652

except diarrhoea, the rate of mortality from the otherprincipal zymotic diseases last year in the Belgian townswas considerably below the rate in the largest Englishtowns. With regard to the remarkably high death-ratefrom diarrhoeal diseases in the urban population of Belgium,we may note, in conclusion, that in Gand, with an

estimated population of 147,912, the deaths referred to i

these diseases were 897, equal to a rate of 6’06 per 1000;while the highest death-rate from diarrhoea last year in thetwenty-eight English towns was 1’54 in Preston. It is not

surprising to find, with this remarkably high death-ratefrom diarrhoea, that the rate of mortality among infantsunder one year of age in Gand was equal to 282 per 1000 ofthe registered births.

THE SERVICES.

ARMY MEDICAL STAFF.—Surgeon-Major John Latchford,M.B., is granted retired pay (dated March 27th, 1889).ARMY MEDICAL RESERVE OF OFFICERS.—The under-

mentioned Officers to be Surgeons, ranking as Captains(dated March 27th, 1889):-Surgeon William Collingridge,M.D., the Woolwich Division Volunteer Medical StaffCorps; Surgeon James Denholm, M.B., 2nd (Berwickshire)Volunteer Battalion, the King’s Own Scottish Borderers;Acting Surgeon Charles Lanchlin Fraser, lst Berwick-on-Tweed Artillery Volunteer Corps ; Acting Surgeon DavidLennox, M.D., 1st Volunteer Battalion, the Black Watch(Royal Highlanders); and Acting Surgeon Geo. May Lowe,M.D., 1st Volunteer Battalion, the Lincolnshire Regiment.ADMIRALTY. - The following appointments have been

made: Surgeons John Dowson and Chaworth L. Nolan toHongkong Hospital, and Donald Currie, M.D., to be Snr-geon and Agent at Skelmorlie (all dated March 25th, 1889);Surgeon Alexander J. J. Johnston to Chatham Hospital(dated April 14th, 1889); Surgeon George Albert Dreaperto the Wanderer and Surgeon George Henry Foott to theFirebrand (both dated March 25th, 1889).VOLUNTEER CORPS. —Artillery: lst East Riding of

Yorkshire: Honorary Assistant Surgeon G. Nelson, M.D.,resigns his commission; also is permitted to retain his rankand to continue to wear the uniform of the Corps on hisretirement (dated March 23rd, 1889).-Engineers (Fortressand Railway Forces): 1st Cheshire : Edwd. Murray Laffan,Gent., to be Acting Surgeon (dated March 23rd, 1889).-Rifle: 1st London (City of London Rifle Volunteer Brigade):William Edward Ramsden Wood, M.D., to be ActingSurgeon (dated March 23rd, 1889).

Correspondence.

THE SCHOOL OF SALERNO

"Audi alteram pattern.’

To the Editors of THE LANCET.SIRS,—The interesting account of Constantine and the

School of Salerno which Dr. Wilks contributed to the lastissue of THE LANCET contains so many statements whichare contrary to what has been taught by those who areaccepted as the best authorities on these subjects that thestatements ought not to be allowed to pass unchallenged ;especially when it is remembered that most of Dr. Wilks’sstatements command a ready acceptance. Among thosewho take interest in such studies it is agreed that there arefew subjects of equal interest in medical history aroundwhich so much error, prejudice, and ignorance have accu-mulated. Many of the accounts which have been publishedhave little foundation in fact, and are quite misleading.Thanks, however, to the labours of Henschel, De Renzi, andDaremberg we now possess, if not a complete, at least asatisfactory account. Those who wish to become acquaintedwith the details of the history should consult one or all ofthe following works :—(I) De Renzi : Storia Documentatadella Souoto Medica di Salerno. Second edition. Naples.1857. (2) Henschel, Daremberg, and De Renzi: CollectioSalernitana &c. Naples. 1852-59. 5 vols. , (3) Daremberg:Introduction to Meaux Saint-Marc’s " L’Pcole de Salerne.Tradnetion en Vers Français." Paris. 1880. Of these thelast named is the most accessible, and to it the followingspecified references are made :-

Dr. Wilks states: "Salerno had been taken by the Normans,under Robert Guiscard, at the end of the eleventh century,and this hero soon after founded what was the earliest andlong the greatest medical school in Christian Europe,known as the Schola Salernitana." Premising that theterm " Schola Salernitana" is commonly applied, not to theschool, but to the poem " Regimen Sanitatis Salernitanum,"it is certain that the medical school of Salerno had existedfor more than two centuries before Salerno was taken in1077 by Robert Guiscard. The precise date of the origin ofthe medical school is unknown. Some have placed it asearly as the middle of the seventh century, and thismay or may not be true. It is, however, known thatthe archives of Naples contain the names of physiciansof Salerno from the year 846 ; and that the texts of theeleventh and twelfth centuries agree in representing theSchool of Salerno as very ancient (Daremberg, p. 13).In the year 984 Adalberon, the Bishop of Verdun, went toSalerno to be treated by the physicians. About the year1050 Peter d’Amiens (fl. 1040-1070) spoke of Gariopontus,one of the masters of Salerno, as already an old man andwell versed in medical literature. (Dicam quid mihi Gario-pontus senex, vir videlicet, honestissimus, apprime litteriseruditus ac medicus retulit.) Writing of an event whichhappened in the year 1059, Oderic Vitalis (1075-1150) speaksof Salerno as having possessed from very early times thebest and most celebrated schools of medicine. ("InurbePsalernitana, ubi maximpe medicorem scholæ ab antiquotempore habentur."

Dr. Wilks further states that before the time of Constan-tine ’’the standard medical works had been those ofAristotle, Hippocrates, and Galen, with the Arabianwritings.’’ (The italics are mine.) Though it is obviousthat some of the Greek medical authors must have beenread (probably in Latin translations), there is, I believe, notrace of Arabian medicine at Salerno before the time ofConstantine. Indeed Arabian medicine only came intovogue there, as in the rest of Western Europe, at the endof the twelfth century (Daremberg, p. 22).

Again, Dr. Wilks says: "At this time [i.e., Constantine’s]Robert, the eldest son of William the Conqueror, ...... beingwounded by an arrow at the Conquest of Jerusalem, repairedto Salerno to have the ’listula’ healed. Whilst there a poementitled Regimen Sanitatis Salernitanum’ was writtenespecially for his benefit, and dedicated to him as King ofEngland. Whether the poem was written by combineclhands or by Constantine solely is not very certain.’The first Crnsaders did not leave France till the end of

the year 1096, and as Robert was present at the taking ofJerusalem in 1099, he could not have been at Salerno beforethe year 1100. At that time Constantine had been deadtwelve or thirteen years (1087). It is certain, therefore, that.if the poem was " written especially for the benefit" of Robert,Constantine had nothing to do with it. The probability isthat neither conjecture is correct. There is, I believe, nota particle of historical evidence in support of the opinionthat Constantine wrote the poem or any part of it, andthere is strong internal evidence that lie did not. In the-editio princeps of the poem, that of Arnaldus de VillaNova, the influence of Hippocrates, Galen, Dioscorides, andPliny is sufficiently evident, but there is nothing thatbetrays the influence of the Arabians (Daremberg, p. 42). In.fa.ct, neither the date nor authorship of the " Itegimen

" is.known. Daremberg suggests that it is the work of manyhands--medical rhapsodists-and that it represents a poeticafcycle extending from the middle of the eleventh to thecommencement of the fifteenth centuries. The oldestmanuscripts only go ba"k to the fourteenth century. Thewords "Anglorum regi" in the preamble are vague andobscure. It is often thought to refer to Robert, son ofWilliam the Conqueror ; but it should not be forgotten thatwhile the French and German manuscripts have 11 Analorun-tregi," most of the English manuscripts have "Francorumregi," and there is one manuscript in Paris which gives" Roberto regi." Whether these are mere casual and inci-dental dedications, varied from time to time or not, it isclear, as Daremberg pertinently remarks, we do not knowto which king, of England or of France, this term can beproperly applied (p. 41).

Lastly, Dr. Wilks says: " Contantine was a man ofgreat celebrity, being the head of the School of Salerno.......But now original teachers arose, the most famous amongstthem being Constantine the African, who made the Schoolof Salerno famous throughout the civilised world." Beforethe time of Constantine there were many eminent medical