Part 31
But to return to our barbers.--These ambitious shavers gradually attempted to glean in the footsteps of the regular chirurgeons, and even to encroach upon their domain, by performing more important operations than phlebotomy and tooth-drawing; the audacious intruders were therefore very properly brought up _ex officio_ by the attorney-general of France, and forbidden to transgress the boundaries of their art, until they had been duly examined by master chirurgeons; although these said masters were not better qualified than many of the barbers. Such was their ignorance indeed, that Pitard, an able practitioner, who had successively been the surgeon of St. Louis, Philip the Brave, and Philip the Fair, obtained a privilege to examine and grant licences to such of these masters who were fit to practise, without which licence all practitioners were liable to be punished by the provost of Paris; and in 1372 barbers were only allowed to dress boils, bruises, and open wounds.
Although this account chiefly refers to France and its capital, yet the same distinction and division between surgeons and barbers prevailed in almost every other country; and privileges were maintained with as much virulence and absurdity as the present controversial bickerings between physicians and surgeons.
In 1355 these master-surgeons constituted a faculty, which pocketed one-half of the penalties imposed upon the unlucky wights who had not the honour of belonging to their body. They also enjoyed various immunities and exemptions; amongst others, that of not keeping guard and watch in the city of Paris. To increase their emoluments, they granted as many honorary distinctions as they could in decency devise, and introduced the categories of bachelors, licentiates, masters, graduates, and non-graduates of surgery. The medical faculty now began to complain of the encroachments of the master-surgeons on their internal domain of poor mortality with as much bitterness as the masters complained of the impertinent invasion on the part of the barbers, of their external dominion. To court the powerful protection of the university against these interlopers, the surgeons consented to be considered as the scholars of the medical faculty, chiefly governed by clerical physicians.
In 1452 a fresh source of dissension arose amongst clerical physicians, lay physicians, master surgeons, and barbers. Cardinal Etoutville abolished the law which bound the physicians of the university to celibacy, when, to use the historian's words, "many of the clerical physicians, thinking there was more comfort to be found in a wife without a benefice than could be expected in a benefice without a wife, abandoned the priesthood, and were then permitted to visit their patients at their own houses." Thus thrown into the uncontrolled practice of medicine, these physicians became jealous of the influence of the surgeons, to whom they had been so much indebted; and they had recourse to every art and manoeuvre that priestcraft could devise to oppress and degrade them. To aid this purpose, they resorted to the barbers, whom they instructed in private, to enable them to oppose the master-surgeons more effectually. The surgeons, indignant at this protection, had recourse to the medical faculty, supplicating them to have the barbers shorn of their rising dignity. Thus for mere motives of pecuniary interest, and the evident detriment of society, did these intriguing practitioners struggle for power and consequent fees; and, according to the vacillation of their interests, the barbers became alternately the allies of the physicians or the mercenary skirmishers of the surgeons.
From this oppression of the art, for nearly three centuries surgery was considered a degrading profession. Excluded from the university, not only were surgeons deprived of all academic honours and privileges, but subjected to those taxes and public burdens from which the members of the university, being of the clerical order, were exempted. This persecution not only strove to injure them in a worldly point of view, but the priests carried their vindictive feelings to such a point of malignity that when Charles IX. was about to confer the rites of apostolical benediction upon the surgeons of the long robe, the medical faculty interposed on the plea of their not being qualified to receive this benediction, as they did not belong to any of the four faculties of the university; and as the chancellor, or any other man, had not the power of conferring a blessing without the pope's permission and special mandate, both surgeons and barbers ought to be irrevocably damned. The apostolical benediction in those days was considered of great value, since it exempted all candidates from examination in anatomy, medicine, surgery, or any other qualification, when they applied for a degree.
Ever since the healing art ceased to be a clerical privilege, and a state of rivalry prevailed between spiritual and corporeal doctors, the former have sought to represent their opponents as infidels and atheists--the unbelief of physicians became prevalent, and to this day medical men are generally considered freethinkers;--an appellation which in a strictly correct acceptation might be considered more complimentary than opprobrious, since it designates a man, who extricating his intellectual faculties from the meshes of ignorance or prejudices, takes the liberty of thinking for himself.
Sir Thomas Brown in his "Religio Medici," alludes to this injurious opinion entertained of medical men, when he says, "For my religion, though there be several circumstances that might persuade the world I have none at all, _as the general scandal of my profession_, the natural course of my studies, the indifferency of my behaviour and discourse in matters of religion--yet in despite thereof, I dare, without usurpation, assume the honourable style of Christian."
Sir Kenelm Digby in his observations on the work from which the above is extracted, entertains a similar opinion, and quotes Friar Bacon in support of it. The following are his words: "Those students who busy themselves much with such notions as reside wholly in the fantasy, do hardly ever become idoneous for abstracted metaphysical speculations; the one having bulky foundations of matter, or of the accidents of it, to settle upon--at the least with one foot; the other flying continually, even to a lessening pitch in the subtile air. And accordingly it hath been generally noted, that the excellent mathematicians, who converse altogether with lines, figures, and other differences of quantity, have seldom proved eminent in metaphysics or speculative divinity. Nor again, the profession of their sciences in other arts, much less can it be expected that an excellent physician, whose fancy is always fraught with the material drugs that he prescribeth his apothecary to compound his medicines of, and whose hands are inured to the cutting up, and eyes to the inspection of anatomized bodies, should easily and with success ply his thoughts at so towering a game, as a pure intellect, or separated and unbodied soul."
That such ideas should be maintained in former days, when bigotry and prejudice reigned paramount, we cannot be surprised; but one must marvel to see a modern and intelligent annotator of Brown's work,[27] coincide in this illiberal opinion, in the following terms:
"Imaginative men, that is, persons in whom the higher attributes of genius are found, seldom delight in the sciences conversant with mere matter or form; least of all in medicine, the object of which is the derangement, or imperfection of nature, and the endeavour to substitute order and harmony in the place of their opposites. Brought thus chiefly into contact with diseased organization, surrounded by the worst elements of civil society, (for their experience must in general be among the intemperate and the vicious,) they may be said to exist in an infected moral atmosphere, and it is therefore not greatly to be wondered at that among such persons a highly religious frame of mind should be the exception and not the rule."
The absurdity of this observation can only be equalled by its extreme illiberality. Can it be for one moment entertained, that the physician who gives his care to every class of society and at all ages "exists in an infected moral atmosphere?" Supposing that he is not fortunate enough to attend upon the opulent and the great, and is limited to a pauper or an hospital practice, does Mr. St. John mean to say that instances of intemperance and vice are confined to the indigent, although want of education, and poverty may degrade them in crapulous pursuits? If there does exist a profession pre-eminent for its philanthropic character, and the power of discrimination between good and evil, and right and wrong, it is undoubtedly that of medicine. The finest feelings of humanity are constantly brought to bear, both in seeking to relieve bodily sufferings and solacing an afflicted mind--whether it be with the scalpel in hand in an anatomical theatre, or by the bedside of an agonized sufferer, whom he hopes, under Providence, to restore to health and to his family, the physician has daily opportunities of beholding the wonders of the creation and the benevolence of the Creator--he is a constant witness of the fervent supplication of the unfortunate and the heartfelt gratitude of those suppliants at the throne of mercy, whose prayers have been heard. A man of exalted benevolence (and such a physician ought to be), he must be alive to all the generous feelings of humanity, and he is doomed more frequently to move in an _infected moral atmosphere_, when gratuitously attending some of the troublesome and pedantic legislators of the republic of letters, than when exerting his skill to relieve the grateful poor who may fall under his care.
It has been maintained that the physician seeking in the arcana of nature the causes of every vital phenomenon becomes a materialist: nothing can be more unjust, nay, more absurd, than such a supposition. The study of physiology teaches us, more perhaps then any other pursuit, to admire the wonderful works of our Creator, and Voltaire has beautifully illustrated the fact in the following lines:
Demandez a Sylva par quel secret mystere Ce pain, cet aliment dans mon corps digere, Se transforme en un lait doucement prepare; Comment, toujours filtre dans des routes certaines, En longs ruisseaux de pourpre il court enfler mes veines; A mon corps languissant donne un pouvoir nouveau, Fait palpiter mon coeur et penser mon cerveau; Il leve au ciel les yeux, il s'incline, il s'ecrie Demandez le a CE DIEU qui m'a donnez la vie.
Broeseche has justly said, _Tanta est inter deum, religionem, et medicum connexio, ut sine Deo et religione nullus exactus medicus esse queat_; and it has truly been said by a later writer, "that a philosophic physician must seek in religion, strength of mind to support the painful exertions of his profession, and some consolation for the ingratitude of mankind."
Amongst the many glaring absurdities which retarded the progress of medical studies, one cannot but notice the presumptuous claims of the physicians to the exclusive privilege of teaching surgery to their pupils, while anatomy was solely professed by surgeons, and not considered necessary in the instruction of a physician. All these anomalies can be easily traced to that spirit of dominion, exclusion, and monopoly, which invariably characterized clerical bodies. To such a pitch was this destructive practice carried, that surgeons were only allowed to perform operations in the presence of one or more physicians: nor were they permitted to publish any work on their profession until it had been licensed by a faculty who were utterly ignorant of the matter of which it treated. The celebrated Ambrose Pare could only obtain as a special favour from his sovereign, the permission to give to the world one of its most valuable sources of information.
So late as 1726 we find the medical faculty of Paris making a formal representation to Cardinal de Noailles and the curates of that capital to prevent surgeons from granting certificates of health or of disease, and this application was grounded on the pious motive of enforcing a more rigid observance of Lent! They further insisted that this indispensable mortification was eluded in consequence of the facility of obtaining certificates that permitted persons stated to be indisposed to eat animal food, eggs, and butter, whence infidelity was making a most alarming progress, threatening the very existence of church and state, and the overthrow of every ancient and glorious institution. The faculty were formally thanked for their pious zeal in the true interests of religion, and the spiritual welfare of their patients; and orders were affixed upon the door of every church, anathematizing all certificates that emanated from the unholy hands of surgeons and barbers.
These unfortunate barbers, although they humbly submitted to the sway of both physicians and surgeons when it suited their purpose, were in turn persecuted by both their allies and alternate protectors; so much so, that the clerical practitioners at one time prohibited them from bleeding, and conferred this privilege upon the bagnio-keepers. From the well-known nature of these establishments, various may be the reasons that led to this patronage, which was clearly an attempt to qualify bagnio-keepers to extend their convenient trade.
At last, in the year 1505, barbers were dignified with the name of surgeons. Their instructions were delivered in their vernacular tongue, until the university again interfered, and ordered that lectures should be delivered in Latin; once more closing alma-mater against illiterate shavers, who were, however, obliged to give a smattering of classical education to their sons destined to wield alternately the razor and the lancet. In 1655, surgeons and barber-surgeons were incorporated in one college; a union which was further confirmed, in 1660, by royal ordonnance, under some limitations, whereby the barbers should not assume the title of licentiates, bachelors, or professors, nor be allowed to wear the honourable gown and cap that distinguished the higher grades of learning. Red caps were in former times given by each barber to his teacher on his being qualified, and gloves to all his fellow-students.
Thus we find that the high state of perfection which the surgical art has attained is solely due to the efforts of industry to free itself from the ignoble trammels of bigotry and prejudice. Intellectual progress has invariably been opposed in every country by those powerful and interested individuals who derived their wealth and influence from the ignorance of society. Corporate bodies monopolizing the exercise of any profession will invariably retard instruction and shackle the energies of the student. It is, no doubt, indispensable that the practice of medicine in all its branches should only be allowed to such persons as are duly qualified; but whenever pecuniary advantages are derived from the grant of the permission, abuses as dishonourable as they are injurious to society will infallibly prevail. In Great Britain the period of study required in medical candidates is by no means sufficient. Five or six years is the very lowest period that should be insisted on; and, when duly instructed, degrees and licences should be conferred without fee, on all applicants, by a board of examiners unprejudiced and disinterested. This mode of granting licences would add to the respectability of the profession, while it would ensure proper attendance to the public. Physicians and surgeons would then become (what to a certain extent the latter are at present, though illegally as far as the laws of the college go), general practitioners, and society would no longer be infested by the swarms of practising apothecaries, who, from the very nature of their education, can only be skilled in making up medicines, or who must have obtained experience in the lessons taught by repeated failures in their early practice, unless perchance they have stepped beyond the usual confined instruction of their class. The consequences that arise from this fatal system are but too obvious. These men live by selling drugs, which they unmercifully supply, to the material injury of the patient's constitution. If, after ringing all the changes of their materia medica without causing the church-bell to toll, they find themselves puzzled and bewildered, a physician or a surgeon is called in, and too frequently these practitioners are bound by tacit agreement not to diminish the revenue that the shop produces. If it were necessary to prove the evils that result from the monopolizing powers vested in corporate institutions, the proof might be sought and found in the virulence and jealousy which they evince in resisting reform, from whatever quarter it may be dreaded; and it may be said that too many of the practising apothecaries of the present day stand in the same relative situation in the medical profession as the barbers of olden times.
This faculty of exercising every branch of the profession, however qualified, is of olden date, and we find on the subject the following lines in the writings of Alcuin in the time of Charlemagne:
Accurrunt medici mox Hippocratica tecta: Hic venas findit, herbas hic miscet in olla; Ille coquit pultes, alter sed pocula perfert.
ON DREAMS.
Philosophical ingenuity has long been displayed in the most learned disquisitions in an endeavour to account for the nature of these phenomena. The strangeness of these visionary perturbations of our rest--their supposed influence on our destinies--their frequent verification by subsequent events--have always shed a mystic _prestige_ around them; and superstition, ignorance, and craft, have in turns characterized them as the warnings of the Divine will, or the machinations of an evil spirit.
Macrobius divided them into various categories. The first, the mere _dream_, _somnium_, he considers a figurative and mysterious representation that requires to be interpreted. Dion Cassius gives an example of this in the case of Nero, who dreamt that he saw the chair of Jupiter pass into the palace of Vespasian, which was considered as emblematical of his translation to the empire.
The second distinction he terms a _vision_, _visio_, or a foreboding of future events. The third he deemed _oracular_, _oraculum_, and this was the case when a priest, or a relative, a deity, a hero, or some venerable person, denounced what was to happen, or warned us against it. As an example of this inspiration, for such it was considered, an anecdote of Vespasian is related. Having heard that a man in Achaia had dreamt that a person unknown to him had assured him that he should date his prosperity from the moment that Nero should lose a tooth,--a tooth just drawn from that emperor being shown to him the following day, he foresaw his destinies: soon after Nero died, Galba did not long survive him, and the discord that reigned between Otho and Vitellius ultimately placed the diadem on his brow. These inspirations were considered by Cicero, and various philosophers, as particularly appertaining to the shrine of the gods; those who sought that heavenly admonition were therefore recommended to lie down in temples. The Lacedaemonians sought slumber in the temple of Pasithea; Brizo, the goddess of sleep and dreams, was worshipped at Delos, and her votaries slept before her altars with their heads bound with laurel, and other fatidical symbols; hence divination by dreams was called _Brizomantia_. Supplications were offered up to Mercury for propitious visions, and a caduceus was placed for that purpose at the feet of beds; hence was it called [Greek: ermies].
Diodorus informs us that dreams were regarded in Egypt with religious reverence, and the prayers of the devout were often rewarded by the gods with an indication of appropriate remedies. But the confidence in supernatural agency and the power of magic, was only deemed a last resource, when human skill had been baffled. Some persons promised a certain sum of money for the maintenance of sacred animals, consecrated to the divinity whose aid they implored. In the case of infants, a certain portion of their hair was cut off and weighed, and when the cure was effected an equal quantity of gold was given to the successful intermediator.
The fourth division was _insomny_, _insomnium_, which was characterized by a disturbed repose, caused either by mental or bodily oppression, or solicitude. The fifth class of dreams was the _phantasm_ or _visus_, which takes place between sleeping and waking, in a dozing and broken slumber, when the person thinks himself awake, and yet beholds fantastic and chimerical figures floating around his couch. Under this class is placed the _ephialtes_, or night-mare. Macrobius represents the phantasm and the insomnium as little deserving of attention, being of no use in divination and prediction.
When these notions prevailed, the interpretation of dreams became a profitable trade; and it is a lamentable truth, that, to the present day, it is considered a speculation upon credulity. We find in Plutarch's Life of Aristides that there were tables drawn out for this purpose; and he speaks of one Lysimachus, a grandson of Aristides, who gained a handsome livelihood by this profession, taking up his station near the temple of Bacchus. Rules of interpretation were formed by Artemidorus, who lived in the reign of Antoninus Pius, and he drew his conclusions from circumstances considered either propitious or sinister. Thus, to dream of a large nose, signified subtlety; of rosemary or sage, trouble and weakness; of a midwife, disclosure of secrets; of a leopard, a deceitful person. These interpretations became so multiplied, that at last it was decreed that no dreams which related to the public weal should be regarded, unless they had visited the brains of some magistrates, or more than one individual. But what limits can any enactment assign to the influence of credulity and superstition? Cicero informs us that the Consul Lucius Julius repaired to the temple of Juno Sospita, in obedience to a decree of the senate regarding the dream of Caecilia, daughter of Balearicus.
In more modern times we have often seen dreams resorted to, in order to assist the speculations of policy and priestcraft; some of them as absurd in their nature as revolting in their interpretation. Monkish records relate that St. Bernard's mother dreamed that she had a little white dog barking about her, which was interpreted to her by a religious person as meaning "that she should be the mother of an excellent dog indeed, who should be the hope of God's house, and would incessantly bark against its adversaries, for he should be a famous preacher, and cure many by his medicinal tongue." Our Archbishop Laurence, to whom we owe the church of Our Lady at Canterbury, was about to emigrate to France under the discouragement of persecution, until warned in a dream, and severely scourged by St. Peter for his weakness. It was on the relation not only of this dream, but on actually exhibiting the marks of the stripes he had received, that Eadbald was baptized, and became a protector of the church. It was in a dream of this description that St. Andrew instructed Peter Pontanus how to find out the spear that had pierced our Saviour's side, and which was hidden somewhere near Antioch. Antioch was at that time besieged by the Persians, and half famished; but this weapon being carried by a bishop, enabled the besieged to beleaguer Caiban, the Persian general.
The Peripatetics represented dreams as arising from a presaging faculty of the mind; other sects imagined that they were suggestions of daemons. Democritus and Lucretius looked upon them as spectres and _simulacra_ of corporeal things, emitted from them, floating in the air, and assailing the soul. A modern writer, Andrew Baxter, entertained a notion somewhat similar, and imagined that dreams were prompted by separate immaterial beings, or spirits, who had access to the sleeper's brain with the faculty of inspiring him with various ideas. Burton divides dreams into natural, divine, and daemoniacal; and he defines sleep, after Scaliger, as "the rest or binding of the outward senses, and of the common sense, for the preservation of body and soul."