nor are you, learned friend, the least renowned, 
Whose fame, not circumscribed with English 

ground. 
Flies like the nimble journies of the light. 
And is, like that, unspent too in its flight. 
Whatever truths have been by art or chance 
Eedeemed from error or from ignorance, 
Thin in their authors like rich veins of ore, 
Your works unite, and still discover more. 
Such is the healing virtue of your pen 
To perfect cures on books as well as men. 

Charleton's copious writings are sufficient to show 
that clinical study was not universally cultivated 
among the physicians who were contemporaries of 
Mayerne and Glisson. Only one man of that time 
outshines Glisson in the exposition of clinical 
medicine, and that man is, of course, Sydenham. 

I need not dwell on the well-known events 
of the life of this great man, who, born in 1624, 
took his first medical degree at Oxford in 1648, 

I 2 



116 LECTURE III 

and his doctor's degree at Cambridge in 1676, 
and after practising in London for a little more 
than a quarter of a century, died on December 29, 
1689. 

As Mayerne may be said to have first definitely 
established in England the clinical study of medicine 
and the method of recording observations, and 
Glisson to have set the example of the study of the 
relation of the symptoms to the anatomical appear- 
ances of disease, so Sydenham may be regarded as 
the first who attempted to arrive at general laws 
about the prevalence and the course and the treat- 
ment of disease from, clinical observation. 

How admirable is Sydenham's account of measles, 
and, when i% is- compared with the books of his 
time and before, how original, how clearly he 
describes the onset and the method of appearance 
of the rash, and. how well contrasts the circum- 
stances which attend it with those of small-pox. 
* The symptoms of the Measles do not abate by the 
eruption as in the small-pox, yet I never observed 
the vomiting afterwards, but the cough and fever 
increase with the difficulty of breathing, weakness 
of the eyes and the defluxion on them,, with continual 
drowsiness and want of appetite as before.' His 
obvious originality is one reason for the great repute 
of his writings, and this originality is due not 
merely to his having thought differently, but also 
to his having seen more than his predecessors. 
Though Sydenham's is a general account, it is as 
distinctly based upon many clinical observations as 



STUDY OF CLINICAL MEDICINE 117 

if the notes of the cases he had seen were appended.^ 
Of the score of cases which he particularizes most 
are mentioned in illustration of points of treatment, 
but those of Thomas Chute, nephew of Lady Dacres, 
a young man with small-pox, and of Malthus,^ the 
apothecary, who had a chronic arthritis, are excellent 
illustrations of his daily observations. 

A great mind constantly occupied in arguing 
within itself on observations must sometimes furnish 
incomplete conclusions and imperfect hypotheses, 
and though Sydenham says when discussing the 
possible relation between certain visceral symptoms 
and the size of the pustules in small-pox, ' I do not 
determine ; for I only write a History, and do not 
pretend to solve problems,' he elsewhere tries to 
argue out a general pathology of fevers.^ * A 
fever,' he believes, *is Nature's instrument to per- 
form the separation of some matter from the blood.' 
This is the process * also in the plague '. 

Charleton, had he described small-pox, would 
probably have done so in much the same way as 
Bernard or Gaddesden ; some of the authors he 
mentioned might have been different, but he would 
proceed by way of scholastic discussion and quota- 
tion, and tell little of what he had himself seen. 
How entirely different is the method of Sydenham.* 

* Of the Epidemic Diseases from the Year 1675 to the Year 1680. 

* I suppose this Malthus was the ancestor of the political 
economist, since Sydenham was used as a Christian name in 
more than one generation of his family. 

^ Of the Continual Fevers in the Years 1667, d-c, 

* Of the Hegular Small-pox. 



118 LECTURE III 

The distinct begin with shivering and coldness, 
which is presently followed by excessive heat, and 
a violent pain in the head and back, vomiting, 
a great propensity to sweat (I mean in grown 
persons, for I never yet observed any such disposi- 
tion in children, either before or after the rash 
came out), a pain at the cavity of the breast beneath 
the region of the heart, if it be pressed with the 
hand, dullness and sleepiness, and sometimes con- 
vulsive fits ; and if these happen to those that have 
all their teeth, I reckon the Small-pox are at hand, 
which most commonly coming out a few hours 
after sufficiently answer the prognostication. For 
instance, if the child has a convulsive fit in the 
evening, as it usually happens, the small-pox appear 
next morning. 

His description of the severe neuralgia which 
sometimes is the last symptom of a malarial fever, 
and his determination of the fact that it really 
belongs to the disease, and must be treated in the 
same way, is a remarkable example of his close 
observation.^ 

But here it is to be noted that I have observed 
a certain symptom, sometimes like a nephritic pain, 
as to the intolerable pain of the loins, which being 
wont to follow ague, arises from a translation of the 
febrile matter upon the muscular parts of the body, 
but this symptom requires no other method of 
cure than the ague whereon it depends, for it is 
heightened by frequent bleeding, or any other 
evacuation, and the patient's life is endangered 
thereby. I thought good to mention this much of 
this symptom, that it might not impose on any one. 

The neuralgia is sometimes so severe and so 
^ Of the Epidemic Diseases from the Year 1675 to the Year 1680. 



STUDY OF CLINICAL MEDICINE 119 

different from what has gone before, and so remote 
from the beginning of the disease, that it seems 
more hke a separate morbid condition ; but Syden- 
ham perceived its actual relation to the disease. 
His description of gout and of hysterical diseases 
and of chorea are further examples, too well 
known for me to quote, of the minuteness and 
precision of Sydenham's clinical observations. He 
scarcely considers morbid anatomy, but endeavours 
to determine the species, and ascertain the course 
and the treatment of diseases by cHnical observation 
only. 

This is the general method of the Hippocratic 
writings, and while Sydenham is often regarded as 
the originator of modern medicine his works might 
also be considered the culmination of the effects of 
the Eenaissance. 

The writings of Thomas Willis contain many 
cases, but it is clear that he only took a general 
view, and did not make frequent precise observa- 
tions. After a short account he generally proceeds 
to pathological hypotheses, and this is so, even 
in his accounts of saccharine diabetes, of which 
he is regarded as the first describer. Willis, 
like Glisson, discusses the morbid anatomy of his 
cases. He often uses them to illustrate pathological 
doctrines rather than as studies in the natural 
history of disease. His interesting descriptions of 
the illness successively of five children in a family 
of a scarlet fever with subsequent uraemia, 
are perhaps the best cUnical reports to be found 



120 LECTURE III 

in his writings. His account of the case of Lord 
Shaftesbury, who had a hydatid cyst of the Hver 
which was opened, when compared with the precise 
description of the same case by Locke, ^ shows that 
WilHs often wrote from memory and not from 
notes made day by day. His works contain more 
hypotheses than minute observations. 

The cases mentioned by Martin Lister, and those 
of some other writers of this period are too brief to 
deserve record as examples of clinical notes. 

A clinical observer whose works show the 
practice of generalization from clinical observation 
as well as the Cjareful records of the events of 
disease as observed at the bedside, is Kichard 
Morton, who became a Fellow of this College in 
1678, and died in 1698, His Phthisiologia, 
a treatise on wasting diseases, contains numerous 
cases showing careful clinical note-taking and 
judicious deduction from his observations, and so 
does his Pyretologia, a general treatise on febrile 
diseases. He belongs to the school of Sydenham, 
but he makes a more general use of morbid anatomy 
and describes more cases. 

The physicians whom I have mentioned, Caius 
and Harvey, Mayerne and Glisson, Sydenham and 
Willis and Morton, were of course not the only 
clinical observers of their times. We may be 
certain, for example, that Lower, who so acutely 
reasoned on the causes of dropsy, followed the same 
method. Mayerne, Glisson, and Sydenham are the 

^ Shaftesbury Papers in Record Office : Note in Locke*s hand. 



STUDY OF CLINICAL MEDICINE 121 

three clinical observers of the seventeenth century 
whose work deserves the first place. Mayerne and 
Sydenham gave themselves up almost entirely 
to bedside observation. Glisson, while equally 
assiduous afc the bedside, was also a morbid 
anatomist. Glisson's mind most naturally turned 
towards the discovery of pathological laws, and to 
questions of etiology. Mayerne and Sydenham 
were most occupied with the solution of problems 
of treatment and of prognosis. All three were 
close observers of nature. Glisson was a dis- 
coverer in anatomy, for he described the capsule 
of the liver, in physiology he first perceived the 
irritabihty of tissues, and in clinical medicine he 
first described completely a disease not known in 
the world of science before him. Sydenham had 
on the whole the greatest influence on times after 
him. Mayerne was a less man than Glisson and 
Sydenham, but was a great physician of vast attain- 
ments, of hfelong mental activity, and in his own 
time an influence to make all men bedside 
observers. All three observed carefully the general 
aspect of the patient, and the external features of 
his body. The breathing, the character of the 
pulse, the state of the tongue, the locality of pain, 
the indications of fever, the excreta, and the 
appearances of extracted blood were considered. 
Tumours were felt, and the degree of dropsy 
estimated. Any impairment of the senses or of 
muscular power was noted. The liver and the 
spleen were examined by palpation. The history 



122 LECTURE III 

was carefully considered, and facts bearing on 
heredity were recorded. 

This was the extent to which observation at the 
bedside was practised by these physicians. Mayerne 
seems most in personal relation to the patient, 
thoroughly investigating his mind and body ; 
Glisson is most considerate of the interpretation 
of well-observed symptoms given by the morbid 
anatomy. Sydenham had always before him the 
endeavour to establish general laws in relation to 
disease, and hoped to do so by a precision of 
description such as that of the botanists in the 
description of plants. It is to Mayerne, Glisson, 
and Sydenham that the estabhshment of the study 
of clinical medicine in England is due. 



LECTURE IV 

THE HISTORY OF THE STUDY OF CLINICAL 
MEDICINE IN THE BRITISH ISLANDS 

Mr. President, Censors, and Fellows of the 
College, — The study of clinical medicine was estab- 
lished in England by the practice and the writings 
of Mayerne, Glisson, and Sydenham. Though 
Mayerne was not an Englishman by birth or educa- 
tion, GHsson and Sydenham were thoroughly English 
in habit of mind and owed, I think, nothing to any 
foreign influence. The admirable Ohservationes of 
John James Wepfer of Schaffhausen, published in 
1658 and enlarged in 1678, in which he demon- 
strated the relation between apoplexy and cerebral 
haemorrhage, was eight years later than the Tractatus 
de Bachitide of Glisson, and though the subject is set 
forth in different forms the scientific method of the 
two books is the same. Wepfer observed cases 
during life and explained their relation to the 
anatomical changes demonstrated after death, yet 
his book seems to have been little read in England. 
It is not, for example, mentioned in the controver- 
sies which arose about the attack of apoplexy which 
was the beginning of the fatal illness of King 
Charles II, nor is there the least allusion to it in 
the Cerebri Anatome of Willis, published in 1664. 

The three books of observations of Nicholas 
Tulpius, beautifully printed by Louis Elzevir at 
Amsterdam in 1641, contain one hundred and sixty- 



124 LECTURE IV 

four brief but lucid notes of extraordinary circum- 
stances or unusual symptoms of disease, amongst 
them the first description of the sputa of fibrinous 
bronchitis which he took to be the branching pul- 
monary veins detached from the substance of the 
lung ; but these notes are not to be compared 
to the daily observations of the three great con- 
temporaries of Tulpius in England. 

In the times following those of Sydenham, six 
celebrated physicians, Eadcliffe, Garth, Arbuthnot, 
Freind, Sloane, and Mead, had all great opportunities 
of clinical observation and understood their impor- 
tance. Eadcliffe showed by his magnificent bene- 
factions how much he cared for learning and for 
medicine, and his reputation among physicians was 
chiefly due to his acute observation of disease, yet if 
he made notes none have survived either in print or 
manuscript. Sir Samuel Garth wrote little on medi- 
cine. The medical writings of Arbuthnot, though 
worth reading, contain no cUnical notes, but those of 
his contemporary, Dr. John Freind, are among the 
best of his period. The numerous cases in his nine 
commentaries on fever, in his Epistola de FurgantihuSf 
and in his Emmenologia are admirably related and 
often with many details. The form in which he 
records his cases is modelled upon that of the 
Hippocratic writings, yet is free from any trace of 
archaism. The writings of Mead contain occasional 
reminiscences of cases but no real notes of them, and 
it is, I think, obvious from the character of his 
Medical Precepts and Cautions that he made very few 



STUDY OF CLINICAL MEDICINE 125 

clinical notes. Sir John Floyer's book, The 
Physician's Pulse-Watch^ published in 1707, tended 
to make physicians count the pulse, a proceeding 
not only useful in itself but tending to encourage 
observation of the patient. Clinical observation was 
firmly established in England at the beginning of the 
eighteenth century as essential in the practice of medi- 
cine, and physicians became more and more addicted 
to it. Its perfection in precision before the develop- 
ment of special methods of physical observation 
is reached in the Commentarii de Morborum Historia 
et Curatione of Dr. William Heberden, published in 
1802, the last important medical treatise in England 
which appeared in Latin. Dr. Heberden lectured at 
Cambridge on medicine, where he was a Fellow of 
St. John's College, before he settled in London. It is 
worth while to consider the reading which Heberden 
thought useful in the study of medicine before pro- 
ceeding to consider his method of observation and the 
effect of his work. Some manuscript notes of his 
lectures made by Dr. Erasmus Darwin,^ who attended 
them in 1752, show what books he had used, while 
his Commentaries demonstrate the accuracy with 
which he pursued clinical medicine. He had a 
systematic method of recording and using his clinical 
observations. His custom was to make notes, as far as 
circumstances allowed, in the sick room both of what 
he saw and what he was told. He read through these 
notes every month, and wrote into a sort of medical 
commonplace book under the heads of diseases 
^ Lent to me by Dr. Francis Darwin. 



126 LECTURE IV 

whatever seemed to him worth preserving. From 
the notes contained in this book, when he was 
seventy-two years of age, he wrote his single volume 
of commentaries on the history and cure of diseases. 
He entrusted the manuscript to his second son, and 
desired that it should not be published during his 
lifetime. He died when more than ninety years 
old, in 1801, and the book was then published by 
this son, himself a physician of repute. Nearly the 
whole of this remarkable book is of permanent 
value, so closely has Heberden recorded the sum 
of many precise clinical observations. Increased 
observations have no doubt added much to the know- 
ledge of the diseases he has described, but in very 
few instances has it depreciated the value of his 
statements. The book is so simple in style that 
it is only after it has been read several times that 
its originality is fully perceived. Heberden owes 
nothing to any other writer. He does not attempt 
such wide generalizations as Sydenham, and his sole 
object seems to have been to make the experience 
of his long life as useful as possible to future 
physicians. Except that the pulse was counted the 
method of examining a patient in the time of 
Heberden scarcely differed from that of Galen in 
the reign of Marcus Aurelius Antoninus. Ausculta- 
tion, the ophthalmoscope, the laryngoscope, elec- 
trical and other methods of examination of the 
nervous system, the minute examination of the blood 
— all these additions to the fullness of observation, 
besides the results which they yield, have also tended 



I 



STUDY OF CLINICAL MEDICINE 127 

to make general clinical examination more thorough 
because they detain the observer near the patient. 

As the practice of precise observation has become 
general the importance of the regular keeping of 
notes of patients in hospitals has been recognized. 
Dr. A. J. G. Marcet, an exact writer, in his Essay 
on the Chemical History and Medical Treatment of 
Calculous Disorders, published in 1817, mentions 
that no great London hospital then kept any regular 
record of cases. Such records are now, I believe, 
carefully kept in nearly all the hospitals of London. 
Sydenham, who had studied the works of Ray, felt 
the charm of the precision to which botanists 
attained in their descriptions and classification — 
even in the state of botany before Linnaeus — and 
longed for a similar exact definition in medicine. 
In the preface of his Ohservationes Medicae there are 
several passages which show how much he had con- 
templated the methods of botany with a view to 
applying them to medicine. * First of all,' he says, 
* it is desirable that aU diseases should be reduced 
to certain and well-defined species with the same 
diligence and exactness we see used by botanists in 
their plant books.' It is clear that botany had an 
influence upon this most famous of English medical 
observers, and that its study stimulated him to be 
laborious and exact in his observations of disease. 

The study of natural history and the devotion 
of some excellent physicians to one or other 
branch of it had much effect in improving the 
general observation of diseases. The minute annota- 



128 LECTURE IV 

tion of the growth and structure of plants and of 
the life of animals cultivated in the observer a habit 
which caused him to study the effects and progress 
and treatment of disease according to the methods 
of natural history. The influence of botanical and 
zoological studies confirmed and enlarged the 
method of clinical note-taking already established, 
and thus most observers became more precise and 
mor^ observers were to be found. Dr. James 
Douglas is a good example of this relation of the 
study of natural science to that of medicine. He was 
the first to demonstrate exactly the relations of the 
peritoneum to the viscera, and wrote several excellent 
papers of observations in morbid anatomy. He pub- 
lished a folio volume on Lilium Sarniense in 1725 
and another folio on the coffee plant ^ in 1727, besides 
papers in the Philosophical Transactions on the 
flower of Crocus autumnalis and other botanical 
subjects. His Myographiae Comparatae Specimen, 
printed in 1707, shows an extensive knowledge of 
comparative anatomy, and his BiUiographiae Anatomi- 
cae Specimen ^ gives a concise and accurate account of 
all anatomical writers from Hippocrates to Harvey. 
He cared also for literature, and published in 1739 
a text of the first ode of Horace and a catalogue of 
all the editions of the poet which were in his library, 
a long series even from the editio princeps of 1476 to 
the year 1739, for that learned historian, Mr. Eichard 
Copley Christie, who also had a collection of copies 

* Arbor Yemensis Fmctum Cofe Ferens. London, 1727. 
^ London, 1715. 



STUDY OF CLINICAL MEDICINE 129 

of Horace, used to say that the printed editions 
were sufficient in number to provide one for each 
year from the Augustan age to our own time. 

Douglas became a Fellow of our College in 1721, 
and his discoveries, extensive learning, and indus- 
trious life deserve to be better remembered than 
they are. Even a man so learned in his own depart- 
ment of practice as the late Dr. Matthews Duncan 
did not know after whom the fold of Douglas was 
named. Douglas used sometimes to go round the 
wards of St. Bartholomew's Hospital, and there 
made an observation which, pursued a little further, 
would have placed him among the great discoverers 
in clinical medicine. He published his observation 
in the Philosophical Transactions for 1715. The 
case was one of hypertrophy of the heart with 
adherent pericardium, mitral and aortic valvular 
disease. * I lately opened,' he says, * a young 
man in St. Bartholomew's Hospital that died of 
the palpitation of the heart, whose violent beating 
and prodigious subsultory motion for some months 
before his death was not only easily felt by laying 
the hand on the region of the heart, but seen 
to rise and fall by raising the bedclothes that 
covered it, and which is almost incredible, some- 
times the trembling and throbbing made such a 
noise in his breast as plainly could be heard at some 
distance from his bedside.' Douglas then describes 
the adherent pericardium and the disease of the 
mitral and of the aortic valves. The loud noise was 
probably that rare physical sign of which I have 

MOOKB K 



180 LECTURE IV 

met with a few examples ^ in the wards and out- 
patients' room at St. Bartholomew's, a systolic 
murmur of aortic obstruction loud enough to be 
heard without touching the patient or even stooping 
over him. How near did Douglas come to the dis- 
covery of the cause of cardiac murmurs. 

Dr. Edward Tyson, who was elected a Fellow 
in 1683 and whose portrait hangs in our hall, 
was the first man in England who wrote mono- 
graphs on the structure of particular animals. He 
described from his own dissections the anatomy of 
the chimpanzee, the musk hog, the porpoise, the 
Virginian opossum, the rattlesnake, the embryo 
shark, the lump fish, the tapeworm, and the round 
worm. Tyson's medical writings, which are to be 
found in the Acta Medica of Thomas Bartholinus 
and in the Philosophical Transactions^ are accurate 
accounts of remarkable cases, two of them of ill- 
nesses in dogs. A case of a plasterer who died 
from changes in his lungs due to inhaling some nails 
which he was holding in his mouth ^ is also recorded 
by Morton. 3 They saw the case together, and it is 
interesting to discover that while Tyson's note was 
clearly written down at the time, Morton's has some 
of the dimness of a recollection as distinct from an 
immediate record. 

Sir Hans Sloane, President of this College from 

^ St. Bartholomew'' s Hospital Reports, vol. xxvi. 
^ Tyson in Acta Medica et Fhilosqphica Hafniensia Bartholini, 
V. 91, Hafniae, 1680. 

^ Opera Medica, Phthisiologia, p. 105, Geneva, 1696. 



STUDY OF CLINICAL MEDICINE 131 

1719 to 1735 and of the Eoyal Society from 1727 to 
1741, was an excellent naturalist, and is the founder 
of the great national collections known as the 
British Museum. He was born at Killileagh, in 
Ulster, in 1660, studied medicine at Paris and 
Montpelier, and graduated M.D. in the University 
of Orange in 1683. After his return he lived for a 
time with Sydenham. In early life he had enjoyed 
the study of plants, and his reading had made 
him long to see the plants and animals of the 
West Indies. This inclination remained after he 
had begun practice in London and become a Fellow 
of the College of Physicians and of the Eoyal 
Society. The opportunity of gratifying his wish 
came in 1687, when he was offered the appointment 
of physician to the Duke of Albemarle, then going 
out as supreme commander in Jamaica. Sloane 
perhaps hesitated for a moment as to whether it 
was right to interrupt his practice as a physician 
in London, but, remembering that the ancient 
physicians travelled to the regions whence came 
particular drugs, satisfied himself that it might be 
useful as well as pleasant to visit the West Indies, 
and accepted the appointment. He stayed in the 
West Indies for fifteen months and made many 
observations in natural history and a collection of 
eight hundred species of plants. He studied the 
zoology as well as the botany of Jamaica, dried 
plants, and employed an artist to make drawings of 
birds and plants. Sloane showed some of his plants 
to his fellow-countryman, Sir Arthur Kawdon, of 

k2 



182 LECTURE IV 

Moira, in the county Down, who sent a gardener to 
collect examples in the West Indies, and afterwards 
gave Sloane several further species, so that in 1696 
he was able to publish a catalogue of the plants 
of Jamaica, in which each plant is described, its 
locality mentioned, and many references given to 
the writings of botanists. The book is dedicated 
to the Koyal Society and to this College, and 
received the imprimatur of our President, Dr. 
Samuel Collins, and the Censors. Sloane, on his 
return, became involved in a great professional 
practice and in various official duties, and thus the 
publication of the large book which he had planned 
on the Natural History of Jamaica was long delayed. 
His West Indian collections and journals were the 
materials and he consulted Eay as to its best 
arrangement. The first folio volume appeared in 
1707, and the second in 1725, of A Voyage to the 
Islands of Madeira, Barbados, Nieves, St. Christopher, 
and Jamaica, with the Natural History of the last of 
those Islands, It is a work full of original observation 
on men, animals, and plants, and even the music of the 
African inhabitants is noted. He records many cases 
of various diseases from notes made at the time, which 
show that he was as a medical observer worthy of the 
friendship which he had enjoyed with Sydenham. 

The collections of Sloane were not only of objects 
of natural history. Besides antiquities, medals, 
coins, crystals, vessels of agate, cameos, seals, and 
gems, his bequest from which the British Museum 
was formed included more than 40,000 volumes 



I 



STUDY OF CLINICAL MEDICINE 133 

printed or in manuscript. A complete Index ^ to 

the manuscripts was only finished in 1904. As 

regards medicine the collection contains vast 

materials for the history of English medicine. 

Here are the holograph volumes of Harvey's Frae- 

lectiones Anatomicae of 1616 and of his scarcely less 

interesting De Musculis of 1627. The manuscripts 

of Mayerne I have described in my first lecture. 

Twelve closely written volumes of lectures, notes, 

and philosophical and medical collectanea, mostly 

if not entirely in the small and rather difficult 

handwriting of Glisson, are there, and so are the 

commonplace books of Sir Thomas Browne, as well 

as his Miscellanies, Observations on Plants, and other 

papers in his own hand ; and the medical notebooks 

and many other notes of his son, Dr. Edward 

Browne. There are letters of nearly all the famous 

physicians of England of the seventeenth century 

and of the eighteenth century up to the time of 

Sloane. There is the little filled notebook of 

Dr. Nathaniel Hodges, the recollection of whose 

death in a debtors' prison after his heroic conduct 

during the plague of 1666 brought tears to the eyes 

^ Index to the Sloane manuscripts in the British Museum by- 
Edward J. L. Scott, M.A., D.Litt., London, 1904. The collec- 
tion includes more than 3,700 manuscripts, and to have brought 
so complex a work to a conclusion within a reasonable time is 
a public service of great importance, useful to students of many 
kinds. If the authorities of the Museum should hereafter see 
fit to issue a descriptive catalogue of the MSS. on Medicine, as 
full as Dr. S. H. O'Grady's catalogue of the Irish MSS., 
it would be a work of great advantage to the study of the 
history of medicine in England. 



134 LECTURE IV 

of Dr. Johnson, and there is the manuscript book 
which Francis Bernard, who also scorned to flee 
from the plague, used to take round the wards of 
St. Bartholomew's. There is the original manu- 
script of the Latin poems of Raphael Thorius, who 
died from the plague in 1622, and of the Anatomia 
Bestaurata of Highmore of the Antrum. There are 
many notes of cases sent up for the opinions of 
physicians and some accounts of post-mortem 
examinations. There are letters to Sloane himself 
from physicians and surgeons and apothecaries and 
patients, from men of science, from great men 
in the State and in the world of letters, and from 
people in need of help, such as Mr. Samuel Boyce, 
a distressed poet, who writes : *You were pleased 
to give my wife the enclosed shilling last night. 
I doubt not but you thought it a good one, but as it 
happened otherwise you will forgive the trouble 
occasioned by the mistake ! ^ ' This collection of 
manuscripts is a rich mine of medical and hterary 
information. Tyson and Douglas and Sloane were 
physicians whose cultivation of natural history 
undoubtedly had a general effect in improving by 
example in observation the study of clinical medicine 
in England. The repeated observations and the 
careful note-taking of naturalists were seen to be 
essential for the acquirement and for the increase 
of knowledge in medicine. 

Sir Thomas Molyneux, a physician, who occupied 
in Ireland a position in the world of medicine 
' Sloane MS. 4056. 



STUDY OF CLINICAL MEDICINE 135 

resembling that of Sir Hans Sloane in England, 
was, like him, an ardent student of natural history. 
Molyneux was the great grandson of another Sir 
Thomas Molyneux, a subject of Queen Mary Tudor, 
who left his home in Calais when the town was 
taken from the English by the Duke of Guise in 
1558, and afterwards settled in Ireland, where in 
1590 he became Chancellor of the Exchequer. The 
physician was born in Dublin in 1661 and graduated 
there at Trinity College, to the foundation of which 
his ancestor was one of the contributors. In 1683, 
when a Bachelor of Physic, he went to Leyden to 
continue his medical studies, and his letters ^ give 
an interesting account of his adventures by the way 
and of his stay in Holland. He stayed in London 
and its neighbourhood from May 12 to July 20 and 
fell into excellent company while there. The first 
man of science he saw was Nehemiah Grew, the 
botanist, a Fellow of this College, and the earliest 
great discoverer in vegetable physiology, who gave 
him much useful information about Holland. He 
next visited the Duke of Ormond, who had obtained 
its first charter for the Irish College of Physicians in 
1667, and there met Thomas Burnet the geologist, 
who was tutor to Ormond's grandson. He went to 
the house of Eobert Boyle and there met Sir William 
Petty, the first English political economist, a Fellow 

^ Dublin University Magamne, vol. xviii, I have to thank 
Mr. F. W. Stronge for information about the original manu- 
script of the diary of Sir Thomas Molyneux, which is in the 
possession of a member of his family. 



136 LECTURE IV 

of our College. He saw Newton and Tyson and 
Evelyn at a meeting of the Koyal Society, and came 
to know Flamsteed the astronomer. He also met 
Dr. Edward Browne, who told him that Sir Thomas 
Browne's Be Flantis Sacrae Scripturae was about to 
be published. Having enjoyed the acquaintance of 
these heads of the world of science he was in June 
no less fortunate in the world of letters, for he met 
Dryden, then its acknowledged head. He does not 
say where this took place, but it was very likely at 
the house of Ormond, who delighted in Dryden's 
society. Molyneux visited Cambridge and seems 
to have gone into every college, to have looked at 
Oliver Cromwell's rooms at Sidney, to have seen 
Henry More the Platonist at Christ's, to have noted 
the growth of saffron in the district, and the fact 
that grey-backed crows, common in Ireland but rare 
in England, were to be seen in Cambridgeshire. He 
afterwards went to Oxford where he found the 
professor of physic lecturing on the first Aphorism 
of Hippocrates and on the shortness of man's life 
since the Flood and its length before. After ten 
weeks thus happily spent he reached Holland, and 
soon after settled down to work at the University 
of Leyden. A few months later he met Locke 
there and they became friends and correspondents, 
and the friendship of Locke afterwards extended to 
William Molyneux, his brother, and it was at this 
brother's instance that Locke printed his treatise 
On Education. Thomas Molyneux returned to Dublin 
in 1687 and took his M.D. degree. When the Irish 



STUDY OF CLINICAL MEDICINE 137 

College of Physicians was reconstituted in December, 
1692, he was named as one of the Fellows in the 
charter. He rapidly attained considerable practice 
and became President of the King's and Queen's 
College of Physicians in 1702. He published in 
the Philosophical Transactions an account of the 
anatomy of the sea mouse, the iridescent hairs of 
which he noticed on opening the stomach of a 
cod-fish. His also was the first accurate descrip- 
tion of the skeleton of the Irish elk in A Dis- 
course concerning the Large Horns frequently found 
Underground in Ireland. He published notes on 
the Giant's Causeway which are remarkable for 
their demonstration of the then new notion that 
it was a work of nature and not of man, and a 
paper in the form of a letter^ to the Bishop of 
Clogher on certain swarms of scarabaeus arhoreus 
which appeared in the West of Ireland in 1688 and 
continued till 1697. His medical writings are 
observations on conditions of his own time, on an 
epidemic of coughs and colds, ^ and on an epidemic 
of eye disease.^ He died in 1733, and there is a 
fine statue of him by Koubiliac near his tomb at 
Armagh. He was the first great physician in 
Ireland, and in his excellence both in medicine and 
natural science and in the obvious effect of his 

^ Published in A Natural History of Ireland, by Several 
Hands. Dublin, 1726. 

"^ On the Late Coughs and Colds : Philosophical Transactions, 
1694. 

^ Notes on an Epidemic of Eye Disease which occurred at 
Castletown, Delvin, Co. Westmeath, 1701. 



138 LECTURE IV 

natural history studies upon his medical work 
resembled Sir Hans Sloane. The venerable hill 
on which is the last resting-place of Molyneux is 
a short day's journey from the birthplace of Sloane. 

Dr. John Stearne, who became a senior Fellow 
of Trinity College the year before Molyneux was 
born, was one of the fourteen original Fellows of 
the Irish College of Physicians, was the chief 
physician in Ireland at the period of the Restoration, 
and a man of great learning, but no medical writings 
of his have been preserved. 

Dr. Richard Helsham, Regius Professor of Physic 
in the University of Dublin in 1733, an intimate 
friend of Swift, is addressed by Arbuthnot in a way 
which shows that he must have been a physician of 
the same kind as Arbuthnot himself, but he also 
has left no medical writings from which his attain- 
ments in clinical medicine might be estimated. It 
is indeed difficult to collect much evidence of the 
regular study of clinical medicine in Ireland at any 
period before the influence of the Edinburgh school 
began to be felt there. 

The object of my lectures has been to make clear 
the growth of clinical study in the British Islands 
from its commencement to the time when it was 
fully established as an essential part of the work of 
all who pursue any part of medicine : yet, having 
described the attainments of Molyneux, who is 
certainly the first great figure in medicine in 
Ireland, I will venture to pause in the pursuit of 
the particular subject of my lectures to consider 



STUDY OF CLINICAL MEDICINE 139 

what was the earlier state of medical learning there. 
The history of learning in Ireland, including our 
branch of it, is naturally divided into two parts. One 
part is mediaeval and all its literature is in Irish or 
in Latin ; the other part is modern and, except a 
few Latin books, is wholly in English. The books 
of the modern period form a valuable part of English 
literature and English science. The mediaeval 
literature may be said to have begun with the 
introduction of writing into Ireland from Italy in 
the fifth century and to have lasted as long as Irish 
books continued to be produced and to circulate in 
manuscript only — a condition which lasted till about 
the end of the first half of the nineteenth century. 
This literature was in a language which, though it 
underwent progressive changes, was never, like 
Anglo-Saxon, permeated by other tongues so as to 
lose its identity. A large part of its vocabulary, 
its syntax, and many of its grammatical forms 
remained unchanged. The Irish never became a 
printed literature, and circulated or was preserved 
in libraries in manuscripts of varying kinds, some 
large bibliothecae, containing many varieties of com- 
position, others containing particular treatises only. 
It thus presents us at the present day with a specimen 
of a literature unaffected by the printing press, and 
enables the student to observe all the peculiarities 
and incidents of literature before the invention of 
printing. 

The earliest mention of our profession in this 
interesting literature is perhaps a gloss in a 



140 LECTURE IV 

manuscript now in the library of Karlsruhe, of 
Bede's treatise, De Batione Temporum, which belongs 
to the end of the eighth or beginning of the ninth 
century. On folio 35a of this venerable manuscript 
the word ^ archiater ' is glossed by the Irish word 
huasallieig — that is, Jiuasal noble, and lieig physician. 
Both words are found throughout literature during 
the thousand years which have elapsed since some 
Irishman in the monastery of Eeichenau wrote these 
glosses. Diancecht, a hero who appears in ancient 
stories and poems, is described as a physician. In 
the Dinmhenchm,^ or Hill Lore, a composition in 
prose and verse of which a twelfth century MS. 
is extant, 2 his name occurs, as also in the Coir 
Anmann, * Fitness of Names.' ^ * Diancecht i. ainm 
suithe leigis Eirenn ' — Diancecht, that is the name 
of the learned man of physic of Ireland. In the 
laws with commentaries, known as the ^Senchus 
Mor ', a physician and medical treatment are men- 
tioned in the part which treats of distress. The 
levy of distress was the remedy for a great variety 
of wrongs. The person who had been wronged and 
desired to obtain justice came to the residence of 
the wrongdoer and sat fasting by his door. This 
was a sort of notice, and if no food was offered and 
the fasting terminated at its due period the distress 
claimed became greater. If the wrongdoer gave 
security, then the cause was in time tried by a judge. 

' S. H. O'Grady, Silva Gadelica, London, 1892, ii. 525. 
* Book of Leinster. 

^ Whitley Stokes in Irische Texte mit Ubersetzimgen tmd 
Worterbuch, Dritte Serie, 2. Heft, Leipzig, 1897. 



STUDY OF CLINICAL MEDICINE 141 

Five days' notice with one day's fasting was to be 
given in a variety of cases which are enumerated, 
amongst them * for providing him (the sick man) a 
physician ' ^ and * for guarding against the things 
prohibited by the physician '. The guarding against 
things prohibited by the physician shows a respect 
to his opinion. It is further dwelt upon in a later 
part of the commentary. * For guarding against the 
things prohibited by the physician, i. e. that the 
sick man may not be injured, i.e. by women or 
dogs, i. e. that fools or female scolds be not let into 
the house to him, i. e. or that he may not be 
injured by forbidden food.' ^ The physician was to 
give notice that this care should be taken. * If 
the physician has given notice,' says the com- 
mentary, *he is safe. If he has not given notice 
he is subject to fine, i. e. he is fined a young heifer, 
and this is divided in two between the aggressor 
(disturber) and the wounded man. If notice has 
been given by the physician then the aggressor pays 
the heifer to the wounded man, and the physician 
for his skill receives one-third of the fine.' In a 
summary of the occasions of exemption from 
distress occurs * a man going to obtain a physician 
for a person on the point of death '.^ In another 

^ Hi tairec a lega, Ancient Laws of Ireland, Senchus Mor, 
vol. i, p. 122, line 16 ; and Im dingbail aurcuilte a reir lega, 
line 18. Dublin, 1865. 

^ Ancient Laws of Ireland, Senchus Mor, vol. i, translation, 
p. 131. 

^ Dlomtar turbuid — no lega do neoch biss fri bas, Ancient 
Laws, Senchus Mor, vol. i, 266, and Harley MS. 432. 



142 LECTURE IV 

passage in the Senchus Mor, under the heading 
' What is the distress of each sort of men of art ', 
there is the statement, * The distraint of a physician, 
let his horsewhip or his wand be taken. If he has 
not a complete equipment let a thread be tied about 
the finger next his little finger.' ^ The object of the 
peculiar distraint was probably to shame the phy- 
sician into the discharge of what was claimed from 
him. 2 There are some clauses difficult from their 
brevity which apply to what we should call actions 
for malpraxis. An impartial physician is to say 
whether the bleeding was rightly used and the 
practice good or bad.^ 

In the Irish Chronicles physicians are mentioned 
from time to time, and many passages make it clear 
that, like law and literature, medicine was hereditary 
in particular families. There were many families 
who possessed lands in right of their profession. 
Some were hereditary keepers of a shrine, of a saint's 
bell, or of an ancient book. Of such a kind were 
the O'Breslans, who long kept in Donegal the bell 
of St. Connla Cael, now in the British Museum. 
Others were hereditary judges, such as the 
MacAedhagains, of whom, from the thirteenth 
century to the sixteenth, twenty-seven judges or 
legal authorities are mentioned in the chronicles. 
Others were hereditary chroniclers, poets, or public 

^ Caidi aithgabail each aes dana, S.M., ii. 118. 
' Aithgabail lega : togthar an echlaisc ocus a fraig. Senchus 
Mor, ii. 118. 
^ Ancient Laws of Ireland, Book of Aicill. 



Plate VIII. 




nr 






tU-U^V' 4T).lLtri4iat oy4rTX>7W- ^^rSl^.^he- jfjv 43i mitt^ -o^uH^ 














Treatise on Materia Medica. 
Translated into Irish and written by Cormac MacDuinntsIeibhe, a.d. 1459. 

To face page 143. 



STUDY OF CLINICAL MEDICINE 143 

orators, such as the Maic Conmidhe, whose first 
works occur in the middle of the thirteenth century 
and whose last representatives still lived near their 
ancient inheritance at the beginning of the nine- 
teenth century ; or the famous race of O'Dalaigh, of 
whom more than eighty are said to have been 
known as poets. 

These legal, historical, or medical families appear 
in the chronicles about the beginning of the thir- 
teenth century, and many of them still held their 
lands in the sixteenth century, and some of their 
later descendants were to be found in their original 
districts in the nineteenth century, though both 
they and their patrons, the more powerful chiefs, 
had long been dispossessed. In the province of 
Ulster the family of MacDuinntsleibhe were here- 
ditary physicians. They were attached to the 
family of O'Donnell and held lands in Kilmacrenan, 
the original territory of the Cinel Luidhech, or 
O'Donnells, who gradually conquered nearly the 
whole of Donegal. The MacDuinntsleibhes had 
been driven out of Down by John de Courcy, the 
Norman, and settled in the west of Ulster. Muiris, 
who died in 1395, Donnchadh, who died in 1527, 
and Eoghan his son, who died in 1586, are other 
members of this medical clan whose names have been 
preserved.^ One of the family translated Gualterus 
on the doses of decoctions into Irish, and his manu- 
script is in the British Museum (Harley, 546). On 

^ O'Donovan, Annals of the Four Masters, iv. 742, v. 1389, 
V. 1856. 



144 LECTURE IV 

fol. 11a is the author's own note of his work. * Here 
ends Gualterus' book of the doses of medicines. 
Cormac MacDuinntsleibhe has put this summary 
into Irish for Dermot MacDonall O'Line and to 
him and his sons may so profitable a commentary 
render good service. On the fourth day of the 
kalends of April this lecture was finished at Cloyne 
in the year 1459.' Other members of the family 
seem to have followed literature, for Maurice Ulltach, 
who attested the authenticity of the chronicles used 
by Michael O'Clery and his colleagues in the com- 
pilation of their great book of annals, and Chris- 
topher Ulltach, guardian of the Franciscan convent 
of Donegal in 1636, were of the same race. Ulltach 
means an Ulsterman, and was used for the 
MaicDuinntsleibhe because they had been chiefs of 
Down, the southern half of the region called Ulidia 
by Irish Latin writers, into which the most ancient 
kings of Ulster had been driven, and which their 
descendants ruled till turned out by the Normans. 
The family were dispossessed in Donegal at the 
plantation of Ulster in the reign of James I. In 1745, 
one of them pubHshed in Paris a long Catechism in 
Irish of some literary merit. Some of the race still 
lived in my boyhood as tenants on the lands which 
they anciently owned in Kilmacrenan. Part of 
another manuscript (Arundel 333) shows that Cormac 
had taken a degree, probably in some university 
of France. It contains the note : * Here ends this 
summary and treatise upon the organs of animals 
from Isaac ^^ In dietis particularibus ". Cormac 



PtAlE IX. 









*^*!wl« m^ ijT^i **f-^ ^ . « 




«'5n4T*-«^,^j^:; 







7^>^>7<I;K1^>' 



MaXUSCRIPT WRiriEN BY CoRMAC MacDi'INXTSI.EIRHE. 

Chapter on Gout. 



To face page 144. 



Plate X. 



Pi' 









-s-iiCBjfe^j'^ 4ft, *-5r-»,_, <;< r-.^ 



Manuscrii't written by Cormac MacDuinxtsleibhe. 
Chapter on Epilepsy. 



To face page 145. 



STUDY OF CLINICAL MEDICINE 145 

MacDuinntsleibhe, bachelor of physic, it is that has 
put it into Irish and written it for Denis O'Eachoid- 
hern in this document. And let each one whom it 
shall profit pray for those two/ Cormac also wrote 
in the same bibliotheca two Aristotelian disquisitions 
and a small section on plants, and a short treatise on 
the virtues of gems, a subject often discussed in the 
medical books of the Middle Ages. 

Nial O'Glacan, a physician who became professor 
of medicine in the University of Toulouse in the 
reign of Charles I, was born in Donegal, and from 
a remark in his Tractatus de Peste, published at 
Toulouse in 1629, it may be inferred that he 
received a medical education from one of the 
families of hereditary physicians and perhaps from 
the MaicDuinntsleibhe. He was appointed physician 
to the King of France, and in 1646 migrated to 
Bologna, where in 1655 he published a Cursus 
medicuSj including six books on physiology, three 
on pathology, and four entitled Semeiotica. It is 
a mediaeval work, without any reports of cases or 
modern ideas. 

The UiCallanains were the hereditary physicians 
of MacCarthy riabhach, one of the great chiefs of 
the south of Munster. Aonghus O'Callanain and 
Nicholas O'Hicidhe wrote in 1403 a version with 
commentary of the Aphorisms of Hippocrates, of 
which a small fragment is preserved. Dr. Standish 
Hayes O'Grady, in his catalogue of the Irish 
manuscripts in the British Museum, has sug- 
gested that this physician was probably the man 



146 LECTURE IV 

in whose beautiful handwriting is written a treatise 
entitled, * Suidigud tellaigh Temrach/ the arrange- 
ment of the hearth of Tara, which occurs in the 
noble manuscript called the Book of Lismore, from 
its having been found in the castle of Lismore. 
The colophon of the treatise is : 'Angus O'Callan- 
ain has written this for MacCarthy, that is Finghin, 
son of Dermot, and a blessing go with it to him.' ^ 
The UiHicidhe or O'Hickeys, of which family this 
Nicholas was one^ were hereditary physicians of the 
Dal Cais, the group of allied clans who owned the 
northern part of Munster, long known as Thomond, 
and now as the county Clare. In the British 
Museum ^ there is a fine vellum manuscript which 
belonged to a member of this family. The manu- 
script contains a record of the date at which it was 
written. 3 * The year of the Lord when this book 
was written 1482, and that was the year when 
Philip son of Thomas Barry slew Philip son of 
Kichard Barry.' And another note shows that it 
was still in the possession of its original scribe in 
1489.* ^ I grieve for this news I hear now : that 
my mother and my sister are dead in Spain. 
A.D. 1489.' A third note^ records its sale to 
Gerald Earl of Kildare, Lord Justice of Ireland 
from 1478 to 1513. ' A prayer for Gerald the Earl, 
Justice of Ireland, that bought this book for twenty 

^ ' Aonghus o Callanain do scribh so do Mag Carthaigh .i. 
Finghin mac Diarmada ocus bennacht leis do.' S. H. O'Grady's 
Catalogue of Irish MSS. in British Museum, p. 222. 

"" Egerton 89. ^ ^ 92, 4 y. 95. ° R 192 b. 



STUDY OF CLINICAL MEDICINE 147 

cattle. Two and twenty folded skins are in this 
book. The rent of East Munster six score kine 
just come in to the Earl on the day when this com- 
putation was written. Thomas O'Mailconaire levied 
that rent for the earl. This year in which I am is 
the year of grace one thousand and five hundred 
years, the age of the Heavenly Lord at this time — 
all which above stated is true.' In the fifteenth 
century money was hardly in use in Ireland outside 
the seaboard towns, and this earl, the greatest man 
of the Norman Irish, paid in cattle for this fine 
manuscript. It is a translation of the Lilium 
Medicinae of Bernard de Gordon, a writer of the 
early part of the fourteenth century and of the 
school of Montpelier, who was widely read, and whose 
works have been translated into several European 
languages. Thomas O'Hicidhe wrote a treatise on 
the Calendar ^ in 1589. I saw in Belfast many years 
ago a fine early fifteenth-century manuscript on 
medicine in the hand of one of the O'Hickeys.^ 

Some manuscripts of the family of O'Liaigh, 
another race of hereditary physicians in Thomond, 
are preserved, and are, as I am told by Mr. S. H. 
O'Grady who has examined them, of the same kind 
as those of Cormac MacDuinntsleibhe. 

The Ui Caiside were a medical clan and were 
the hereditary physicians of MacUidhir. Finghin 
O'Caiside, who died in 1322 ; Gilla na naingel, who 

^ British Museum : Cotton MS. Appendix LI. 
^ It then belonged to Mr. Kobert Macadam, and afterwards 
became the property of Bishop Keeves, 

l2 



148 LECTURE IV 

died in 1335 ; Tadhg, who died in 1450 ; Feoiris, who 
died in 1504 ; and Feidhlimidh, who died in 1520, 
are mentioned in the annals of Ireland as professors 
of medicine (ollam leighis). All these hereditary 
2)hysicians read some books of the school of Saler- 
num, the Arabian physicians, and Bernard de Gor- 
don. I have not met with any fragment of Mirfeld 
in those of their manuscripts which I have examined, 
but John of Gaddesden was known to them. 

The hereditary physicians of Ireland had brethren 
in Scotland.^ In early times all the literary associa- 
tions of Alba, as Scotland is still called by her Celtic 
inhabitants and neighbours, were with Ireland, and 
the name Scotland is itself a proof that the language, 
customs, and social institutions of the country 
appeared to its neighbours to be identical with those 
of the inhabitants of Ireland, the Scoti. Most of 
the families who could trace their ancestry far into 
the past, traced it to some branch of the half-historic, 
half-mythological family tree of the Irish, the clan 
of Miledh, the descendant of Gaedhel Glas. Temhair, 
now called Tara, was for them the greatest seat of 
royal splendour, where King Cormac mac Airt had 
ruled, surrounded by the most redoubted champions, 
and with vast herds of cattle grazing on fertile 
plains as far as the eye could reach. The prose and 
the verse of the Dinnshenchus and the Agallamh 

* And no doubt in Wales, as shown in 2'he Physicians of 
Myddvai, translated by John Pughe, F.K.C.S., and edited by 
the Rev. John Williams ap Ithel. Welsh MSS. Society, 
Llandovery, 1861. 



STUDY OF CLINICAL MEDICINE 149 

na Sen6rach, which, under the guise of a narrative 
of fact, clothed so many mountains, plains, rivers 
and lakes with romance, were known to them, and 
they had heard the solemn but often obscure and 
involved verses of the Amhra in which Dalian 
Forgaill had celebrated Columba. The kings of 
Scotland, though they came to be by descent, resi- 
dence, and language associated with the southern 
part of their subjects, yet Hked to preserve the 
tradition of connexion with the remote generations 
of the race of Gaedhel Glas. At the Scottish 
coronation of Charles I it is said, but on what 
authority I do not know ^, that some part of the 
ancient Gaelic phrases of installation were used for 
the last time. 

When James I came to England he brought with 
him a physician who seems likely to have belonged 
to a famous clan of hereditary physicians in the 
Highlands, Dr. David Betthun. On August 20, 
1624:, May erne ^ drew up a long paper on the use of 
remedies for the treatment of King James and of 
Charles, then Prince of Wales, and this is addressed 
by him as Eegis Medicus Primarius to the other five 
royal physicians. Dr. Henry Atkins, Dr. J. Chambers, 
Dr. Jo. Craig, Dr. Matthew Lister, and Dr. David 
Betthun. Dr. Betthun had taken a degree at Padua. 
The transition from acquiring knowledge as a 

* Related to me as a Highland tradition by Field-Marshal 
Sir Patrick Grant, who was well acquainted with the language 
and whose memory was full of old stories and verses. 

2 Opera, p. 288. 



150 LECTURE IV 

member of a family in which some branch of 
learning was hereditary to its acquirement in a 
college or university is to be observed here and 
there. Thus Tadhg an tsleibhe, one of the here- 
ditary historians of Tirconnell, having become 
a Franciscan of the convent of Donegal, collected 
the Irish Chronicles as a regular historian with 
other hereditary historians into the great book com- 
monly known as the Annals of the Four Masters, 
and Cormac MacDuinntsleibhe, of the hereditary 
physicians of Kilmacrenan, at the end of the fif- 
teenth century had taken the degree of Bachelor 
of Physic,^ probably in some French University. 
David Betthun, if my surmise about him be correct, 
in addition to the medicine which he inherited 
from the Isles, where his family were hereditary 
physicians, had graduated at Padua. David became 
a Fellow of our College, and may be regarded as 
the sole connecting link between the mediaeval 
hereditary physicians of Eire and Alba and the 
medicine of the Eenaissance. 

A manuscript now in the British Museum ^ be- 
longed in the sixteenth century to John MacBetha, or 

^ Arundel 333, in British Museum, f. 113 b: 'Tairnic an 
sin suim ocus trachtad ball nainminntedh o ysac in dietis par- 
ticularibus ocus cormac mac duinnleibe basiller a fisigecht do 
cuir a ngaigdeilg ocus do scrib do deinis o eachoidhern annsa 
cairtsi h^.* 'Here is an end of Summary and treatise on the 
organs of animals from Isaac, "In dietis particularibus.*' Cormac 
Mac Donlevy, Bachelor of Physic, put it into Irish and wrote 
it for Denis O'Eachodern in this document.' 
2 Additional MS., 15582. 



STUDY OF CLINICAL MEDICINE 151 

Beton, one of this race of physicians. It was written 
for him by two Irish scribes, Daibhi O'Cearnaigh and 
Cairbre. A note (folio 29 b) shows that its pro- 
duction was not unattended by difficulties : ^ There 
it is from me to thee oh ! John and as I think indeed 
it is not too good, and no wonder that, for I am ever 
on the move, flying before certain English up and 
down Niall's wood and in that very wood I have 
written a part of it and prepared the skin. I am 
Cairbre.' The colophon gives the date. * There is 
the end of this book for thee John Beton (MacBetha) 
by David O'Cernaigh and the three virtues and 
graces go with it to thee. And the age of the Lord 
when this book was written was one thousand five 
hundred three score and three years.' Some other 
pages of the manuscript are in the hand of a James 
Beton, and there are five memoranda in his hand on 
folio 61. In one written at Sleat in Scotland, in 
1588, he gives his genealogy for ten generations. 
Another ends : * That is enough for this day, Satur- 
day; seeing that the woman of this house is very 
ill, the daughter of MacDubhgall, son of Eanald. 
I am James Beton and great is my sadness to-day 
for as Galen says Medicus et imitator naturae the 
physician is but the imitator of Nature.' The 
manuscript begins with a piece from John of Gad- 
desden, and also contains a fragment of a mediaeval 
composition: Hippocratis Capstda ehurnea, and of 
excerpta from Gaddesden, Bernard de Gordon, and 
Platearius of Salernum. The names of Gerardus 
Cremonensis, Avicenna, Serapion, Kogerius of Parma, 



152 LECTURE IV 

Arnaldus, and Bruno occur in some other passages. 
There are also a section on Materia Medica, and one 
from Galen on the Humours, an abstract of the 
Liber urinarum Theophili and numerous shorter 
paragraphs. I published in 1874, in the St. Bar- 
tholomew's Hospital Reports, an account of this and 
of the other eight manuscripts on medicine in the 
Irish language in the British Museum, and a much 
fuller and more learned analysis of all their contents 
has since been printed by Mr. Standish Hayes 
O'Grady in his Catalogue of the Irish MSS. in the 
British Museum, a work of extraordinary learning 
which reflects the greatest credit not only on its 
writer but also upon the authorities of the Museum, 
who have seen that in so recondite a subject a de- 
scription of the manuscripts with copious extracts 
from them would be the most useful form of 
catalogue. The physicians who studied books on 
medicine in the Irish language, whether in Ireland 
or Scotland, all belonged to the same school of 
medicine as the doctor of physic in Chaucer. 
I am glad for the sake of the continuity of history 
that one of the race became a Fellow of this College. 
On the eastern and southern and the extreme 
northern bounds of this Celtic nation of Scotland, 
Teutonic and Scandinavian lords and their followers 
steadily encroached. They became the dominant 
part of the State, and their Teutonic language de- 
veloped a fine literature of its own. Their natural 
foes, from the geographical situation of their country, 
were their kinsmen the English, and they lived in a 



STUDY OF CLINICAL MEDICINE 153 

relation of social hostility and of varying degrees of 
political alliance with the inhabitants of the moun- 
tains and of the Western Isles. They looked for 
friends to France and to the Low Countries. Many 
circumstances tended to prolong this friendship 
after the conditions of its origin no longer existed. 
The medicine which made the University of Edin- 
burgh famous throughout the world was derived 
from Holland, and from Edinburgh spread its in- 
fluence not only in Scotland and Ireland but also 
in England, where clinical studies were already 
habitual among physicians. 

The systematic teaching of medicine in the Uni- 
versity of Edinburgh began at the end of the first 
quarter of the eighteenth century, and was largely 
due to the example and exertions of Alexander 
Monro, the father of the anatomist after whom the 
cerebral foramen is named. He studied under 
Boerhaave at Leyden in 1718, and lectured on 
general anatomy and physiology, comparative ana- 
tomy and surgical operations, in one comprehensive 
course lasting from October to May for thirty-nine 
years from 1725. He edited, in 1732, the first 
volume of the Medical Essays and Observations pub- 
lished by a Society in Edinburgh These essays were 
many of them dissertations on some particular sub- 
ject, yet among them are sufiicient clinical observa- 
tions to show that the publication had the effect of 
encouraging clinical observations in Scotland and 
elsewhere. Dr. John Kutherford, another pupil of 
Boerhaave, who had also received instruction from 



154 LECTURE IV 

Dr. James Douglas in London, gave in 1748 the 
first clinical lectures in Edinburgh. Eutherford's 
lectures, of which there is a manuscript volume in 
the library of the Eoyal Medical and Chirurgical 
Society, are good clinical descriptions of patients 
with comments upon their symptoms and the treat- 
ment. Similar lectures were given by his successors, 
John Gregory in 1768 and WiUiam Cullen in 1769, 
but neither of these shows the same power of direct- 
ing the attention of the student to what is to be 
seen in the patient. Robert Whytt gave clinical 
lectures at the Edinburgh Eoyal Infirmary in 1760, 
and his Observations on the Nature, Causes, and Cure 
of those Disorders which are commonly called Nervous, 
Hypochondriac, or Hysteric, which appeared in 1764, 
contains many notes of the symptoms and daily 
progress of cases of nervous disease. He also had 
studied under Boerhaave. 

The influence of Boerhaave on medical studies of 
all kinds at Edinburgh may be further understood 
from the fact that when Dr. John Fothergill, who 
took his M.D. degree in 1736, studied there, his five 
teachers — Monro, Alston, Eutherford, Sinclair, and 
Plummer — had all been pupils of that illustrious 
Dutchman. The aphorisms of Boerhaave were first 
published in 1708 at Leyden. Their point, clearness, 
and comprehensiveness show upon how much clinical 
observation they were based. Men naturally flocked 
to Leyden to receive instruction from a teacher who 
knew so much and who could impart his knowledge 
in a style so easy to comprehend. No one who 



STUDY OF CLINICAL MEDICINE 155 

went was disappointed. The aphorisms were even 
translated into Arabic, and from Constantinople to 
Dublin pupils of Boerhaave were to be found. The 
learned and instructive commentaries of Van 
Swieten prolonged the study of Boerhaave so 
that his influence as a teacher of medicine lasted for 
nearly a century. The clinical and the systematic 
medicine of Scotland were altogether derived from 
Boerhaave. Eutherford, Gregory, and CuUen spread 
his fame with their own wherever the doctors they 
had taught went to dwell. Many were carried to 
Ireland, among them a pupil of Alexander Monro, 
Dr. George Cleghorn, whose Observations on the 
Endemial Diseases of Minorca from the year 1744-49, 
shows a high degree of clinical observation. He 
lived in Minorca, then a British possession, from 
1736 to 1749. He had noted the meteorology and 
collected the plants and animals of the island, and 
had made systematic notes on the diseases of the 
natives and of the troops both as to symptoms and 
post-mortem appearances. He gives a clear account 
of cases of continued fever, of pneumonia, and of 
dysentery in men who already had tertian ague, and 
some of these seem certainly to have been examples 
of enteric fever, others perhaps of Mediterranean 
fever. The book was widely read, for four editions 
appeared in his lifetime. He went to Dublin in 1751, 
and there remained for the rest of his Hfe practising 
medicine and lecturing on general anatomy, of which 
he became professor in the university. He died in 
1789. 



156 LECTURE IV 

Cleghorn, when a student at Edinburgh, formed 
a friendship with John Fothergill which lasted 
throughout his life. Both had a taste for botany 
and both cared for clinical medicine. Fothergill, 
who took his M.D. degree at Edinburgh in 1736, is 
perhaps an example of the spread of the influence 
of Boerhaave to England. In 1748 Fothergill 
published An Account of the Sore-throat attended with 
Ulcers, The book contains some clinical observations. 
He shows that the cases of malignant sore-throat 
which he had seen were quite distinct from quinsy, 
but does not follow out the cases sufficiently in detail 
to establish their identity if they were all of the same 
kind, or, if they were not, their differences. Some of 
the cases seem to have been examples of diphtheria, 
and others of a form of scarlet fever. The work 
is good as far as it goes, but the investigation is 
imperfect. 

Dr. John Huxham is another example of the 
influence of Boerhaave in England on the study of 
clinical medicine. Huxham studied under the 
master at Leyden in 1715. His Essay on Fevers, 
which appeared in 1755, contains many original 
observations. His treatise. On the Malignant Ulcerous 
Sore-throat, famous as it is, is not, in my opinion, so 
good an example of clinical observation as the work 
of Fothergill. It has the same fault of failing to 
distinguish between cases which we should call 
diphtheria and others which were probably scarlatina 
anginosa, but Huxham excels Fothergill in that he 
seems to have noticed that paralysis of the soft 



STUDY OF CLINICAL MEDICINE 157 

palate followed some cases of malignant ulcerous 
sore-throat. 

These pupils or members of the school of 
Boerhaave seem to be more on the look-out for 
something startling or suitable for clinical demon- 
stration than were the followers of GHsson and of 
Sydenham, who were content to make no selection, 
but to observe every circumstance of an illness and 
by observing everything in many cases hoped to 
arrive at useful conclusions of general application. 
Yet the effect of the teaching of Boerhaave and of 
that of the University of Edinburgh, which was 
derived from him, was to increase the enthusiasm 
for clinical observations. The study of clinical 
medicine among English physicians originated in 
the learning of the Eenaissance, while the origin of 
clinical study in Scotland is to be found in the 
teaching of Boerhaave. Such has been the history 
of the study of clinical medicine in the British Isles. 
Methods of clinical observation have been improved 
and elaborated since it has been fully established. 
Amidst the pursuit of the extensive sciences related 
to medicine it is for us, the physicians of to-day, to 
see that the precise observation of disease at the 
bedside is never displaced in teaching or in practice 
by other studies. 



APPENDIX 

I. CHAETEES WITNESSED BY GEIMBALD 

I. Witnesses of Henry I's grant of ten hides of 
land at Lifesholt to Abingdon Abbey. 

Testibus : Eannulfo cancellario et Grimaldo 
medico et lurardo archidiacono et Watero archi- 
diacono : et Willelmo de Albini et Eogero filio Eicardi 
et Nigello de Oilli et Eadulfo basset et Goiffredo filio 
pagani : Apud Wodestocam. Descripta est autem 
huius concessionis carta Anno ab incarnatione 
dominica M. C. XV. 

Cartulary of the Abbey of Abingdon 
(Claudius C. ix British Museum, 
f. 147 b). 

II. Henricus rex Anglorum Eicardo episcopo Lund, 
et Hugoni de Bochelanda et baronibus suis omnibus 
et fidelibus Londonie et Middelsexe salutem. Sciatis 
me concessisse ecclesie sancte Marie de Abbendona 
et Faritio abbati perpetuo habenda hospitia sua de 
Lundonia in Westmenstrestret cum omnibus rebus 
pertinentibus ad hospicia omnino ab omnibus quieta 
sicut melius unquam ilia ecclesia et quietus habuit 
tempore patris et fratris mei. Testibus : Grimaldo 
medico et Nigello de Albini apud Windesor. 

Id. f. 150 a. 

III. Henricus rex Anglorum Eicardo episcopo 
Londoniensi et Hugoni de Bochelanda et omnibus 
baronibus suis francis et anglis de Londonia et de 
Midelsessa Salutem. Sciatis me dedisse sancte 
Marie de Abendonia et Faritio abbati unam mansam 
terre que fuit Aldewini in Suthstreta iuxta hospicium 



GRIMBALD IN CHARTERS 159 

Abbatis paci. Et uolo et precipio ut bene et quiete 
et honorifice teneat illam terram sicut quietus tenet 
ibi aliam terram suam. Testibus : Rogero episcopo 
Salesburie et Giliberto de Aquila et Otuero filio 
Comitis et Grimbaldo medico et Waltero de Bello- 
campo apud Westmonastermm. 

Id. f. 150 a. 

IV. Henricus rex Anglorum Willelmo vicecomiti 
de Oxenefordscira Salutem. Precipio tibi ut ilia hida 
quam Droco et Andelei dedit sancte Marie de 
Abbendona ita sit quieta de hoc geldo et de omnibus 
consuetudinibus sicut melius fuit quieta in tempore 
patris mei et fratris mei et nichil aliud aduersum 
earn requiras. Testibus Waldrico cancellario et 
Grimaldo medico. Apud Romesi. 

Id. f. 149 a. 

V. Mathildis regina anglorum Hugoni de boche- 
landa et omnibus fidelibus suis de berchescira 
francis et anglis salutem. Sciatis me dedisse Faritio 
abbati Abendonie domos et omnia edificia de 
insula sancte Mariae ad reficiendum monasterium 
ipsius sancte Marie et ipsam insulam predicto 
monasterio in perpetuum redidisse. Et hoc totum 
dominus mens rex Henricus michi predictoque 
abbati meipsa interveniente concessit. Testibus 
Rogero cancellario et Grimaldo medico. 

Id. f. 145 b. 

VI. Henricus rex Anglorum omnibus constabulis 
et omnibus fidelibus suis de curia salutem. 
Prohibeo ne aliquis hospitetur in villa Abbendune 
nisi licentia abbatis. Teste Grimaldo medico apud 
Oxeneford. 

Id. f. 151a. 

VII. Henricus rex Anglorum Hugone de Boche- 
landa et Godrico et Baronibus de 'Berchscire : 
francis et anglis salutem. Volo et precipio ut 
ecclesia sancte Marie de Abbendona habeat et teneat 



160 APPENDIX II: CHARTER 

terrain suam de Winicfelda cum omnibus sibi per- 
tinentibus ita bene et honorifice et in firma pace 
sicut melius eam tenuit tempore patris et fratris mei. 
Et precipio ut calumpnia quam Godricus prepositus 
de Windresores super eam terram facit de baia 
omnino et perpetualiter remaneat. Testibus : Rogero 
bigot et Grimaldo medico apud l^orhsimtoniam. 

Id. f. 152 a. 

VIII. Henricus rex Anglorum Nigello de Oillei et 
omnibus venatoribus et mariscalcis suis in curia 
salutem. Prohibeo ne aliquis uestrum hospitet in 
Wateleia terra sancte Marie de Abbendona quia 
clamo eam quietam de hostagio pro anima patris 
mei et matris mee. Testibus Grimaldo medico et 
Areta falesia apud Corneberiam. 

Id. f. 151 a. 



II. CHARTER WITNESSED BY JOHN OF 
LONDON THE PHYSICIAN 

ClKOGKAPHUM | 

Sciant Presentes et futuri quod Ego Gilehertus 
Prior ecclesie sancte Marie de butteleia et conuentus \ 
eiusdem loci concessimus hospitali sancti Bartholomei 
hindoniarum et fra^ribus eiw^dem hospitalis totum 
tenementum | de feodo Radulfi de Ardena quod 
tenuit Jeremias de eccksia sancte Marie de butteleia 
in uico I sancti Nicholai Apud nouum macellum 
tenenduw^ de nobis iure perpetuo. Reddendo nobis 
annu|atim Pro omm seruicio . x . solidos Ad duos 
terminos. scilicet ad festum sancti Michaelis v. | 
solidos et Ad Pascha v solidos, Vt Autew conuencio 
ista perpetuet. sigilli nostri Auctoritate et \ sigilli 
liospitaKs sancti Bartho/omei testimonio roboratwr. 
His testibus. Huberto Waltero decano | eboracensi. 
Oseberto de Glamvilk. Jurdano de scheltuna. 



WITNESSED BY JOHN OF LONDON 161 

Magistro Koberto subem. Eojgero Waltero. Henrico 
de ^egga Nicholao Pincerna. Walram Janitore 
turris lon|doniarwm. Henrico de GornhuYLa. 'Rsidulfo 
fratre eius, Bicardo filio Reineri. Henrico de lun- 
dene|stona. Eogero le due. Rogero filio Alani. 
Galfrido Albo. Andrea Albo. Petrofilio | Nevelowis. 
Roberto de edelmetuna, Johanne Medico hindoniarum. 

The Priory of Buttley was founded by Ranulf de 
Glanvilla in 1171, and his sister was mother of 
Herbert Walter who was made Dean of York in 
1186 and consecrated Bishop of Salisbury in 1189. 
His successor as Dean of York was appointed 
September 6, 1189. Henry of Cornhill and Richard, 
son of Reiner, were sheriffs (vicecomites) in 1189. 
Henry of Cornhill was the supporter of Longchamp, 
Bishop of Ely, in the political struggle of October, 
1191, when John (Comes Moretoniae) came to London 
with William of Coutances, Archbishop of Rouen. 

John at that time stayed in the house of Richard, 
son of Reiner, who died later in 1191. It is probable 
that Reiner, son of Berenger, who was sheriff in 1156, 
was father of this Richard. 

Henry of Londonstone was so called because his 
house stood where the Salters Hall now is, not far 
from the ancient monolith called Londonstone, now 
fixed into the wall of the church opposite the front 
of Cannon Street Station. 

He was the first mayor of London and between 
1193 and 1212 appears in charters as Henricus filius 
Ailwini maior Londoniarum. 

Peter, son of Nevelon, was sheriff in 1191. 

Roger le due was sheriff in 1189 and again with 
Roger, son of Alan, in 1192. 

Roger, son of Alan, became (in the Exchequer year 
1213) the second mayor of London. 

Galfridus Albus is probably the Galfridus Blund 
(Geoffrey the fair) who often appears in London 
charters of the reigns of Richard I and John, and 



162 APPENDIX III 

Andreas Albus is Andrew Blund, also a frequent 
witness of that period. 

The street of St. Nicholas apud novum macellum 
(St. Nicholas Fleshshambles) was in the city of Lon- 
don in the region between Newgate and St. Martins 
le Grand. Jeremias had a daughter Cristina, who 
married Galfridus Aspoinz, and they had two sons, 
Joseph and William, and Joseph retained a yearly 
rent of a pound of cumin in this land. 

III. MAYERNE'S NOTE ON THE HEALTH 
OF JAMES I 

British Museum, Sloane MS. 1679, f. 42. 

Scriptum B. B. Medicis Begijs ordinarijs de Sanitate 
E, M, tuenda, et praesentihus morbis curandis delihera- 
turis datum, a me Bemayerne Begis Medico primario die 
Becemhris 1623. 

Iacobvs I. Magnae Britan. Rex Natus est Edim- 
burgi. Anno 1566. 19 Junij. hora matutina XI^. 

Nunc agit annum aetatis Quinquagesimum septi- 
mum cum Mensibus Diebus. 

Nutricem Vnam habuit, Ebriosam. Ablactatus 
intra annum. 

Cerebrum habet firmissimum quod a mari, a vini 
potu, a vectione in Rheda, nunquam fuit per- 
turbatum. 

Afficitur facile a frigore et crudorem patitur, frigida 
et humida tempestate. 

Thorax ipsi Latus est optime conformatus, et quae 
in eo continentur vitales partes validum et vegetum 
calorem habent, nee vnquam laborant nisi ex 
accidenti propter aliarum o-vixiraOeidv. Inde fit vt 
pulmo frequenter fluxione tentetur ; cujus materiam 
ope Cordis calidissimi citissime percoquit. 

Hepar naturaliter bonum, magnum, sanguinis 
multi, Laudabilis ferax ; Calidum ; ex accidenti 



THE HEALTH OF JAMES I 163 

obstructionibus obnoxium, et ad plurimam bilem 
generandam pronum. 

Lien nunc facile congerit succum Melancholicum, 
cujus praesentiam vt varia arguunt symptomata ; sic 
ejus importuna sarcina bonis E. M^^ rebus per vias 
conuenientes subinde a natura deponitur. 

Nullus in his duobus visceribus tumor, nulla 
coUectio quam durities prodat ; sed vtrumque hypo- 
chondrium molle, nunquam nisi flatu distenditur. 

Ventriculus vt ad Vberioris alimenti onus subeun- 
dum continuo paratus sit, sic ad noxium aut graue 
vtrinque (magis tamen per inferiora) reijciendum 
promptus est. Bene appetit naturaliter, justam 
portionem debite concoquit. Sitit frequentissime. 
flatu importuno qui vel cruditatis, vel fermentationis 
soboles est continuo quasi turget. 

Intestina lubrica sunt, et mollis semper ac fluida 
fuit aluus. 

Mesenterium in vasorum suorum Maeandris ob- 
structionibus, et biliosae vtique ac pituitosae saburrae 
coaceruandae quam maxime deditum. 

Eenes calidi, ad arenas et calculos generandos 
dispositi. 

Tibiae a natura graciles, minusque firmae ad 
molem corporis sustinendam. 

Habitus rarus et texturae peruiae, facile calet 
calore sicco. Cutis tenuis et delicata admodum quae 
prurit facillime. 

Fauces angustae difficultatem faciunt in deglu- 
tiendo, quod vitium E. M^ haereditarium est k 
matre, et Auo Jacobo quinto Scotiae Eegibus. 

Facultates Animales et Vitales inculpatae Na- 
turales quae sunt sub Altrice satis firmae, ex accidenti 
tantum fere ob repletionem interturbantur. 

Functiones omnes naturaliter bonae, pro re nata, 
manifestissime autem et plurimum ab animi pertur- 
bationibus peruertuntur. 

Exuberant preter naturam In hepate et venoso 

m2 



164 



APPENDIX III 



A6r. 



Cibus. 



Potus. 



vmum 
muscatel- 
linum tur- 
bidum vn- 
de diarrhoea 



Motus 

et 
quies. 

Somnus 

et 
Vigilia. 

Animi 
pathemata. 



genere flaua bills, et (quod graulssimorum morbonim 
varlls sul partibus vberiima atque potentlsslma causa 
est) serum. In Ventrlculo et Cerebro Pltuita. humor 
melanchollcus In Llene. 

Quoad res non naturales. 

E. M. Omnem facile et satis impune fert aeris 
intemperiem in actiuis qualitatibus. Austro flante 
et humidiori tempestate, hyemali praesertim, afficitur, 
et conflictatur Catarrho. 

In Cibis non admodum peccat, nisi quod nihil 
comedit panis ; Assatis carnibus fere vescitur, Elixatis 
aut raro, aut nunquam, nisi bubula. 

Dentibus carens (qui excidere a Catarrho) non 
masticat cibos sed deglutit. 

Fructus o)paLovs quauis hora diej et noctis edit, 
satis parce tamen quauis vice, sed sine ordine. 

In Potu peccat quoad QuaHtatem, Quantitatem, 
frequentiam, tempus, Ordinem. 

Promiscue bibit Cereuisiam, Alam, Vinum His- 
panicum, Gallicum dulce, album (qui ipsi ordinarius 
potus est) vt plurimum crassum et turbidum. 

Aliquando, praesertim fluente aluo, Alicanticum 
tinctum. 

Attamen non curat sit vinum generosum dummodo 
dulce. Summa ipsj cum Aqua et omnibus aquatili- 
bus antipatheia. 

Violentissimis olim Venationis exercitijs deditus 
Kex nunc est quietior, et plus quam par esset jacet 
aut sedet ; sed id ab imbecillitate tibiarum arthriti- 
carum. 

Male naturaliter dormit, et inquiete : Saepissime 
expergiscitur noctu, vocatque cubicularios, neque 
nisi legente Anagnoste obrepit somnus vt plurimum. 

Animus facile mouetur cum impetu ; Iracundis- 
simus est, sed cito euanescit pathema. Nunc ex 
accidenti Melanchollcus Liene in sinistro hypochon- 
drio turbas excitante. 



[ 



THE HEALTH OF JAMES I 165 

Multiim mungit. Sternutat saepissime. Non Excreta 
spuit multum, nisi k catarrho. et 

Ventriculus facile nauseat, si contineat cruditates ^®*®^*^* 
vel bilem. Vomit tamen cum magno conatu, ita vt 
post vomitum tota facies maculis rubris per diem 
vnum et alterum variegata appareat. 

Flatus multi vtrinque prorumpunt. Nidorosi k 
ventriculo praesagiunt morbum. 

Aluus est admodum Lubrica, et pro ratione inge- 
storum excrementa variant, quae vt plurimum mollia, 
biliosa, et admodum foetida egeruntur. 

Si ab ingestis natura grauata fuerit, paul6 post 
sese per intestina salutariter exonerat. 

Vrinae fluunt Laudabiles vt plurimilm in sub- 
stantia, Colore, contentis ; Copiosae satis. Tartareae, 
et sabulosae post sedimenti longam depositionem. 
Intenduntur ab exercitio, a bilis per familiarem 
Icterum permistione. 

Nonnunquam friabiles calculi, vel potius com- 
pactae arenulae excernuntur. 

Sudat facile ob cutis tenuitatem, noctu praesertim 
post exercitium, post Largiores epulas. Sudoris 
impatiens, vt omniiim. 

Ab anno 1619 post grauem morbum. In quo 
fuerunt affixae ano hirudines, fluunt copiose singulis 
fere diebus haemorrhoides, cum maxima euc^opta. 
Si sistantur (id quod imminente morbo aliquando 
contingit) euadit. Eex valde iracundus, Melancho- 
licus, Ictericus, calet impensiiis, deijcitur appetitus. 
Eeduce fluxu omnia in melius mutantur. 

Morbi praegressi et praesens ad varias dis- 
positiones morbosas aptitude. 

Bex ad sextum vsque aetatis annum non poterat NB 
incedere, sed gestabatur, adeo debilis fuit h, mali 
lactis temulentae nutricis suctu. 

Inter secundum et quintum Variolae, Morbilli. 



166 



APPENDIX III 



Quinto per horas 24 substitit vrina, nihil tamen 
aut arenosi aut pituitosi ejectum. 
Colic. Saepissime Laborauit dolore Colico k flatu (qui 

affectus etiam fuit matri familiaris) hie ad 24:^^^ 
vsque aetatis annum grauior, deinceps mitior semper 
euasit. Causae istius doloris eaedem fuerunt semper, 
lejunium, Moeror, frigus nocturnum. A contrariis 
leuamen. 
Cholera. Frequenter, et fere quotannis juuenis corripiebatur 

Cholera morbo, cum rigore, Vomitum et fluxum 
biliosum praecedente. 
Diarrhoea. DiarrJieae per totam vitam obnoxius, Vere, et 
Autumno, potissimum autem circa finem Augusti vel 
initio Septembris post esum fructuum. Aliquando 
cum febricula, saepius sine febre. 

Praeludia hujus diarrh§iea fere Moeror animi, 
suspiria, suspicio omnium, caeterdque Melancholica 
symptomata. Anno 1610 sub finem Parlamenti 
solutis supremorum Eegni ordinum comitiis post 
summum moerorem, Dominus defunctus longissima 
variorum symptomat^m serie, non sine vitae peri- 
culo per octiduum profusissima Diarrha§a Laborauit, 
per quam excreta aquosa, biliosa foetidissima, tandem 
atra. Cardialgia, palpitatio, Suspiria, moestitia, etc. 
Vomitus bis ter-ue quotidie recurrens. Per se sine 
effatu dignis remedijs Kex conualuit. 

1612. 4 Decemb. post mortem filii Melancho- 
licus paroxysmus, cum omnibus symptomatis 
successit Diarrhoea : soluta omnia intra paucos 
dies. 

1619. Post Keginae mortem praeuiis doloribus 
Arthriticis et Nephritidis cum crassiorum arenarum 
iterata exclusioneEostonii febris continua. Diarrhoea 
biliosa, aquosa profusissima per totum morbi decur- 
sum. 

Singultus aliquot dierum. Aphthae totum os 
cum faucibus, ips6que oesophago occupantes. 

Fermentatio humoris acerrimi in ventriculo ebul- 



THE HEALTH OF JAMES I 167 

lientis, qui per spumam ex ore efferuescens, liquamine 
suo instar muriae acri, Labia et mentum exulce- 
rabat. 

Animi defectio, suspiria, Metus, Moestitia incredi- 
bilis pulsus, Intercidens. Notandum tamen banc 
pulsus intercidentiam in Domino esse frequentem 
tumultuante quantumuis leuiter humore melan- 
cholico. 

Nephritis per quam sine vllo remedio excreuit 
calculum pro more friabilem. 

Semel cum vrina effluxit semen^ 

Durauit morbi istius omnium quos vnquam passus 
est Eex periculosissimi vigor per 8 dies, in quo 
foeliciter vsurpata haec remedia. Clyster frequens, 
Julepi cardiaci cum vitrioli spiritu aciduli. Elec- 
tuaria Bezahardica. Lapis Brunellae. Magisterium 
perlarum et corallorum dulce. Tartari cremor etc. 
Purgatio k qua manifesta omnium symptomatum 
remissio, et postea successit vi naturae paulatim 
curatio. Affixae tunc ano hirudines, atque vtiliter 
in accessione Melancholica applicatae regioni Lienis 
cucurbitulae. 

Post istum morbum per biennium satis bene se 
habuit Eex, immunis ab aliis etiam consuetis affe- 
ctionibus. Deinceps recurrit pro more saepius 
Diarrhaea minus violenta. 

Hoc anno 1623 sub finem Autumni durauit per 
duos tresue dies. Sedes amplae, Liquidae putres, 
cum aliqua virium dejectione. Ab ista euacuatione 
Leuior quae successit in variis juncturis Arthritis, 
ita vt praeter solitum nunc paucissimis saltem 
elapsis a dolorum cessatione diebus (septimanis S^us) 
Eex sine adminiculo incedat, qui antea per menses 
aliquot vel in cathedra sedere et gestari, vel aliorum 
sustentaculo vti cogebatur. 

Notandus euacuationis spontaneae per secessum 
effectus foelix. 

Bominus Catarrho h Cerebro in subjectas partes 



168 



APPENDIX III 



decumbente vt supra dictum facile concepto frigore 
molestatur ; humoris pars Coryzam aliquando creat : 

Catar- Vt plurimum pulmones afficit ; sequitur tussis 

rhus. violentissima, sed breuis et (quod mirabile) intra 

biduum triduum-ue coquitur materia, tussis cessat, 
et illapsus humor ex bronchiis rejicitur crassus, 
viscidus, niger. Jactare solet contractum frigus ante 
cessare qukm praeparari possint k Pharmacopoeo 
remedia. 

febris. Bar6 febricitat, si per aliquos affectus inuadit febris 

breuis ea est et fere Ephemera. 

Icterus. Male si se habeat quocunque modo, atque in E. 

M*® Laborent siue animus, sine corpus, facile 
succedit Icterus, et fiauescunt oculi, symptomate 
tamen fugaci, quod paul6 post sponte euanescit. 

Melancholiae hypochondriacae admodum ob- 
noxius. 

Continuus vel saltum pene quotidianus fluxus 
haemorrhoidiim facit vt aliquando non sine dolore 
anus inuertatur, et sequatur Tenesmus. 

Nephritis. Ante plures annos post Venationis 
exercitium, et longam equitationem saepissime 
redditae vrinae turbidae et rubrae instar vini Ali- 
cantici (quae sunt Domini verba) etiam sine dolore. 
12 Julii 1613 cruentum Lotium cum arenulis rubris, 
mox faeculentum et cum crasso sedimento. Vrinae 
ardor. Dolores renis sinistri : Vomitus crebri caetera- 
que Nephritica symptomata. Eadem sed grauiora 
17 Augusti. 1615 Octobr. Non leuiora. Paroxys- 
mos hosce omnes cum leuamine excepit fluor alui 
consuetus. Deinceps saepius rediuiuum malum, 
atque in variis accessionibus rejecti calculi, vel potius 
conglobatae, et viscida ferruminatione cohaerentes 
arenulae friabiles, cum morbi solutione. 

Arthritis. Arthritis, Multis abhinc annis Inuasdre primo 
pedem dextrum dolores, cujus inter ambulandum 
antiqua contorsio, et Vestigiorum a mala consuetu- 
dine minus recta positio hunc altero debiliorem 



Haemor- 
rhoid. 



Nephritis. 



THE HEALTH OF JAMES I 169 

ab ineunte aetate fecit. Postea successere con- 
tusiones variae, ab allisione ad tignum, ab illapso 
saepius equo, al3 ocreae et stapediae attritu, et alijs 
causis externis, quas ingeniose scrutatur, et graphice 
notat Eex vt internarum accusationem apud Medicos 
eludat. Solet autem dolor pedis dextri affligere vt 
plurimum non digitos, non pedis cum tibia articula- 
tionem, sed sub externo malleolo earn metapedii 
partem cui Podi^us Musculus adhaeret. Nihilominus 
obseruaui saepius totum intumuisse pedem, et 
tantam superfuisse post sedationem dolorum debili- 
tatem vt per plures septimanas ineptus ad motum a 
consuetis exercitiis abstinere et in lecto vel Cathedra 
haerere coactus fuerit. Jm6 anno 1616 vltra quatuor 
menses perseuerauit debilitas cum tumore Oedema- 
toso totam tibiam aegram et vtrumque pedem dis- 
tendente. 

Subsequentibus annis contigit vt dolor aggressus 
sit aliarum partium articulos, pedis sinistri poUicem 
et malleolos, vtrumque genu, humeros, ipsasque 
manus ; aliquando (non semper) cum rubore, cum 
tumore saepiiis. Dolor est acutus primis duobus 
tribus-ue diebus, Noctu vt fluxionibus ordinarium 
saeuit, atque exacerbatur, mitescit posted, succedit 
imbecillitas, quae non nisi longo dierum decursu vel 
domatur vel euanescit. 

Hyemali tempestate potissimilm molesta est 
Arthritis, nee vnquam firmi absolute sunt artus 
donee sol redux annum aestiuis caloribus Domino 
reddat propitium. 

Ter in vita correptus fuit acerbissimis coxae 
doloribus, nuperrime 28 Octobris 1623 quodam 
veluti spasmo musculorum et tendinum tibiam 
sinistram flectentium ; a vapore et flatuoso spiritu 
pertinacissime nocturnis horis partes istas velli- 
cante, 

Observanda tibiarum tenuitas et veluti atrophia, 
ob intermissionem motus non appellentibus spiriti- 



170 APPENDIX 111 

bus et alimento ad partes inferiores, quae fuerunt 
ab incunabulis graciles et infirmae. 

Kex ex Scotia veniens in Angliam ex equo lapsus 
fregit clauiculam dextram. Alio tempore a casu 
passus est summam Omoplatae sinistrae contusionem. 
Curatus fuit optime. Ab eo tamen tempore factus 
humorum in brachium dextrum decubitus, vnde 
exortae glandulae siue Excrescentiae phlegmaticae 
scrofularum aemulae, quae nunc tumidae cum rubore 
et dolore, nunc subsidentes, tandem ad suppura- 
tionem deductae curatis vlceribus, Licet satis longo 
tempore, attamen extincto subinde rediuiuo fomite 
persanatae fuerunt. 

Notandum saltem ex reliquiis istius humoris, vel 
forsan ex arthritico succo descendente ad Olecranon 
dextrum, duobus vltimo elapsis annis, ortum vna 
nocte tumorem flatu sero-que turgidum, qui citra 
apertionem cutis idoneis remediis foeliciter cessit. 
Semel ab illapso equo pene attritus, et fere fractis 
costis, per tridutim satis leuiter febricitauit. 

Conualuit sine sanguinis missione. 

Alias fibula alterius tibiae pondere equi in planam 
figuram compressa cum totius tibiae periculosa con- 
tusione et sugillatione, solis topicis, sine febre 
curatus fuit. 

Exquisitissimi sensus est, dolorum impatientissi- 
mus, qui dum suam exercent carnificinam, violen- 
tissimis motibus jactatur animus atque aestuat circa 
praecordia bills, vnde non Lenitur, sed exasperatur 
malum. 

Leuamen poscit et Indolentiam, de causis morbi- 
ficis parum sollicitus. 

De Eemediis. 

Medicinam ridet et tam parui pendit Kex vt 
medicos parum Vtiles minus necessaries pronuntiet. 
Art em meris conjecturis prae incertitudine inualidis 
fultam asserit, et dum naturae tribuit omnia, ipsam 



THE HEALTH OF JAMES I 171 

proprio fretus judicio non contemnendis fulcris 
destitutam si non subuertit, saltern in proprium 
excidium concitatius mere incautus sinit. 

Purgantibus naturam destrui, et solis Eccoproticis 
ipsam opus habere affirmat. 

Attrahentia pharmaca, e certis partibus certos 
humores ducentia, vanitatis arguit et accusat. 

Abhorret ab iis quae cient tormina vt a Sena. 
Insipida postulat si eis sit opus. 

Clysterem nunquam ante 17 Augustj 1613 admisit. 
deinceps autem aliquoties hoc remedij genere in 
Nephriticis doloribus, In diarrhoea, In constipatione 
alui vsus est ; Hcet semper adsit aliquid quod carpat, 
praesertim increpans quod ab Enemate flatibus 
oppleta intestina cum dolore post ipsum rejectum 
distendantur. 

Vnicam potionem assumpsit Catharticum ex Eha- 
barbaro, Sena, tamarindis Manna, idque faciUime, 
sine nausea, cum optimo successu. Miranti medico 
quod tam placide ventriculo excepisset pharmacum, 
respondit sibi omnia faciHa quae semel facienda 
statuisset. In summa Id quod vult valde vult. 

Julepos sitiens aut Intemperie caUda aestuans non 
rejicit, ex tincturis florum cordiahum extractis cum 
Vitrioli spiritu, addito ad dulcedinem (qua in omni- 
bus delectatur) syrupo violato. de pomis, Julepo 
Alexandrino vel saccharo. 

Vt plurimum circa horam somni sitiens variis 
de causis, succum Granatorum dulcium haurit ad 
I iij. vel iiij. Alias Limonibus vel aurantiis dulci- 
bus sitim sedat. 

Jusculis medicatis aliquando vsus est, a quibus 
sitis matutina demulcebatur, saltern minus bibebat 
jejuno ventriculo. 

In iis nonnunquam fuit dissolutus Tartari cremor, 
cujus vires commendat, assumptionem non asper- 
natur. 

In Arthritide solis pultibus siue Cataplasmatis 4 



172 APPENDIX III 

suum dat suffragium, quae Anodyna praefert caeteris, 
eaque ad quamuis vel leuissimam dolorum vmbram 
proferri et applicari jubet. 

Vult saepius renouari applicationes in quarum 
apparatu, aeri exponit juncturas et diu et Im- 
portune. 

Ordo applicationum is est vt Anodynis, sedato 
dolore roborantia quantum per Dominum licet 
vsurpentur. 

Linimentis, Emplastris fomentis non vtitur nisi 
perfunctorie, et per transennam. 

Emplastra omnia et Topica calida pruritum 
mouent, ide6 breuissimo ea fert temporis spatio. 
3 Nephritis hactenus cessit Clysteribus et fomentis, 

nonnunquam exhibitus foeliciter Lapis Brunellae. 
2 Melancholica symptomata Tabellis cardiacis sedata, 

cum conf. Alkdom. Lapide Bezahar etc. 
1 Catarrhus et tussis Tabellis de Althea, Trochiscis 
bechicis albis, Saccharo anisato et similibus cesserunt. 

Praeterea nihil quod S9iam Eegiae Majestati fuit 
administratum. 

Nunquam missus phlebotomo sanguis, semel 
extractus vt praedictum per hirudines. 

Agenda. 

Vrgent potissimiim congeneres (quoad causam 
materialem si ejus originem respicias) affectus 
Arthritis et Nephritis. Diarrhoeae frequentia per- 
pendenda. Hypochondriacus flatus haud negli- 
gendus. Harum affectionum praecautionem, praesen- 
tium curationem, et symptomatum sedationem, 
Eex a suis Doctoribus Medicis postulat, et expectat, 
etiam citra expugnationem causae. 

Statuendum igitur. 

Quodnam sit Eegiae Majestatis temperamentum, 
quae inaequalis partium Intemperies. 



THE HEALTH OF JAMES I 173 

Quinam et quibus in partibus redundent in ipsius 
corpore humores. 

Quae sint et fuerint praeteritorum affectuum quae 
pertimescendorum causae. 

Quibus morbis futuris videatur maxime obnoxius 
Rex, et quibus prognosticis (quorum tamen successum 
auertat Deus) monendus sit vt sibi magis consulat in 
posterum. 

Quinam errores in victu crassi, et non ferendi (in 
eo qui sanitatem curat et colit) sint emendandi juxta 
capita r^s BLaLTrjTiKrj^;, In cibo, potu, Animi motibus 
etc. 

Quomodo emendandi gradus Intemperiej variae. 

Quomodo toUendae obstructiones mesenterii 
Hepatis, Lienis. 

Quibus artibus praeparandi peccantes succi assig- 
natis remediis quam gratissimis, quae potius sub 
alimenti quam sub medicamenti specie exhibean- 
tur. 

Quibus Catharticis non ingratis, tormina non An vtilia 
cientibus, corpus non perturbantibus purgandi ■^"^®*^^*- 
humores, qui et quando. Hie describenda vsualia 
primas vias euerrentia atque e longinquo ducentia, 
solida, liquida. 

Quibus corroborantibus hepatis conseruandus 
tonus, ejusque adjuuanda at/xarwcrt?, quibus recre- 
andi spiritus deinceps muniendum cor aduersus 
tetros hahtus ab inferiori sentina expirantes ; quibus 
confirmandus ventriculus aduersus molem crudi- 
tatum prouentu quotidiano Luxuriantium : Quibus 
Cerebrum contra frigoris appulsum et Catarrhi 
materiam muniendum. 

An conueniant Regi Diuretica ad materiam Arth- 
ritidis eliminandam bene repurgato corpore. Jtem 
ad calculosam saburram euerrendam. Quae. Quando, 
Quoties exhibenda. 

An profutura sint Diaphoretica, quae vel assumpta 
vel Ichores absorbeant et siccent, vel prouocato 



174 APPENDIX III 

sudore totum venosum genus per habitum hoc inutile 
veluti lixiuio exhauriant. 

De particularibus euacuationibus per os et nares 
etc. 

An Thermae vtiles, an necessariae ad articulorum 
robur. An noxiae, et quaenam ab ipsis metuenda 
incommoda. 

Quid de phlebotomia, cum satis superque fluant 
haemorrhoides. 

Num fouendus naturam sibi ipsi reHnquendo hie 
fluxus, num ab eo pene quotidiano et satis largo 
aliquid impendeat periculi. 

Num si non cohibendus saltem moderandus et 
corrigenda sanguinis qualitas per chalybeata. Hie 
de Aquis mineralibus. At fluente sanguine optime, 
restitante eo male se habet Eex. 

Quid de Pyroticis vtrjque brachio inurendis ad 
interceptionem et euacuationem materiae arthriticae? 
post crudorem cerebri vt plurimum paroxysmum 
suscitantis. 

Quoad mokbos et Symptomata. 

4 Quid in Diarrhoea tam frequenti vt fraenos demus 
humoribus non sine virium jactura et spirituum 
dispendio nimium fluentibus. An relinquendum 
Naturae negotium, cum praesertim resumptis viribus 
Eegi sit ab istis fluxibus melius ? 

An non error est quod fluente aluo vel a principle 
bibit Alicanticum, et granatorum succum? Quae 
roborantia post imminutum fluxum danda. Quae 
eo perseueranda Cathartica, et quomodo exhibenda. 

1 Quibusnam Cerebrum curandum ? 

2 Quibus bechicis tussis licet breuis expugnanda, 
vel lenienda, quippe violentissima ? 

3 Quid ad affectum hypochondriacum, et pulsus 
intercidentiam ? 

Quid ad praecautionem Nephriticorum symptom- 
matum et renum contemperationem, atque expurga- 



THE HEALTH OF JAMES I 175 

tionem ? Quid ad dolorem praesentem quoad 
interna et externa remedia. Assumenda. Injicienda. 
Admonenda. 

Quid ad Arthritidis praecautionem vt ejus materia 
diuertatur et deriuetur ab articulis longe aliquo 
vsuali et quotidiano remedio non ingrato. Quaenam 
commodissimoe ad istas intentiones viae. Stomachi, 
Alui, Eenis et Vesicae habitus ? 

Quomodo confirmandae juncturae vt minus pronae 
sint ad suscipiendas fluxiones et vt causis dolorificis 
per ligamentorum astrictionem et desiccationem 
mediocrem resistant. 

Quid faciendum In principio dolorum. 

Quae conueniant Anodyna praesertim sub forma 
Cataplasmatis. Describenda tamen Linimenta, 
Emplastra fomenta dolores lenientia, vt pro re nata 
ex penu possint depromi. 

An in implacabili cruciatu plane rejicienda 
Narcotica, praesertim Altercum quod in Arthritide 
adeo ab authoribus commendatur ? 

» Quaenam ab eo timenda noxa, quibus emendanda, 
si probetur. Quid de Laudano et similibus in 
Diarrhoea in arthritide. 
Quaenam Eoborantia ad dolorum finem Cata- 
plasmata Emplastra Linimenta Balnea, fomenta. 

An non Anodyni Cataplasmatis vsus quod multam 
recipit Cassiam, et Mucilagines, nimius vsus noxius 
ob relaxationem articulorum ? 
I An non Domino noxium toties renouare remedia, 
g et artus aeri frigido tam saepe negligenter exponere ? 
g Quibus mediis sanguis et spiritus ad flaccescentes 
^ tibias attrahi possint. 

o Quid in subitaneo casu vt Apopl. faciendum in hoc 
subjecto ? 



ns 



•73 

u 
O 



Omnia haec Viri Excellentissimi Eegis Medici 
ordinarii, prudentiae vestrae sigillatim examinanda, 
et sedula Lance perpendenda proponuntur. In 



176 APPENDIX IV 

quibus quum de optimi Principis conseruatione 
im6 de vita agatur, aequum est vt (siquidem nihil in- 
praesentiarum vrget ade6, et sopitae brumali frigore 
causae morbificae aliquas dant inducias) singuli 
remotis arbitris, serio apud se, consultis mutis 
Doctoribus, ex propria experientia et obseruationum 
commentariis efficacissima arma depromant ad istos 
tarn Augusti capitis hostes debellandos. Descri- 
bantur a vobis remedia, nequid in iis omissum 
neglectum-ue possit accusari, et vt manus vestrae 
voluntatis et officii Domino nostro praestiti, atque 
sedulitatis indefessae testes, ipsum ad Medicas leges 
alacrius capessendas, atque ad propriam valetudinem 
juxta praesentem necessitatem vt oportet curandam 
non trahant nolentem : sed volentem (id quod bonis 
omnibus in votis esse debet) ducant. 

Demayerne. 
Kegis Medicus primarius. 



IV. MAYERNE'S NOTE ON THE HEALTH OF 
QUEEN HENRIETTA MARIA 

British Museum, Sloane MS. 1679, ff. 67-9. 

Anno 1641 Mense Julio, Regina abituriens trans 
mare, tam animi quam corporis curandi ergo, in 
sequenti valetudinis statu, sequens accepit et secum 
detulit consilium. 

1. Ventriculi cruditas a parum cauta victus racione 
et frequens aTroa-iria viscerum et praesertim. 

2. Hepatis fervida intemperies quod est sanguinis 
Biliosi sero multo acri scatentis ferax. 

3. Ohstructio venarum Mesaraicarum jecoris lienis, 
vnde mala succi alimentarii attractio, mala, sangui- 
ficatio, mala distributio, Assimilatio pejor. Inde 
Atrophia. 



QUEEN HENRIETTA MARIA 177 

4. Tumor cum duritie Hepatis et lienis, non 
tantum a flatu hypochondria frequenter distendente, 
sed etiam ^ materie congestione in ipso partium 
parenchymate cujus dispositio moHs incrementum 
minatur non sine ahcujus sinistri eventus metu et 
imminente periculo : 

5. Aim segnities vt plurimum et excrementorum 
siccitas ordinaria, nisi quando fructibus horaeis sese 
ingurgitat. Cerasis, peponibus, Bericoccis, presertim 
apersicis, &c. 

6. Hypochondriaca affedio, Licet temperamentum 
vniversale sit caHdum et siccum Biliosum : attamen 
animo naturaUter prepensa est in MelanchoUam. 

7. Scorbutica dispositio patens in gingiuis quae facile 
intumescunt, fundunt sanguinem, et vlceratae 
abscidunt a dentibus. 

8. Hysterica symptomata, licet menses satis com- 
mode fluant Potius insurgit ad motus animi vterus, 
quam ad Odores gratos quibus E. M. delectatur, 
abhorret a foetidis. 

9. Macies ingens, Marcor drpoc^ta, Tabes prae 
foribus. 

10. Benum impuritas arenosa. Excreuit plures 
calculos paruos a rene dextro ; In hoc patrissat. 

11. Cor palpitat aliquando si mens percellatur. 

12. Pulmo in angusto locatus saepius fluxione 
tenui premitur, vnde tussis frequens vt plurimum 
minus humida, quae hactenus licet satis importuna, 
subinde tamen cessit remediis bechicis. Noctu 
inualescit, vnde cogimur saepe confugere ad hypno- 
ticum syrupum de Papauere. Nunquam dedi 
Laudanum. Sputa satis laudabilia. Tractu tem- 
poris timenda, et quauis arte arcenda avv 6e(o 
Fhthoe vnde maximum impendet discrimen : Ita vt NB 
videatur naturae cursu futurus hinc E. M. terminus. 

13. Caput tam calidum vt nulla diu ferre possit 
integumenta, sine oculorum incommodo, qui (dexter 
praesertim) saepe rubet et cum palpebris cito inflam- 

MOORE ^ 



178 APPENDIX IV 

matur. Variis in locis glabrum est. In Infantia 
saepius habuit achoras, et nunc saepissime per poros 
illaesa cute exsudat materia seu sanies oleosa, Untea 
tenacissime maculans. Obnoxia fuit fere vsque ad 
eruptionem mensium scabiei siccae, et valde pungenti 
nares, et Labium superius rediuiua eruptione 
Subinde occupanti cujus etiam nunc aliqua apparent 
saepe rudimenta. 

14. Labia sicca sunt et finduntur persaepe. 

15. Oculi saepe fluxionem acrem experiuntur. 

16. Dolor capitis frequens. 

17. Catarrhus tenuis ordinarius. 

18. Animi Pathemata violenta, Ira brevis, Meastitia 
longa. Lachrymae frequentes. 

19. Contorsio spinae scoliosis. 

20. Latus dextrum (brachium, manus) altero 
macilentius veluti arescit. 

21. Ante aliquot annos vtero gerens, passa est 
prime stuporem ingentem. Deinde aliquam reso- 
lutionem alterius lateris. 

22. Debilitas Vniuersalis summa. 

23. Consumptio Vniuersalis ab altricis facultatis 
mala dispensatione. Nihil adhuc funesti k pulmoni- 
bus. Sed Caue. 



Perpendenda. 



Ventriculus. 

Mesenterium. 

Hepar. 

Lien. 

Eenes. 

Intestina Aluus. 

Hypochondria. 

Vterus. 

Pulmo. 

Caput. Cerebrum. 

Oculi. 

Spina, neruL 



Pulmonum corruptela. 



QUEEN HENRIETTA MARIA 179 

(Debilitas 
sive 
Atrophia. 
Praecauenda ( Vitio hepatis 
Tabes siue 
Consumptio 

Domina solum vertere et extra Angliam proficisci 
quocunque modo constituit. 

Praetendit Aquarum Spadensium potum quae 
praeterquam quod in praesenti corporis statu ipsi 
futurae sunt admodum noxiae, im6 funestae ; nunc 
inclinante anno, et post longam ariditatem, in- 
gruentibus nimbis circa medium mensis Augusti 
quo vix in eo Loco in Belgio quem sibi metam 
itineris Domina statuit pedem fixura est. E. M. 
plene erunt intempestiuae. 

Animum rege qui nisi paret Imperat, &c. 

In Obsequium (cui me deuinctum tenet Muneris 
mei conditio), sequentia mihi propono capita ad 
scribendum consilium quo Domina vtatur pro re 
nata ex medicorum praesentium directione. 

Pertractanda. 

De Aquarum Spadanarum vsu. 

Noxiae futurae sunt quia. 1. Penetrant nimis. 
2. Siccant corpus jam satis exsuccum. 3. Caput 
opplent. 4. Humores fluidos reddunt et fluxionem 
irritant in pulmones. 5. Nocent Pulmonibus. 

Distingue tempera. 

Pete ex fonte et serua. Ne vtaris tamen. 

Ferpendenda, 

Vis imaginationis circa coelum mutandum. 
Coelum non animum mutant qui trans mare 

currunt. 
De Aere, Aquis et locis in Belgio. Vtrecht. 
Arneim. 



N2 



180 APPENDIX IV 

Solitude, vel saltern turbae fuga confert ad 
sumenda remedia. 

Obstructio et tumor manifestus in hepate et liene. 

Instauranda partium nutritiarum Oeconomia. 

Kenes semel et simul euerrendi. 

Procurandus liber commeatus spiritibus Impedi- 
menta toUendo, Purgatione per Epicrasin. 

Epicerastica quae bonum succum reponunt in 
locum mali. 

Analeptica. 

Corroborantia J p ^ 

aequaliter 1 ^ , 
^ ( Cerebrum 

( Humectantia 

Habitum I Mollificantia 

( Implentia 

(Eecreantia 
Clarificantia 
Multiplicantia 
in Corde et Cerebro. 

Post vniuersalia instauratis viribus et repleto 
habitu, Idonea tempestate, vt post annum, &c., 
deliberandum erit de Aquis Spadanis Puguensibus, 
forgensibus ad 

Tollendam Intemperiem viscerum calidam. 

Aperiendas vias. 

Corroboranda viscera. 

Euerrendos renes. 

Si velit Domina eas potare, 
Vt quod vult valde vult. 

Praecauenda erunt earum incommoda, vt si non 
prosint saltem non noceant. 

Praescribendum aequiualens, ex d^ 

An 
Interim et exsucco corpore tuto possunt admini- 
strari d^ 'V^ ^ (D. 

Dubito, nisi magna cum cautione. 



181 



V. HAEVEY'S NOTES ON GALEN 

Sir George Paget many years ago published, with 
a facsimile, an English letter of Dr. William Harvey 
which was preserved, with a skull to which it refers, 
in an ancient oak cabinet in the library of Sidney 
Sussex College. This publication led to the proof 
that the manuscript in the Sloane collection in the 
British Museum entitled Gulielmus Harveius de 
Musculis Motu Locally &c., was altogether in the 
handwriting of Harvey; and Sir George Paget, in 
his Notice of an Unpublished Manuscript of Harvey, 
London, 1850, has described the contents of the 
manuscript, and the peculiarities of its writing and 
annotation. In the same publication he states that 
but six specimens, of which two were signatures 
only, of Harvey's handwriting were then known. 
Five more, two of them only signatures, are 
described by Dr. Aveling in his Memorials of Harvey, 
London, 1875 ; while Dr. Munk, in his valuable 
Notae Harveianae, published in the St. Bartholomew's 
Hospital Keports for 1887, has mentioned two more, 
a letter to Dr. Baldwin Hamey and two sheets of 
Harvey's will. Sir George Paget says, * It seems 
not unreasonable to expect the discovery of other 
MSS. of Harvey ' ; and with regard to his manu- 
script lectures on general anatomy says, ' This 
MS. has of late years been sought for in vain ; but 
doubtless it still exists, and will sooner or later be 
found.' This hope has been fulfilled. The MS. 



182 APPENDIX V 

was found in 1877 in the British Museum, and Sir 
Edward Sieveking, in his Harveian Oration in that 
year, pubKshed a passage from it. In 1886 this 
most interesting manuscript was edited by a com- 
mittee of the Eoyal College of Physicians of London, 
and published with an autotype reproduction of the 
original. It exhibits in every part the peculiarities 
of Harvey's writing and annotation described 
thirty-six years before by Sir George Paget, whose 
careful elucidation and description of the letter at 
Sidney Sussex CoUege must be regarded as the 
origin of most of the recently acquired knowledge 
of the discoverer of the circulation of the blood, of 
his methods of observation, of his reading, and 
of his systems of arrangement and of verbal 
exposition. 

Having been a member of the committee 
appointed in 1885 by the College of Physicians 
to supervise the publication of the Prelectiones 
Anatomiae Universalis, I had the pleasure of examin- 
ing every word of the writing with Mr. Edward 
Scott of the British Museum, to whom the arduous 
task of transcribing Harvey's crabbed manuscript 
was entrusted, and by whom it was executed with 
astonishing precision and expedition. Having thus 
studied Harvey's handwriting under the able tuition 
of Mr. Scott, I was sufficiently acquainted with it 
to recognize as Harvey's thirty-five lines written on 
a blank page at the end of a copy of Goulston's 
Opuscula Varia of Galen, into which I had occasion 
to look in the British Museum. The book evidently 



HARVEY'S NOTES ON GALEN 183 

belonged to Harvey, who has underlined and 
annotated many passages. The peculiar conjoined 
W. H. which he was accustomed to prefix or affix 
to original notes, which Sir George Paget describes 
in his account of the manuscript notes on the 
muscles, and which occurs again and again in the 
Frelectiones Anatomiae Universalis, appears in several 
places on the margins of the pages of this Galen, 
amongst others on pp. 101, 234, 235, 236, 239, 246. 
It is, perhaps, unnecessary with this autograph 
initial signature to describe other peculiarities which, 
to those unacquainted with Harvey's hand, can be 
of little weight ; but an x for exemplum, which 
precisely resembles that so used in the Frelectiones, 
is to be seen in the Galen, and also a similar * N. B. ' 
The date of the Frelectiones is 1616, and that of the 
De Musculis 1627, while these notes in Galen were 
made after 1640, thus showing that Harvey's 
manuscripts have the same pecuHarities throughout 
his life. 

This edition, Claitdii Galeni Fergameni Opuscula 
Varia, consists of Greek texts with Latin translation 
printed in parallel columns, and was the work of 
Dr. Theodore Goulston, a learned fellow of the 
College of Physicians, the founder of the Goul- 
stonian Lectures still delivered every year at the 
College in accordance with the terms of the founder's 
will. Goulston lived in the same parish as Harvey, 
that of St. Martin, Ludgate, and they were, of 
course, as fellows of the College of Physicians, 
acquainted with one another. Goulston died in 



184 APPENDIX V 

1632, and this Galen was published in 1640 by 
his friend Thomas Gataker. The British Museum 
copy has been rebacked, but is otherwise in the 
binding of its period, with a stamped gold pattern 
in the middle, a border fleury at the corners, and a 
plain linear border at the outermost part of each 
side. There is a pattern on the edges of the sides, 
and the leaves are gilt. A copy of the book, also in 
contemporary binding, which is in the library of 
the Eoyal Medical and Chirurgical Society, has a 
leather binding without any gilding, so that 
Harvey's may have been a presentation copy. 

Many passages and words are underlined, and the 
frequent corresponding notes, often of only a single 
word, in the margin prove that the ink Hnes were 
made by Harvey. He has invariably annotated 
the Latin, and the Greek columns are without 
marks throughout. 

The first work is Galen's Exhorfatio ad Medicinam 
et Artes, and this contains underlined passages in 
six of its nine chapters. Three on athletes and 
their qualities are not annotated. One example 
of the notes may be given. In the margin of 
chapter i. Harvey has written ^ Eationali ', and 
has underlined the words printed in italics : 
* Has igitur ob causas, quanquam reliquis etiam 
animantibus hand deest Eatio, tamen homo solus oh 
eminentiam, qua caeteris praestat, Bationalis vocatur.' 

Now and then a fresh illustration of Galen's 
sentiments occurs to Harvey. Learning, says 
Galen, is to be preferred to rank, which is only of 



HARVEY'S NOTES ON GALEN 185 

value in its own country, * nobilitatem, qua tant- 
opere turgent baud absimilem civitatum esse nmnmis^ 
qui apud eos valent, qui instituerunt ; apud alios, 
quasi aduUerini repudiantur/ The italics mark 
Harvey's underlining, and in the margin, apparently 
as an example of artificial exterior elevation as 
opposed to the genuine exaltation of worth or 
learning, he has written * wooden leggs'. 

The second treatise is Quod Optimus Medians idem 
et FhilosopJius, and has but few notes. The third, 
JDe Sectis ad Tyrones, is noted throughout ; but the 
fourth. Be Optima Secta, has very few marks of 
having interested the reader. The remaining 
treatises, De Cognoscendis et Corrigendis cujusque 
Animi Ferturbationihus, Be Bignoscendis et Corrigendis 
cujusque Animi Erratis, and Quod Animi mores 
sequantur Temperamentum Corporis, are marked or 
have marginal notes of one or more words on almost 
every page. I hope in the St. Bartholomew's 
Keports to publish a full account of his marginal 
annotations. 

The thirty-five lines in Harvey's hand on the 
terminal blank page are references to subjects 
treated on certain pages of the book. 

The notes are all brief, but with the under- 
linings are interesting as showing how carefully 
Harvey had considered the remarks of Galen, 
which of the sentiments of that great physician 
he applauded as he read them, which of his state- 
ments he questioned, and which confirmed from 
his own experience. 



186 APPENDIX V 

Harvey had a profound respect for Aristotle, 
a passage in whose writings suggested to him, as 
he says in his PrelectioneSj the idea of the circula- 
tion ; and this copy of Galen shows him to us in 
the act of studying and criticizing the thoughts of 
another great master of the ancient world. 



INDEX 



Abercorn, Earl of, Mayerne*s notes 

on, 109. 
Abetot, Vrso de, 8. 
Abingdon, Abbey of, 8 ; cartulary 

of, 158 ; charter in register, 8. 
Abingdon, Abbot of, 9. 
Abstinence, dealt with in Flora- 

rium, 47. 
Account of the sore-throat attended 

with ulcers, 156. 
Acre, Bishop of, 21. 
Acta Medica of Thomas Bartho- 

linus, 130. 
Adam, the physician, 15, 16. 
Adherent pericardium, described 

by Douglas, 129. 
Aesculapius, 19, 20. 
Aetius, 3. 
Agallamh na Senorach, prose and 

verse of the, 148. 
Agincourt, 70. 
Albemarle, Duke of, takes Sloan e 

to Jamaica, 131. 
Albini, Nigell de, 8. 
Albreda, wife of R. de Quatre- 

mares, 23. 
Albus, Galfridus, the same as 

Galfridus Blund, 161. 
Alcuin, 6. 
Aldermanesburi, grant of land in, 

10. 
Aldermen of the city, 7. 
Aldewin, queen's chamberlain, 10. 
Alexander, physician of Eleanor 

of Provence, 15, 16. 
Alexander the Great, known to 

Mirfeld, 51. 
All Hallows Church, in Bread 

Street, 23. 
Alston, pupil of Boerhaave, 154. 
Amhra, poem in praise of St. 

Columba, 149. 
Amsterdam, printing in, 123. 
Anaemia, 115. 
Anatomia Restaurata, by High- 

more, 134. 



Anatomical Writers from Hippo- 
crates to Harvey, account of, by 

Dr. James Douglas, 128. 
Anatomy, 66. 
Anecdota Oxoniensia, 29. 
Angers, hospital of, 22. 
Anglo-Saxon (nation), 6; per- 
meated by other tongues, 139. 
Annals of the Four Masters, ed. 

O'Donovan, 143, 150. 
Anne of Denmark, Mayerne's 

notes on, 106. 
Anselm, St., writings known to 

Mirfeld, 51. 
Antidotarium, of Nicholas, 48. 
Antioch, Prince of, 13. 
Antitheriaca, essay by Heberden, 

28. 
Aortic valves, disease of, described 

by Douglas, 129. 
Apoplexy, 40 ; relation between, 

and cerebral haemorrhage, 123. 
Apothecary brings patient to 

Mirfeld's master, 27. 
Aquinas, St. Thomas, works known 

to Mirfeld, 51. 
Arabs, the, books of, read by old 

Irish physicians, 148. 
Arbor Yemensis Fructum Cof4 Fe- 

rens, by Dr. James Douglas, 128. 
Arbuthnot, understood impoi-tance 

of clinical observation, 124 ; 

same kind of Physician as Hel- 

sham, 138. 
* Archiater,' glossed by Irish word 

huasallieig, 140. 
Aristotle, 64; H. W. Chandler's 

knowledge of, 32 ; parts familiar 

to Mirfeld, 50 ; works known 

to Mirfeld, 51. 
Arnaldus, name occurs in Beton's 

MS., 152. 
Arthritis, May erne's notes on 

James I, 103. 
Arundel, Earl of, collection of 

works of art, 72. 



188 



INDEX 



Arundel House, in the Strand, 
77. 

Ashmole, Order of the Garter, 81. 

Ashridge, Religious house of, 46. 

Aspoinz, Galfridus, 162. 

Aspoinz, Joseph, son of Galfridus, 
162. 

Aspoinz, William, son of Galfridus, 
162. 

Atkins, Dr. Henry, physician to 
James I, 149. 

Attainments, necessary to be 
styled medicus, 17. 

Augustan age, editions of Horace 
since, 129. 

Augustine, St., rule of, 21 ; writ- 
ings known to Mirfeld, 51. 

Augustine, St., Library of Abbey 
of, at Canterbury, 20. 

Aveling, Dr., Memorials of Harvey, 
181. 

Averrois, 20. 

Avicenna, 48 ; his writings on 
medicine, 50 ; Ludford's copy 
of, 68 ; wished to find out 
origins of diseases, 88 ; quota- 
tions from, in works of Middle 
Ages, 89 ; name occurs in 
Beton's MS., 151. 

Bacon, Roger, knew Greek, 54. 

Baillie, Matthew, writings of, 93. 

Balthazar, 40. 

Barry, Philip, son of Thomas 
Barry, 146. 

Barry, Philip, son of Richard 
Barry, 146. 

Bartholomew, St., Hospital of, 4 ; 
grant to, 7 ; an early document 
of, 11; ancient regulations of, 
23 ; sick always treated there, 
24 ; patients known to Mirfeld, 
31 ; Terne Assistant Physician 
to, 74 ; description of case seen 
there by Dr. James Douglas, 
129 ; Hospital Reports, paper on 
Douglas in, 130. 

Bartholomew, St., Convent of, 26 ; 
Mirfeld at, 29 ; accident to 
Canon of, 42. 

Bartlott, Dr. Richard (Bertholetus 
medicus), 31, 56. 

Bath, Anne of Denmark visits, for 
gout, 107. 



Bathonia,Reginaldu8 de,physician 
to P]leanor of Provence, 15, 16. 
Baxter, Thomas, 46. 
Beauvais, 79. 
Bede, 6, 48; De Ratione Tem- 

porum, 140. 
Bell, Dr. le, lecture on surgical 

operations, 79. 
Benet, Dr. Christopher, 75 ; 

method similar to that of 

Glisson, 113. 
Bentley, opinion of Warburton, 

76 ; his remarks on his own 

writings, 89. 
Bentley, Mrs., lamented that her 

husband devoted so much time 

to criticism, 90. 
Bernard, works of, in Dover 

Priory, 20. 
Bernard, Francis, MS. book of, 

134. 
Bernard, St., writings known to 

Mirfeld, 51. 
Besace, Master Ranulphus, 13. 
Besace, Ranulphus, Canon of St. 

Paul's, 14, 16. 
Beton, James, notes in the hand 

of, 151. 
Betthun, Dr., physician to James I, 

149 ; took degree at Padua, ib. 
Beza,Theodore, who gave Codex to 

University of Cambridge, 94. 
Bihliographiae Anatomicae Speci- 
men, by Dr. James Douglas, 

128. 
Bibliotheca Hispamca,^r8t Spanish 

dictionary published in London, 

63. 
Bigod, Roger, 8. 
Blackmore, praises Cole's work, 

85. 
Blackstone, Sir William, 4. 
Boerhaave, of Leyden, 153 ; 

Aphorisms published at Leyden, 

154 ; attitude of his school, 157. 
Boethius, 48 ; de Consolatione 

Philosophia, known to Mirfeld, 

51. 
Bonetus, of Geneva, consulted by 

Mayerne as to publication, 109. 
BotalluB mentioned by Sydenham, 

84. 
Botanical Studies, influence on 

medical, 128. 



I 



INDEX 



189 



Botany, inheritance from Middle 
Ages, 66. 

Boyce, Samuel, distressed poet, 
extract from letter of, in Sloane 
MSS, 134. 

Boyle, Robert, entertains Moly- 
neux, 135. 

Bracey, Ion, 98. 

Bradele, Walter de, treasurer of 
Eleanor of Provence, 14. 

Bradshaw, Henry, 20. 

Brady, Dr. Robert, Master of 
Caius, 84 ; Fellow of College of 
Physicians, 85 ; Keeper of re- 
cords in the Tower, ib. ; wrote 
a History of England, ib. ; wrote 
a treatise on cities and boroughs, 
ib. ; Regius Professor of Physic 
at Cambridge, ib. : represented 
Cambridge, ib. ; kept medical 
act for degree before Glisson, 
ib. 

BreviaHum Bartholomei, by Mir- 
feld, 25 ; examination of, 31, 
46, 55. 

Bridges, Dr. Robert, 69. 

British Islands, growth of clinical 
study in, 138. 

British Museum, foundation due 
to Sir H. Sloane, 130. 

British Plutarch, Wrangham's, 
90. 

Brotherhood of early Irish, 
Scotch and Welsh Physicians, 
148. 

Browne, Edward, admitted a 
Fellow, 1675, 69; published a 
volume of travels, tb. ; his edu- 
cation, 70; published a trans- 
lation of the Discourse of the 
Cossacks, ib. ; enters Trinity 
College, 1642, 71 ; applies for 
admission to M.B. degree, ib. ; 
studies and diversions, 72 ; 
attends lecture at Chirurgeon's 
Hall, 73 ; attends Dr. C. Terne's 
lectures, 74 ; marriage, 75 ; 
dines with Windet, ib. ; calls 
on Dey and King, 77 ; return 
to Norwich and further studies, 
78 ; goes to Paris, 79 ; visits 
Montpellier and cities of Italy, 
ib. ; travels with Dr. Paman, 
ib. ; studies anatomy at Padua 



under Marchetti, ib. ; visits 
Montpellier and Paris again, 
80 ; catches smallpox, ib. ; re- 
turns home, ib.; goes abroad 
again (1668), visits Holland, 
Vienna, Larissa, Hungary, 
Styria, Carinthia, home in 1669, 
ib. ; meets Lambecius, ib. ; 
Fellow of College of Physicians, 
ib. ; elected physician to St. 
Bartholomew's Hospital, 1675, 
ib. ; died, 1708, ib. ; attain- 
ments and knowledge of lan- 
guages, 81 ; his reading, ib. ; 
medical degrees, 82 ; notebooks 
in Sloane Collection, 133; 
meets Molyneux, 136. 

Browne, Joseph, edition of 
May erne's writings, 106, 109. 

Browne, Sir Thomas, father of 
Edward Browne, 69 ; writings 
and letters, 70 ; advises his son 
as to reading, 82 ; Common- 
place Books in Sloane Collec- 
tion, 133 ; Miscellanies, Observa- 
tions on Plants, in Sloane Collec- 
tion, 133 ; De Plantis Sacrae 
Scripturae, 136. 

Bruno, name occurs in Beton's 
MS., 152. 

Burke, 1. 

Burnet, Bishop, description of 
beginning of illness of Charles 
II, 77. 

Burnet, Thomas, geologist, 135. 

Burwell, G. de Mandeville's 
charter probably attested at, 
11. 

Bustorum Aliquot Reliquiae, 2. 

Buttley, Suffolk, Priory of Augus- 
tinian canons of, 11, 161. 

Csedmon, 6. 

Caesar, Julius, 5. 

Cairbre, an Irish scribe, 151. 

Caius, Dr. John, attainments of, 
2 ; praises Bartlott's learning, 
31, 56 ; Greek scholar and 
zoologist, 57, 58 ; description 
of his works on Natural History, 
60 ; De Ephemera Britannica, 
ib. ; one of the representatives 
of the kind of knowledge with 
which the College of Physicians 



190 



INDEX 



began, 66; first wrote an 
original description of disease 
observed in his own time, 90 ; 
living in St. Bartholomew's 
Hospital in 1555, 91. 

Calais, 79; taken by Duke of 
Guise (1558), 135. 

Calculi, 114. 

Calpurnius, father of St. Patrick, 
5. 

Cambridge, University of, 20. 

Canterbury, 79. 

Canterbury, Hubert Walter, Arch- 
bishop of, 12. 

Canterbury Tales, 20. 

Carinthia, 80. 

Cartulary of Abingdon, of Holy 
Trinity, Aldgate, 10. 

Casaubon, Isaac, Mayerne's notes 
on illness of, 110. 

Catalogue of Royal MSS., by Mr. 
J. P. Gilson, 45. 

Cecil, Sir Robert, Earl of Salis- 
bury, 95. 

Celtic inhabitants of Scotland, 
relation to inhabitants of 
Western Isles, France, and Low 
Countries, 153. 

Censors, with President, give im- 
primatur to Sloane's Catalogue, 
132. 

Cerebri Anatome, 11 ; by Willis, 
123. 

Chalcondylas, Demetrius, 55. 

Chambers, Dr. J., Physician to 
James I, 149. 

Chambre, Dr., original Fellow of 
the College of Physicians, 10. 

Chandler, the late Professor Henry 
William, 32. 

Charles I, letter to Mayerne, 109 ; 
Gaelic phrases said to have 
been used at his coronation, 
149 ; Mayerne's paper on re- 
medies for, when Prince of 
Wales, 110. 

Charles II, attack of apoplexy, 
123. 

Charles V, abdication ceremony 
of, 61. 

Charleton, Dr. Walter, wanted to 
recast Mayerne's notes, 110 
physician to Charles I, 114 
Exercitationes Pathologicae, llA 



praised in a poem by Dryden, 
115; method of description, 117. 

Chaucer's physician, 19, 152. 

Chaumpneys, legacy to prisoners 
in Newgate, 25. 

Cheapside, 5. 

Chemical History and Medical 
Treatment of Calculous Dis- 
orders, Marcet, Dr. A. J. G., 127. 

Chlorosis, 115. 

Christ Church, Canterbury, library 
of, 20. 

Christie, Mr. Richard Copley, his 
collection of editions of Horace, 
128. 

Chronic Rheumatism, Mirfeld on, 
39. 

Chute, Thomas, account of his 
smallpox, 117. 

Cicero, 81. 

Cicero, Quintus, 5. 

City, charter to Deorman pre- 
served by, 6. 

Clarumbald, physician and chap- 
lain, 10. 

Cleghorn, Dr. George, pupil of 
Alexander Munro, 155 ; Obser- 
vations on the Endemial Diseases 
of Minorca from the year 1744- 
9, ib.; practised and lectured 
at DulDlin, ib. ; friendship with 
John Fothergill, 156. 

Clement V, Pope, confirmed pre- 
sentation of living of Reculver, 
29. 

Clement, Dr. John, president in 
1544, 57 ; translated theologi- 
cal works, ib. ; Professor of 
Greek at Oxford, ib. ; one of the 
representatives of the kind of 
knowledge at beginning of 
College of Physicians, 66. 

Clinical medicine in England, 
origin of renaissance in the, 157. 

Clinical observation firmly estab- 
lished in England at beginning 
of eighteenth century, 125. 

Clogher, Bishop of, letter from 
Molyneuxto, 137. 

Close Rolls of Edward III, passage 
in, relating to St. Bartholo- 
mew's Hospital, 24. 

Clowes, William, surgeon to St. 
Bartholomew's Hospital, 93. 



INDEX 



191 



Cloyne, 144. 

Coffee plant, Dr. James Douglas 

wrote on, 128. 
Cole, Dr. William, appreciated 

Sydenham, 84 ; wrote on inter- 
mittent fever, 85. 
Colet, 57. 
College of Physicians, 1-3 ; sole 

guardian of medical learning, 

67 ; examination of candidates, 

82. 
Cologne, 80. 
Columquille (or Columba), 

Saint, 41 ; life of, at Schaff- 

hausen, 54. 
Comniuna, 7. 
Comparison of works of Sir T. 

Browne and Dr. Windet, 76. 
Confessions of Patrick, 5, 6. 
Connla Gael, St., bell of, 142. 
Conqueror, the, grants charter to 

Deorman, 6. 
Constable of Henry I, 8. 
Constantin, quotations from, in 

works of Middle Ages, 89. 
Constantine, one of the Seven 

Sleepers of Ephesus, 37. 
Constantinus Africanus, 48. 
Continent, the, of Rhazes, 48. 
Cook, Dr., book on Nervous 

Diseases, 44. 
Cormac mac Airt, king of Ire- 
land, 148. 
Cornhill, Henry of, sheriff (1189), 

161. 
Coroticua, Epistle against, 5. 
Courcy, John de, drove the Mac- 

Duinntsleibhes out of Down, 

143. 
Coutances, William of, Arch- 
bishop of Rouen, 161. 
Craig, Dr. John, physician to 

James I, 149. 
Cremonensis, Gerardus, name 

occurs in Beton's MS., 151. 
Cristina, daughter of Jeremias, m. 

Galfridus Aspoinz, 162. 
Crocus autumnalis, Dr. James 

Douglas wrote on, 128. 
Crokestone, Abbot of, 17. 
Cromwell, Oliver, his rooms in 

Sidney College, 136. 
Cross, St., Hospital of, 13. 
Crutched Friars, 77. 



Cullen, William, lecturer on 

medicine, 154. 
Cursus Medicus, by Nial O'Glacan, 

145. 
Cusa, Nicholas de, 52. 

Dacres, Lady, aunt of Thomas 
Chute, 117. 

Dal Cais, a group of allied clans, 
146. 

Damascien, 20. 

Dapifers, 8. 

Darwin, Dr. Erasmus, his MS. 
notes on Heberden's lectures, 
125. 

Degree of M.A., slight control of 
Universities over holders, 67. 

Deorman, charter granted to, 6. 

Dey, Dr. Joseph, 77. 

Diemerbrock, mentioned by Sy- 
denham, 84. 

Dinnshenchus, or Hill Lore, 140 ; 
prose and verse of, 148. 

Dionysius, one of the Seven 
Sleepers, 37. 

Dioscorides, botanical work of, 
66 ; quotations from, in works 
of Middle Ages, 89. 

Dominicans, John de Sancto 
Egidio gives Hospital of St. 
James to, 30 ; installed at St. 
Bartholomew's Priory by Queen 
Mary, 31. 

Donegal, the O'Breslans in, 142 ; 
Franciscan convent of, 144. 

Donnchadh, member of the Mac- 
Duinntsleibhe family, 143. 

Douglas, Dr. James, example of 
relation of study of Natural 
Science to that of Medicine, 
128 ; Lilium Samiense (pub- 
lished 1725), 128; Myogra- 
phiae Comparatae Specimen^ 
ih. ; Bihliographiae Anatomicae 
Specimen, ih. ; his text of First 
Ode of Horace and his catalogue 
of his editions of Horace, ih. ; 
became Fellow of the College 
(1721), 129; 'Fold' of, ih.; 
observations published in Philo- 
sophical Transactions, ih. ; came 
close to discovery of cause of 
cardiac murmurs, 130. 

Dover, 79. 



192 



INDEX 



Dover Priory, 19. 

Doyley, Thomas, knowledge of 
Spanish, 62 ; his generosity, 63 ; 
buried in Church of St. Bar- 
tholomew's Hospital, ih. ; one 
of the representatives of the 
kind of knowledge with which 
the College of Physicians be- 
gan, 66. 

Dryden, Epistle to Dr. Charleton, 
69; on 'a happy genius', 76; 
acknowledged head of world of 
letters, 136. 

Dublin, University of, 1. 

Dublin University Magazine, letters 
of Molyneux printed in, 135. 

Duff, Mr. J. D., note on Plutarch, 
43. 

Duncan, Dr. Matthews, 129. 

Dyneau, Dr., lectures on fever, 
79. 

Edinburgh, birthplace of James I, 
97 ; University of, first syste- 
matic teaching of medicine in, 
153. 

Edward VI, king, Wotton's book 
dedicated to, 58. 

Elector Palatine, letter from 
May erne to Har\'ey on treat- 
ment of, 108. 

Elizabeth, reign of, 93. 

Elzevir, Louis, of Amsterdam, 
printer, 124. 

Emnienologia, by Dr. John Freind, 
124. 

England, intolerable state of, 11. 

English Rose, by John of Gaddes- 
den, 48. 

Ent, Sir George, 69. 

Enteric fever, cause of death of 
Prince Henry, 96. 

Eoghan, member of the Mac- 
Duinntsleibhe family, 143. 

Epicurean philosophy, 82. 

Epilepsy, 40. 

Erasmus, 57. 

Ernulf, the physician, 11. 

Erpingham, Sir Thomas, statue 
of, 70. 

Essex and East Anglia, kingdoms 
of, 6. 

Essex, Castle of Pleshy in, 11. 

Essex, Earl of, 10. 



Estria, Prior Henry de, 20. 

Eudo, 8. 

Exchequer, officials of, 7 ; Hubert 

Walter, baron of, 11 ; court of, 

13. 

Faritius, Abbot of Abingdon, 9. 

Feidhlimidh (died in 1520), Pro- 
fessor of Medicine, 148. 

Feoiris (died 1504), Professor of 
Medicine, 148. 

Fever, May erne's notes on James 1, 
102. 

Finch, Sir John, of Christ's 
College, Cambridge, 79. 

Fitz-Patrick, Mrs., foundress of 
the Fitz-Patrick Lectures, 1. 

Fitz-Patrick, Dr. Thomas, in 
whose memory the Fitz-Patrick 
Lectures were founded, 1. 

Flamsteed, the astronomer, 136. 

Florarium Bartholomei, the, 44, 
46. 

Floyer, Sir John, author of The 
Physician s Pulse-Watch, 125. 

Foreigners, in London, 7. 

Forgaill, Dalian, poet, 149. 

Foster, Sir Michael, History of 
Physiology, 113. 

Fothergill, Dr. John, his five 
teachers all pupils of Boer- 
haave, 154; M.D. Edin. (1736), 
156 ; compared with Huxham, 
ih. 

Foxe, Bishop Richard, encourages 
Wotton in Greek, 58. 

France, king of, 16. 

Franciscan Convent, of Donegal, 
150. 

Freind, Dr. John, wrote The 
History of Physic from the time 
of Galen to the beginning of the 
Sixteenth Century, 3 ; medal 
struck in honour of, 56 ; under- 
stood importance of clinical 
observation, 124 ; Epistola de 
Purgantihus and Emmenologia, 
ib. 

French, the, in London, men- 
tioned in charters before Eng- 
lish, 7. 

Gaddesden, John of, 20 ; Rosa Ang- 
Uca, 40, 48 ; his works read by 



INDEX 



193 



Mirfeld, 50 ; known to old Irish 
physicians, 148 ; quoted by- 
James Beton, 151. 

Galen De Temperamentis, 2, 3, 5 ; 
works of, in Dover Priory, 20 ; 
his plan generally followed in 
mediaeval systems of medicine, 
34 ; observations on paralysis, 
43 ; his books read by Mir- 
feld, 48, 50 ; reverenced by 
both Mediaeval and Renais- 
sance physicians, 55 ; Opuscula, 
translated by Goulston, 65 ; 
read by Browne, 81 ; only 
once mentioned by Syden- 
ham, 84 ; true spirit of obser- 
vation obvious in, 88 ; quota- 
tions from, in works of Middle 
Ages, 89 ; quoted by James 
Beton, 151 ; on the Humours, 
quoted in Beton's MS., 152. 

Garth, understood importance of 
clinical observation, 124. 

' Gaspar fert mirram,' &c., verse 
repeated in ear of epileptic 
patients, 40. 

Gataker, Thomas, published Goul- 
ston 's work, 184. 

Gerald, Earl of Kildare, Lord 
Justice of Ireland (1478-1513;, 
146. 

Gerard, botanist, 66. 

Gesner, Conrad, naturalist, 60. 

Giant's Causeway, Molyneux's 
notes on, 137. 

Giffard, the chaplain, 10. 

Gilbert, the physician, 10 ; works 
of, in Dover Priory, 20 ; English 
(Anglicus), Mirfeld recom- 
mends a remedy of, 40 ; and 
acquaintance with works of, 48, 
50. 

Gilbert, William, De Magnete, 64 ; 
one of the representatives of 
the kind of knowledge with 
which College of Physicians 
began, 66 ; understood impor- 
tance of scientific observation 
in medicine, 92. 

Gilla na naingel (died 1335), Pro- 
fessor of Medicine, 148. 

Gilson, Mr. J. P., iv ; discoverer of 
the Florarium Bartholomei, 44. 

Glan villa, Ranulf de, 161. 



Glasgow, University of, 10. 

Glauber, the chemist, 81. 

Glissou, Dr. Francis, influence on 
medicine, 65, 66; Regius Pro- 
fessor of Physic, 72 ; lectures 
and disputations, 81 ; portrait 
of, 111 ; president of College 
(1667), 111 ; Tractatus de Rachi- 
tide, fii-st English complete 
account of a disease, ib. ; me- 
thod, 112 ; praised by Virchow, 
113; De Ventriculo, 113; one 
of the three great clinical 
observers in the seventeenth 
centurj-, 120; one of those who 
established the study of clini- 
cal medicine in England, 123 ; 
twelve volumes of lectures, &c., 
in Sloane Collection, 133. 

' Gold-headed cane,' 3. 

Goldsmith, Oliver, 1. 

Goodall, Goulstonian Lecturer, 
Harveian orator, and President 
of College, 85. 

Gordon, Bernard de, 38 ; books 
read by Mirfeld, 50 ; writer of 
the school of Montpelier, 147 ; 
books of, read by old Irish phy- 
sicians, 148 ; quoted in James 
Beton's MS., 151. 

Goulston, Theodore, made trans- 
lations from Galen, 65 ; his 
copy of the Opuscula of Galen, 
182 ; lived in parish of St. 
Martin, Ludgate, 183; ac- 
quainted with Harvey, ib. ; 
died 1632, ib. ; work on Galen, 
published 1640, ib. 

Grammar School at Norwich, 
70. ^ 

Grandison (or Cronson), John, 
Bishop of Exeter, 46. 

Grant, Field-Marshal Sir Patrick, 
knowledge of Gaelic, 149. 

Gratitude, of lecturer to, H. 
Bradshaw, 20 ; H. W. Chandler, 
32; R. C. Christie, 128; F. 
Darwin, 125; J. P. Gilson, iv ; 
Sir P. Grant, 149; J. H. 
Herbert, iv; R. Macadam, 147; 
S. H. O'Grady, 145, 147 ; R. W. 
Raper,41 ; Royal College of Phy- 
sicians, iv ; T. W. Stronge, 145. 

Gravesend, 79. 



194 



INDEX 



Great Seal, affixed to letters 
patent, 17. 

Greek, knowledge of, in Western 
Europe in Middle Ages, 54 ; 
importance of, at time of be- 
ginning of College of Physicians, 
66 ; Greek literature, predo- 
minant influence in College at 
its foundation, 89. 

Greffier, M. le Natier, Mayerne's 
note on, 106. 

Gregory, John, lecturer on medi- 
cine, 154. 

Gregory IX, Pope, 14. 

Grew, Nehemiah, botanist, Fellow 
of College, 135. 

Grey-backed crows observed by 
Molyneux, 136. 

Grimbald, physician to Henry I, 
8 ; witnesses charter of Abbey 
of Abingdon, 8 ; witnesses grant 
of Queen Matilda, 9 ; various 
other charters witnessed by, 
158, 159, 160. 

Grosseteste, Robert, Bishop of 
Lincoln, his classical and medi- 
cal knowledge, friendship with 
John de Sancto Egidio, 30 ; 
his considerable attainments in 
Greek, 54. 

Gualterus, Irish translation of, 
143. 

Guildhall, 6. 

Guise, Duke of, takes Calais, 135. 

Haemorrhoids, Mayerne's notes 
on James I, 102. 

Haimo, 8. 

Hali Abbas, 34. 

Hall, Bishop, Epistle to Mr. Mil- 
ward, 71. 

Harney, Dr. Baldwin, wrote Bus- 
torum Aliquot Reliquiae, 2 ; 
Harvey's letter to, 181. 

Hamo Magi^tter, 12. 

Harveian Oration, delivered by 
Terne, 75. 

Harvey, William, Harney's epi- 
gram on, 2 ; his additions to 
knowledge, 65; one of the repre- 
sentatives of the kind of know- 
ledge with which the College 
of Physicians began, 66 ; ac- 
quaintance with Sir G. Ent, 69 ; 



mutual esteem of Harvey and 
Hobbes, 86 ; handwriting, 181. 

Heberden, Dr. William, one of 
the greatest English physicians, 
wrote (in 1745) Antitheriaca, 28 ; 
wrote Commentarii Morborum 
Historia et Curatione, 125 ; last 
important Latin Medical trea- 
tise in England, ib. ; lectured at 
Cambridge, ib. ; Fellow of St. 
John's College, Cambridge, 
ib. ; Commentaries showing his 
method, ib. ; method of exam- 
ining patients, 126 ; death, ib. 

Helme, Brother John's mixture 
against plague, 35. 

Helsham, Dr. Richard, Regius 
Professor of Physic in the Uni- 
versity of Dublin, 138 ; friend- 
ship with Swift, ib. ; same kind 
of physician as Arbuthnot, ib. 

Hemicrania, 40. 

Henrietta Maria, queen,Mayerne's 
notes on, 107, 176 ; letter to 
May erne, 109. 

Henry I, king, grants land to 
Abingdon, 8 ; other charters 
and an ordinance, 9 ; founda- 
tion of Hospital and Priory of 
St. Bartholomew in reign of, 26. 

Henry II, king, witness of a char- 
ter, 12. 

Henry III, king, queen of, 14; 
Jew physicians in London in 
his reign, 17; medical studies 
in his reign, 30. 

Henry, Prince of Wales, Mayerne 
consulted in last illness of, 96 ; 
Mayerne's notes on, 110. 

Heraclius, patriarch of Jerusalem, 
13. 

Herbert, Bishop, of Norwich, 9. 

Herbert, Mr. J. H., IV. 

Hereditary physicians of Ireland, 
142. 

Hereditary professions of Ireland, 
142. 

Hertford, John of, abbot of St. 
Albans, 14. 

Hertfordshire, Ashbridge in, 46. 

Hervey, Bishop, of Bangor, 8. 

Hieracosophion of de Thou, 36. 

Higden, Ranulf, 48. 

Highmore of the antrum, 134. 



INDEX 



19.5 



Hippocrates, MSS. of, 2; works 
at Dover Priory, 20 ; observa- 
tions on injury to brain, 43 ; 
quoted by Plutarch, 44 ; in- 
fluence on Linacre and his con- 
temporaries, 55 ; practised at 
Larissa, 80 ; Aphorisms, 81, 145 ; 
often mentioned by Sydenham, 
84, 88. 

History of the Study of Clinical 
Medicine in the British Islands 
(Lecture III), 84. 

Hodges, Dr. Nathaniel, notebook 
in Sloane Collection, 13-3 ; 
heroic conduct and sad death 
of, lb. 

Holland, 80 ; medicine in Univer- 
sity of Edinburgh derived from, 
153. 

Holy Land, Hubert Walter goes 
to, 12. 

Holy Sepulchre, Hubert Walter 
admitted to, 12. 

Holy Trinity, Aldgate, Augusti- 
nian Priory of, 10; Prior of, 
11. 

Horace, works of, known to Mir- 
feld, 48, 50. 

Hospitallers, Master of the, 13. 

Hospitals, statutes of, 22 ; under 
care of Augustinians, 24. 

H6tel Dieu, at Amiens, 23 ; at 
Angers, 22 ; at Paris, Browne 
visits, 79 ; at Troyes, 24. 

Hungary, 80. 

Hunter, William, 10. 

Hutton, Richard, 46. 

Huxham, Dr. John, example of 
influence of Boerhaave in Eng- 
land, 156 ; Essay on Fevers, ih. ; 
treatise On the Malignant Ulcer- 
ous Sore-throat, ih. ; compared 
with Fothergill, ih. 

Hydatid of the ?t>er, Harvey's notes 
on, 92. 

Hydrocephalus, case of operation 
on by Mirfeld'p master, 26. 

Hysterical aphonia, possible case 
of, 27. 

Index to the Sloane MSS., by 

Edward J. L. Scott, 133, to 

the Fitz-Patrick Lectures by 
MUicent Moore, 187. 



Initials in MS., making Mirfeld'a 

name, 45. 
lona, St. Columba sees vision in, 

42. 
Ireland, history of learning in, 

139. 
Irish, never a printed literature, 

139 ; catechism in, published in 

Paris, 144. 
Irish elk, first described by Moly- 

neux in A Discourse concerning 

the Large Horns frequently found 

Underground in Ireland, 137. 
Isaac, son of Solomon, 48. 
Isaac, quotations from, in worka 

of Middle Ages, 89. 
Isidore, St., of Seville, Liher Etij- 

mologiarum, 19 ; works known 

to Mirfeld, 48, 51. 
Islip, Simon, constitutions of, 

45. 
Italy, St. Columba's vision of fire 

in, 42. 
Iwod, the physician, 11. 

Jacobin, origin of name, 30. 

Jamaica, Sloane's catalogue of 
plants of, 132. 

James, Dr. Montague Rhodes, 20. 

James, St., Hospital of, in Paris, 
given by John de S. Egidio to 
Dominicans, 30. 

James I, king, Mayerne's notes on, 
97-105, 149. 

Jaundice, Mayerne's notes on 
James I, 1( 2. 

Jenner, William, writings of, 93. 

Jeremias, father of Cristina, 162. 

Jerome, St., writings known to 
Mirfeld, 51. 

Johannes Scotus Erigena, trans- 
lated the Pseudo-Dionysius, 54. 

Johannicius on Scrophulus, 40. 

John, Bishop of Bath and Wells, 
witnesses charter of Henry I, 8. 

John {Comes Moretoniae), after- 
wards King John, makes grant 
to St. Bartholomew's Hospital, 
7 ; illness and death, 17 ; his 
visit to London in 1191, 161. 

John, Dr., of London, physician 
to Richard I, 13. 

John, Dr., of St. Giles (de Sancto 
Egidio), 16, 30, 31. 



196 



INDEX 



John, one of the Seven Sleepers 
of Ephesus, 37. 

John, Bon of Alexander, the car- 
penter of Walthamstead, 15. 

John, son of Walter le Lever, 15. 

John, the physician, receives 
grant from Dean of St. Paul's, 
10. 

John the Baptist, St., illumina- 
tion of. in MS., 32. 

Johnson, Dr. , affected by fate of 
Hodges, 134. 

Justiciar of England, Hubert 
Walter, 12. 

Justiciars of foreign birth, 7. 

Karlsruhe, MS. at, 140. 

Kent, Kingdom of, 6. 

Kilmacrenan, 143. 

King, Mr., surgeon, afterwards Sir 

Edmund, 77 ; attends Charles II 

in his last illness, ib. 

La Charite, Browne visits, 79. 

Lambecius, Librarian at Vienna, 
80, 81. 

Lambeth Palace, MS. in, 47. 

Lambeth, St. Thomas's Hospital 
in, 25. 

Lanfranc, works known to Mirfeld, 
48, 50. 

Larissa, 80. 

Latin, the language of com- 
position and communication 
at time for foundation of 
College of Physicians, 66. 

Laycock Abbey, Mayeme sees 
Queen at, 106. 

Lea, James, writes commendatory 
verse to Spanish Dictionary, 64. 

Lsabhar Breac, 41. 

Le Bell, Dr., lectures on surgery, 
79. 

Leland, Commentarii de Scrip- 
tor ibus Britannicis, 31 ; esti- 
mate of Bartlott, 56. 

Leprosy, Bernard of Gordon on, 

Letters of famous Physicians, in 

Sloane Collection, 133. 
Leviathan, The, 86. 
Lewis of France, invasion of 

England, 17. 
Leyden, University of, 136. 



Liher de Ephemera Britannica, by 
CaiuB, 90. 

Liber Etymologiarum, known to 
Mirfeld, 48, 51. 

Liber urinarum Theophili, abstract 
of in Beton's MS., 152. 

Lifesholt, grant of land in, 8. 

Lilium Medicines, by Bernard de 
Gordon, Mirfeld's knowledge of, 
38, 48 ; Irish translation of, 
147. 

Lilium Sarniense, Dr. James 
Douglas on, 128. 

Linacre, Thomas, Founder of the 
College of Physicians, 3, 10, 55 ; 
Greek Studies, 55, 57, 89; takes 
degree of M.D. at Padua, 55 ; 
one of the representatives of 
the kind of knowledge with 
which the College of Physicians 
began, 66. 

Lincoln, Bishop of, 18. 

Lincolnshire, Abbey of Swinestead 
in, 17. 

Linnaeus, botanists precise before 
his day, 127. 

Lismore, Book of , 146. 

Lister, Sir Matthew, goes with 
Mayerne to Exeter, 108 ; Phy- 
sician to James I, 149. 

Lister, Martin, made brief notes, 
120. 

Little Britain, 77. 

Lives of the British Physicians, by 
MacMichael, Munk and others, 3. 

Lobel, 66. 

Locke, Two Treatises on Civil 
Government, 86, on Shaftes- 
bury's case, 120. 

London, inRoman times, 5; foreign 
influence in, 6,8; Magnates of, 7 ; 
Civil institutions of, ib. ; first 
large monastic foundation in, 
10 ; Bishop of, ib. ; Physician of, 

Londonstone, Henry of, first 
Mayor of London, 161 ; its 
position, ib. 

Longchamp, Bishop of Ely, 161. 

Louis, writings of, 93. 

Low Countries, 80. 

Lower, Richard, 120. 

Lucretius, 5, 81. 

Ludford, Simon, 68. 



INDEX 



197 



Macadam, Robert; former owner 

of an O'Hickey MS., 147. 
MacBetha, or Beton, John, of a 

race of physicians, 151. 
MacCarthy riabhach, chief in 

south of Munster, 145. 
MacCarthy, Finghin, son of 

Dermot, 146. 
MacDubhgall, son of Ranald, 

daughter of, 151. 
MacMichael, Gold-headed Cane, 

3. 
MaicAedhagain, hereditary Irish 

judges, 142. 
Maic Conmidhe, hereditary poets 

or orators, 143. 
MaicDuinntsleibhe, family of 

hereditary physicians, 143; Cor- 

mac, works of, 144, 145 , his 

MSS. compared to those of the 

O'Liaigh, 147 ; took degree of 

Bachelor of Physic, 150. 
Malchus, one of the Seven 

Sleepers of Ephesus, 37. 
Malthus, the Apothecary, 117 ; 

political economist, ih. 
Mandeville, Geoffrey de, chief 

Constable of the Tower, 10. 
Marcellus Empiricus, medical 

charm from, 41. 
Marcellus, wrote on materia 

medica, 50. 
Marcet, Dr. A. J. G., an exact 

writer, 127. 
Marchetti, demonstrator of 

Anatomy at Venice, 79. 
Marci, Serlo de, great landowner 

of Essex, 7. 
Marci, William de, agreement 

with Dean and Canons of St. 

Paul's, 10. 
Marcian, one of the Seven 

Sleepers of Ephesus, 37. 
Marshalsea, Chaumpney's legacy 

to prisoners in, 25. 
Martin-le-Grand, St., Deans of the 

College of, 7. 
Martiniere de la, travels in Arctic 

regions, 81. 
Mary-le-Bow, St., Church of, 5. 
Mary without Bishopsgate, St., 

Hospital of, 25. 
Mary, Queen, gave Priory of St. 

Bartholomew to Dominicans, 31. 



Mary, Princess, taught by Linacre, 
57. 

Mary, St., of Dunmow, cartulary 
of, 7. 

Mason, Sir John, 58 ; his career, 
61. 

Matilda, Queen, grants by, 8, 9. 

Maureau, Dr., lectures on hernia, 
79. 

Maximian, one of the Seven 
Sleepers of Ephesus, 37. 

Maxwell Lyte's (Sir H. C.) 
Appendix to Ninth Report of 
Historical MSS. Commission^ 29. 

Mayerne, near Geneva, 94. 

Mayerne, Sir Theodore Turquet 
de, settled in England 1611, 65 ; 
knowledge of Chemistry, ib. ; 
date of death, 66 ; dedication 
of Pharmacopoeia, 67 ; devoted 
himself to minute clinical 
observation, 93 ; his note book, 
94 ; at Heidelberg, ih. ; M.D. of 
Montpellier, ih. ; attacked for 
using chemical remedies, 95 ; 
physician to King of France, 
and to King James I (1611), 
ih. ; goes to Queen Henrietta 
Maria at Exeter, 108; letters, 
110; portrait, ih.-, his works 
— method, 111; clinical ob- 
servations, 120 ; one of those 
who established the study of 
clinical medicine in England, 
123 ; his MSS. in Sloane Col- 
lection, 133; notes on the 
health of James I, 162-76; 
note on the health of Queen 
Henrietta Maria, 176-80. 

• Mayor,' origin of term, 7. 

Mead, understood importance of 
clinical observation, 124 ; Medi- 
cal Precepts and Cautions, 125. 

Measuring time by psalms and 
prayers, 39. 

Mediaeval learning in Ireland, 
139. 

Mediaeval physicians, method of 
study, 55. 

Medical Register of time of 
Henry III, 16. 

Medicine, outline of Mirfeld's at- 
tainments in, 51. 

Melchior, 40. 



198 



INDEX 



Mercia, kingdom of, 6. 

Middle Ages, reading thought 
chief source of medical know- 
ledge in, 19. 

Miledh, clan of, descendant of 
Gaedhel Glas, 148. 

Mirfield, John, Fourteenth Cen- 
tury MS. of, 19 ; writings of, 
25 ; his account of his Master, 
26 ; his Master treats a Canon 
of St. Bartholomew's, 42 ; on 
broken bones and materia 
medica, 44 ; initials, in MS., 
making his name, 45 ; warning 
against love of money, 47 ; 
attainments and character, 48, 
49 ; summary, 51 ; seems to 
have been unknown to ancient 
Irish physicians, 148. 

Mithridates, King of Pontus, 28. 

Mithridatium, 28. 

Modern languages, study of, in 
England, 62. 

Modern learning in Ireland, 139. 

Molins, Roger de. 13. 

Molyneux, Sir Thomas, born in 
Dublin 1661, 135 ; great grand- 
son of Sir Thomas Molyneux, 
of time Queen Mary, ih. ; gradu- 
ated at Trinity College, Dublin, 
ib. ; studies at Leyden, ib. ; 
letters of, ih. ; visits Cam- 
bridge and Oxford, 136 ; further 
studies at Leyden, ib. ; M.D. 
Dublin, 1687, ih. ; President of 
the Kings and Queen's College 
of Physicians in 1702, 137; 
medical writings, 137 ; accounts 
of the sea-mouse, Irish elk. 
Giant's Causeway, 137 ; died 
1733, ib. ; tomb at Armagh, ib. ; 
first great physician in Ireland, 
ih. ; resemblance to Sloan e, 138. 

Molyneux, William, brother of 
Sir Thomas, 136. 

Money, little in use in Ireland in 
the 15th century, 147. 

Monkwell Street, 73. 

Monro, Alexander, set example of 
systematic medical teaching in 
Edinburgh, 153 ; Medical Essays 
and Obsetrations published by a 
Society in Edinburgh, ib. ; pupil 
of Boerhaave, 154. 



Montpellier, 79. 

More, Henry, the Platonist, 

136. 
More, Sir Thomas, 57. 
Morgagni, writings of, 93. 
Morton, Richard, a careful 

observer. Fellow of College, 

1678, 120; description of case 

of a plasterer, 130. 
Mowat, late J. L. G., edited part 

of Mirfeld's works, 29. 
Muiris, member of the Mac- 

Duinntsleibhe family, 143. 
Munk, Dr. William, 3 ; Notae 

Harveianae, 181. 
Munster, 146. 
Muray, William, takes letter to 

Mayerne, 109. 
Muscegros, seneschal of Eleanor 

of Provence, 14. 
Music, African, noted by Sloane, 

132. 

Natural History of Ireland, by 

several hands, 137. 
Nero, 4. 
Newark, Abbot of Crokestone 

attended King John at, 17. 
Newcastle, Duchess of. New 

Blazing World, 81. 
Newgate Street, grant of land on 

south side of, 11. 
Newington, stall of, in St. Paul's, 

14. ' 
Newton, at meeting of Royal 

Society, 136. 
Niall, wood belonging to, 151. 
Nicholas, wrote on Materia 

Medica, 50. 
Norfolk, ravaged by King John, 

17. 
Norfolk, Duke of, 72. 
Norman Conquest, 6. 
Normans in London, 7. 
Northampton, charter witnessed 

at, 9. 
Northumbria, kingdom of, 6. 
Norwich Cathedral, 9. 

O'Breslans, the, Hereditary 
keepers of the bell of St. 
Connla Gael, 142. 

O'Caiside, the hereditary physi- 
cians of MacUidhir, 147, 



INDEX 



199 



O'Caiside, Finghin, died 1322, 
Professor of Medicine, 147. 

O'Callauain, Aonghus, writer, 
145. 

O'Callanains, the hereditary- 
physicians of MacCarthy, 145. 

O'Cearnaigh, Daibhi, an Irish 
scribe, 151. 

O'Clery, Michael, 144. 

O'Dalaigh, race of poets, 143. 

O'Donnell family, 143. 

O'Eachoidhern, Denis, translation 
made for, 145, 150. 

O'Glacan, Nial, Professor of 
Medicine at Toulouse, 145 ; 
Tractatus de Peste, 145. 

O'Grady, Standish Hayes, Cata- 
logue of Irish MSS., 133, 145, 
152 ; opinion of the O'Liaigh 
MSS, 147. 

O'Hicidhe, Nicholas, writer, 145. 

O'Hicidhe, Thomas, wrote a 
treatise on the Calendar 
(Cotton, Appendix LIj, 147. 

Oilei, Roger de, 8. 

Oilley, Nigel de, 9. 

O'Liaigh, hereditary physicians 
in Thomond, 147. 

O'Line, Dermot MacDonall, trans- 
lation made for, 144. 

O'Mailconaire, Thomas, levied 
rent for the Earl of Kildare, 
147. 

Oribasius, 3. 

Ormerod, Dr. J. A., 69. 

Ormond, Duke of. obtained first 
charter for Irish College of 
physicians, 135. 

Otuel, son of the Earl, 10. 

Ovid, 48, 50. 

Oxfordshire, Sheriff of, 9. 

Padua, 79. 

Paget, Sir George, 181. 

Palestine, Ranulf of Bisacia ac- 
companies King Richard to, 13. 

Paman, Dr. Henry, public orator 
at Cambridge, 84. 

Paracelsus, lectures at Basle, 87. 

Paris, 79. 

Paris, Matthew, 13, 14, 15, 16, 30. 

Parkinson, the botanist, 66. 

Patin, Dr. Guy, a staunch Galenist, 
79. 



Paul's Cathedral, St., charters at, 
9, 10, 29 ; MS. of Avicenna at, 
21 ; orchard held of, 23 ; Deans 
of, 7. 

Payne, Dr. J. F.,4. 

Pembroke College, Oxford, copy 
of Mirf eld's book at, 31. 

Percy vail, Richard, 63. 

Peter, St., ad Vincula, burial- 
place of Nicholas de Cusa, 54. 

Peter, son of Nevelon, sheriff in, 
1191, 161. 

Peterborough, Lord, 78. 

Petty, Sir William, first English 
political economist. Fellow of 
College of Physicians, 135. 

Pharmacopoeia, published by the 
College, 67. 

Philip Augustus, 30. 

Philosopher, the, quotations from, 
89. 

Philosophical Transactions,!! , 128, 
130, 137. 

Physicians, mentioned in records, 
8 ; education of, in the seven- 
teenth century. 50; Irish pro- 
visions concerning, 141. 

Pinckay, Mr., commissary of the 
royal army, 1 14. 

Plague, 133, 134. 

Plague, Mirfeld on, 34. 

Platearius (of Salernum), 38, 48, 
50, 151. 

Pleshy, remains of Castle of, 10. 

Plummer, pupil of Boerhaave, 154. 

Plutarch, his interest in medicine, 
43. 

Portsmouth, Lady, 77. 

Printing, 55, 76. 

Ptolemy, 65. 

Pulse, first counted by Nicholas 
de Cusa, 53. 

Purchas his Pilgrims, 81. 

Pyretologia, by Richard Morton, 
120. 

Quatremares, Ralph de, 23. 
Queensbury and Dover,I)uke of, 70. 
Quintus Serenus Samonicus, 28. 

Radcliffe, understood importance 
of clinical observation, 124. 

Rahere, Founder of Hospital and 
Priory of St. Bartholomew, 26. 



200 



INDEX 



Raleigh, History of the World, 81. 
Ranulf, the chancellor, 9. 
Ranult, Bishop of Durham, 8. 
Raper, R. W., his gift, 41. 
Rawdon, Sir Arthur, of Moira, 

sent Gardener to collect in 

West Indies, 132. 
Ray, 127 ; consulted by Sloane 

on arrangement of work on 

Natural History, 132. 
Reculver, living of, 29. 
Redvers, Hugh de, 10. 
Reeves, Bishop, owner of an 

O'HickeyMS.,147. 
Regimen Sanitatis Salertti, 44, 47. 
Reginald, Dr., 14. 
Reginald, physician, priest of St. 

Albans, 16, 
Reichenau, monastery of, 140. 
Reiner, son of Berenger, sheriff 

in 1156, 161. 
Relations between Hospital and 

Priory of St. Bartholomew, 26. 
Renaissance, medicine in the, 55. 
Rhazes, works of, in Dover Priory, 

20 ; The Continent of, 48 ; his 

writings, 50 ; endeavour to 

ascertain origins of diseases, 

33; quotations from, in works 

of Middle Ages, 89. 
Rhys, Professor, 41. 
Richard, formerly Archdeacon of 

Poictiers, 13. 
Richard, Bishop of London, 8. 
Richard Coeur de Lion, 12, 13. 
Richard, son of Reiner, sheriff in 

1189, 161. 
Richardo magistro, IB. 
Riverius, physician to king of 

France, 95. 
Robert, Bishop of Lincoln, 8. 
Robert, Earl of Essex, 63. 
Rochester, 79. 

Roger, Bishop of Sarum, 8, 9. 
Roger le due, sheriff in 1189 a,nd 

1192, 161. 
Roger, son of Alan, second mayor 

of London, 161. 
Roger of Salernum, 48, 50. 
Rogerius of Parma, 151. 
Rohaisia, wife of Geoffrey de 

Mandeville, 11. 
Roll of the Royal College of Phy- 
sicians of London, 8. 



Rome, 79. 

Romsey, charter witnessed at, 9. 

Rosa Anglica, of J. of Gaddesden, 
40. 

Roubiliac, statue by, 137. 

Round, Mr, J. R., History of Geoffrey 
de Mandeville, 11. 

Royal Medical and Chirurgical 
Society, copy of Goulston's 
work in Library, 184. 

Rufus, 20. 

Rutherford, Dr. John, pupil of 
Boerhaave and Douglas, gave 
first clinical lectures in Edin- 
burgh, 1748, 154. 

St. Albans, Abbey of, 15. 

Saladin, 13. 

Salisbury, Bishop of, 11, 161. 

Salisbury, John of, 48. 

Salisbury, Lord, Mayerne's notes 
on, 106. 

Salters' Hall, on site of house of 
Henry of Londonstone, 161. 

Samian ware, 4. 

Sancroft (W. Saner.), Archbishop, 
47. 

Sancto Egidio, John de (John of 
St. Giles), 16 ; studied at Ox- 
ford, Paris, and Montpellier, 
lived in Paris, gave Hospital of 
St. James to the Dominicans, 
Doctor of Divinity, became a 
Dominican, died in England, 
30-1. 

Scandinavian encroachment into 
Scotland, 152. 

Scoti, ancient name of inhabitants 
of Ireland, 148. 

Scotland, kings of, 149 ; queen 
of, 15. 

Scott, Mr. Edward, 133, 182. 

Sea air, formerly considered un- 
wholesome, 36. 

Seals to Richard of Poictier's 
charter, 13. 

'Senchus Mor,' Irish laws with 
commentaries, 140, 141, 142. 

Serapion, 48; depicted lecturing 
plant in hand, 52. 

Serapion, one of the Seven 
Sleepers of Ephesus, 37. 

Seven Sleepers of Ephesus, men- 
tion of still made by Arabs, 37. 



INDEX 



201 



Shaftesbury, Lord, 120. 

Shandy, Captain Toby, 71. 

Shipley, Mr. A., 80. 

Short, Dr. Thomas, 85, 86. 

Sidney Sussex College, letter of 
Harvey preserved in Library, 
181. 

Sieveking, Sir Edward, 182. 

Sinclair, pupil of Boerhaave, 154. 

Sinonima of Mirfeld, 29. 

Sittingbourne, 79. 

Sleaford, Castle of, 17. 

Sleat, 151. 

Sloane, Sir Hans, 2 ; owned many 
of Mayerne's papers. 111 ; un- 
derstood importance of clinical 
observation, 124 ; President of 
College of Physicians, 130 ; 
President of the Royal Society, 
131; Founder of British Museum, 
ih. ; studied at Paris, Mont- 
pellier, and Orange, ih. ; visited 
W. Indies, ih. ; works, 132 ; 
originator of British Museum, 
ih. 

Smithfield, St. Bartholomew's 
Priory in, 26. 

Somerset, John, 21. 

Southwark, St. Thomas's Hospi- 
tal formerly in, 25. 

Standard-bearers, 8. 

Standards of England, Hubert 
Walter reforms, 12. 

Stearne, Dr. John, one of the 
original Fellows of Irish 
College of Physicians, 138. 

Stephen, king, 9; state of Eng- 
land in reign of, 11. 

Stokes, Whitley, 140. 

Stronge, Mr. F. W., 135. 

Study of medicine, best prepara- 
tion for, 83. 

Styria, 80. 

Suetonius, 4. 

Suffolk, ravaged by King John, 17. 

Sussex, kingdom of, 6. 

Suthwelle, Johannes de, 45. 

Swammerdam, the zoologist, 81. 

Sweating sickness, Caius on, 91. 

Swift, 1 ; friendship with Dr. 
Richard Helsham, 138. 

Swinestead, Abbey of, 17. 

Sydenham, felt importance of 
observation, 84 ; work on small- 



pox, 88 ; degree at Oxford, 115 ; 
degree at Cambridge, 116; 
practised in London, ih. ; died 
1689, ih.; his works, 118, 119; 
a great clinical observer, 121 ; 
services to medicine in England, 
123 ; studied works of Ray, 127. 
Sylva, Don Vasco de, 63. 

Tahidorum Theatrum, by Benet, 

75. 
Tadhg an tsleibhe, hereditary 

historian, 150. 
Tara, 'Temhair', hearth of, 146, 

148. 
Templar, as witness, 11. 
Terne, Dr. Christopher, 74. 
Terne, Henrietta, marries Edward 

Browne, 75. 
Teutonic encroachment into 

Celtic Scotland, 152. 
Thames, 5. 
Theophrastus, 65. 
Theriaca, 28. 
Thessaly, 80. 
Thomas the Apostle, St., name of 

Hospital changed to, 25. 
Thomas the Martyr, St., hospital 

of, 25. 
Thomond, old name for part 

of Munster, now Co. Clare, 

146. 
Thorius, Raphael, poem, 110; 

MS. of his Latin poems, 134. 
Treatment of diseases of animals 

in Middle Ages, 36. 
Trinity College, Dublin, 1. 
Trismegistus, 19. 
Trousseau, advance of knowledge 

of epilepsy in his day, 51. 
Tulpius, Nicholas, three books of 

observations, 123. 
Tyngewich, Master Nicholas, 28 ; 

lectures of, 29. 
Tyriacum, attributed to Mithri- 

dates, 28. 
Tyson, Dr. Edward, portrait in 

College, 130 ; his works, ih. 

Ui Hicidhe or O'Hickey, heredi- 
tory physicians, 149. 

— Nicholas, 146. 

— MS. in the British Museum, 
146. 



202 



INDEX 



Ulidia, name of later kingdom 

of the Ultu, 144. 
Ulltach, Maurice, 144. 
UUtach, Christopher, 144. 
Ulster, plantation of, by James I, 

144. 
Ulster, kings of, 144. 

Valdes, Don Pedro de, 63. 

Van Swieten's commentary on 

Boerhaave, 155. 
Vandyke, portraits of Henrietta 

Maria, 107. 
Veau, Doctor de, godson of 

Mayerne, 73. 
Venice, 79. 
Vienna, 80. 

Villa Nova, Arnaldus de, 48. 
Virchow, Professor, Croonian 

lecture, 113. 
Virgil, 48. 
Vitry, Jacobus de, Bishop of Acre, 

Historia Occidentalis, 21. 

Walbrook, 5. 

WaldriCjChancellor of Henry I, 8. 
Walter, Hubert, Dean of York, 

Bishop of Salisbury, 11, 161 ; 

Archbishop of Canterbury, 12. 
Walter, son of Richard, 8. 
Walterus, filius Roberti, 7. 
Warburton, Dr., 76. 
Wards of the City, 7. 
Webb, Mr. E. A., 29. 
Wendover, Richard of, physician, 

Canon of St. Paul's, 16. 
Wepfer, John James, 123. 
Werelwast, William de, 8. 
Wessex, kingdom of, 6. 
Westminster Abbey, land held of, 

23. 
Westminster, charter witnessed 

at, 9. 
Westminster Street, hospice in, 8. 
Whytt, Robert, lecturer, pupil of 

Boerhaave, 154. 
Wilks, Sir S., writings of, 93. 



William, son of Adam, 15. 

William, Dean of St Paul's, grant 
by, 10. 

William III, king, Bmdy refuses 
to take the oath to, 85. 

William, physician of St. Albans, 
15. 

Willis, Thomas, 77 ; writings of, 
119; Cerebri Anatome, 123. 

Wincfeld, land at, 9. 

Winchester, Richard of Poictiers, 
Bishop of, 13. 

Windet, Dr., poems by, 75. 

Windsor, grant made at, 8. 

Winterton, Ralph, edition of 
Aphorisms of Hippocrates, 81. 

Witch trial, 70. 

Wrangham, relates anecdote of 
Bentley, 90. 

Wren, 5. 

Writers on medicine in Middle 
Ages, 89. 

Writing introduced into Ireland 
from Italy, 139. 

Woodstock, charter issued at, 9. 

Worcester, King John's body 
carried to, 18. 

Wotton, Edward, Greek lecturer 
at Corpus Christi College, 
Oxford, 58; President, 1541, 
57 ; takes M.D. degree at 
Padua, 58 ; De Differentiis 
Animalium, ib. ; studied chiefly 
Greek, 89 ; represents the kind 
of knowledge with which the 
College of Physicians began, 
66. 

Wulstan, St., 18. 

York, Hubert Walter, Dean of, 12. 
Ysaac, his work on diet, read by 
Mirfeld, 50. 

Zoological collection in St. James's 

Park, 74. 
Zoological studies, influence on 

medical, 128. 



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