What is of special interest to us here, however, in this volume, is the fact that Pope John [XXII] gave all the weight of the Papal authority, the most important influence of the time in Europe, to the encouragement of medical schools, the maintenance of a high standard in them, and the development of scientific medicine. At this time medicine included many of the physical sciences as we know them at the present time. Botany, mineralogy, climatology, even astrology, as astronomy was then called, were the subjects of study by physicians, the last named because of the supposed influence of the stars on the human constitution. Because of his encouragement of medical schools and his emphatic insistence on their maintaining high standards, Pope John must be commended as a patron of science and as probably having exerted the most beneficial influence in his time on education.

James J. Walsh, The Popes and Science (1908)

At this time, during the first half of the sixteenth century, the Papal Medical School begins to assume an importance in the history of medicine which it was to continue to hold for the next two centuries. After the refoundation of the Sapienza by Pope Alexander VI., and its development under Pope Leo X., special care was taken and no expense spared by their successors, to secure the greatest teachers in anatomy in the world for the medical department of the Papal University. At this time all the great physicians were distinguished for their attainments in anatomy, somewhat as in the nineteenth century great physicians obtained their prestige by original work in pathology.

The situations in the two centuries had much more in common than the casual reader of history or even the ordinary student of medicine would appreciate. The list of Papal Physicians, then, becomes to a great extent the roll of the professors of anatomy at the Papal University Medical School. The Popes of this period were wise enough in their generation to realize that the men who devoted themselves to original research in increasing the knowledge of the human body, were also those likely to know most about the diseases of the body and their treatment. These scientific anatomists, with the chastening knowledge of the complexity of the human body before them, probably made less claims to power to cure diseases than many an enthusiastic therapeutist of the time, who thought, as have representatives of this specialty in every generation, that he has many infallible remedies for the cure of disease, though subsequent generations have not agreed with him.

James J. Walsh, The Popes and Science (1908)

The greatest surprise is to be found in Professor Draper’s ignorance of the history of his own profession. He says, “It had always been the policy of the Church to discourage the physician and his art; he interfered too much with the gifts and profits of the shrines.” Professor Draper apparently knew nothing of the magnificent medical schools attached to the universities in the medieval period, whose professors wrote great medical and surgical text-books, which have come down to us, and whose faculties required a far higher standard of medical education than was demanded in America in Professor Draper’s own day. For about 1871 anyone who wished might enter an American medical school practically anywhere in the country, without any preliminary education, and having taken two terms of ungraded lectures, that is, having listened to the same set of lectures two years in succession, might receive his degree of doctor of medicine. In the Middle Ages he could enter the medical school only after having completed three years of preliminary work in the undergraduate department, and then he was required to give four years to the study of medicine, and spend a year as assistant with another physician before he was allowed to practise for himself. This is the standard to which our university medical schools gradually climbed back at the beginning of the twentieth century–a full generation after Draper’s time.

We know now that in those earlier centuries they had thorough clinical teaching in the hospitals, that is, physicians learned to practise medicine at the bedside of the patient, and not merely out of books and by theoretic lectures. Clinical teaching had not developed in Professor Draper’s day to any extent. The medieval hospitals had trained nurses and magnificent quarters, while the trained nurse was only introduced into America in 1871, and our hospitals at that time were almost without exception a disgrace to civilization, according to our present standards of hospital construction. Our surgery was most discouraging, because there were so many deaths in the unclean hospital conditions. The medieval hospital surgeons operating under anesthesia, boasted of getting union by first intention, and were in many ways doing better work than their colleagues of 1870, Professor Draper’s own time, before Lister’s great discovery.

James J. Walsh, The Popes and Science (1908)

With our rather complacent modern method of belittling the past and our disinclination to admit that the Spaniards were doing anything in science that the English Americans were not to think of for nearly two centuries, it would be easy to conclude that the teaching at these medical schools must have been altogether trivial and of no significance. When it is learned that most of the teaching was founded on Hippocrates and Galen some of our generation might think it hopelessly backward, but it would be well for those who think so, to be reminded that during the century following the sixteenth, Sydenham in England, and Boerhaave in Holland, the most distinguished medical men of their time who are deservedly looked up to with great reverence by most of the distinguished teachers of ours, were both of them pleading for a return to the broad, sane views and insistence on clinical observation of Hippocrates and Galen. As a matter of fact the medical schools of both the University of Mexico and of Lima were furnishing quite as good a medical training as the average medical school of Europe at that time. They were modelled closely after the Spanish universities and were in intimate relations with them, even exchanging professors and students, and at the middle of the seventeenth century at least maintaining excellent standards.

From the very beginning, then, the Spanish Americans made a definite attempt to develop scientific knowledge in America. In medicine, in botany, in pharmacology, as well as in geography, philology, ethnology, and anthropology, there are magnificent contributions made by Spanish scholars. Many a Spanish university student and teacher spent time in this country investigating the properties of plants, especially their relations to medicine, and laying precious foundations in botany. Besides there were university scholars at home in Spain taking advantage of these field investigations to compile works of serious character which are well known by those who are familiar with the history of botany and pharmacology. What the Spaniards were doing in America the Portuguese were doing in India and South Africa, and a very serious attempt was made during the sixteenth and seventeenth centuries to bring to Europe every possible material, plant or mineral, that might be of value for human health and at the same time to increase the bounds of human knowledge by careful investigation.

James J. Walsh, The Popes and Science (1908)

Here then is the answer that a modern historian and educator makes to all the representations with regard to the development of anatomy and the practice of dissection during the Middle Ages. If the practice of dissection was permitted it was in spite of the Popes. The fact that there were a dozen of medical schools in Italy at which dissection was carried on is ignored. The great anatomists of the fourteenth and fifteenth centuries simply did not exist–Dr. White knows nothing about them. There must be no admission that the Popes permitted dissection or any other form of science. Dr. White makes his last stand by a really marvelous tour d’esprit. It was Venice defying the Vatican that permitted dissection. This, he supposes, may help him, for anatomy did develop very wonderfully at Padua when it was Venetian territory. But, as pointed out by Roth, dissection was practiced very successfully, and the anatomical tradition established at Padua, before it came under the dominion of Venice. At all the other important cities of Italy dissection was carried on. We have given some of the evidence for Verona, for Pisa, for Naples, for Bologna, for Florence, and, be it remembered, even for Rome. Padua was the rival of Bologna in anatomy only for a comparatively short time. Bologna always maintained a primacy in the field of anatomy, and never more so than after she became a Papal city at the beginning of the sixteenth century. Vesalius taught and demonstrated not at Padua alone, but also at Bologna and at Pisa. For two centuries Rome was the most successful rival of Bologna, and hundreds of dissections were done in the Papal Medical School.

Of course, the appeal to Venetian opposition to the Papacy as an explanation for dissection being carried on in Italy in spite of ecclesiastical regulations to the contrary is only a subterfuge. It can only be found in histories written by those who refuse to see facts as they were, because those facts do not accord with pet theories as to Papal Opposition to Science, and the Warfare Between Theology and Science, which must be maintained at all costs, though with an air of apology always for having to tell such unpleasant truths of these old-time religious authorities.

James J. Walsh, The Popes and Science (1908)

Denifle calls attention to the fact that there are letters of Pope John XXII. which show that he paid out of the Papal revenues the salary of a teacher of physic at the University of the City of Rome while the Papal Court was at Avignon. It is rather interesting to find the names of the two Popes, Boniface VIII. and John XXII., whose Papal decrees are supposed to have prevented the study of anatomy and chemistry, thus cropping up on unquestionable authority as the founder and the patron of medical teaching in the City of Rome. Pope Boniface VIII. is now generally credited with having been the founder of the Sapienza, the medical school of which, at the beginning of the sixteenth century, was to develop into one of the most important schools of its kind in Europe, and to have on its faculty list the greatest teachers of their time, who had been tempted to come to Rome because the Popes wished to enhance the prestige of the medical school of their capital.

While it may be a surprise for those who have been accustomed to think of the Popes as inalterably opposed to all science, and especially to medical science, thus to find them encouraging and fostering medical teaching, it will only be what would naturally be expected by those who know anything of the real history of medicine in the earlier Middle Ages. There is no doubt at all, that during the so-called “dark ages,” that is, when the invasion of the barbarians had put out the lights of the older civilizations, it was mainly ecclesiastics who preserved whatever traditions there were of the old medical learning and carried on whatever serious teaching of medicine, in the sense of medical science, that existed during this time. The monks were the most prominent in this; and the Benedictines, after their foundation in the sixth century, added to their duties of caring for the other temporal needs of the poor, who so often appealed to them, that of helping them as far as they could in any bodily ailments with which they might be afflicted. There are even definite traditions that a certain amount of training in medicine, or at least in the care of the sick, was one of the features of the Benedictine monasteries.

James J. Walsh, The Popes and Science (1908)

The second quotation shows, in fact, that Mondino had the custom sometimes of boiling his bodies before dissecting them when he wished to demonstrate special features, and he promises to make such an anatomy for his students at another time. If the bull of Pope Boniface VIII. was misinterpreted in any way to prohibit dissection, this would surely be the practice supposed to fall under its provisions. Here we find Mondino, less than twenty years after the promulgation of the bull, writing about this very practice, however, and calmly suggesting that he follows it as a routine, in a book that was published without let or hindrance from the ecclesiastical authorities, and that became for the next two centuries the most used book in the teaching of anatomy in educational institutions that were directly under ecclesiastical authorities. If the bull was misinterpreted so as to forbid dissection, as has been said, surely this flagrant violation of it would not have been permitted. It is clear that, if there was a misinterpretation, it must have come later in the history of anatomy. But of that we shall find no trace any more than at this time.

At the present moment such formal permissions are required quite as much in all civilized countries as they were during the Middle Ages. In certain parts of the United States a bond has to be filed by applicants before permission to dissect will be given. Dissection is recognized generally as a practice that needs definite regulation. Without such regulation all sorts of abuses would creep in. During the Middle Ages popular feeling was all against dissection. It was difficult, in many places, for the university authorities to obtain permission for dissection from their immediate political rulers. As a consequence of this they reverted to the theory, very generally accepted at that time, that the university was independent of the political authorities of the place in which it was situated, in educational matters, and an appeal was made directly to the ecclesiastical authorities for permission to dissect, as coming under their jurisdiction in education. They had thus obtained many other educational privileges that would not have been allowed them by municipalities, and they were successful also in this. Anyone who knows the details of the struggle of the universities to maintain the rights of their students and faculties against the encroachments of municipal and state authorities, will appreciate how much this possibility of appeal to the Pope meant for the universities of that time.

The permission to dissect was only another, but a very striking example, of ecclesiastical authority granting privileges to universities beyond those which they could have obtained from the local governments under which they existed. Such permissions, far from showing that the Popes were hampering or prohibiting dissection, prove, on the contrary, that they were securing for educational institutions what local popular prejudice would not have allowed them. That this is the proper way to view this question will be best appreciated by a review of the history of anatomy during the two centuries and a half in which ecclesiastical authorities are said to have prevented or discouraged its development. From this it will be seen very clearly that the nearer to Rome the medical schools were, the more dissection was done in them; that dissection was most common in Rome, at least during the latter part of this period; that the golden age of anatomy developed most luxuriantly in Bologna when that was a Papal city, and in Rome itself; and that in general the Popes must be looked upon as having fostered and patronized the medical sciences and anatomy in every possible way, while there is not the slightest hint anywhere to be found of the ecclesiastical opposition that is supposed to have dominated these centuries of medical history.

James J. Walsh, The Popes and Science (1908)