Characters and precepts of the Salernitana Medical School

The Scuola Medica was born and developed thanks to the presence of great characters related to the Church, ecclesiastics and monks, who exercised their profession for material well-being, as well as spiritual, of the poor, of the rich and of the noble.

The monasteries, and especially the one dedicated to St. Benedict, were also destined to accommodate the sick, hostels for their infirmities. And great doctors were great ecclesiastics, first among all Alfano, glory of Salerno, of the Medical School, of the Benedictine order, and of culture.

But more than anything, to explain how important the care of the bodies connected with that of souls is the idea behind the teaching of the School: that harmony and balance are really the source of health.

Harmony among the four elements that make up the Creation, namely air, water, earth and fire, which are the same elements at the base of our human body, and whose imbalances generate diseases.

Balance between mind and food, to find in joy and diet the best care.

Balance between disease and its care, especially due to “laboratory” herbs, which, cultivated in the gardens of the convents, cure everything.

And so it is written at the beginning of the Regimen Sanitatis Salernitanum, the text in Latin verses, which is the summary of the wisdom of the School, and which was sent to memory by every doctor. Thus says the debut of the poem, dedicated to King Richard of England, which in Salerno was healed:

“If you want to look at the evils, if you want to be healthy, cast off serious worries, do not abandon yourself to anger. Be sober in drinking, moderate in eating, do not be burdensome to walk after lunch, avoid afternoon sleep, do not hold the orine, do not compress the anus with effort. If you look at these rules carefully, you will live healthy long. If you miss doctors, you have doctors these three principles: lie mind, rest, moderate diet”.

But what was taught in the Medical School in the known era? How was teaching organized?

First of all, it is necessary to say that the School was secular, and this is its most important organizational aspect: a medieval university whose organization was entirely entrusted with lay orders, although, many, among the greatest masters, were men of church and clinics often corresponded with monasteries.

In the heart of Mediterranean Europe, in the centuries before the millennium, it already flourished a cultural institution that responded only to itself and its aims of teaching and care of the bodies. And, then, medicine was only one of the fields of teaching, because in Salerno there was teaching and conferring degrees also in philosophy, because no science is valid if it is not helped by love for knowledge.

Over the centuries its structure and its teachings have changed, but, some elements have remained fixed: relationship between self care and displacement from diseases, body care and spirit, attention to diets, use of natural medicines derived from plants cultivated in the gardens of the city.

At the beginning, the School was of practical medicine, that is, it based teaching on the precepts and observation of the experienced doctors; the elaborate writings were, fundamentally, of the compendium type, that is, pure and simple review of norms and principles.

After the age of Alfano, which translates from Greek, and Constantine, which presents texts from Arabic, often also Greek translations, you go to the commentary, and, that is, to the critical reworking of classical texts, enriched with glosses and comments. Thus, the method of teaching changes, which, from the pure observation of practice and the collection of cases and empirical methods, passes to the study of classics, to the erudite comparison between daily practice and theory.

At this point, the need to structure the School also organizedly, and a corporate structure, already existing in ancient times: the Medical College. The existence of a professional body, to protect the interests of the doctors of Salerno, was warned and, at least in part, realized since the early centuries of the Medical School. But, only in the second half of the fifteenth century, the actual College was born, that is, an autonomous institution, equipped with statutory regulations and formed by a number of life members. The Collegium Doctorum was the sole holder of the right to give degrees, and retained this privilege until the end of its centuries-old history.

The College consisted of ten ordinary members, of whom the oldest was the Prior, followed, then, the Promotor, the Bank Chief, the First Collegiate and so on.

All the doctors from Salerno were Alunni and had the right to access the College over time.

The prestige of the Prior was witnessed by the settlement ceremony. The College invited the Promoter, a senior member to whom the right of succession was entitled, to occupy the vacant post for the death of the Prior. The Promotor sat in a separate armchair from the Collegiate bank, received the prioral cap, gloves and gilded lace, exchanged the kiss of peace with the Collegials.

The Prior, not only, conferred the degrees, but ruled, as well, the justice between the Collegials, the Alunni and the Aromatarians (i.e. pharmacists). Its power also extended to the controls of pharmacies and spices and, therefore, to the release of licenses and, finally, controlled the trade of spices and drugs at the Fair.

A great corporate power, which extended not only, therefore, to the exercise of the profession, but also to trade and justice. And this lasted for centuries, until the closure of the School, in 1811.

The aspect of the Medical School that is important to note is that of its cultural openness, and its willingness to accept contributions that come from all sides. Truly Greek and Arabic culture, philosophy and empirical science, study and application are the elements that have made great the Medical School of Salerno.

Among the thousand doctors of Salento there were so many from afar, and the greatest among them was Constantine the African.

He arrived in Salerno from Carthage, where he was born, and, as Pietro Diacono tells, after long pilgrimages in the Mediterranean. First

he went to Cairo to study grammar, dialectic, rhetoric, geometry, arithmetics, mathematics, astronomy, negromancy, music and physics of the Chaldeans, Arabs, Persians and Saracens; he would then continue his journey to India and Ethiopia. Returning to Carthage his great erudition would have made him unconscious to the citizens, who even thought of killing him. That’s how Constantine fled to Salerno.

Other versions speak of a Constantine kidnapped by Salento pirates and sold as a slave. Here he would have healed from a serious illness the prince who would immediately free him.

If he is uncertain his life before Salerno, then we can know for sure that after living as a scholar and translator from Arabic in the city, he went to Montecassino to close his life as a monk.

Of course, he left us a series of important texts written in his hand and a series of translations such as to make it one of the most famous doctors of the School, and of course it was what most helped to transform it from school of practical medicine to real university.

We like to remember the figure of this great with his quote, which reveals what is, beyond the doctrine, the true mission of a doctor: “The good doctor, when he visits the sick person, does not bear his heart towards his wife, does not hold his eyes on his daughter and servant: for this blinds the heart of man. He must only be aware of the disease he has been confided to him: sometimes in fact, the patient reveals to the doctor what is shameful to trust the family. Escape lust, look at the inebriating delights of the world that disturb the mind and strengthen the vices of the body. You love perseverance in the study to be able to take care of body health. Make profit from the lessons without getting bored so, if he happens to lose the books, the memory can come to help him. He is not bothered to visit sick people of any kind, so as to be more and more able in practice. Be pious, humble, of good character, loving, ready to ask for divine help”.

(From the Prologue to the De Comminibus medical cognitu necessary locis. )

What seems useful to us to tell about the Salernitana Medical School is its practical and empirical spirit.

As in business, so in the sciences of doing, and therefore in medicine, count ability to observe, practice, experience. And in Salerno these methods were particularly alive and transmitted. Important is reading and study, important knowledge of Hippocrates and Galeno, fundamental theories on elements and four temperaments.

But the good doctor is what he observes, experiences, remembers and compares. And in the School this practical approach also comes to the study of anatomy, obviously not the human one, because it was forbidden to dissect bodies that will have to rise, but that of animals, to understand how they are formed and by comparison, as men are made.

Practical and without prejudice, so without prejudice to allow women to exercise medical art.

Medical women in Salerno have been many, and the most famous of all is Trotula, author of the famous throughout Europe “De mulierum passionibus in front and post partum”.

The poisons were the specialty of the doctors of Salerno, and this is also witnessed by the history of Sichelgaita, the wife of Roberto the Guiscardo, accused of having tried to poison the stepdaughter.

But the female medical art in Salerno also covers other treatments, those of cosmetics: “Salernitane women put the root of vine in honey and then with this honey join the face: so they cure the cracks and the face rejuvenates”.
(Bernardo Provenzale).

The body should be treated, therefore, because it remains healthy and, let’s say, also beautiful. What’s wrong?