Operations above all for cataract have been practised from very early
times, and are mentioned also by many medieval writers on medicine and
surgery. It is not surprising, then, to find that the medieval surgeons
particularly discussed a number of eye diseases and the operations for
them. Pope John XXI., who before he became Pope was known as _Petrus
Hispanus_ (the Spaniard), and who had been a professor of surgery and a
papal physician, wrote a book on eye diseases in the latter half of the
thirteenth century, which has come down to us. He had much to say of
cataract, dividing it into traumatic and spontaneous, and suggesting
operation by needling, a gold needle being used for that purpose. Pope
John describes a form of hardness of the eye which would seem to be what
we now call glaucoma, and has a number of external applications for eye
diseases. Most of his collyria had some bile in them, the bile of various
kinds of animals and birds being supposed to be progressively more
efficient for the cure of external affections of the eye. This very
general use of bile, or of an extract of the livers of animals or fishes,
seems to be a heritage from biblical times, when old Toby was cured of his
blindness by the gall of the fish.[13] The Pope ophthalmologist (see
_Opthalmology_, Milwaukee, January, 1909) recommended the urine of infants
as an eye-wash, experience having evidently shown that this fluid, which
is usually bland and unirritating, a solution of salts of a specific
gravity such that it would not set up osmotic processes in the eye, was
empirically of value. In the Middle Ages the idea of using it would be
much less deterrent, because it was quite a common practice for physicians
to taste urine in order to test it for pathological conditions.
Spectacles were rather commonly used in the Middle Ages, probably having
been invented in the second half of the thirteenth century by Salvino de
Armato of Florence. Bernard de Gordon mentions them under the name _oculus
berellinus_ early in the fourteenth century. They were originally made
from a kind of smoky crystal, _berillus_, whence the German name _Brillen_
and the French _besicles_ (Garrison). Guy de Chauliac suggests that when
collyria failed to improve the sight spectacles should be employed. Almost
needless to say, this use of spectacles meant very much for the comfort
and convenience of old people. Up to that time most of those who reached
the age of three-score would be utterly unable to read, and would have to
depend either on others or on their memory for teaching and many other
purposes. External eye troubles, as those due to trichiasis and to various
disturbances of the lachrymal apparatus, were treated by direct mechanical
means. Some very ingenious suggestions and manipulations were made with
regard to them.
CHAPTER IX
MEDICAL EDUCATION FOR WOMEN
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