Medieval Contributions to the Search for Truth in Clinical Medicine

Experimentum ad hoc et est verum: lacerte murorum decoquantur ter in oleo et ex oleo inungantur supercilia. (Tried and true: lizards of the walls are cooked three times in oil and (when removed) from the oil are smeared on the eyebrows.) [1, p. 28; 2, fol. 115r]

The above prescription for alopecia of the eyebrows is found in the Eye Book of Master Peter of Spain, written in the mid-13th century. After advocating cooked lizards, Peter went on to suggest the method of Constantine:

Stercus lupi, in quo oriuntur quasi pili de eo fit pulvis et oleo laurino commisceatur et ungantur supercilia. (Wolf dung, in which hairs seem to sprout; from it a powder is made and mixed with oil of laurel and rubbed into the eyebrows.)

As these examples suggest, prescriptions used in Western Europe during the Middle Ages tended to be complex and expensive, often assembled from ingredients obtained over great distances. Although apothecaries became available in many cities toward the end of this era, often serving the dual role of compounders of medicines and purveyors of spices [3], physicians were expected to be able to compound many of their own prescriptions, and they may also have supervised the work of apothecaries. Fairly specific directions were provided in contemporary medical texts:

A collyrium made of bile of swallow, of partridge, juice of fennel, rue all in equal parts. This should be used two to three times a day for treatment of adhesion of the eyelid to the eye globe. For itching of the eyes, powdered excrement, placed in the eye has been proven useful on many occasions. For pannus [membranous covering of the cornea or other opaque cornea] and ungula [pterygium] of the eyes, take rock salt and cuttlefish bone and the dried excrement of a boy, in equal parts. Heat each separately in a new pot. Finally, in like manner, you should grind each, powder them and sieve through a fine linen cloth. You may place that powder in the eyes. In the same circumstance, take soda, washed with water, grind it finely in a mortar and pass it through the fine cloth sieve. Then introduce the powder into the eye. You may always employ it against pannus and other moderate white opacities. [1, pp. 17-35; 2, fol. 115v-116r]

The manuscripts containing these prescriptions use a recognizable system of apothecary weights and symbols, described by Thompson in his text on the history of apothecaries [4].

The late Middle Ages was a time when medicine was emerging from the long darkness of unquestioned tradition, tradition of often unremembered origin but clearly felt validity. Much of Greek and Arabic medicine was born again in the Western world during this period: Aristotle and Galen were rediscovered, and Avicenna was widely admired. The Church dominated all scholarship and regulated medical thought through control of its clergy and of the roots of education. Like physicians from earlier times, medieval scholars bundled together functions now separate, so that a single man, educated as a priest, might function as both philosopher and physician; physicians were often scholars and scholars were churchmen. Medicine was one of the recognized postgraduate programs of study; those who would be surgeons followed a course of apprenticeship. Prominent among the 13th-century physician-scholars was Peter of Spain (d. 1277), probably a native of Lisbon. Peter had had extensive education in philosophy and theology in Paris, as well as a medical education in Paris (or perhaps Montpelier or Salerno). He was a successful physician and scholar of medicine and philosophy; he may also have been the Peter who wrote an important treatise on logic. Peter of Spain's Church career was so successful that in 1276, he became Pope John XXI [5, 6]. In addition to his Eye Book, Peter wrote a book on general medicine, and also wrote...