Treatises on Medicine
This 190-leaf parchment manuscript, written primarily in steady Caroline minuscule script, originated in England around 1145, likely in Hereford. The original composition can be dated based on a list of 12 popes that ends with a contemporary note on Eugenius III (1145–1153). Variations in handwriting throughout the marginal notes indicates that it remained in English libraries for at least five centuries. The manuscript itself contains over forty different texts that reflect the entire range of medieval health knowledge. Its centerpiece is a set aphorisms from Hippocrates, which are supported by theoretical discussions of anatomy, physiology, and disease classification, as well as more practical texts about prognosis and diagnosis—particularly the reading of pulses and urine. Treatments include plasters, herbal remedies, magical cures, dietary advice, and manual interventions such as surgery or bloodletting.
In many ways, this manuscript documents an intermediate stage between earlier utilitarian medical texts and later speculative works. While some passages hint at growing theoretical concerns, the focus largely remains on practical matters. Sources include direct Greek-to-Latin translations, writing by Arabic figures such as Isaac Israeli and Constantine the African, and the work of Byzantine authors like Oribasius and Alexander of Tralles. Southern Italian influences are also clear, but there is little mention of the debates being conducted at the School of Salerno at the time—despite repeated references to John Scarpellus the “Salernitan.” With interlinear notes indicating Scholastic commentary but a design clearly intended for consultation instead of teaching, the manuscript reflects a transitional era—one that bridges the gap between the monastic infirmary and the emerging university medical faculty.
The Articella
The Articella—or “Little Art”—is a selection of medical works that were often bound together and used as a reference manual during the Medieval Period. First published in Latin around 1100 CE, the collection is made up of five main texts: Hunayn ibn Ishaq’s Isagoge Ionatii ad Tegni Galieni, Hippocrates’s Aphorisms and Prognostics, Theophilus Protospatharius’s De Urinis, and Philaretus’s De Pulsibis. Though they usually appeared in a single volume, these works in fact came together over a long period of time. The roots of the Articella can be traced to the writing of Hippocrates of Kos—often called the “father of medicine”—whose theories originated in ancient Greece around 400 BCE. During the Roman Period, Hippocrates’ ideas were developed by Galen of Pergamon in his Ars Medica or “Art of Medicine,” which became a popular reference book throughout Europe and across the Mediterranean. Taken together, the works of Hippocrates and Galen formed the core of Classical medical knowledge.
Following the fall of the Western Roman Empire around 500 CE, Byzantine physicians began teaching the theories of Hippocrates and Galen alongside more recent works by figures like Protospatharius and Philaretus as part of the standard medical curriculym. However, it was a relatively short text written by the Arabic author Hunayn ibn Ishaq al-‘Ibadi—also known as Joannitius (ca. 809–873)—that helped to turn this collection into what became the Articella. While serving as the Christian director of the Abbasid Caliph’s House of Wisdom in Baghdad, Joannitius summarized Galen’s ideas in his Questions on Medicine for Scholars, which was translated into Latin and circulated in Europe as the Isagoge Ioannitii ad Tegni Galieni. This treatise clearly divided knowledge about health into theory and practice, and provided the basis for the earliest university medical curriculums. In addition to the works of Hippocrates, Protospatharius, and Philaretus, the Isagoge thus served as the nucleus around which the Articella would eventually develop over the course of the Medieval Period.
![Folio 2 recto from Hippocrates Aphorismi, sive sententiae. The printer has left space for a hand-written, decorative initial letter of the first Aphorism ([V]ita brevis, ars aut[em] longa), but the letter 'V' was never added.](images/Hippocrates-Aphorismi-Sive-Sententiae_9413024.jpg)
Arabic Legacies
Following the founding of the Abbasid Caliphate around 750 CE, Baghdad became a veritable seedbed of medical learning. Cross-fertilized by Persian-Mesopotamian, Byzantine-Greek, and Indian traditions, the fabled city drew Muslim, Jewish, and Christian scholars who cooperated to make available a wealth of ancient and modern texts, an enterprise facilitated by the recent introduction of paper. The most productive workshop was that of Hunayn ibn Ishaq al-'Ibadi (ca. 809–873), whose lucid Questions on Medicine translated the work of numerous classical Greek and Persian works into Arabic. Together with the explosion of reading materials, Hunayn's careful organization of his subject matter inspired the composition of various encyclopedias that were consulted for centuries afterward, including the Royal Book of All Medicine by Ali ibn Abbas al-Majusi (“Haly Abbas“) and the Canon of Medicine by Ibn Sina (“Avicenna”).
![Folios 236 recto and 237 verso of Ali ibn al-'Abbas al-Majusi's Kamil al-sina'ah al-tibbiyah. [The complete book of the medical art] written in arabic script using brown and red ink. Folio 237 is the colophon to a copy of al-Majusi's Complete Book of the Medical Art in which it is stated that the copy was finished on 7 Dhu al-Qa‘dah 604 [= 15 May 1208] by the Christian scribe Tawmā ibn Yūsuf ibn Sarkis al-Masīḥī, who copied it for Maḥmūd ibn Zaki al-Ruqiy al-Shihabi.](images/Haly-Abas-Kamil_9401918.jpg)
Ibn Sina and later philosophers—most notably Ibn Rushd (“Averroes”) and Moses ben Maimon (“Maimonides”)—helped to widen the range of theoretical medicine. Practical teaching was also enriched thanks to the pharmacology of Yuhanna ibn Masawayh (“Mesue”), the clinical work of Abu Bakr Muhammad ibn Zakariyya al Razi (“Rhaze”), and the surgery of Abu l'Qasim (“Albucasis”). Though most of these works were initially produced in Baghdad, over time Arabic medical knowledge moved westward to cities such as Damascus, Cairo, Palermo, and Cordoba. From there, it spread to Latin-speaking Europe through the translations of Constantine the African (d. 1087). In particular, his version of the Royal Book of Haly Abbas—known as the Pantegni—exerted a strong influence on the earliest universities. Subsequently, the university medical curriculum drew heavily on a second wave of Arabic works, which were translated in Spain—particularly Toledo—from around 1100 CE onwards.
![Folio 231b of Abu Bakr Muhammad ibn Zakariya al-Razi's al-Juz al-thalith min kitab al-Hawi fi al-tibb. [The third part of the comprehensive book on medicine] featuring the colophon in which the unnamed scribe gives the date he completed the copy as Friday, the 19th of Dhu al-Qa‘dah in the year 487 [= 30 November 1094] written in brown ink fading to a lighter shade, with headings in red.](images/Razi-Kitab-al-Hawi_9404682.jpg)
The School of Salerno
Founded around 800 CE, the Schola Medica Salernitana—or “Medical School of Salerno”—was one of the most important sources of medical knowledge in Western Europe during the Medieval Period. The city of Salerno itself was a large port, which connected southern Italy with North Africa, Greece, and the Middle East. This meant that members of the school had easy access to the growing corpus of medical works being produced in the Arabic Caliphate and the Byzantine Empire. Over time, a number of important manuscripts accumulated at the neighboring monastery of Monte Cassino, where they were translated into Latin by monks such as Constantine the African (d. 1087). Physicians from the School of Salerno—which included both men and women—soon became famous all across Europe for their skill and depth of knowledge. The lasting impact of this institution can be seen today in the number of Salernitan manuscripts that still remain in English libraries.
Initially, the School was best known for producing a wealth of practical advice about health. These ideas were collected in medical summaries such as the Regimen Sanitatus Salernitanum—or “Sanitary Regimen of the School of Salerno”—and the famous volume of women’s medical advice known as the Trotula. However, following the arrival of Constantine the African, the School became increasingly interested in theoretical approaches to medicine, including Aristotle’s concept of “physis”—or “nature”—from which the term “physician” is derived. For this reason, manuscripts from this period often combined practical guidance with more speculative philosophical ideas, as evident in Constantine’s Viaticum —or “Book of Travel”—and Joannes de Sancto Paulo’s Breviary on Signs, Causes, and Cures of Diseases. Works such as these often employed Socratic dialogue in their commentaries and sought to ground their claims in theories derived from the classical Greco-Roman tradition.
English Physick
The National Library of Medicine is the repository for a large number of medical books and manuscripts that originated in England between 1200 and 1600 CE, many of which were published in Medieval centers of learning such as Hereford, Winchester, and Oxford. These works typically drew on one of two different medical traditions: either leechcraft or physick. Leechcraft—from the Anglo-Saxon “laece” or “physician”—was a practical type of healing that relied on local plants to treat illness. Early forms of leechcraft were often found in unorganized recipe collections like the Medieval English Leechbook. In contrast, physick—from the Latin word “physica” or “nature”—was a more organized and theoretical system of medicine, one that tended to draw on Classical sources such as Hippocrates and Galen. Vernacular works of physick, like the English translation of Peter of Spain’s Treasuri of Helth, often embraced highly-speculative treatment methods—such as uroscopy, astrology, and bloodletting.
English translations from Latin during this time, as well as works copied or composed locally, reveal the impact of medical sources from not only Western Europe but also more distant locations—including Salerno, Byzantium, and the Abbasid Caliphate. These influences are particularly evident in treatises like Gilbertus Anglicus’s Compendium of Medicine—published around 1230 as a compendium of herbal remedies—and John of Gaddesden’s English Rose, which served as a practical encyclopedia of prior medical writing. Despite the pervasive interest in health, surprisingly few Medieval English authors addressed the topic of surgery—with the possible exception of John Aderne in his well-known Opera Chirurgica. On the other hand, no field seems to have been the subject of more rigorous analysis than diet and nutrition. This may in part explain why English translations of dietary guides like the Salernitan Regimen of Health remained in print all the way up to the Early Modern period.
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About
This website celebrates the medieval manuscript holdings of the National Library of Medicine, with a special focus on medicine and medical literature in medieval England, on the sources and transmission of the manuscript texts, and on their later manifestations.
The content of this website is drawn from a display held at the National Library of Medicine, May 18, 2000 to August 15, 2000. The display was curated by Carol Clausen who was then Conservation Librarian at NLM.
You can view the original website created to accompany the display archived in the NLM Institutional Archives web collection.