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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 MOORE, M.D., CANTAB. 
 
 Felloic of the Royal College of Physicians 
 Physician to St. Bartholomew's Hospital 
 
 OXFORD 
 
 AT THE CLARENDON PRESS 
 1908
 
 HENRY FROWDE, M.A. 
 
 PUBLISHER TO THE UNIVERSITY OF OXFORD 
 
 LONDON, EDINBURGH 
 NEW YORK AND TORONTO
 
 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 Kichard II. 
 
 The second lecture treats of the reading and 
 general attainments of physicians from the founda- 
 tion of our College, 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 Royal College 
 of Physicians of London for the honour which 
 they conferred upon me by appointing me to deliver 
 these lectures before them.
 
 CONTENTS 
 
 LECTUKE I 
 
 PAGE 
 
 MEDICAL STUDY IN LONDON DURING THE MIDDLE AGES . 1 49 
 
 Dr. Thomas Fitz-Patrick 1 
 
 Dr. Bartlot 2 
 
 Dr. Baldwin Hamey .... . . . 2 
 
 Dr. William Munk 3 
 
 Dr. Mac Michael . ' . . . . . . ' 3 
 
 Dr. John Freind . . . . . . . 3 
 
 Grimbald the Physician . . ... . 8 
 
 Physicians known to Matthew Paris - . . . 16 
 
 Robert Grosseteste ...... . . 18 
 
 Medical Books in Monastic Libraries . . . .19 
 
 Hospitals in the Middle Ages . . . . . 21 
 
 John Mirfeld . . . . . . 25 
 
 LECTUKE 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 Mayerne .... 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 or 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. (12J in. 
 
 x3|in.) ..... To face page 31 
 
 II. BREVIARIUM BARTHOLOMEI. Verses indicating the 
 
 author's name. (12 in. x 8 in.) To face page 33 
 
 III. BREVIARIUM BARTHOLOMEI. On Materia Medica. 
 
 (12iin. x3fin.) . . . To face page 36 
 
 IV. FLORARIUM BARTHOLOMEI. Introduction. 
 
 x9in.) ..... Tofacepage 44 
 
 V. FLORARIUM BARTHOLOMEI. Chapter on Physicians. 
 
 . x9in.) . . . Tofacepage 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 
 
 of Cusa. (Actual size of column) To face page 53 
 
 VIII. TREATISE ON MATERIA MEDICA, in the hand of 
 Cormac MacDuinntsleibhe, written in 1459. 
 (8f in. x5|in.) .... Tofacepage 143 
 
 IX. MANUSCRIPT OF CORMAC MACDUINNTSLEIBHE. 
 
 Chapter on Gout. (8|in. x5|in.) Tofacepage 144 
 
 X. MANUSCRIPT OF CORMAC MACDUINNTSLEIBHE. 
 Chapter on Epilepsy. (8| in. x 5| in.) . 
 
 Tofacepage 145
 
 LECTURE I 
 
 MEDICAL STUDY IN LONDON DURING 
 THE MIDDLE AGES 
 
 MR. PRESIDENT, Censors, and Fellows 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. Richard 
 
 MOORE 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 Reliquiae. 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 
 
 "Ei/ T To- names /ecu tvl Tra.cn
 
 STUDY IN LONDON 3 
 
 In Latin 
 
 Tune 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 Royal 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 TJie History of 
 Physick from the time of Galen to the beginning of tJie 
 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 William 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 Eoman inscriptions, pottery, 
 glass and coins discovered at various times through- 
 out the city, as well as the fragments of Roman 
 walls and roads, help us to realize that in the time 
 of Galen London was within the sphere of influence 
 of Roman civilization. 
 
 London had some share, however small, in the 
 intellectual life of Rome, and through Rome 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 
 Romano-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 Romano-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 Rex 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 Caedmon, 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 Deorman, 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 earh'er 
 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, 1 uses a similar form : ' Walterus filius 
 Roberti 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, 1 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 ', Banulf, Bishop of Durham ; John, Bishop 
 of Bath and Wells ; Hervey, Bishop of Bangor ; 
 Kobert, Bishop of Lincoln ; Roger, 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, Roger Bigod, and Haimo. Three 
 other witnesses follow, Urs de Abetot, Walter, son 
 of Richard, and Roger 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. 2 
 
 The next charter in the beautiful register of the 
 abbey of Abingdon 3 is addressed to Richard, Bishop 
 
 1 Claudius C. ix, f. 159 a (British Museum). 
 8 f. 150 a. 8 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 l to the same abbey, ad- 
 dressed to the sheriff of Oxfordshire and executed 
 at Romsey, 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. 2 
 A grant of Queen Matilda 3 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 4 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 1 5 about land 
 at Wincfeld belonging to the abbot of Abingdon 
 is witnessed at Northampton by Roger Bigot and 
 Grimbald the physician. Another deed addressed 
 to Nigel de Oilley is witnessed by Grimbald. Thus 
 it is clear that Grimbald lived in the royal court 
 and travelled about with the king. Two charters of 
 the reign of Henry I, now at St. Paul's Cathedral, 
 
 1 Claudius C. ix, f. 149 a. 2 f. 147 b. 
 
 8 f . 145 b. f. 151 a. 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, 1 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 Redvers, Aldewin the queen's 
 chamberlain, and Giffard the chaplain, Clarumbald, 2 
 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 
 
 1 Hist. MSS. Com., Ninth Keport, p. 67. 2 Ib. 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, Rohaisia, and the 
 last two are Ernulf the physician and Iwod the 
 physician. Mr. J. H. Round 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. 1 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 
 
 1 J. H. Kound, 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 Cosur 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 Eichard, 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 iiithe 
 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. 1 
 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, 2 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 
 
 1 Matthew Paris (Rolls Series), ed. Luard, vol. ii, p. 442 ; 
 Hoveden (Rolls Series), ed. Stubbs, vol. iv, p. 433. 
 
 2 Printed with facsimile in Warner and Ellis, Facsimiles of 
 Cliarters.
 
 STUDY IN LONDON 13 
 
 et Ricardo medicis.' King Henry was going abroad 
 with Heraclius, the patriarch of Jerusalem, and 
 Roger 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 Richard, 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 Ranulphus Besace, a contemporary of 
 Dr. John of London, who was physician to King 
 Richard 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?' 
 
 1 Luard (Matthew Paris: Bolls 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. Ranulphus 
 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 l Robert Muscegros, her seneschal ; Walter de 
 
 1 Matthew Paris (Eolls Series), ed. H. K. 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 
 Reginaldus de Bathonia. 1 She sent him to see her 
 daughter, the Queen of Scotland, and when he came 
 1 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 
 1 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 Register of the time of 
 King Henry III. 
 
 Adam, physician practising at St. Albans. 
 Alexander, physician to Queen Eleanor of 
 
 Provence. 
 Bathonia, Reginald de, physician to Queen Eleanor 
 
 of Provence ; sent on a mission to the court of 
 
 Scotland. 
 Besace, Ranulphus, Canon of St. Paul's (1217-43). 
 
 Served in the crusade with King Richard 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. 
 Reginald, physician ; a priest resident in St. 
 
 Albans Abbey, sent on a mission from the 
 
 abbey to Rome (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 accendit.' 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
 
 18 LECTURE I 
 
 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 tune 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 ornaments was borne to Worcester, where 
 the royal tomb may be seen to this day. 
 
 Kobert 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 tc 
 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 19 
 
 another verse of the * Regimen Sanitatis Salerni * 
 in his thoughts : 
 
 Gignit et humores melius vinum meliores. 
 
 After a prescription in a fourteenth-century manu- 
 script (Mirneld) is written : ' Et dicitur hoc esse 
 per Robertum 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 Trismegistiis 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 
 
 c 2
 
 20 LECTURE I 
 
 works of Hippocrates, Galen, Bhazes, 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, Kufus, and Gilbert 
 are the others absent in the Christ Church library. 
 These three catalogues have been printed by 
 Dr. Montague Rhodes 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. Heading 
 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 
 
 1 lacobi de Vitriaco, Primum Acconensis deinde Tusculani 
 Episcopi : libri duo quorum prior Orientalis sive Hierosolymitanae, 
 alter Occidentals Historiae nomine inscribitur. 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 l 
 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 
 1 Le Grand, Statuts. Paris, 1901.
 
 STUDY IN LONDON 23 
 
 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 Ralph 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 Rolls 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 mulieribus genitos usque 
 septennium, si dicte mulieres infra hospitale pre- 
 dictum decesserint.' The last part of this extract 
 from the Close Rolls 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 IN 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, 1 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 shillings 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- 
 tholomeij 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 
 1 Ninth Report 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 Rahere, 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 meus ', 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. Mirfeld'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 
 seen 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 folium, 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 be
 
 STUDY IN LONDON 29 
 
 allowed to hold the living of Reculver, and the 
 other Pope Clement V's letter confirming the 
 presentation. His name also occurs in a charter 
 of the same period at St. Paul's Cathedral. 1 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 
 
 1 H. C. Maxwell Lyte, Ninth Report 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 Robert 
 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, King 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 Revolutionists 
 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 Englishman 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 Robert 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. 
 
 j-.aii.-f a fafy twd 6<n mm<jl^><aj ^ l ftft 4 i/^ 
 <ut''.-.wp^f(Vrt-*Fof''*iit^)4ift / ' . pjJT^^ni f5i 
 i-wlCwfcjtiilttfjuJcify >rO- fpAt- rfi>*il iu tf^ft ttirt 
 
 ajxr i'a>fli<Mf(nii ibitem ifM jvfejg 
 
 BREVIARIUJI BARTHOI.O.MEI OF JOHN MIHFELD. 
 Introduction. 
 
 To face patjt ^i.
 
 STUDY IN LONDON 31 
 
 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 Scriptoribus Britannicis men- 
 tions having a conversation with ' Bertholetus 
 medicus ', who had certainly studied the medical 
 writings of Mirfeld. This Bertholetus was 
 Dr. Richard 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, * Richard Bartlot in Medicinis doctor.' The 
 Breviarium Barthokmei 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 library 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 
 weeks 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
 
 PlATE II. 
 
 tte- Zft&? BtAv'. kfr<ft Gn(U* 4&' 
 irffc|0 p^Wtrt*- A ! pa^H* 
 
 g^j^^jOMTft'iwJW^gTrt 
 
 BKEVIARIUM BARTIIOLOMEI OF JOHN MIRKKLD. 
 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. 
 ?o /ace pope 33.
 
 STUDY IN LONDON 33 
 
 interest in human nature, and his kindly disposition 
 made his conversation as delightful 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 216 
 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 2 1 & make the words : * Ora pro nobis sancte 
 bartholomee ait iohannes dde Mirfeld ut digni 
 efficiamur 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 quern 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 ' l begins 
 with the statement that such epidemics come in 
 rotten and sterile seasons when the crops are 
 blighted and the ah* 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 
 
 1 136.
 
 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. 
 Syrup 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 l 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 l . Epidemic disease in cattle, he says, may be 
 
 1 The Hieracosophion sive De Be Accipitraria of J. A. Thuanus
 
 PLATE III. 
 
 >fut prtt* 2 a 
 **** J 
 
 aps 4Mif, x r^iv^rtw *,' Tv^HufA i" ~ 
 
 aJCtjCiWB^ *? tffe- 
 
 ^^ t^TS S QL^jfAH ffB^^iffrz^tcxSr 
 
 *^ ^ ^ ^C'p.JtfW * w^,^ 1 Af^f* ap F" ^ '?***? *^*^^ * 
 
 BHEVIAHIITM BARTHUI.OMEI OK JOHX MIRKEI-D. 
 
 On Materia Medica. 
 Sulfuraca. Sulfur. Spinac. Talpa. Taraarindi. Tamarisms. Tapsia. 
 
 To face page 36
 
 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, Constantine, 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.
 
 38 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- 
 pellier 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 39 
 
 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 
 
 Tune assus non comme- 
 
 datur 
 
 Vas supponatur 
 Sagmen ut accipiatur 
 Istud pinguamen 
 Dat gutte cuique levamen 
 Anseris unguentum 
 Valet hoc super omne 
 
 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 multiplied 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 Eosa Anglica. 
 Verses are to be repeated in the ear of the epileptic 
 man as he lies 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 Empiricits, 1 and Professor Rhys 2 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 polla 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. 3 
 
 Sancte Columquille remove mala dampna faville 
 Atque Columquillus salvet ab igne domus. 
 
 The lines were repeated as a charm to stop the burn- 
 ing of a house. In the life of St. Columcille or 
 Columba in the Leabhar Breac, a fifteenth-century 
 
 1 Medici antigui omnes (Aldus), Venice, 1547, containing 
 Marcellus de Medicamentis, p. 107 6. I like to quote from this 
 edition since it reminds me of the friendship of Mr. R W. Raper, 
 of Trinity College, Oxford, who gave me a fine copy of it in a 
 splendid ancient binding. 
 
 1 Celtae and Galli : Proceedings of the British Academy, vol. ii, 
 1905. 
 
 8 Oxford MS. of Breviarium, f. 253 a, col. 1.
 
 42 LECTURE I 
 
 manuscript, occurs this passage : ' A great flame 
 came towards him once hi 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.' l 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 
 
 1 ' 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 
 male ocus ingena.' Leabhar breac : facsimile. Dublin, 1878, 
 f. 33, Part I, col. a, line 67 to col. b, line 3. First edited by 
 Whitley Stokes in Three Middle Irish Homilies. Calcutta, 1897.
 
 STUDY IN LONDON 43 
 
 opened his mouth a little. 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 little, 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) : " ttHTTTtp ot larpol Xeyovcrt ras TOIV V(avvfjLO)v 
 TrXrjyag TTJV atcr^crtv ef rots Se^iots avafiepew" 
 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 
 hand, 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 
 Breviarium, that on preserving health, is based on 
 the ' Regimen Sanitatis Salerni '. 
 
 Another work of Mirfeld's is the Florarium 
 Bartholomew. 1 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 : 
 
 1 MS. Royal 7 F. xi (British Museum).
 
 Pl.MK IV. 
 
 CMT^ JM 
 
 qx**e&6 
 
 L<f..Z^& 
 
 rfU.A5^r3b.*.i* : Oi>i^,7- J 'eH^- 
 a^,rtirwj-pj Wa. *f, c^r*- 
 
 Wtf u t >r^,if,^&. -*,J&L3e 
 
 ~ t ^ i *- 
 
 Ki.oiiAiur>r BARTHOLOMKI OK JOHN MIRFEI.D. 
 Introduction, with verses at foot indicating how to find the 
 
 author's name. 
 
 Ad IHS incipies capitales inde notahis 
 Nunc quo vado scies : venio simul unde probabis. 
 
 To face jxif/e 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 ; Raymundus ; Foemina ; Rex ; 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 Rex, 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 R was used in the acrostic. 
 Mr. J. P. Gilson has mentioned as indications of 
 the date of composition in his catalogue of the Royal 
 MSS. that the constitutions of Simon Islip of 1362 
 are quoted, 1 and that a sermon of John Grandison 2 
 (written Cronson), Bishop of Exeter, 1328-69, is 
 1 f. 69. * f. 181.
 
 46 LECTURE I 
 
 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 Bartholomei, 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 
 Button. 1 
 
 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 
 
 1 ' Iste liber constat Thome Baxter vicario perpetuo ecclesie 
 parochialis de Stikeford : Eicardus Hutton : Qui Eicardus con- 
 tulit istum librum domui religiose de asherug ibidem in 
 biblioteca permansurum. Anno domini, 1518.' Florarium, 
 f. 259
 
 PLATE V. 
 
 tt-hcxxviii. 
 
 Q-V- 
 
 ftf,f e(*499* tt>? 4-*f<>1eiX-nir~g 
 
 fT.r <r, *{<:,< <*> tfl^isis^ %' 
 ,tf< s^c* M/*tf r fc** 1 _?~fp && 
 
 , UU.,A **.. fcr&cfvf*?,,.,,;^ -T9 
 .^...n/ltf,.- .,. 
 
 ftrlP'fir tfiifrtiMv*) Qtoft tuftr^iMifcf 
 
 <y QoMro^*'"^ fp^jny r^p-"c rgM<r ""-J^r 'P*^ " f< " rf5f^J> "I"' t *'*^K 
 
 ij rw/li'Xcyrtoi.tr-^- fr.r5iir-.jj /^lnV mrt*/' i.</4"^ f^Rtdt <f&titat^<Ri~ 
 
 yYio' tf^ 4M"<:in >ia cSpetit f.n 
 V.AI^ 8..TT"'r/"*S*^-'^'a^ 
 C , / Ai../ 1 tfV fch^'' ^".^^/Wcr 
 P '' ^AS ,? . nf <v : 4Tf ' "' 
 
 ,^,,,9c ?(> *<*1T 
 
 '""k. ^ , ,._ .^l,,^^. 
 
 * A.-SUnir ^S,.r.- ^ .p 1^ * f* 
 
 **" ft^-^*r J ef ( ""?"" f* ^ 
 
 'Sf..* Wrtf l^~rs^! * n 
 
 Sfc^V^ArV^.* f .^t^v-TT 
 
 ,,~ iinn On.i '7"prc- ,1 7~yij> 
 re^^'-ii-c- AII<- -f> i^o V<'*><&>.t>?&* 
 ,,- 1V ..^^- 
 
 4.~ t..n v.. -.* pit-.v e?E^ JZ^Kfi?-* /AI-<: *rf"^ i.ftnrft 
 
 w^gart.jv,,*- f itfi^o Wo^fit^.** 1 . ^. 4 X r t n}tfkt &f>1 
 
 ^?^'?? e ~!r^f*rj$* l*l* t 4B^5p*>^*)ur* ft^'A" 
 
 ^fjj.- <^-crc,,.rr_^ ^. L^ ^VA*J-*-^^^^^lR'^ 
 
 t,v, rt f ,; i - ih^. T^*S>5t- Sjf <a H.<r^>,pa cv7-/fnrsr; 
 
 ^.P,/}w -V .r^M,A%r A~f^- ^"S- ^-^^rC^^^^TT^.- ,.^ 
 
 , ./ftr 5 "> *7<np<. -,'MK-:- 
 
 f. o<i <fT? ..<) <Jivr TpefaJftrRttA 
 .yfS^n&f.S. if <"cS<V.<fii.e *</<<* 
 c'ciT jW/MiMMft|fM^ Sir** 
 frt,,. t<r K*t** t -fllW J-i>^r" *f*C 
 Vcff'^: ^< ** fc 0^ cAl>^ d 
 fifitnv - H' .v'.wlfrn i~$<N]fa 
 
 cir- i XneQ*i6*n>te9**y*r*fnZif'*b* 
 
 ^ I A, -A ^~U"- * 2f'- ^ 
 "< i/ A,,f9.T-<~^c/'r lt ,-^^ 
 
 (fV*Ml ~^ I 
 
 (S^^f^fj 
 
 <? pypi,-.i .patt&p 
 
 FLORAHIUM BARTHOLOMEI OF JOHN MIRFELD. 
 Chapter on physicians and their medicines. 
 ITo /ace pa^re 46.
 
 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 
 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 
 Holy Eucharist could say nothing but 'thirteen 
 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 'Regimen Sanitatis Salerni ') : 
 
 Sit cena levis 
 Vel cena brevis 
 Sit raro molesta 
 Magna nocet 
 Medicina docet 
 Res 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. l 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 Jokannis 
 Mirfeld. It ends, * Explicit iste tractatulus multum 
 necessarius.' In these three works Mirfeld does 
 not mention any vernacular writer. The English 
 men of letters with whose works he was familiar, 
 Bede, John of Salisbury, John of Gaddesden, Ranulf 
 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 Hose 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 Roger 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 Virtutibus were his chief reading 
 in pharmacology. Mirfeld had observed patients
 
 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 CENTURY 
 
 ME. 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 Roger and 
 Lanfranc, medicine in some books of Galen, in 
 Rhazes, 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 De Consolatione Philosophiae of 
 Boethius l 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 
 Etymologiamm 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 tune, 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 
 
 1 Mirfeld was neither the latest nor the most famous medical 
 writer who was versed in Boethius. Sy denham , in his chapter 
 De morbis acutis in genere, quotes Book II, Metrum III, of the 
 De Consolatione Philosophiae : 
 
 Constat aeterna positumque lege est, 
 Ut constet genitum nilril. 
 
 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, 1 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 
 1 Harley, 3745.
 
 PLATK VI. 
 
 itcr ftmgumtf 
 
 sfi^K q* nccfn c tc tdti cattmt 
 ecs fttftqcnree rnK A qi tjn aimt fc 
 
 mtcr 
 
 ^i m tmc% 
 
 m aho/cpn^'remcmoonnr t 
 at amtmmipttH figmn^ttiiMtm 
 i.^.tvmcrn^Minr mm cii (&T rai 
 7 4hnitc ftu ftnc ftwz itmint 01^7 
 mtf.nnatiimi lafct^ wanni 
 
 pntfi tnjlibj m 
 
 ^t m wrof ccnmn 
 
 LIBER SERAPIONIS DE MEDICINIS SIMPLICIBUS. 
 Initial showing a lecture on medical plants. 
 
 7b /ace page 52
 
 PLATE VII. 
 
 L 
 i .. 
 
 LIBER SEHAPIONIS. 
 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 De 
 Consolatione PMlosophiae 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 Schaffhausen 
 copy of Adamnan's Life of Columba. 1 Johannes 
 Scotus Erigena, it is certain, knew Greek well 
 enough to translate the Pseudo-Dionysius, and both 
 Koger Bacon and Robert 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- 
 1 William Beeves : Life of St. Columba. 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 Renaissance, 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 literature 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 Renaissance 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 Renaissance, 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 Richard Bartlot. 
 
 Linacre, our first President, and Dr. John Clement, 
 president in 1544, were physicians of the Renais- 
 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 2^ai/>a 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 
 Richard 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, De Differentiis 
 Animalium, 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, l 
 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 
 
 1 Edoardi Wottoni Oxoniensis De Differentiis Animalium 
 Libri Decem : 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 iXias and tXXas, and others rvXas ; 
 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 De 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 
 /AW/DOT?;?. 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 Republic 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 assemblie, 
 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 
 
 1 Dispatch quoted in Motley, Else of the Dutch Republic, 
 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 ' BiUiotJieca 
 Hispanica ; by Eichard Percyvall : Gent.' The 
 dedication to 'Robert 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 collubet ergo loqui. 
 Expetit Hispanus Belgas evincere, regem 
 Gallorum per vim regno depellere, regnum
 
 64 LECTURE II 
 
 Diripere Anglorum, quid non ? Cupit esse monarcha : 
 Cum rege hoc tanto, collubet ergo loqui. 
 
 Cum quibus aut bellum cupimus, commercia, pacem, 
 
 Horjim 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 De 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 Opuscula 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 Renaissance 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 publication 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, De dissections 
 partium corporis humani libri ires a Carolo Stephano, 
 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, 
 
 Illiterates. 
 
 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. Kobert 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 hi 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 Dr. 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 travelling. 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 Eeligio 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.' l 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 
 his notebooks. It states that he had studied 
 
 1 Bishop Hall : Epistle to Mr. Milward. 
 1 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 o 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 Regius 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 Rome. 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 
 
 t
 
 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 Hellebor aster, 
 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, 1 and saw a human body dissected the third 
 he had seen. In the morning Dr. Christopher 
 
 1 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, 
 arid 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. 1 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 Bennet's Tabidorum 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 Restoration 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 Restoration ', 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 
 
 1 Edward Browne's notes are printed in Wilkin, Works of 
 Sir Thomas Browne.
 
 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 unlike 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.' 1 
 
 1 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 all 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 little 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 Rome. 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, 1 a connexion by 
 
 1 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.K.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 Ralph 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 Hippocratie treatises on air, water, and 
 situation, as well as the Epidemics. He had also 
 read parts 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, Raleigh'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.
 
 LECTURE III 
 
 THE HISTORY OF THE STUDY OF CLINICAL 
 MEDICINE IN THE BRITISH 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. William 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 liked to 
 feel that he had brothers in the world of learning 
 in his day. Brady was a man both of active life 
 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 Regius 
 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 Glisson, 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.' l 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 
 1 Of the Irregular Small-pox, 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 Rhazes, Avicenna, Isaac, Constantin, the Philo- 
 sopher (as Aristotle is generally called), Dioscorides, 
 or Galen, this is no proof that other statements 011 
 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 Roger 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/ l I can imagine 
 that some of the physicians of the Kenaissance 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- 
 
 1 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. 1 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,' a and 
 
 1 Johannis Caii, Liber de Ephemera Britannica. Ed. S. Jebb, 
 M.D. London, 1721. 
 
 2 Prelectiones Anatomiae Universalis (1886), Autotype f. 39 6.
 
 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 moriens 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 
 show 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, 1 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 
 1 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, l 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. 2 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 Robert 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. 
 
 1 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 
 
 1 Sloane MS. 1679. I have given the original in the 
 Appendix, as it has not been printed before.
 
 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 fermentation 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 ill 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, 
 
 Hi
 
 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 Parliament, 1 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 Royston 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, 
 
 1 Parliament was dissolved Feb. 11, 16J-, 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. Remedies 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, l 
 '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. 
 
 Mayerne's notes on Queen Henrietta Maria, 1 
 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 eyelids, 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 
 1 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 Mayerne's works l 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 
 
 TraVTOL (TVV 060), d/Xrp 
 
 the history of a journey to Exeter 2 undertaken to 
 restore the health of the Queen, then seriously ill. 
 He left London on May 21, 1644, 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 
 
 1 Opera, p. 361. 
 
 2 ' 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, ayant 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. K. 
 
 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
 
 110 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 Raphael 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
 
 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. 1 
 
 A great part of Mayerne'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 Rachitide appeared in 1650. It deserves 
 high praise as an example of clinical observation as 
 
 1 In rege qui avOpnyiro^ayia edit, Cranium humanum in ossium 
 Bubulorum Rasuram poterit permutari. 
 
 2 In the British Museum there is a magnificent drawing of 
 him by Rubens, 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 prognostic^ 
 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 113 
 
 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, 1 in his interesting 
 lectures on the History of Physiology, has shown 
 that in his De 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 Eachitide 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 Tabi- 
 dorum Theatrum sive Phthisios Atrophiae et Hecticae 
 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 
 
 1 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 
 Koyal Army, who had shown him fifty renal calculi 
 which he had passed, and afterwards carried about 
 in an ivory box. Charleton's Exercitationes Patlw- 
 kgicae, 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, Raritas, Consistentia, Fluiditas,
 
 STUDY OF CLINICAL MEDICINE 115 
 
 Tenacitas, Friabilitas, Tensitas, Laxitas, Rigiditas, 
 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 
 Redeemed 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 it 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. 1 
 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, 2 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. 3 * 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 diiferent, 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. 4 
 
 1 Of the Epidemic Diseases from the Year 1675 to the Tear 1680. 
 
 2 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. 
 
 3 Of the Continual Fevers in the Years 1667, <kc. 
 * Of the Regular 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. 1 
 
 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 
 1 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 like 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 clinical 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 Renaissance. 
 
 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 clinical 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 liver 
 which was opened, when compared with the precise 
 description of the same case by Locke, 1 shows that 
 Willis 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 careful records of the events of 
 disease as observed at the bedside, is Richard 
 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 
 
 1 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 at 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 
 irritability 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 lifelong 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 establishment 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, Glisson and Sydenham were thoroughly English 
 in habit of mind and owed, I think, nothing to any 
 foreign influence. The admirable Observationes 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 Eachitide 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, Radcliffe, Garth, Arbuthnot, 
 Freind, Sloane, and Mead, had all great opportunities 
 of clinical observation and understood their impor- 
 tance. Kadcliffe 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 clinical 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 Purgantibus, 
 and in his Emmenokgia 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, 1 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 
 1 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
 
 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 Observations 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 all 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 
 more 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 
 peritoueum 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 l 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 JBibliographiae Anatomi- 
 cae Specimen z 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. Richard 
 Copley Christie, who also had a collection of copies 
 
 1 Arbor Temensis Ftuctum Cofe Ferens. London, 1727. 
 
 2 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
 
 130 LECTURE IV 
 
 met with a few examples l 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 Medico, of Thomas Bartholinus 
 and in the Phiksophical 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 2 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 
 
 1 St. Bartholomew's Hospital Reports, vol. xxvi. 
 
 2 Tyson in Acta Medica et Philosophica Hafniensia Bartholini, 
 v. 91, Hafniae, 1680. 
 
 3 Opera Medica, Phthisiologia, p. 105, Geneva, 1696.
 
 STUDY OF CLINICAL MEDICINE 131 
 
 1719 to 1735 and of the Royal 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 Royal 
 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 Rawdon, of 
 
 K2
 
 132 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 Eoyal 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
 
 STUDY OF CLINICAL MEDICINE 133 
 
 printed or in manuscript. A complete Index 1 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 Prae- 
 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 
 
 1 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 Kaphael Thorius, who 
 died from the plague in 1622, and of the Anatomia 
 Eestaurata 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 ! l ' This collection of 
 manuscripts is a rich mine of medical and literary 
 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 
 1 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 l 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 Robert Boyle and there met Sir William 
 Petty, the first English political economist, a Fellow 
 
 1 Dublin University Magazine, 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 Royal Society, and came 
 to know Flamsteed the astronomer. He also met 
 Dr. Edward Browne, who told him that Sir Thomas 
 Browne's De Plantis 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 1 to the Bishop of 
 Clogher on certain swarms of scarabaeus arboreus 
 which appeared in the West of Ireland in 1688 and 
 continued till 1697. His medical writings are 
 observations on conditions of his own tune, on an- 
 epidemic of coughs and colds,- and on an epidemic 
 of eye disease. 3 He died in 1733, and there is a 
 fine statue of him by Roubiliac 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 
 
 1 Published in A Natural History of Ireland, by Several 
 Hands. Dublin, 1726. 
 
 2 On the Late Coughs and Colds : Philosophical Transactions, 
 1694. 
 
 3 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. Kichard 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 Ratione Temporum, which belongs 
 to the end of the eighth or beginning of the ninth 
 century. On folio 35 A of this venerable manuscript 
 the word ' archiater ' is glossed by the Irish word 
 huasallieig that is, huasal noble, and lieig physician. 
 Both words are found throughout literature during 
 the thousand years which have elapsed since some 
 Irishman in the monastery of Keichenau wrote these 
 glosses. Diancecht, a hero who appears in ancient 
 stories and poems, is described as a physician. In 
 the Dinnshenchus, 1 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/ 3 ' 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. 
 
 1 S. H. O'Grady, Silva Gadelica, London, 1892, ii. 525. 
 
 2 Book of Leinster. 
 
 3 Whitley Stokes in Irische Texte mit Ubersetzttngcn und 
 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 ' 1 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.' 2 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'. 3 In another 
 
 1 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. 
 
 2 Ancient Laws of Ireland, Senchus Mor, vol. i, translation, 
 p. 181. 
 
 s 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.' l 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. 3 
 
 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 Gael, 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 
 
 1 Caidi aithgabail each aes dana, S.M., ii. 118. 
 1 Aithgabail lega : togthar an echlaisc ocus a fraig. Senchus 
 Mor, ii. 118. 
 3 Ancient Laws of Ireland, Book of Aicill.
 
 PLATE VIII. 
 
 
 
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 TREATISE ON MATEIUA MEDICA. 
 
 Translated into Irish and written by Cormac MacDuinntsleibhe, A.D. 
 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. 1 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 
 
 1 O'Donovan, Annals of the Four Masters, iv. 742, v. 1389, 
 v. 1856.
 
 144 LECTURE IV 
 
 fol. 11 a 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 published 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
 
 PLATE IX. 
 
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 WRITTEN BY COR.MAC 
 Chapter on Gout 
 
 To face page 144.
 
 PLATE X. 
 
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 m~ ** t L ii i 
 
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 4mf ^^1 trtsiwWAiiic^A^^r" I'^F^l^T 111 ^ T < ^^T 
 
 ^t *T " / - r" i_/2rsr '3 Hr YD r* 
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 MANUSCRIPT WRITTEN HY CORMAC MAC-DITINNTSLKIBHE. 
 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 Tractattts 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 
 medicus, 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.' l 
 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 2 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 
 Richard Barry.' And another note shows that it 
 was still in the possession of its original scribe in 
 1489. 4 ' I grieve for this news I hear now : that 
 my mother and my sister are dead in Spain. 
 A.D. 1489.' A third note 5 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 
 
 1 '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. 
 
 2 Egerton 89. 8 F. 92. F. 95. 5 F. 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 lAliwn 
 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 l 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. 2 
 
 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. Finghiii 
 O'Caiside, who died in 1322 ; Gilla na naingel, who 
 
 1 British Museum : Cotton MS. Appendix LI. 
 
 2 It then belonged to Mr. Robert Macadam, and afterwards 
 became the property of Bishop Beeves. 
 
 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 
 physicians 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. 1 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 
 
 1 And no doubt in Wales, as shown in The Physicians of 
 Myddvai, translated by John Pughe, F.K.C.S., and edited by 
 the Kev. John Williams ap Ithel. Welsh MSS. Society, 
 Llandovery, 1861.
 
 STUDY OF CLINICAL MEDICINE 149 
 
 na Senrirach, 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 liked 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 J , 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, Mayerne 2 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 Regis 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 
 
 1 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, 1 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 Renaissance. 
 
 A manuscript now in the British Museum 2 be- 
 longed in the sixteenth century to John MacBetha, or 
 
 1 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, Ddibhi 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 Ranald. 
 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 Capsula eburnea, 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 Ley den 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 sufficient clinical observa- 
 tions to show that the publication had the effect of 
 encouraging clinical observations in Scotland and 
 elsewhere. Dr. John Rutherford, 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. Rutherford's 
 lectures, of which there is a manuscript volume in 
 the library of the Royal 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 William 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 Royal 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, Rutherford, 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. Rutherford, Gregory, and Cullen 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 
 1786 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 life 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-throatj 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 Glisson 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 Renaissance, 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. CHARTEKS WITNESSED BY GRIMBALD 
 
 I. Witnesses of Henry I's grant of ten hides of 
 land at Lifesholt to Abingdon Abbey. 
 
 Testibus : Rannulfo cancellario et Grimaldo 
 medico et lurardo archidiacono et Watero archi- 
 diacono : et Willelmo de Albini et Rogero filio Ricardi 
 et Nigello de Oilli et Radulfo 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 Ricardo 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 Ricardo 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 terrain 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 Westmowasteriww. 
 
 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 meus rex Henricus michi predictoque 
 abbati meipsa interveniente concessit. Testibus 
 Rogero cancellario et Grimaldo medico. 
 
 Id. I 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. 151 a. 
 
 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 earn tenuit tempore patris et fratris mei. 
 Et precipio ut calumpnia quam Godricus prepositus 
 de Windresores super earn terrain facit de baia 
 omnino et perpetualiter remaneat. Testibus : Rogero 
 bigot et Grimaldo medico apud Norhamtoniam. 
 
 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 earn 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 
 
 ClROGEAPHUM | 
 
 Sciant Presentes et futuri qwod Ego Gilebertas 
 Prior ecclesie sancte Marie de butteleia et conuentus \ 
 eiusdem loci concessimus hospitali sancti Bartholomei 
 lundoniarum et frafribus eiwsdem hospitalis totum 
 tenementum | de feodo Radulfi de Ardena quod 
 tenuit Jeremias de ecclesia sancte Marie de butteleia 
 in uico | sancti Nicholai Apud nouum macellum 
 tenendum de nob^s iure perpetuo. Reddendo uobis 
 annu|atim Pro omwi seruicio . x . solidos Ad duos 
 terminos. scilicet ad festum sancti Michaelis v. j 
 sol^os et Ad Pascha v sol^os. Vt Autem cowuencio 
 ista perpetuet. sigilli nostri Auctoritate et \ sigilli 
 hospitals sawed B&rtholomei testimonio roboratwr. 
 His testibus. Huberto Waltero decano | eboracensi. 
 Oseberto de Glamvilla. Jurdano de scheltuna.
 
 WITNESSED BY JOHN OF LONDON 161 
 
 Magistro Roberto subera. Rojgero Waltero. Henrico 
 de flegga Nicholao Pincerna. Walram Janitore 
 twrris lonjdoniarwm. Henrico de Corn/mlla. Radw/b 
 fratre eius. Ricanfo filio Reineri. Henrico de lun- 
 dene|stona. Rogero le due. Rogero filw> Alani. 
 Galfrido Albo. Andrea Albo. Petrofilw) | Neveloms. 
 Roberto de edelmetuna, Johawwe Medico \undoniarum. 
 
 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 fan*) who often appears in London 
 charters of the reigns of Richard I and John, and 
 
 MOOKX M
 
 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 D. D. Medicis Eegijs ordinarijs de Sanitate 
 E. M. tuenda, et praesentibus morbis curandis delibera- 
 turis datum, a me Demayerne Eegis Medico primario die 
 Decembris 1623. 
 
 IACOBVS I. MAGNAE BRITAN. EEX Natus est Edim- 
 burgi. Anno 1566. 19 Junij. hora matutina XIJ. 
 
 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-v/u,7ra#iai/. Inde fit vt 
 pulmo frequenter fluxione tentetur ; cujus materiam 
 ope Cordis calidissimi citissime percoquit. 
 
 Hepar naturaliter bonum, magnum, sanguinis 
 multi, Laudabih's ferax ; Calidum ; ex accidenti
 
 THE HEALTH OF JAMES I 163 
 
 obstructionisms obnoxium, et ad plurimam bilem 
 generandam promim. 
 
 Lien mmc facile congerit succum Melancholicum, 
 cujus praesentiam vt varia arguunt symptomata ; sic 
 ejus importuna sarcina bonis E. M is rebus per vias 
 conuenientes subinde a natura deponitur. 
 
 Nullus in his duobus visceribus tumor, nulla 
 collectio 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 inferior a) 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. 
 
 Renes calidi, ad arenas et calculos generandos 
 dispositi. 
 
 Tibiae a natura graciles, minusque firmae ad 
 molem corporis sustinendam. 
 
 Habitus rams 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 1 haereditarium est a 
 matre, et Auo Jacobo quinto Scotiae Regibus. 
 
 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 aniini pertur- 
 bationibus peruertuntur. 
 
 Exuberant preter naturam In hepate et venoso 
 
 M2
 
 164 APPENDIX III 
 
 genere flaua bills, et (quod grauissimorum morborum 
 variis sui partibus vberrima atque potentissima causa 
 est) serum. In Ventriculo et Cerebro Pituita. humor 
 melancholicus in Liene. 
 
 Quoad res non naturales. 
 
 gr< E. M. Omnem facile et satis impune fert aeris 
 
 intemperiem in actiuis qualitatibus. Austro flante 
 
 et humidiori tempestate, hyemali praesertim, afficitur, 
 
 et conflictatur Catarrho. 
 bus. 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 a)paCov<s quauis hora diej et noctis edit, 
 
 satis parce tamen quauis vice, sed sine ordine. 
 >tus. In Potu peccat quoad Qualitatem, Quantitatem, 
 
 frequentiam, tempus, Ordinem. 
 
 num Promiscue bibit Cereuisiam, Alam, Vinum His- 
 
 uscatel- panicum, Gallicum dulce, album (qui ipsi ordinarius 
 dim vn" P o * us es *) ^ plurimuin . crassum et turbidum. 
 i diarrhoea. Aliquando, praesertim fluente aluo, Alicanticum 
 
 tinctum. 
 
 Attamen non curat sit vinum generosum dummodo 
 
 dulce. Summa ipsj cum Aqua et omnibus aquatili- 
 
 bus antipatheia. 
 
 otus Violentissimis olim Venationis exercitijs deditus 
 
 et Rex nunc est quietior, et plus quam par esset jacet 
 
 lies - aut sedet ; sed id ab imbecillitate tibiarum arthriti- 
 
 carum. 
 
 unnus Male natural iter dormit, et inquiete : Saepissime 
 
 , e t. expergiscitur noctu, vocatque cubicularios, neque 
 lg nisi legente Anagnoste obrepit somnus vt plurimum. 
 
 nimi Animus facile mouetur cum impetu ; Iracundis- 
 
 ithemata. s i mus es t ? sed cito euanescit pathema. Nunc ex 
 
 accidenti Melancholicus Liene in sinistro hypochon- 
 
 drio turbas excitante.
 
 THE HEALTH OF JAMES I 165 
 
 Multum mungit. Sternutat saepissime. Non Excreta 
 spuit multum, nisi a catarrho. et 
 
 Ventriculus facile nauseat, si contineat cruditates retenta - 
 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 a 
 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, pau!6 post 
 sese per intestina salutariter exonerat. 
 
 Vrinae fluunt Laudabiles vt plurimum 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 omnium. 
 
 Ab anno 1619 post grauem morbum, In quo 
 fuerunt affixae ano hirudines, fluunt copiose singulis 
 fere diebus haemorrhoides, cum maxima evfopia. 
 Si sistantur (id quod imminente morbo aliquando 
 contingit) euadit. Kex valde iracundus, Melancho- 
 licus, Ictericus, calet impensius, deijcitur appetitus. 
 Keduce fluxu omnia in melius mutantur. 
 
 Morbi praegressi et praesens ad varias dis- 
 positiones morbosas aptitudo. 
 
 Hex ad sextum vsque aetatis annum non poterat NB 
 incedere, sed gestabatur, adeo debilis fuit a 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. 
 
 Saepissime Laborauit dolore Colico & flatu (qui 
 affectus etiam fuit matri familiaris) hie ad 24 tum 
 vsque aetatis annum grauior, deinceps mitior semper 
 euasit. Causae istius doloris eaedem fuerunt semper, 
 lejunium, Moeror, frigus nocturnum. A contrariis 
 leuamen. 
 
 Frequenter, et fere quotannis juuenis corripiebatur 
 Cholera morbo, cum rigore, Vomitum et fluxum 
 biliosum praecedente. 
 
 Diarrheae 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 diarrhoea fer& Moeror animi, 
 suspiria, suspicio omnium, caeter^que Melancholica 
 symptomata. Anno 1610 sub finem Parlamenti 
 solutis supremorum Regni ordinum comitiis post 
 summum moerorem, Dominus defunctus longissima 
 variorum symptomatum serie, non sine vitae peri- 
 culo per octiduum profusissima Diarrhaa 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 Rex conualuit. 
 
 1612. 4 Decemb. post mortem filii Melancho- 
 licus paroxysmus, cum omnibus symptomatis 
 successit Diarrhoea : soluta omnia intra paucos 
 dies. 
 
 1619. Post Reginae mortem praeuiis doloribus 
 Arthriticis et Nephritidis cum crassiorum arenarum 
 iterata exclusioneRostonii 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 hanc 
 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 Rex 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 a qua manifesta omnium symptomatum 
 remissio, et postea successit vi naturae paulatim 
 curatio. Affixae tune ano hirudines, atque vtiliter 
 in accessione Melancholica applicatae regioni Lienis 
 cucurbitulae. 
 
 Post istum morbum per biennium satis bene se 
 habuit Rex, 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 saltern 
 elapsis a dolorum cessatione diebus (septimanis 3 bus ) 
 Rex 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. 
 
 Dominus Catarrho a Cerebro in subjectas partes
 
 168 
 
 APPENDIX III 
 
 decumbente vt supra dictum facile concepto frigore 
 molestatur ; humoris pars Coryzam aliquando creat : 
 Vt plurimum pulmones afficit ; sequitur tussis 
 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 quam praeparari possint a Pharmacopoeo 
 remedia. 
 
 Hard febricitat, si per aliquos affectus inuadit febris 
 breuis ea est et fere Ephemera. 
 
 Male si se habeat quocunque modo, atque in E. 
 M te Laborent siue animus, siue corpus, facile 
 succedit Icterus, et flauescunt oculi, symptomate 
 tamen fugaci, quod paul6 post sponte euanescit. 
 
 Melancholiae hypochondriacae admodum ob- 
 noxius. 
 
 Continuus vel saltum pene quotidianus fluxus 
 haemorrhoidum 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 
 coiisuetus. Deinceps saepius rediuiuum malum, 
 atque in variis accessionibus rejecti calculi, vel potius 
 conglobatae, et viscida ferruminatione cohaerentes 
 arenulae friabiles, cum morbi solutione. 
 
 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
 
 THE HEALTH OF JAMES I 169 
 
 ab ineunte aetate fecit. Postea successere con- 
 tusiones variae, ab allisione ad tignum, ab illapso 
 saepius equo, ab ocreae et stapediae attritu, et alijs 
 causis externis, quas ingeniose scrutatur, et graphice 
 notat Rex 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 Podieus 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 pollicem 
 et malleolos, vtrumque genu, humeros, ipsasque 
 manus ; aliquando (non semper) cum rubore, cum 
 tumore saepius. 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 potissimum 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 III 
 
 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 saltern 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 triduum satis leuiter febricitauit. 
 
 Conualuit sine sanguinis missione. 
 
 Alias fibula alterius tibiae pondere equi in planam 
 figuram compress^ cum totius tibiae periculosa oon- 
 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 bilis, vnde non Lenitur, sed exasperatur 
 malum. 
 
 Leuamen poscit et Indolentiam, de causis morbi- 
 ficis parum solh'citus. 
 
 De Remediis. 
 
 Medicinam ridet et tarn parui pendit Rex vt 
 medicos parum Vtiles minus necessaries pronuntiet. 
 Artem 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 soils 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 ; licet semper adsit aliquid quod carpat, 
 praesertim increpans quod ab Enemate flatibus 
 oppleta intestina cum dolore post ipsum rejectum 
 distendantur. 
 
 Vnicam potionem assumpsit Catharticum ex Rha- 
 barbaro, Sena, tamarindis Manna, idque facillime, 
 sine nausea, cum optimo successu. Miranti medico 
 quod tarn placide ventriculo excepisset pharmacum, 
 respondit sibi omnia facih'a quae semel facienda 
 statuisset. In summa Id quod vult valde vult. 
 
 Julepos sitiens aut Intemperie calida aestuans non 
 rejicit, ex tincturis florum cordialium extractis cum 
 Vitrioli spiritu, addito ad dulcedinem (qua in omni- 
 bus delectatur) syrupo violate, de pomis, Julepo 
 Alexandrine vel saccharo. 
 
 Vt plurimum circa horam somni sitiens variis 
 de causis, succum Granatorum dulcium haurit ad 
 B 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 Kegiae Majestati fuit 
 administratum. 
 
 Nunquam missus phlebotomo sanguis, semel 
 extractus vt praedictum per hirudines. 
 
 Agenda. 
 
 Vrgent potissimum 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, 
 Rex a suis Doctoribus Medicis postulat, et expectat, 
 etiam citra expugnationem causae. 
 
 Statuendum igitur. 
 
 Quodnam sit Regiae 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 rfjs SICUTTJTI/CTJS. In cibo, potu, Animi motibus 
 etc. 
 
 Quomodo emendandi gradus Intemperiej variae. 
 
 Quomodo tollendae 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 vtili; 
 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 cu/Aareoo-is, quibus recre- 
 andi spiritus deinceps muniendum cor aduersus 
 tetros halitus 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 relinquendo hie 
 fluxus, num ab eo pene quotidiano et satis largo 
 aliquid impendeat periculi. 
 
 Num si non cohibendus saltern 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 MORBOS ET SYMPTOMATA. 
 
 4 Quid in Diarrhoea tarn frequenti vt fraenos demus 
 humoribus non sine virium jactura et spirituum 
 dispendio nimium fluentibus. An relinquendum 
 Naturae negotium, cum praesertim resumptis viribus 
 Regi sit ab istis fluxibus meliiis ? 
 
 An non error est quod fluente aluo vel a principio 
 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, Renis 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 Roborantia 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? 
 
 S An non Domino noxium toties renouare remedia, 
 | et artus aeri frigido tarn saepe negligenter exponere ? 
 
 Quibus mediis sanguis et spiritus ad flaccescentes 
 > tibias attrahi possint. 
 
 ,0 Quid in subitaneo casu vt Apopl. faciendum in hoc 
 subjecto? 
 
 Omnia haec Viri Excellentissimi Regis 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 August! 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. 
 Eegis 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, tarn 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 d/Trocrma viscerum et praesertim. 
 
 2. Hepatis fervida intemperies quod est sanguinis 
 Biliosi sero multo acri scatentis ferax. 
 
 3. Obstrtictio 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 a materie congestione in ipso partinm 
 parenchymate cujus dispositio molis incrementum 
 minatur non sine alicujus sinistri eventus metu et 
 imminente periculo : 
 
 5. Alui segnities vt plurimum et excrementorum 
 siccitas ordinaria, nisi quando fructibus horaeis sese 
 ingurgitat. Cerasis, peponibus, Bericoccis, presertim 
 apersicis, &c. 
 
 6. Hypochondriaca affectio, Licet temperamentum 
 vniversale sit calidum et siccum Biliosum : attamen 
 animo naturaliter prepensa est in Melancholiam. 
 
 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 dr/oo^ta, Tabes prae 
 foribus. 
 
 10. Renum impuritas arenosa. Excreuit plures 
 calculos paruos a rene dextro ; In hoc patrissat. 
 
 1 1. 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 6tu 
 Phthoe vnde maximum impendet discrimen : Ita vt NB 
 videatur naturae cursu futurus hinc E. M. terminus. 
 
 13. Caput tarn cah'dum 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, lintea 
 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. Lotus dextrum (brachium, manus) altero 
 macilentius veluti arescit. 
 
 21. Ante aliquot annos vtero gerens, passa est 
 primo stuporem ingentem. Deinde aliquam reso- 
 lutionem alterius lateris. 
 
 22. Debilitas Vniuersalis summa. 
 
 23. Consumptio Vniuersalis ab altricis facultatis 
 mala dispensatione. Nihil adhuc funesti & pulmoni- 
 bus. Sed Caue. 
 
 PERPENDENDA. 
 
 Ventriculus. 
 
 Mesenterium. 
 
 Hepar. 
 
 Lien. 
 
 Renes. 
 
 Intestina Aluus. 
 
 Hypochondria. 
 
 Vterus. 
 
 Pulmo. 
 
 Caput. Cerebrum. 
 
 Oculi. 
 
 Spina, nerui.
 
 QUEEN HENRIETTA MARIA 179 
 
 [ Debilitas 
 Vniuersalia \ sive 
 
 ( Atrophia. 
 
 Praecauenda ( Vitio hepatis 
 Tabes siue 
 Consumptio 1 Pulmonum corruptela. 
 
 * 1 
 
 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, imo 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 tempora. 
 
 Pete ex fonte et serua. Ne vtaris tamen. 
 
 Perpendenda. 
 
 Vis imaginations 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. 
 
 Renes semel et simul euerrendi. 
 
 Procurandus liber commeatus spiritibus Impedi- 
 menta tollendo, Purgatione per Epicrasin. 
 
 Epicerastica quae bonum succum reponunt in 
 locum mali. 
 
 Analeptica. 
 
 Corroborantia ^ 
 v , \ Cor 
 aequahter | Cerebmm 
 
 Humectantia 
 
 Habitum 
 
 Spiritus 
 
 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 saltern non noceant. 
 
 Praescribendum aequiualens, ex o* 
 
 An 
 
 Interim et exsucco corpore tuto possunt admini- 
 strari & If f - 
 
 Dubito, nisi magna cum cautione.
 
 181 
 
 V. HARVEY'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 LocaU^ &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 Reports 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, published a passage from it. In 1886 this 
 most interesting manuscript was edited by a com- 
 mittee of the Royal 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 College 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 UniversaliSj 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 
 Prelectiones 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 Prelectiones, 
 is to be seen in the Galen, and also a similar * N. B. ' 
 The date of the Prelectiones 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 peculiarities throughout 
 his life. 
 
 This edition, Claudii Galeni Pergameni 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 Royal 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 lines were 
 made by Harvey. He has invariably annotated 
 the Latin, and the Greek columns are without 
 marks throughout. 
 
 The first work is Galen's Exhortatio 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 * Rationali ', and 
 has underlined the words printed in italics : 
 4 Has igitur ob causas, quanquam reliquis etiam 
 animantibus haud deest Ratio, tamen homo solus ob 
 eminentiam, qud cseteris prsestat, Rationalis 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 nummis, 
 qui apud eos valent, qui instituerunt ; apud alios, 
 quasi adulterini 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 Medicus idem 
 et Philosophus, and has but few notes. The third, 
 De Sectis ad Tyrones, is noted throughout ; but the 
 fourth, De Optima Secta, has very few marks of 
 having interested the reader. The remaining 
 treatises, De Cognoscendis et Corrigendis cujusque 
 Animi Perturbationibus, De Dignoscendis et Corrigendis 
 cujtisque Animi Erratis t and Qwd 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 Prelectiones, 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 Sen orach, prose and 
 
 verse of the, 148. 
 Agincourt, 70. 
 Albemarle, Duke of, takes Sloane 
 
 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 Cof6 Fe- 
 
 rens, by Dr. James Douglas, 128. 
 Arbuthnot, understood importance 
 
 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, Mayerne'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,Reginaldus de,physician 
 
 to Eleanor 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. 
 Bibliographiae Anatomicae Speci- 
 men, by Dr. James Douglas, 
 
 128. 
 Bibliotheca Hispanica, first 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 Consolations. 
 
 Philosophia, known to Mirfeld, 
 
 51. 
 Bonetus, of Geneva, consulted by 
 
 Mayerne as to publication, 109. 
 Botallus mentioned by Sydenham, 
 
 84. ^ 
 Botanical Studies, influence on 
 
 medical, 128.
 
 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, 93. 
 
 Bradele, Walter de, treasurer of 
 Eleanor of Provence, 14. 
 
 Bradshaw, Henry, 20. 
 
 Brady, Dr. Robert, Master of 
 Cams, 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. 
 
 Brevianum Bartholomew, 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 
 Mayerne'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. 
 
 Caedmon, 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, 77 ; 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,114: ; 
 
 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 Dublin, 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 
 Molyneux to, 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 
 
 fuardian of medical learning, 
 7 ; examination of candidates. 
 
 82. 
 
 Cologne, 80. 
 Columquille (or Columba), 
 
 Saint, 41 ; life of, at Schaff- 
 
 hausen, 54. 
 Communa, 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. 
 Constantino, 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- 
 
 Duinntsleibb.es 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 Sarniense (pub- 
 lished 1725), 128; Myogra- 
 phiae Comparatae Specimen, 
 ib. ; Bibliographiae Anatomicae 
 Specimen, ib. ; his text of First 
 Ode of Horace and his catalogue 
 of his editions of Horace, ib. ; 
 became Fellow of the College 
 (1721), 129; 'Fold' of, ib. ; 
 observations published in Philo- 
 sophical Transactions, ib. ; 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, ib. ; 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 Harvey on treat- 
 ment of, 108. 
 
 Elizabeth, reign of, 93. 
 
 Elzevir, Louis, of Amsterdam, 
 printer, 124. 
 
 Emmenologia, 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, Mayerne'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, 
 ib. 
 
 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 
 Purgantibus and Emmenologia, 
 ib. 
 
 French, the, in London, men- 
 tioned in charters before Eng- 
 lish, 7. 
 
 Gaddesden, John of, 20 ; Rosa Ang- 
 lica, 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 Bartholomew, 44. 
 
 Glanvilla, 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 Rnchi- 
 tide, first English complete 
 account of a disease, ib. ; me- 
 thod, 112; praised by Virchow, 
 113; De Vtntriculo, 113; one 
 of the three great clinical 
 observers in the seventeenth 
 century, 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, 1 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, t'6. ; 
 died 1632, ib. ; work on Galen, 
 published 1640, ib. 
 
 Grammar School at Norwich, 
 70. 
 
 Grandison (or Cronson), John, 
 Bishop of ttxeter, 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. 
 
 Hamey, Dr. Baldwin, wrote Bus- 
 torum Aliquot Reliquiae, 2 ; 
 Harvey's letter to, 181. 
 
 Hamo Magister, 12. 
 
 Harveian Oration, delivered by 
 Terne, 75. 
 
 Harvey, William, Hamey's epi- 
 
 fram on, 2 ; his additions to 
 nowledge, 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 Morboruni 
 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 etudies 
 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 ant ruin, 134.
 
 INDEX 
 
 195 
 
 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, 133 ; 
 heroic conduct and sad death 
 of, ib. 
 
 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 August inians, 24. 
 
 Hfitel 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, 16. ; 
 treatise On the Malignant Ulcer- 
 ous Sore-throat, ib. ; compared 
 with Fothergill, ib. 
 
 Hydatid of the liver, 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 
 Milicent 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 works 
 
 of Middle Ages, 89. 
 Isidore, St., of Seville, Liber Ety- 
 
 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 Erigeua, 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, son 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. 
 
 Lanf ran c, 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, Mayerne 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 Scn'p- 
 toribus Britannicis, 31 ; esti- 
 mate of Bartlott, 56. 
 
 Leprosy, Bernard of Gordon on, 
 38. 
 
 Letters of famous Physicians, in 
 Sloane Collection, 133. 
 
 Leviathan, The, 86. 
 
 Lewis of France, invasion of 
 England, 17. 
 
 Leyden, University of, 136. 
 
 Liber de Ephemera Britannica, by 
 
 Caius, 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 
 
 Mac Michael, 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. 
 MacBetba, 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. 
 MaicAedh again, hereditary Irish 
 
 judges, 142. 
 Maic Conmidhe, hereditary poets 
 
 or orators, 143. 
 MaicDuinntsleibhe, family of 
 
 hereditary physicians, 143; Cor- 
 
 mac, works of, 144, 145 , his 
 
 MS3. 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, ib. 
 Mandeville, Geoifrey de, chief 
 
 Constable of the Tower, 10. 
 Marcellus Empiricus, medical 
 
 charm from, 41. 
 Marcellus, wrote on materia 
 
 medico, 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. 
 Marti n-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, ib. ; M.D. of 
 Montpellier, ib. ; attacked for 
 using chemical remedies, 95 ; 
 physician to King of France, 
 and to King James I (1611), 
 ib. ; goes to Queen Henrietta 
 Maria at Exeter, 108; letters, 
 110; portrait, ib. ; 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 
 medico, 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 Maiy , ib. ; gradu- 
 ated at Trinity College, Dublin, 
 ib. ; studies at Leyden, ib. ; 
 letters of, ib. ; visits Cam- 
 bridge and Oxford, 186 ; further 
 studies at Leyden, ib. ; M.D. 
 Dublin, 1687, ib. ; President of 
 the King's 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, 
 ib. ; 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 Observations 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 Cael, 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 LI), 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, 114. 
 
 Plague, 133, 134. 
 
 Plague, Mirfeld on, 34. 
 
 Platearius (of Salernum), 38, 48, 
 50, 151. 
 
 Pleshy, remains of Castle of, 10. 
 
 Plummer, pupil ot'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,Duke 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'Hickey MS., 147. 
 Regimen Sanitatis Salerni, 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 ; hie 
 
 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, 13. 
 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 and 
 
 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, 3. 
 
 Rome, 79. 
 
 Romsey, charter witnessed at, 9. 
 
 Rosa Anglica, of J. of Gaddesden, 
 40. 
 
 Roubiliac, statue by, 137. 
 
 Round,Mr. J. tt.,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. 
 
 Bancroft (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, 1 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, 
 ib. ; studied at Paris, Mpnt- 
 pellier, and Orange, ib. ; visited 
 W. Indies, ib.; works, 132; 
 originator of British Museum, 
 ib. 
 
 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, ib. ; died 
 1689, ib.; 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. 
 
 Tabidontm 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 pollege, 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, ib. 
 
 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. 
 Ulltach, 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 
 
 May erne, 73. 
 Venice, 79. 
 Vienna, 80. 
 
 Villa Nova, Arnaldus de, 48. 
 Virchow, Professor, Croonian 
 
 lecture, 113. 
 Virgil, 48. 
 Vitry, Jacobus de, Bishop of Acre, 
 
 Historic* Occidentalis, 21. 
 
 Walbrook. 5. 
 
 Waldric, Chancellor 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, Brady 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 
 
 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. 
 
 Oxford : Printed at the Clarendon Press, by HORACE HART, M.A.
 
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