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History of Medicine

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Medieval Manuscripts in the National Library of Medicine Medieval Manuscripts in the National Library of Medicine home National Library of Medicine in blue lettering. National Library of Medicine logo which is a link to the National Library of Medicine homepage. Historiated inital O featuring a physician consulting a book at his patient's bedside which is a link to the History of Medicine Division homepage.
Salerno, the Mother of Medical Schools written in red lettering.

Medical practice and learning in the vibrant city of Salerno were nourished by the Greek past of southern Italy, favored by healing shrines in the tradition of Cos and Epidauros, energized by trade with Sicily and across the Mediterranean, and fostered by monastic bibliophiles at Monte Cassino. The fame of Salerno's practitioners, women as well as men, had spread across Europe by the end of the eleventh century, when it was surpassed by the distinction of its teachers and eclipsed by the bookish legacy of the monk Constantine the African (d. 1087). Nevertheless, practical concerns remained manifest even in writings of Constantine, for example the Viaticum, a medical guide for travellers. Summaries of all medical knowledge commonly bore the title Practica. Common-sense dietetics were compiled and soon became popularized as the Regimen of the School of Salerno "for the King of England."

Through the twelfth century, Salernitan masters showed a growing interest in theoretical foundations. They speculated about natural philosophy in numerous Questions, drew on Aristotle's views of nature (physis) which contributed to the labeling of medicine as physica or physick, (hence "physician") saw the need of a better knowledge of anatomy, and pursued dialectical inquiry in their commentaries on authoritative treatises. Principles and procedure were interwoven in encyclopedic manuals of which the Breviary on the Signs, Causes, and Cures of Diseases by Joannes de Sancto Paulo is a model. Both theory and practice were envisioned in the selection of a few simple works for basic medical education, anchored in the Hippocratic-Galenic "Art" and eventually standardized in the Articella. Salerno's empirical orientation endured in the compilation of ob-gyn lore known as Trotula, while its theoretical contributions were preferred by a Scholastic master such as Gerard of Bourges who wrote a Commentary on the Viaticum of Constantine. The reach and durability of Salerno's influence is documented particularly in the large number of Salernitan manuscripts that are extant in English libraries.

Folio 1 recto, the opening page of Joannes de Sancto Paulo's Breviarium de signis, causis, et curis morborum. Brown colored parchment with the majority of the words written in Latin in dark brown ink. The beginning letter A is capitalized filling 6 lines ink red ink.

Joannes de Sancto Paulo.
Breviarium de signis, causis, et curis morborum.
(Breviary on the Signs, Causes, and Cures of Diseases) 13th century.
MS E 27 | View Catalog Record

This Salernitan manual was widely copied across 13th-century Europe.

Folio 1 recto from Gerard of Bourges's Super Viatico Constantini written on parchment. The text is in two columns and is partially erased. In the upper left corner is an illuminated initial, partially cropped and rubbed. On the bottom of the page in a different hand are the words Bibliotheca Weissenaviensis. Folio 53 recto from Gerard of Bourges's Super Viatico Constantini written on parchment in two columns. The remains of an elaborate medieval mend is seen on middle page. The text is written in brown ink with red and blue capital letters. A commentary on Constantine's Viaticum with the original text shown by the underlines.

Gerard of Bourges.
Super Viatico Constantini.
13th century.
MS E 11 | View Catalog Record

A commentary on Constantine's Viaticum with the original text shown by the underlines. The remains of an elaborate medieval mend is seen on this page.

Folio 1 recto from Constantinus Africanus' Viaticum written on parchment with the text heavily rubbed and faded with some text unreadable. On the bottom of the page in a different hand is written Bibli. Weisenav. Folios 92 verso and 93 recto from Constantinus Africanus' Viaticum written on parchment. The folios are written in brown ink with marginal annotations in many different hands.

Constantinus Africanus. Viaticum.
13th century.
MS E 12 | View Catalog Record | View Full Digitized Book

This manuscript contains marginal annotations in many different hands - at least five on this page alone - showing that it was a heavily used text.


Folio 1 recto from Regimen sanitatis Salernitanum which are the beginning words of the folio. There is the Surgeon General's Office Library Stamp in the upper right corner of the page. A capital letter A is written in red ink beginning on the third line and continuing through the sixth line. There are two lines of marginilia in brown ink towards the bottom of the folio. At the top of the folio in brown ink is the signature Johannes Chadwicke. Folio 39 verso from Regimen sanitatis Salernitanum featuring a marginal note that translates into English doggerel verse the text of the Regimen that is printed in bold above it
Sheeps flesh if eaten without wine, Is better meate then flesh of swine. If with your meate you use some wine,
Hogges flesh is meate and medicine.

Regimen sanitatis Salernitanum. Louvain : Johannes de Westfalia, ca. 1480.
WZ 230 R335 1484 | View Catalog Record | View Full Digitized Book

This very early printed edition of the Regimen sanitatis, printed in the Low Countries, must have had an English owner. The marginal note translates into English doggerel verse the text of the Regimen that is printed in bold above it:

Sheeps flesh if eaten without wine
Is better meate then flesh of swine.
If with your meate you use some wine,
Hogges flesh is meate and medicine.
Folio 1 of Experimentarius medicinae. The page has some darkened water stains on it and the Library Surgeon General's Office stamp on the bottom center of the page Folios 4 verso and 5 recto of Experimentarius medicinae. The title of the section is the passion of women, before, in and after the birth, and partly also waiting with the rest of the book of wonderful experimental. On folio 4 verso begins the first chapter on the retention of flowers with an illuminated letter s showng a creature with an hourglass on its back holding the leg of a woman sitting on the ground. On folio 5 recto has chapter two about their small number of monthly with an illuminated letter m showng a man holding up a flask in a workroom filled with books.

Experimentarius medicinae. Argent[orati] [i.e. Strasbourg]: Apud Joannem Schottum, 1544.
WZ 240 E966 1544 | View Catalog Record

The name Trotula, while actually the title of a compilation, has most frequently been assigned to a female teacher in the schools of Salerno. Whatever her name, a Salernitan woman appears to be the source of much in this treatise on diseases of women attributed to Trotula.

Last Reviewed: March 12, 2024