Twentieth Century History of Findlay and Hancock County, Ohio, and Representative Citizens, Part 151

Author: Jacob Anthony Kimmell
Publication date: 1910
Publisher:
Number of Pages: 1189

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We meet with frequent references to squint and are told ; as volition moves the eyes, they

Must needs together shut and lift themselves. (Par. XII. : ) We are told of spirits who carried their chin lifted ups. like a blind man. To note the approach of an angel opens to Virgil and Dante the gates of the city of Dis. V. calls upon Dante to

* * * * "Direct the nerve

Of vision now along that ancient foam." (Inf. IX, 73.)

That the optic nerve effected the sight by having the ras light intercepted and conducted to it by the spirits white found between the lens and choroid was the accepted opit .: in Dante's age. In making known to Dante that the depe .. spirits know things past and to come but are ignorazi things present, a spirit tells him :

" We see, like those who have imperfect sight, The things," he said, "that distant are from us." (Inf. Il

We can safely infer, I think, that Dante has in mind the r' dition of " old sight " or presbyopia.

Roger Bacon (1214-1292 (1298)) knew lenses and : they were useful for near vision in the old. For optical f. poses they appear to have been ground first about 128; certain Salvino degli Armati, said to have died in 131 :. monk of Pisa, Alexander della Spina, who died in 1313, 2- has been accredited with the invention of spectacles and . the promotion of their use. So we see that lenses for op: purposes really came generally into use after Dante's ti- and that presbyopia the cause of the "imperfect sight." sees only, " the things that distant are from us" then went .: corrected.

In the Inferno we find the largest number of references a purely anatomical nature. These are for the most per .. fact almost entirely, very general. The spirits in the Inter. suffering the tortures of the condemned, having their fr. vivisected, torn and mutilated, their every parts exposed. .. meeting our poet thus, would naturally call upon the anato. cal knowledge of Dante to give an adequate account of . he saw. This is done free from all descriptive exactness. " an aim to present the tortures of Hell in the most awful :

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tomy takes in the poem. In the ninth gulf of Hell, Dante ets with Mahomet who is,

ent from the chin to where one breaketh wind.

etween his legs were hanging down his entrails; is heart was visible, and the dismal sack hat maketh excrement of what is eaten. (Inf. XXVIII, 24.)

other shade speaks these words :

arted do I now bear my brain, alas!

rom its beginning, which is in this trunk.1 (Inf. XXVIII, 140.)

: sees a demon clutch a sinner by

* * the sinews of the feet .? (Inf. XXI, 36.)

e unfortunate is transfixed by a serpent

here where the neck is knotted to the shoulders.3

(Inf. XXIV, 98.)

Il another is pierced through

* * in that part " ** * whereat is first received ur aliment * * * * * (Inf. XXV, 85.)

y translates this passage, " In that part whence our life is trished first-" (Donde prima é preso nostro alimento). It generally held down to Dante's time that the human fœtus athed and was nourished through the umbilicus and by xing upon the cotyledons. This opinion is probably based n the study of the placenta in the higher mammals, especi- the pig, which were used almost exclusively for anatomical lies in the Middle Ages, and the results obtained were as- ed to apply also to man. We can readily understand the h in the mentioned belief if we recall that in the non- duate placenta (the forms most commonly met with in the hals thus employed) the chorionic villi are concentrated definite patches or cotyledons, which at birth separate 1 the uterine mucous membrane, without tearing the r away. The spirit of Guido Count of Montefeltro tells te that the deeds he did were given him by his mother

ile I was still the form of bone and pulp. (Inf. XXVII, 73.)

passage conforms with the belief current during the ter part of the Middle Ages, that from the semen are first led the membranes-" pulp "-a portion of these are then sformed into cartilage and bone, another into blood vessels, 3, nerves and so on. In another passage Dante refers to osition standing next to Virgil as being

in that side where people have their hearts. (Purg. X, 48.)

onnection with this line one should recall that Galen, bas- iis opinion upon the finding in animals, assigned also to uman heart, a position in the center of the thoracic cavity. mained so until Vesalius (1513-1564) gave it its true ion.

rhaps of greatest interest among the medical references

inal cord. ndon of Achilles. venth cervical vertebra. le navel.

to inform himself on the natural process involved in the birth and development of the human body, begs Virgil to enlighten him. Virgil prays Statius that he give to our poet the enlight- ment sought. Statius then turns to Dante with

* * * * * "Son, if these words of mine Thy mind doth contemplate and doth receive, They'll be thy light unto the How thou sayest. The perfect blood, which never is drunk up

Into the thirsty veins, and which remaineth Like food that from the table thou removest, Takes in the heart for all the human members Virtue informative, as being that Which to be changed to them goes through the veins. Again digest, descends it where 't is better Silent to be than say; and then drops thence, Upon another's blood in natural vase. There one together with the other mingles, One to be passive meant, the other active By reason of the perfect place it springs from; And being conjoined, begins to operate, Coagulating first, then vivifying What for its matter it had made consistent. The active virtue, being made a soul As of a plant (in so far different, This on the way is, that arrived already) Then works so much, that now it moves and feels Like a sea-fungus, and then undertakes To organize the powers whose seed it is. Now, Son, dilates and now distends itself The virtue from the generator's heart, Where nature is intent, on all the members. But how from animal it man becomes Thou dost not see as yet; this is a point Which made a wiser man than thou once err So far, that in his doctrine separate He made the soul from possible intellect, For he no organ saw by this assumed. Open thy breast unto the truth that's coming, And know that, just as soon as in the fœtus The articulation of the brain is perfect, The primal Motor turns to it well pleased At so great art of nature, and inspires A spirit new with virtue all replete, Which what it finds there active doth attract Into its substance, and becomes one soul, Which lives, and feels, and on itself revolves. And that thou less may wonder at my word, Behold the sun's heat, which becometh wine, Joined to the juice that from the vine distils. Whenever Lachesis hath no more thread, It separates from the flesh, and virtually Bears with itself the human and divine; The other faculties are voiceless all; The memory, the intelligence, and the will In action far more vigorous than before. Without a pause it falleth of itself In marvellous way on one shore or the other; There of its roads it first is cognizant. Soon as the place there circumscribeth it, The virtue informative rays round about, As, and as much as, in the living members. And even as the air, when full of rain, By alien rays that are therein reflected, With divers colors shows itself adorned, So there the neighboring air doth shape itself

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JOHNS HOPKINS HOSPITAL BULLETIN.

Into that form which doth impress upon it Virtually the soul that has stood still. And then in manner of the little flame, Which followeth the fire where'er it shifts, After the spirit followeth its new form. Since afterwards it takes from this its semblance, It is called shade; and thence it organizes Thereafter every sense, even to the sight. Thence is it that we speak, and thence we laugh; Thence is it that we form the tears and sighs,

* *

According as impress us, our desires And other affections, so the shade is shaped, And this is cause of what thou wonderest at." (Purg. XXV, 33.)

I have given this discourse of Statius thus complete, both for its medical interest and for its exemplifying, perhaps better than any other one passage in the Divine Comedy, the wonder- ful power of Dante in blending into poetry his science, phil- osophy and theology. Comments upon this passage are not wanting. Averroës, Thomas Aquinas, Galen, Aristotle and Hip- pocrates are mentioned as co-contributors. Quotations from the lengthy dissertations of these authors bearing on this interest- ing subject cannot be given here, but a few brief notes may serve to add interest to it. The perfect blood which is not taken up by the veins, is the arterial, the abode of the vital spirits, the venous blood serving merely in nutrition. In the heart the blood is perfected; this appears purely an adoption from Galen. Dante's view relative to the "mingling" of the sexual ele- ments to which he refers as blood, is expressed figuratively. The male element, the semen, was believed even in very ancient times to contribute directly as such in the formation of the fœtus, for Hippocrates and Aristotle taught that it came from all parts of the body, and Galen from the blood in the tes- ticle. The female element was generally also regarded as semen ; this Galen leads from the ovary downward through the excretory ducts (the Fallopian tubes) and during and after coition, believes it to be uniformly mixed with the male ele- ment. Hippocrates and Aristotle held the female semen to be a vaginal secretion which during coition was increased in quantity. Aristotle states that the female projects her semen into the os uteri, where also that from the male is received ; these mingling are from thence drawn into the uterus by in- halation, in the manner we inhale through mouth or nostril. Dioscorides, whom Dante mentions by name, and Athenæus, were of the opinion that in the female the menstrual blood serves as the material mass and that the male semen gives form to the new life. The conception that one of the elements is pas- sive and the other active is probably also borrowed from Galen, who taught that the semen of the male was hotter and of denser consistency than that of the female, which latter in accordance with the greater " coldness of women," was colder and very fluid and acted merely as an excipient and nutritive material, giving rise to the fotal membranes only, while the male semen was concerned in the making of the brain, the seat of the rational soul. The comparison Dante draws between the vege- tative soul of man and that of the plant is this, that in man it must be developed, whereas in plants it is from the first com-

plete. In man the vegetative soul in its development > verted into the sensitive soul. The " man " referred to box. ius as wiser than Dante is generally accepted to be Aver: He who taught that the minds of all men were perradk. one and the same universal intellect. It may be added : science and philosophy were confirmed in the opinion the .. soul of the new life was breathed into it by God.

The purely medical references, i. e., to internal medi .: leave no doubt that Dante was in possession of more tus lay knowledge of this branch of medical science. It - markedly apparent that, as compared to the purely anater. references, these are characterized by a much greater scriptive exactness, denoting a keener study and insight :: is this to be wondered at if we stop to recall the state = which anatomy had lapsed during the thirteenth and er fourteenth centuries. Medicine, through the impulse give. by the Arabs and by the freer dissemination of Greek . cine, continued more active and certainly, though in 2. measure, progressive, while anatomy on the contrary rema: where Galen had left it.

Leprosy, so prevalent during the thirteenth century, ist quently referred to by Dante. He tells of two spirits s: E flicted :

I saw two sitting leaned against each other, As leans in heating platter against platter, From head to foot bespotted o'er with scabs; And never saw I plied a currycomb By stable-boy for whom his master waits, Or him who keeps awake unwillingly, As every one was plying fast the bite Of nails upon himself, for the great rage Of itching which no other succor had. And the nails downward with them dragged the scab, In fashion as a knife the scales of bream, Or any other fish that has them largest. (Inf. XXIX, 73.)

Evidently Dante seeks to picture what we today would : nodular or tubercular leprosy, in the advanced stage of v! there is frequently associated pain, irritation and desqui: tion, which latter when excessive gives rise to an appear: not unlike that of ichthyosis, whereupon rests the poet's red. ence to the scales of fish. The ultimate loss of the nails it t- disease finds expression in these words, addressed by Ve ;- to a leper who plies himself with scratching:

"* * * so may thy nails suffice thee To all eternity unto this work." (Inf. XXIX, 89.)

Dante meeting his friend Forese among the spirits in ?. gatory, recognizes him only by hearing his voice, and is pealed to with

" Ah, do not look at this dry leprosy," Entreated he, " which doth my skin discolor, Nor at default of flesh that I may have." (Purg. XXIII, #2)

The nodular form of leprosy, attacking frequently first 1 face and ears, often enlarging these and giving rise to a E- ing of nodules on the brow, with a consequent deepening natural furrows, especially at the root of the nose, ph .. " a peculiar lion-like aspect, to which the ancients gave the Es:

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he crusaders were largely instrumental in disseminating sy in Europe. It had reached its height at about the that Dante lived, abating gradually until in the latter part ne sixteenth century it disappeared practically from the of endemic diseases in middle Europe. The belief in its igious nature, established in ancient times, led to the isola- of those suffering with it. In Europe and especially in · were special institutions (lazzeretti) erected for lepers, ly in secluded places or beyond the city gates. The in- s of these were under general surveillance, and were given many places special clothing, marked to indicate their tion, or had to carry a wooden rattle to make known their oach or a cane with which to point out or touch what they ed. Means of support other than begging was denied , and they were generally shunned or treated as outcasts. is expressed in an address of Dante to two spirits-

not your foul and loathsome punishment

ce you afraid to show yourselves to me." (Inf. XXIX, 107.)

further great scourge, widespread over most of Italy and lern Europe, was malaria. A short excerpt taken from ay's Handbook of Central Italy, depicting the devastation alaria in Italy, is not without interest in this connection. ading of the Lake of Bolsena, in the vicinity of Rome, re informed that, "The treacherous beauty of the lake als malaria in its most fatal forms; and its shores, al- gh there are no traces of a marsh, are deserted, excepting e a few sickly hamlets are scattered on their western 3. The ground is cultivated in many places down to the 's edge, but the laborers dare not sleep for a single night, ig the summer or autumn, on the plains where they work y; and a large tract of beautiful and productive country duced to a perfect solitude by this invisible calamity. ing can be more striking than the appearance of the lake, ut a single sail upon its waters, and with scarcely a n habitation within sight of Bolsena; and nothing per- can give the traveler who visits Italy for the first time re impressive idea of the effects of malaria." In the gulf of Hell the spirits' suffering is intense, such that : writes of it,

t pain would be if from the hospitals aldichiana, 'twixt July and September, of Maremma and Sardinia

he diseases in one moat were gathered, was it here, and such stench came from it rom putrescent limbs is wont to issue. (Inf. XXIX, 46.)

's mention of the time "'twixt July and September " in-

s that period of the year in which malaria was at its The marshy regions of Italy, the Maremma, along the of the Tyrrhenian sea, stretching from the mouth of the Magra to that of the river Volturno, were up to within ratively recent times uninhabitable because of the d prevalence of malaria. Systems of drainage and fill- have now made this region habitable and converted it rich and fertile area. In Dante's time these marshes

about the Lake of Bolsena. What stench must have been created in the hospital wards, such as they were, where coction or suppuration was above all things promoted in the treatment of wounds and other surgical lesions! Of interest is the fol- lowing reference. Dante, who is to mount upon the back of Geryon, becomes unnerved,

Such as he is who has so near the ague Of quartan that his nails are blue already,

And trembles all, but looking at the shade. (Inf. XVII, 85.)

Very probably the chills and rigors characteristic of the cold stage in malaria are here thought of. However the term, quartan, most usually applied to one form of malaria in the present day, had in Dante's age a more general and wider ap- plication. The classification of fevers in vogue then being into semitertians, tertians, quartans, quintans, septans and nonans. The prognosis depended much upon whether these were inter- mittent or protracted, whether diurnal or nocturnal. The quartan fever was considered as not only free from evil conse- quences but even favorably, in that it was thought to often carry off other diseases with which the patient suffered.

The following lines intimate Dante's keen powers of obser- vation and are of interest in their medical allusion. He sees a spirit stung by a serpent; the spirit looked at his aggressor,

* * * but said naught; Nay, rather with feet motionless he yawned, Just as if sleep or fever had assailed him. (Inf. XXV, 88.)

Dante probably gleaned this from observing the lassitude and desire to yawn and stretch which is so commonly felt at the on- set of intermittent fevers and particularly so in the first stage of malarial paroxysms.

In the tenth gulf of Hell, Dante is held fascinated by a dis- pute and wrangle between two sinners, Adam of Brescia, a counterfitter, and Sinon, the Greek, who persuaded the Trojans to accept the wooden horse. Of the former we are given this description :

I saw one made in fashion of a lute, If he had only had the groin cut off

Just at the point at which a man is forked.

The heavy dropsy, that so disproportions The limbs with humors, which it ill concocts,

That the face corresponds not to the belly,

Compelled him so to hold his lips apart

As does the hectic, who because of thirst

One tow'rds the chin, the other upward turns. (Inf. XXX, 49.)

Adam confides to Dante his craving for a drop of water and tells him that his memory of verdant streams dries him up more

Than the disease which strips my face of flesh. (Inf. XXX, 70.)

So heavy is he with his dropsy that in a hundred years he can not move an inch. Upon request of Dante, Adam gives infor- mation of his neighbor, Sinon of Troy, who is smoking as " a wet hand does in winter," and who reeks with acute fever. Sinon becomes angered at Adam for the account given Dante of him, and to avenge this strikes Adam

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JOHNS HOPKINS HOSPITAL BULLETIN.

* * * with the fist upon his hardened paunch It gave a sound as if it were a drum. (Inf. XXX, 102.)

Adam retaliates by striking Sinon in the face " that did not seem less hard," than Adam's paunch. An altercation between these two then follows, in which Sinon addresses Adam with

" And rueful be it to thee the whole world knows it."

" Rueful to thee the thirst be where with cracks Thy tongue," the Greek said, "and the putrid water That hedges so thy paunch before thine eyes." (Inf. XXX, 119.)

To which the false coiner makes reply,

* * * "So is gaping wide

Thy mouth for speaking evil, as 'tis wont; Because if I have thirst and humor" stuff me, Thou hast the burning and the head that aches, `And to lick up the mirror of Narcissus Thou wouldst not want words many to invite thee."

(Inf. XXX, 125.)

To diagnose the disease with which Dante would have us know Adam is afflicted may appear to be of idle purpose; but grant- ing permission to speculate, the heavy dropsy, the wasted fea- tures may be assumed to conform to the ascites and facies met with in hepatic cirrhosis. And the hectic, with cracked tongue longing for water, with a paunch that when struck sounds like a drum, and again the facial expression (Hippocratic facies), brings to mind general peritonitis, for it is common to see these both in one, and the patient down with hepatic cirrhosis dies of secondary peritonitis. Dante's remark, applied to Sinon, whom he saw "smoking like unto a wet hand in winter," is probably learned from Hippocrates. Francis Adams' trans- lation of Hippocrates' treatise on Airs contains the following remarks : " A common fever (epidemic) therefore is such because all draw in the same breath (pneuma)." Hippo- crates afterwards attempts an explanation of the phenomena of rigors, which, however is not very intelligible, and then of the febrile heat and sweats which succeed them. The latter he compares to the "condensed steam of boiling water." The views concerning dropsy current in Dante's day were largely those of Hippocrates and Galen, their opinions being the code taught. Hippocrates held that there were " two kinds of dropsy, the one anasarca, which when formed is in- curable, the other is accompanied with emphysema (tympan- ites?) and requires much good fortune to enable one to triumph over it." Galen's commentary on this informs us that in place of two dropsies there are three at least, meaning by these, anasarca, ascites and tympanites. A like opinion is given by Paulus Ægineta.

The following reference seems in its medical affirmation almost as if spoken by a physician. Dante meets with the spirits punished for soothsaying. They, because they sought to see before them and foretell things, are made to look and move backwards. Dante sees some who

Wondrously * * * seemed * * * distorted, From chin to the beginning of the chest; For tow'rds the reins the countenance was turned,

And backward it behooved them to advance, As to look forward had been taken from them. Perchance indeed by violence of palsy Some one has been thus wholly turned awry; But I ne'er saw it, nor beieve it can be. (Inf. XIX, IL)

The physicians worthy of mention in the Divine ( .. we can dismiss with a few remarks, for in accordance v ... nature of the poem they are given no opportunity to p. their art. For the same reason also we meet with a na sence of any reference to therapeutics. The physicians : " most part are but mentioned by name and grouped wit spirits in interesting assemblages and, like all of Ix: characters, are presented merely as representative types is entering the first circle of the Inferno, the Limbo, whe .. those virtuous but unbaptised, finds among the spirits t.

Galen, Hippocrates and Avicenna, Averroes who the great Comment made. (Inf. IV, 143.)

In their circle also,

Of qualities I saw the good collector, Hight Dioscorides. * * * * (Inf. IV, 140.)

Associated with these are the philosophers and other : spirits, the master of this throng,

All gaze upon him and all do him honor. (Inf. IV, 133.)

is Aristotle. Of these Hippocrates, Averroes and Ats receive further mention in the Comedy. In an allusion Dante makes to the pursuit of worldly things instead 3 vine, he mentions Taddeo, as type representative of the : lowing the former. A like allusion is found in the lite

One after laws and one to aphorisms. (Par. XI, 4.)

Here undoubtedly Dante refers to the well-known Aph of Hippocrates.

Whether or not Dante knew these masters by their " need not concern us, though it is fair to assume that x at least in part and his many commentators appear to c: this, especially on the ground that to join the guild of :. cians and apothecaries some knowledge of medicine mos .: been his as a prerequisite.

To the medical student these names are familiar. Are" Hippocrates and Galen are too well known to require a3; ment, excepting perhaps that Aristotle came in contar: medicine really only through his physiology and his reve .: in the field of comparative anatomy.

Avicenna (980-1037), surnamed by the Arabs, the ?? of Physicians, enjoyed, next to Galen, the greatest ac:" in the medical world of the Middle Ages. The author of hundred and five known writings, his Canon Medkr" system of medicine in five books, was the text and lis medical art and in its Latin translation served this pe as late as the seventeenth century. His reputation hei;">. by the nullity of his time, was gained more through ks" nical abilities and high cast positions than by his se accomplishments. His works were largely mere conp.s

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book on this subject. He is said to have recognized some hundred plants. From among his medicines some are place in the pharmacopeias of today, among others, cas- il, cinnamon, fern and aloes.

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Twentieth Century History of Findlay and Hancock County, Ohio, and Representative Citizens, Part 151

Author: Jacob Anthony Kimmell Publication date: 1910 Publisher: Number of Pages: 1189

Author: Jacob Anthony Kimmell
Publication date: 1910
Publisher:
Number of Pages: 1189