Thursday, November 14, 2013

802--1300 A.D..: The School of Salerno

Figure 1 - An early depiction of the School of Salerno
The Dark Ages of Medicine amid western civilization weren't completely dark.  There were various towns and cities in and around Europe where the old Greek and Roman traditions continued to be studied and worshiped.  One of the most significant of these towns as far as our medical history is concerned is that of Salerno in Naples.  It was here that medical schools were formed amid a flourishing medical community.

Salerno was a town in Southern Italy "that was beautifully situated in a district which as early as the times of the Roman Emperors was famous as a health resort and attracted a number of visitors to it's precincts."   (3, page 187)

Some authorities say the school was founded in 802 by Charlemagne, said historian Thomas Bradford, although no one knows for sure.  Others say if "dates from the destruction of the library of Alexandria by the Arabs." (6, page 103)

Ordericus Vitalis, a historian from the 12th century, said it was started in ancient times.  Another historian speculated it was formed by fugitives from Alexandria.  More realistically, there were probably towns like Salerno all over Europe where Greek tradition continued to flourish.  Physicians in Salerno, therefore, probably had no connection with the clergy that influenced the decline of the Roman Empire.  (3, page 187)

What is known is that a school, hospital, and university were established in in the town of Salerno, thus creating "bridge over which ancient culture took its way during the Middle Ages from East to West. They were the means of crystallizing the great thoughts of the early fathers so that we of the present times are enabled to understand them."  (6, page 106)

Salerno was on the route taken by pilgrims trying to escape the Christians who now ruled much of Europe and Asia, and therefore they took refuge in Salerno. There teachers at the School of Salerno (or Salernum) were a combination of Greek, Arabians and Jews, said Bradford. (6, page 103)

The School was referred to as The Schola Medica Solernitano.  It thrived between the 10th and 13th centuries. While exact dates of when it started and when it closed are unknown to historians, what is known is that the sick who wanted the best medical treatment went there, and medical students who wanted the best education went there.  It became known as the city of Hippocrates (Hippocratica Civitas or Hippocratica Urbs) (4)

By the mid 11th century Salerno it was a full, flourishing medical community that was significant to the evolution of the history of medicine. There were many physicians who worshiped under the traditions of Alexandrian medicine. They studied the works of Hippocrates, Galen, and the other ancient philosophers and physicians.

Here is a portrayal of a hospital at Salerno.  
"Patients eat and rest while workers share a meal and
 others engage in domestic tasks."  From the book:
De donservanda bona valetudine, opusculum
Scholae Salernitanae published 1545. It was written
 by Arnaldus de Villanova  who lived from 1240 to 1311. (5)
The school was a place where traditional Greek and Roman medicine commingled harmoniously with Jewish and Arabic medicine.  Many historians say that both men and women were involved in education there, with the main courses of education being, along with medicine, philosophy, theology and law. (4)

Students were taught by physicians from their own country, and in their own language the various subjects essential to medicine, which included "symptomatology, dietetics, treatment and materia medica," said Bradford.  "but little time was given to anatomy and physiology."  (6, page 104)

Of anatomy, however, Bradford said that:
In the twelfth century Frederick II (1194-1250) ordered a special provision with respect to the study of anatomy at this school, made in his medical code. It is said that by the emperor's direction a dissection was made every five years at Salernum. No one was allowed to practice medicine in the kingdom of Naples who had not been examined and created a master by the college of Salernum. In order to do this the student was obliged to study logic three years, and follow a course of medicine and surgery for five years. In order to become admitted to an examination at the end of the term, the student must present a certificate of his legitimate birth, and that he had attained his 25th year (according to Baas in his 21st year); after this he was examined publicly in the therapeutics of Galen, the first book of Avicenna, and the aphorisms of Hippocrates. He then took an oath to be faithful to good conduct, to submit to the rules of the profession, to give gratuitous attention to the poor and not to share in the profits of the apothecaries, to teach correctly according to the received doctrines, and to administer no poisons. All these things having been fulfilled, the candidate received a ring, a wreath of laurel, a kiss, and finally the benediction. The graduation was in public. Renouard says that after this the candidate must have his diploma confirmed by the proper officer of state, and was then obliged to continue with some experienced physician before entering into independent practice. Baas says that after the graduation he could teach and practice wherever he wished; the office of medical teacher was open also to him.
The degree conferred was that of magister, or doctor. (6, page 104-105)
During it's most prosperous times the "town of Salerno was famous for the skill of physicians." After the decree of Frederick II, it was perhaps the first school since the School of Alexandria in 300 B.C where dissections were performed and anatomy was studied.  (2, page 28)

It was also a town where successful surgeries were performed and where people traveled hundreds and thousands of miles in search of a treatment or cure for ailments.  (3, page 187)(6, page 105)

The schools, hospitals and universities of Salerno gradually declined, "until in the fourteenth century the poet Petrarch mentions the school as a memory." (6, page 103-104)

Two other schools of medicine that were significant to the transfer of medicine from the ancient world to the revival of medicine among western civilization were Monte Casino and Montpellier.  (6, page 102)

Bradford said the school of "Monte Casino was founded by the Benedictines on the site of an ancient temple of Apollo in Campania."  He said school of Monpellier "was first mentioned in 1137 when Bishop Adelbert II went there to listen to its medical teachers."  He said both the Jews and Christians lived among the city.  (6, page 102-106)

  1. Garrison, Fielding Hudson, "An introduction to the history of medicine," 1922, Philadelphia, W.B. Saunders Company
  2. The John Hopkins Hospital bulleton," (volume XV 1904), "from the epoch of the Alexandria School (300 B.C.)"
  3. Suppan, Leo, "The Medical School of Salerno and the Salernitan Writers," The National Druggist, May, 1918, 
  4. "The Ancient Medical School of Salerno,",, accessed 12/5/12
  5. "Arnoldus de Villanova (1240-1311) and the School of Salerno,"Vaulted Treasures,,, accessed 12/5/12
  6. Bradford, Thomas Lindsley, writer, Robert Ray Roth, editor, “Quiz questions on the history of medicine from the lectures of Thomas Lindley Bradford M.D.,” 1898, Philadelphia, Hohn Joseph McVey

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