Kitabı oku: «The Popes and Science», sayfa 3

THE SUPPOSED PAPAL PROHIBITION OF DISSECTION

There is a very general impression that the Roman Catholic Church was, during the Middle Ages, opposed to the practice of dissection, and that various ecclesiastical regulations and even Papal decrees were issued which prohibited, or at least limited to a very great degree, this necessary adjunct of medical teaching. These ecclesiastical censures are supposed to be in force, to some extent at least, even at the present time. The persuasion as to the minatory attitude of the Church in regard to dissection is so widespread among even supposedly well-educated professional men, that, as we have said in the introductory chapter, when there was question some time ago of opening a medical school in New York City under Catholic auspices as a department of Fordham University, a number of more than ordinarily intelligent physicians asked: What would be done about the study of anatomy, since in the circumstances suggested dissection would not be allowed? This false impression has been produced by writers in the history of science who have emphasized very strenuously the supposed opposition of the Church to science, and as these writers had a certain prestige as scholars their works have been widely read and their assertions have been unquestioned, because it would naturally be presumed that they would not make them without thorough investigation of such important questions. Professional men are not to blame if they have taken such statements seriously, even though they are absolutely without foundation. That statements of this kind should have been made by men of distinction in educational circles and should have passed current so long, is only additional evidence of an intolerant spirit in those who least suspect it in themselves and are most ready to deprecate intolerance in others.

Take a single example. Most of what is said as to the opposition of the Church to medicine during the Middle Ages in A History of the Warfare of Science with Theology in Christendom, by Andrew D. White (Appleton's, New York), is founded on a supposed Papal prohibition of anatomy and on a subsequent equally supposed Papal prohibition of chemistry. These two documents are emphasized so much, that most readers cannot but conclude that, even without further evidence, these are quite enough to prove the contention with regard to the unfortunate opposition of the Church to medical science. Without these two presumably solid pillars of actual Papal documents, what is said with regard to the Church and its relations to medical science in the Middle Ages amounts to very little. Much is made of the existence of superstitions in medicine as characteristic of the Middle Ages and as encouraged by clergymen, but medical superstitions of many kinds continue to have their hold on even the intelligent classes down to the present day in spite of the progress of education, and in countries where the Church has very little influence over the people. Dr. White quotes with great confidence and absolute assurance a Papal decree issued in the year 1300 by Pope Boniface VIII., which forbade the mutilation of the human body and consequently hampered all possibility of progress in anatomy for several important centuries in the history of modern science. Indeed, this supposed Papal prohibition of dissection is definitely stated to have precluded all opportunity for the proper acquisition of anatomical knowledge until the first half of the sixteenth century, when the Golden Age of modern anatomy set in. This date being coincident with the spread of the movement known as the Protestant Reformation, many people at once conclude that somehow the liberality of spirit that then came into the world, and is supposed at least to have put an end to all intolerance, must have been the active factor in this development of anatomy, and that, as Dr. White has indeed declared, it was only because the Church was forced from her position of opposition that anatomical investigation was allowed.

Since so serious an accusation is founded on a definite Papal document, it cannot but be a matter of surprise that those who have cited it so confidently as forbidding anatomy, and especially dissection, have never given the full text of the document. It is practically impossible for the ordinary reader, or even for the serious student of the history of medicine, to obtain a copy of this decree unless he has special library facilities at his command and the help of those who are familiar with this class of documents. Many references have been made to this prohibition by Pope Boniface VIII., but no one has thought it worth while to give, even in a footnote, the text of it. The reason for this is easy to understand as soon as one reads the actual text. It has nothing to say at all with regard to dissection. It has absolutely no reference to the cutting up of the human body for teaching purposes. Its purpose is very plain, and is stated so that there can be no possible misapprehension of its meaning. Here we have an excellent illustration of what the editors of the Cambridge Modern History declared to be the breaking up of the long conspiracy against the truth by the consultation of original documents.

Through the kindness of the Rev. D. A. Corbett, of the Seminary of St. Charles Borromeo, Overbrook, Pa., I have been able to secure a copy of Pope Boniface's decree, and this at once disposes of the assertion that dissection was forbidden or anatomy in any way hampered by it. Father Corbett writes:

"The Bull De Sepulturis of Boniface VIII. is not found in the Collectio Bullarum of Coquelines, nor is it incorporated in the Liber Sextus Decretalium Divi Bonifacii Papae VIII., though it is from here that it is quoted in the Histoire Litteraire de la France (as referred to by President White). It appears in an appendix to this sixth book among the Extravagantes, a term that is used to signify that the documents contained under it were issued at a time somewhat apart from the period this special book of decretals was supposed to cover. The Liber Sextus was published in 1298. This 'Bull De Sepulturis' was not issued until 1300. It is to be found in the third book of the Extravagantes, Chapter I."

Even a glance at the title would seem to be sufficient to show that this document did not refer even distantly to dissection, and this makes it all the harder to understand the misapprehension that ensued in the matter, if the document was quoted in good faith, for usually the compression necessary in the title is the source of such errors. The full text of the bull only confirms the absolute absence of any suggestion of forbidding dissection or discouraging the study of anatomy.

"Title–Concerning Burials.[Footnote 2] Boniface VIII. Persons cutting up the bodies of the dead, barbarously boiling them, in order that the bones, being separated from the flesh, may be carried for burial into their own countries, are by the very act excommunicated.

[Footnote 2: See Latin text in full in appendix.]

"As there exists a certain abuse, which is characterized by the most abominable savagery, but which nevertheless some of the faithful have stupidly adopted. We, prompted by motives of humanity, have decreed that all further mangling of the human body, the very mention of which fills the soul with horror, should be henceforth abolished.

"The custom referred to is observed with regard to those who happen to be in any way distinguished by birth or position, who, when dying in foreign lands, have expressed a desire to be buried in their own country. The custom consists of disemboweling and dismembering the corpse, or chopping it into pieces and then boiling it so as to remove the flesh before sending the bones home to be buried–all from a distorted respect for the dead. Now, this is not only abominable in the sight of God, but extremely revolting under every human aspect. Wishing, therefore, as the duty of our office demands, to provide a remedy for this abuse, by which the custom, which is such an abomination, so inhuman and so impious, may be eradicated and no longer be practiced by anyone, We, by our apostolic authority, decree and ordain that no matter of what position or family or dignity they may be, no matter in what cities or lands or places in which the worship of the Catholic faith flourishes, the practice of this or any similar abuse with regard to the bodies of the dead should cease forever, no longer be observed, and that the hands of the faithful should not be stained by such barbarities.

"And in order that the bodies of the dead should not be thus impiously and barbarously treated and then transported to the places in which, while alive, they had selected to be buried, let them be given sepulture for the time either in the city or the camp or in the place where they have died, or in some neighboring place, so that, when finally their bodies have been reduced to ashes or otherwise, they may be brought to the place where they wish to be buried and there be interred. And, if the executor or executrix of the aforesaid defunct, or those of his household, or anyone else of whatever order, condition, state or grade he may be, even if he should be clothed with episcopal dignity, should presume to attempt anything against the tenor of this our statute and ordination, by inhumanly and barbarously treating the bodies of the dead, as we have described, let him know that by the very fact he incurs the sentence of excommunication, from which he cannot obtain absolution (unless at the moment of death), except from the Holy See. And besides, the body that has been thus barbarously treated shall be left without Christian burial. Let no one, therefore, etc. (Here follows the usual formula of condemnation for the violation of the prescriptions of a decree.) Given at the Lateran Palace, on the twelfth of the calends of March, in the sixth year of our pontificate."

The reason for the bull is very well known. During the crusades, numbers of the nobility who died at a distance from their homes in infidel countries were prepared for transportation and burial in their own lands by dismemberment and boiling. The remains of Louis IX., of France, and a number of his relatives who perished on the ill-fated crusade in Egypt in 1270, are said to have been brought back to France in this fashion. The body of the famous German Emperor, Frederick Barbarossa, who was drowned in the river Saleph near Jerusalem, was also treated thus in order that the remains might be transported to Germany without serious decomposition being allowed to disturb the ceremonials of subsequent obsequies. Such examples were very likely to be imitated by many. The custom, as can be appreciated from these instances from different nations, was becoming so widespread as to constitute a serious source of danger to health, and might easily have furnished occasion for the conveyance of disease. It is almost needless to say to our generation that it was eminently unhygienic. Any modern authority in sanitation would at once declare against it, and the custom would be put an end to without more ado. There can be no doubt at all then that Pope Boniface VIII. accomplished good, not evil, by the publication of this bull. So anyone with modern views as to the danger of disease from the foolish custom which it abolished would at once have declared, and yet, by a perversion of its signification, it came to be connected with a supposed prohibition of dissection. For this misunderstanding Pope Boniface VIII. has had to suffer all sorts of reproaches and the Church has been branded as opposed to anatomy by historians(!)

Is it possible, however, that this bull was misinterpreted so as to forbid dissection, or at least certain forms of anatomical preparation which were useful for the study and teaching of anatomy? That is what Dr. White asserts. He shows, moreover, in his History of the Warfare of Science with Theology, that he knew that the document in question was perfectly inoffensive as regards any prohibition of dissection in itself, but insists that by a misinterpretation, easy to understand as he considers, because of the supposed opposition of ecclesiastics to medical science, it did actually prevent anatomical development. President White says: "As to the decretal of Pope Boniface VIII., the usual statement is that it forbade all dissections. While it was undoubtedly construed universally to prohibit dissection for anatomical purposes, its declared intent was as stated in the text; that it was constantly construed against anatomical investigations cannot for a moment be denied."

If a misinterpretation were subsequently made, surely Pope Boniface VIII. must not be held responsible for it; yet in spite of the fact that Dr. White shows that he knew very well that this bull did not forbid the practice of dissection, he does not hesitate to use over and over again expressions which would imply that some formal decision against dissection itself had been made, though this is the only Papal document he refers to. He even goes so far as to say that "anatomical investigation was made a sin against the Holy Ghost." He frequently repeats that for three centuries after the issuance of this bull the development of anatomy was delayed and hampered, and insists that only that Vesalius at great personal risk broke through this Church opposition, modern anatomy would never have developed. He proceeds constantly on the theory that it was always this bull that was in fault, though he confesses that if so, it was by a misunderstanding; and the only fault he can find to attribute to the Pope is a lack of infallibility, as he calls it, because he was not able to foresee that his bull would be so misunderstood.

I suppose we are to understand from this that Dr. White considers that he knows the meaning of the word infallibility. It is not a hard word to understand if one wishes to understand it. The meaning that he gives it in this passage is so entirely different from its accepted meaning among Catholics, that any schoolboy in any of our parochial schools would tell him that the word was never used by Catholics in the sense in which he here employs it. It is so misunderstood popularly outside of the Church, and this Dr. White doubtless knew very well. When a man uses a term in medicine in a different sense to that which is ordinarily accepted, we consider him ignorant; but when he deliberately uses it in another sense for his own purposes because of a false significance attached to it in the popular mind, we have a special name for him.

The whole matter, however, resolves itself into the simple question, "Was dissection prevented and anatomical investigation hampered after the issuance of the bull?" This is entirely a question of fact. The history of anatomy will show whether dissection ceased or not at this time. Now if those who so confidently make assertions in this matter had ever gone to a genuine history of anatomy, they would have learned at once that, far from this being the time when dissection ceased, the year 1300 is almost exactly the date for which we have the first definite evidence of the making of dissections and the gradual development of anatomical investigation by this means in connection with the Italian universities. This is such a curious coincidence that I always call it to the attention of medical students in lecturing on this subject.

The first dissection of which we have definite record, Roth tells us in his life of Vesalius, was a so-called private anatomy or dissection made for medico-legal purposes. Its date is the year 1302, within two years after the bull. A nobleman had died and there was a suspicion that he had been poisoned. The judge ordered that an autopsy be made in order to determine this question. Unfortunately we do not know what the decision of the doctors in the case was. We know only that the case was referred to them. Now it seems very clear that if this had not been a common practice before, the court would not have adopted this measure, apparently as a matter of judicial routine, as seems to have been the case in this instance. Had it been the first time that it was done instead of having the record of the transaction preserved only by chance, any mention of it at all would have appeared so striking to the narrator, that he would have been careful to tell the whole story, and especially the decision reached in the matter.

After this, evidence of dissection accumulates rapidly. During the second decade of the century Mondino, the first writer on anatomy, was working at Bologna. We have the records of his having made some dissections in connection with his university teaching there, and eventually he published a text-book on dissection which became the guide for dissectors for the next two centuries. Within five years after this we have a story of students being haled to court for body-snatching for anatomical purposes, and about this time there was, according to Rashdall in his History of the Universities, a statute of the University of Bologna which required the teacher in anatomy to dissect a body, if the students brought it to him. More than ten years earlier than this, that is, within ten years after the supposed Papal prohibition, there are records of dissections having been made at Venice in public, for the benefit of the doctors of the city, at the expense of the municipal treasury. During the first half of this century money was allowed at Bologna for wine, to be given to those who attended the public dissections, and if we recall the state in which the bodies must have been at a time when the use of preservatives was unknown, we can well understand the need for it. All this shows, as I have said, that the date of Boniface's bull (1300), far from representing the eclipse of anatomy, actually fixes the date of the dawn of modern practical anatomical study.

The most interesting question in this whole discussion is as to how much dissection Mondino actually did during the second decade of the fourteenth century. His book became the manual of dissection that was in practically every dissector's hands for several centuries after. Probably no book of its kind has ever been more used, and none maintained its place as the standard work in this department for so long. No less than 25 printed editions of it appeared altogether. It would seem to be utterly improbable that the author of a text-book of this kind could have made only a few dissections. There are a number of historians who have claimed, nevertheless, that at most he did not dissect more than three or four bodies. This is all that we have absolute evidence for, that is to say, only these dissections are recorded. It is easy to understand, however, that a professor of anatomy might make even hundreds of dissections, and yet have something to say only about a very few which happened to present some special peculiarities. The absence of further records may readily be accounted for also in other ways. The art of printing was not yet invented; paper had only just been discovered and was extremely expensive, and many factors conspired to destroy any records that may have been made.

Outsiders dipping into the history of medicine have made much of our paucity of documentary evidence with regard to what Mondino actually did, and have, when it suited their purpose, insisted that this first author of a dissector's manual did but the three or four dissections explicitly mentioned. Those who are more familiar with the history of medicine, and especially of anatomy, are persuaded that he must have done many. In the first class of writers is Prof. White, for instance, who declares positively that Mondino did not dissect more bodies than those of which we have absolute records. According to his emphatically expressed opinion, the reason why the father of dissection did not dissect more was because of ecclesiastical opposition. Even these few dissections were due to some favoring chance or the laxity of the ecclesiastical authorities, or Mondino might have paid dear for his audacity. No one else, according to Prof. White, dared to encounter the awful penalties that might have been inflicted on Mondino until Vesalius, more than two centuries later, broke through "the ecclesiastical barrier" and gave liberty to anatomists. Prof. Lewis S. Pilcher, of Brooklyn, who has made a special study of Mondino and his times, who has consulted that author's original editions, who has searched out the traditions with regard to him in the very scene of his labors in Bologna, thinks quite differently. Prof. White has a purpose, that of minimizing the work done in anatomy during the fourteenth century; Prof. Pilcher's only purpose is to bring out the truth with regard to the history of anatomy. In the Medical Library and Historical Journal for December, 1906, Prof. Pilcher has an article entitled The Mondino Myth, by which term he designates the idea that Mondino dissected but a few bodies. He says with regard to this subject:

"The changes have been rung by medical historians upon a casual reference in Mondino's chapter on the uterus to the bodies of two women and one sow which he had dissected, as if these were the first and the only cadavers dissected by him. The context involved no such construction. He is enforcing a statement that the size of the uterus may vary, and to illustrate it remarks that, 'a woman whom I anatomized in the month of January last year (1315 Anno Christi), had a larger uterus than one whom I anatomized in the month of March of the same year.' And further, he says, 'the uterus of a sow which I dissected in 1316 (the year in which he was writing) was a hundred times greater than any I had seen in the human female, for she was pregnant, and contained thirteen pigs.' These happen to be the only references to specific bodies that he makes in his treatise. But it is a far cry to wring out of these references the conclusions that these are the only dissections he made. It is quite true that if we incline to enshroud his work in a cloud of mystery, and to figure it as an unprecedented, awe-inspiring feature to break down the prejudices of the ages, it is easy to think of him as having timidly profaned the human body in his anatomizing zeal in but one or two instances. His own language, however, throughout his book is that of a man who was familiar with the differing conditions of the organs found in many different bodies–a man who was habitually dissecting."

As I think must be clear to any one who knows Mondino's book, no other conclusion than this suggested by Prof. Pilcher can be drawn. This opinion has been frankly stated, by every historian of anatomy in recent years. Puschmann says it very clearly. Von Töply is evidently of the same opinion. These are the latest authorities in the history of anatomy. No other conclusion than this could well be reached by anyone who has studied the question seriously. Pilcher confirms this in the article already quoted in the following paragraph:

"Salernum was not alone in its legalization of the dissection of human bodies before the first public work of Mondino, for, according to a document of the Maggiore Consiglio of Venice of 1308, it appears that there was a college of medicine in Venice, which was even then authorized to dissect a body once every year. Common experience tells us that the embodiment of such regulations into formal law would occur only after a considerable preceding period of discussion, and in this particular field, of clandestine practice. It is too much to ask us to believe that in all this period, from the date of the promulgation of Frederick's decree of 1241 to the first public demonstration by Mondino at Bologna in 1315, the decree had been a dead letter and no human body had been anatomized. It is true there is not, as far as I am aware, any record of any such work, and commentators and historians of a later date have, without exception, accepted the view that none was done, and thereby heightened the halo assigned to Mondino as the one who ushered a new era. Such a view seems to me to be incredible. Be that as it may, it is undeniable that at the beginning of the fourteenth century the idea of dissecting the human body was not a novel one; the importance of a knowledge of the intimate structure of the body had already been appreciated by divers ruling bodies, and specific regulations prescribing its practice had been enacted. It is more reasonable to believe that in the era preceding immediately that of Mondino, human bodies were being opened and after a fashion anatomized. All that we know of the work of Mondino suggests that it was not a new enterprise in which he was a pioneer, but rather that he brought to an old practice a new enthusiasm and better methods, which, caught on the rising wave of interest in medical teaching at Bologna, and preserved by his own energy as a writer in the first original systematic treatise written since the time of Galen, created for him in subsequent uncritical times the reputation of being the restorer of the practice of anatomizing the human body, the first one to demonstrate and teach such knowledge since the time of the Ptolemaic anatomists, Erasistratus and Herophilus."

In order to show that Mondino did not perform only the two or three dissections which he himself for special reasons mentions, but many more, Professor Pilcher has made a series of quotations from the Bolognese anatomist's manual of dissection. It is after all quite easy to understand that if dissections were common, there would be no records of most of them, as they would be too commonplace for chroniclers to mention. Only those that have some special feature are by chance mentioned in some accounts of doings at the university. The records of the actual number of dissections at most medical schools, even a century ago, are not now available in most cases. On the other hand, no one can read these quotations from Mondino's book without realizing that the man who wrote these passages had made many dissections, and that it was a common practice for him to make anatomical preparations in many different ways, under many different circumstances and for many different purposes.

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

Here are the quotations from the Anatomy of Mondino which show that he practiced not one but many methods of making dissections, according to the purposes he had in view. The leaf and line references are to the Dryander Edition, Marburg, 1541. (Taken from Prof. Pilcher.)

"I do not consider separately here the anatomy of component parts, because their anatomy does not appear clearly in the fresh subject, but rather in those macerated in water." (Leaf 2, lines 8-13.)

".... these differences are more noticeable in the cooked or perfectly dried body, and so you need not be concerned about them, as perhaps I will make an anatomy upon such a one at another time and will write what I observe with my own senses, as I have proposed from the beginning." (Leaf 60, lines 14-17.)

"What the members are to which these nerves come cannot well be seen in such dissection as this, but it should be liquified with rain water, and this is not contemplated in the present body." (Leaf 60, lines 31-33.)

"After the veins you will note many muscles and many large and strong cords, the complete anatomy of which you will not endeavor to find in such a body, but in a body dried in the sun for three years, as I have demonstrated at another time; I also declared completely their number, and wrote the anatomy of the muscles of the arms, hands and feet in a lecture which I gave over the first, second, third and fourth subjects."

As must be clear to anyone, many of these expressions are, as Professor Pilcher insists, intelligible only if we accept the conclusion that their author had done many dissections, under many and varying circumstances, during his career as an anatomist before writing this volume. We have other evidence, of a much more direct character, for this fact. Mondino uses the expression, that he had demonstrated many times a certain anatomical feature which could only be the subject of demonstration after dissection. The expression occurs in a description of the hypo-gastric region which he calls the sumen. Through this region, he says, there pass to the surface certain veins which transmit fluid in the fetus during the time of its life in utero. For this reason they are better studied in the unborn than in the fully developed, since they lose their function as soon as complete development is reached. In this description Mondino uses the words "ego hoc modo multitotiens monstravi."

As with regard to this, so as to another bit of evidence of Mondino's frequency of dissection, Professor Pilcher has supplied the material. He says in his article on the Mondino Myth, already cited: