The Renaissance

  Medical quacks were still numerous, but medical practice was now more carefully regulated by law. Penalties were prescribed for persons who practised medicine without a medical degree; and this presumed a four-year medical course (1500). No physician was allowed to prognose a grave disease except by consultation with a colleague. Venetian legislation required physicians and surgeons to meet once a month to exchange clinical notes, and to keep their knowledge up to date by attending a course on anatomy at least once a year. The graduating medical student had to swear that he would never protract the sickness of a patient, that he would supervise the preparation of his prescriptions, and that he would take no part of the price charged by the apothecary for filling them. The same law (Venice, 1368) limited the apothecary’s charge for filling a prescription to ten soldi22—coins now impossible to evaluate. We hear of several cases in which the medical fee, by a specific contract, was made conditional on cure.23

  Surgery was rising rapidly in repute as its repertoire of operations and instruments approached the variety and competence of ancient Egyptian practice. Bernardo da Rapallo devised the perineal operation for stone (1451), and Mariano Santo became famous for his many successful lithotomies by lateral incision (c. 1530). Giovanni da Vigo, surgeon to Julius II, developed better methods of ligature for arteries and veins. Plastic surgery, known to the ancients, reappeared in Sicily about 1450: mutilated noses, lips, and ears were repaired by grafts of skin from other parts of the body, and so well that the lines of adhesion could scarcely be detected.24

  Public sanitation was improving. As Doge of Venice (1343–54), Andrea Dandolo established the first known municipal commission of public health;25 other Italian cities followed the example. These magistrati della sanità tested all foods and drugs offered for public sale, and isolated the victims of some contagious diseases. As a result of the Black Death, Venice in 1374 excluded from her port all ships carrying persons or goods suspected of infection. At Ragusa (1377) such arrivals were detained for thirty days in special quarters before being admitted into the city. Marseille (1383) lengthened the detention period to forty days—la quarantine, and Venice followed suit in 1403.26

  Hospitals were multiplying under the zeal of both laity and clergy. Siena built in 1305 a hospital famous for its size and services, and Francesco Sforza founded the Ospedale Maggiore in Milan (1456). In 1423 Venice converted the island of Santa Maria di Nazaret into a lazaretto to hospitalize infected persons; this is the first institution of its kind known in Europe.27 Florence in the fifteenth century had thirty-five hospitals.28 These establishments were generously supported by public and private donations. Some hospitals were notable examples of architecture, like the Ospedale Maggiore; some adorned their halls with inspiring works of art. The Ospedale del Ceppo at Pistoia engaged Giovanni della Robbia to mold for its walls terra-cotta reliefs vividly describing typical hospital scenes; and the façade of the Ospedale degli Innocenti at Florence, designed by Brunellesco, was signalized by the charming terra-cotta medallions placed in the spandrels of its portico arches by Andrea della Robbia. Luther, who was so shocked by the immorality that he found in Italy in 1511, was also impressed by its charitable and medical institutions. He described the hospitals in his Table Talk:

  In Italy the hospitals are handsomely built, and admirably provided with excellent food and drink, careful attendants, and learned physicians. The beds and bedding are clean, and the walls are covered with paintings. When a patient is brought in, his clothes are removed in the presence of a notary who makes a faithful inventory of them, and they are kept safely. A white smock is put on him, and he is laid on a comfortable bed, with clean linen. Presently two doctors come to him, and servants bring him food and drink in clean vessels…. Many ladies take turns to visit the hospitals and tend the sick, keeping their faces veiled, so that no one knows who they are; each remains a few days and then returns home, another taking her place…. Equally excellent are the foundling asylums of Florence, where the children are well fed and taught, suitably clothed in a uniform, and altogether admirably cared for.29

  It is often the fatality of medicine that its heroic advances in therapy are balanced—almost pursued—by new diseases. Smallpox and measles, hardly known in Europe before the sixteenth century, now came to the fore; Europe experienced its first recorded influenza epidemic in 1510; and epidemics of typhus—a disease not mentioned before 1477—swept Italy in 1505 and 1528. But it was the sudden appearance and rapid dissemination of syphilis in Italy and France toward the end of the fifteenth century that constituted the most startling phenomenon and test of Renaissance medicine. Whether syphilis existed in Europe before 1493, or was brought from America by the return of Columbus in that year, is a matter still debated by the well informed, and not to be settled here.

  Certain facts support the theory of an indigenous European origin. On July 25, 1463, a prostitute testified in a court at Dijon that she had dissuaded an unwelcome suitor by telling him that she had le gros mal—not further described in the record.30 On March 25, 1494, the town crier of Paris was directed to order from the city all persons afflicted with la grosse verole.31 We do not know what this “great pox” was; it may have been syphilis. Late in 1494 a French army invaded Italy; on February 21, 1495, it occupied Naples; soon afterward a malady became rampant there, which the Italians called il morbo gallico, “the French disease,” alleging that the French had brought it into Italy. Many of the French soldiers were infected with it; when they returned to France, in October, 1495, they scattered the disease among the people; in France, therefore, it was called le mal de Naples, on the assumption that the French army had contracted it there. On August 7, 1495, two months before the return of the French army from Italy, the Emperor Maximilian issued an edict in which mention was made of malum francicum; obviously this “French disease” could not be ascribed to the French army not yet returned from Italy. From 1500 on, the term morbus gallicus was used throughout Europe to mean syphilis.32 We may conclude that there are suggestions, but no convincing evidence, that syphilis existed in Europe before 1493.

  The case for an American origin is based upon a report written between 1504 and 1506 (but not published till 1539) by a Spanish physician, Ruy Diaz de l’Isla. He relates that on the return voyage of Columbus the pilot of the admiral’s vessel was attacked by a severe fever, accompanied with frightful skin eruptions, and adds that he himself, at Barcelona, had treated sailors infected with this new disease, which, he says, had never been known there before. He identified it with what Europe was” calling morbus gallicus, and contended that the infection had been brought from America.33 Columbus, on his first return from the West Indies, reached Palos, Spain, on March 15, 1493. In that same month Pintor, physician to Alexander VI, noted the first appearance of the morbus gallicus in Rome.34 Almost two years elapsed between the return of Columbus and the French occupation of Naples—sufficient time for the disease to spread from Spain to Italy; on the other hand, it is not certain that the plague that ravaged Naples in 1495 was syphilis.35 Very few bones whose lesions may be interpreted as syphilitic have been found in pre-Columbian European remains; many such bones have been found among the relics of pre-Columbian America.*36

  In any case the new disease spread with terrifying speed. Caesar Borgia apparently contracted it in France. Many cardinals, and Julius II himself, were infected; but we must allow the possibility, in such instances, of infection by innocent contact with persons or objects bearing the active germ. Skin pustules had long since been treated in Europe with mercurial ointment; now mercury became as popular as penicillin is in our day; surgeons and quacks were called alchemists because they turned mercury into gold. Prophylactic measures were taken. A law of 1496 in Rome forbade barbers to admit syphilitics, or to use instruments that had been employed by or on them. More frequent examination of prostitutes was established, and some cities tried to evade the problem by expelling courtesans; so Ferrara and Bologna banished such women in 1496, on the ground that t
hey had “a secret kind of pox which others call the leprosy of St. Job.”38 The Church preached chastity as the one prophylaxis needed, and many churchmen practised it.

  The name syphilis was first applied to the disease by Girolamo Fracastoro, one of the most varied and yet best integrated characters of the Renaissance. He had a good start: he was born at Verona (1483) of a patrician family that had already produced outstanding physicians. At Padua he studied almost everything. He had Copernicus as a fellow student, and Pomponazzi and Achillini to teach him philosophy and anatomy; at twenty-four he was himself professor of logic. Soon he retired to devote himself to scientific, above all medical, research, tempered with a fond study of classic literature. This association of science and letters produced a rounded personality, and a remarkable poem, written in Latin on the model of Virgil’s Georgics, and entitled Syphilis, sive de morbo gallico (1521). Italians since Lucretius have excelled in writing poetical didactic poetry, but who would have supposed that the undulant spirochete would lend itself to fluent verse? Syphilus, in ancient mythology, was a shepherd who decided to worship not the gods, whom he could not see, but the king, the only visible lord of his flock; whereupon angry Apollo infected the air with noxious vapors, from which Syphilus contracted a disease fouled with ulcerous eruptions over his body; this is essentially the story of Job. Fracastoro proposed to trace the first appearance, epidemic spread, causes, and therapy of “a fierce and rare sickness, never before seen for centuries past, which ravished all of Europe and the flourishing cities of Asia and Libya, and invaded Italy in that unfortunate war whence from the Gauls it has its name.” He doubted that the ailment had come from America, for it appeared almost simultaneously in many European countries far apart. The infection

  did not manifest itself at once, but remained latent for a certain time, sometimes for a month… even for four months. In the majority of cases small ulcers began to appear on the sexual organs…. Next, the skin broke out with encrusted pustules…. Then these ulcerated pustules ate away the skin, and… infected even the bones.… In some cases the lips or nose or eyes were eaten away, or, in others, the whole of the sexual organs.39

  The poem goes on to discuss treatment by mercury or by guaiac—a “holy wood” used by the American Indians. In a later work, De contagione, Fracastoro dealt in prose with various contagious diseases—syphilis, typhus, tuberculosis—and the modes of contagion by which they could be spread. In 1545 he was called by Paul III to be head physician for the Council of Trent. Verona raised a noble monument to his memory, and Giovanni dal Cavino graved his likeness on a medallion which is one of the finest works of its kind.

  Before 1500 it was usual to class all contagious diseases together under the indiscriminate name of “the plague.” It was one measure of the progress of medicine that it now clearly distinguished and diagnosed the specific character of an epidemic, and was prepared to deal with so sudden and virulent an eruption as syphilis. Mere reliance on Hippocrates and Galen could never have sufficed in such a crisis; it was because the medical profession had learned the necessity of ever fresh and detailed study of symptoms, causes, and cures, in an ever widening and intercommunicated experience, that it could meet this unexpected test.

  And it was because of such high qualifications, devotion, and practical success, that the better class of physicians was now recognized as belonging to the untitled aristocracy of Italy. Having completely secularized their profession, they made it more respected than the clergy. Several of them were not only the medical but as well the political advisers, and the frequent and favored companions, of princes, prelates, and kings. Many of them were humanists, familiar with classical literature, collecting manuscripts and works of art; often they were the close friends of great artists. Finally, many of them realized the Hippocratic ideal of adding philosophy to medicine; they passed with ease from one subject to another in their studies and their teaching; and they gave the professional philosophical fraternity a stimulus to subject Plato, Aristotle, and Aquinas—as they subjected Hippocrates, Galen, and Avicenna—to a fresh and fearless examination of reality.

  IV. PHILOSOPHY

  At first glance the Italian Renaissance does not seem to offer a reasonable harvest of philosophy. Its product cannot compare with the heyday of French Scholasticism from Abélard to Aquinas, not to speak of “the school of Athens.” Its most famous name in philosophy (if we extend the time limit of the Renaissance) is Giordano Bruno (1548?-1600), whose work lies beyond the period of our study in this volume. Pomponazzi remains; but who now does reverence to his poor heroic skeptical squeak?

  The humanists incubated a philosophical revolution by discovering, and cautiously revealing, the world of Greek philosophy; but, for the most part, and excepting Valla, they were too clever to lay their beliefs on the table. The university professors of philosophy were hobbled by the Scholastic tradition: after spending seven or eight years struggling through that wilderness, they either abandoned it for other fields of study, or drove another generation into it, glorifying the hurdles that had broken their wills and brought their intellects to a safe dead end. And who knows but many of them felt a certain mental and economic security in confining themselves to recondite problems carefully and fruitlessly phrased in unintelligible terminology? In most philosophical faculties Scholasticism was still de rigueur, and already stiffening with the approach of death. The old medieval questions were laboriously reviewed in the old medieval forms of disputation, and in the proud publications of the staff.

  Two elements of life entered to revive philosophy: the conflict between Platonists and Aristotelians, and the division of Aristotelians into orthodox and Averroists. At Bologna and Padua these conflicts became veritable duels, literally matters of life and death. The humanists were mostly Platonists; under the influence of Gemistus Pletho, Bessarion, Theodorus Gaza, and other Greeks, they drank deeply of the wine of the Dialogues, and could hardly understand how anyone could bear the arid logic, impotent Organon, and leaden golden mean of the cautious Aristotle. But these Platonists were resolved to remain Christians; and it was, so to speak, as their representative and delegate that Marsilio Ficino devoted half his life to reconciling the two systems of thought. For this purpose he studied widely, going so far afield as to Zoroaster and Confucius. When he reached Plotinus, and himself translated the Enneads, he felt that he had found in mystic Neoplatonism the silken cord that would bind Plato to Christ. He tried to formulate this synthesis in his Theologia platonica, a confused medley of orthodoxy, occultism, and Hellenism, and arrived hesitantly at a pantheistic conclusion: God is the soul of the world. This became the philosophy of Lorenzo and his circle, of the Platonic Academies in Rome, Naples, and elswhere; from Naples it reached Giordano Bruno; from Bruno it passed to Spinoza and thence to Hegel; it is still alive.

  But there was something to be said for Aristotle, especially if he could be misinterpreted. Was Aquinas right in understanding him to teach personal immortality, or was Averroes right in reading De anima as affirming the deathlessness of only the collective soul of mankind? The terrible Averroes, that ogre of an Arab, whom Italian art had long since pictured as prostrate under the feet of St. Thomas, was so active a competitor for the domination of the Aristotelians that both Bologna and Padua were hot with his heresy. It was at Padua that the Marsilius who took its name had lost his reverence for the Church;* at Padua that Filippo Algeri da Nola, the precursor of Nola-born Bruno, had imbibed those frightful errors for which he was sorrowfully cast into a barrel of boiling pitch.40 Nicoletto Vernias, as professor of philosophy at Padua (1471–99), appears to have taught there the doctrine that only the world-soul, not the individual soul, is immortal;41 and his pupil Agostino Nifo propounded the same notion in a treatise De intellectu et daemonibus (1492). Usually the skeptics sought to sooth the Inquisition by distinguishing (as Averroes had done) between two kinds of truth—religious and philosophical: a proposition, they urged, might be rejected in philosophy from the standpoint of reaso
n, while still accepted on faith in the word of Scripture or the Church. Nifo professed the principle with reckless simplification: Loquendum est ut plures, sentiendum ut pauci—”We must speak as the many do, we must think as the few.”42 Nifo changed his mind or his speech as his hair changed, and reconciled himself to orthodoxy. As professor of philosophy at Bologna he drew lords, ladies, and multitudes to lectures dramatized with grimaces and antics and salted with anecdotes and wit. He became socially the most successful opponent of Pomponazzi.

  Pietro Pomponazzi, the microscopic bombshell of Renaissance philosophy, was so diminutive that his familiars called him Peretto—“little Peter.” But he had a large head, a vast brow, a hooked nose, small, black, penetrating eyes: here was a man doomed to take life and thought with painful seriousness. Born at Mantua (1462) of patrician stock, he studied philosophy and medicine at Padua, took both degrees at twenty-five, and was soon himself a professor there. All the skeptical tradition of Padua descended to him and culminated in him; as his admirer Vanini was to put it, “Pythagoras would have judged that the soul of Averroes had transmigrated into the body of Pomponazzi.”43 Wisdom seems always a reincarnation or echo, since it remains the same through a thousand varieties and generations of error.

  Pomponazzi continued to teach at Padua from 1495 to 1509; then the winds of war swept through the city, and closed its historic University halls. In 1512 we find him established at the University of Bologna. There he remained to the end of his days, marrying thrice, always lecturing on Aristotle, and modestly likening his relation to his master to that of an insect exploring an elephant.44 He thought it safer to offer his ideas not as his own but as implied or explicit in Aristotle interpreted by Alexander of Aphrodisias. His procedure seems at times too humble, apparently subservient to a dead authority; but since the Church, following Aquinas, claimed her doctrine to be that of Aristotle, Pomponazzi may have felt that any demonstration of a heresy as truly Aristotelian would be one way, short of the stake, of teasing the orthodox tail. The Fifth Council of the Lateran, under the presidency of Leo X (1513), condemned all who should assert that the soul is one and indivisible in all men, and that the individual soul is mortal. Three years later Pomponazzi published his major work, De immortalitate animae, in which he sought to show that the condemned view was precisely that of Aristotle. Mind, said Pietro’s Aristotle, is at every step dependent upon matter; the most abstract knowledge is ultimately derived from sensation; only through the body can mind act upon the world; consequently a disembodied soul, surviving the mortal frame, would be a functionless and helpless wraith. As Christians and faithful sons of the Church, Pomponazzi concluded, we are warranted in believing in the immortality of the individual soul; as philosophers we are not. It seems never to have occurred to Pomponazzi that his argument had no validity against Catholicism, which taught the resurrection of the body as well as of the soul. Perhaps he did not take this doctrine seriously, and had no thought that his readers would. No one, so far as we know, urged it against him.