traditions, and a preference for palliative therapy over more aggressive intervention: all
these features are personified by the physician who attend to Theuderic I of Austrasia, the
son of Clovis. Anthinus, a Byzantine exile sent to Metz by the Ostrogothic king
Theodoric, left prescriptions that are nutritional rather than medicinal. When native
practitioners first became literate, they drew on classical traditions not only through
Gallo-Roman schools, as at Marseille or Autun, but also through monastic infirmaries.
By the 10th century, as we learn from a personal appeal by Charles the Simple and a
heralded visit by Bishop Adalbero of Verdun, the oracle and mecca for health seekers
was the center of Salerno, where cures as well as care revolved around a “regimen,” or
dietary governance. The propagation of Salernitan wisdom, even across the Channel, was
aided by emanations from Chartres and by such individuals as the monk Baudouin,
French physician to Edward the Confessor.
Until close to 1100, the majority of acute and chronic ailments that demanded more
intense attention seem to have been treated by monks, faith healers, good Samaritans, and
part-time practitioners. A rising demand for more specifically trained and dedicated
“professionals” is reflected in the 12th-century complaint by the Welsh visitor Giraldus
Cambrensis that the wandering monks of Cîteaux and Clairvaux treated the populace “not
with fresh drugs, selected syrups, or medicines compounded according to the art, but only
with collected and assorted herbs of the fields, as if this would seem to be something
unusual.” A contemporary, the satirist Guiot de Provins, clearly differentiated unschooled
practitioners, the medicus and the apothecary, from the physician who had been
academically trained at Salerno or Montpellier and who commanded a higher
honorarium.
A literate instruction in health care was virtually inaccessible to anyone outside the
clergy. Members of this class, however, faced ethical problems when they wished to
apply their schooling, particularly to lucrative transactions, surgical treatments, and such
unseemly activities as gynecol-ogy or even diagnosis by uroscopy. The practice of
medicine by clerks was initially proscribed at church councils on French soil (at
Clermont in 1130 and at Tours in 1163) and formally prohibited in 1219, but,
paradoxically, it remained more prevalent—and far more physicians held prebends or
church benefices—in France than elsewhere until the 15th century. As further ironies,
even here the secularization of medicine was the result less of ecclesiastical restrictions
than of incorporation in the universities, and it did not preclude the special deference that
academically trained physicians showed to clerical prerogatives in their refusal to treat
the critically ill before they had gone to confession.
As the professionalization of medicine evolved in the university, it accentuated the
social ranking of practitioners on the basis of literacy. The teaching of the art became
paramount, and the title of “doctor” appeared more coveted than those referring to
healing. Nevertheless, the exercise of the art remained the object of school statutes that
required experience as an integral part of training, of many scholastic writings devoted to
diagnostic techniques and therapeutic procedures, and of the professors’ careers and
communal actions outside academe. Once they had gained control of instruction, the
incorporated physicians aimed for the regulation of all practice by means of licensing. An
avowed concern with the public welfare as well as a drive for control, if not for
monopoly, culminated at Paris between 1332 and 1352 in a bitter campaign of the faculty
against two dozen unlicensed practitioners. On account of their Latin book learning and
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