_Lanfranchi and the Medical School of Paris._--According to Edouard Nicaise[64] medicine was not taught publicly at Paris previously to 1160 A. D. The teaching was carried on at that time by associations of physicians, and it was only during the following century (about 1250 A. D.) that something like a university was established in that city. Up to the end of the sixteenth century (1595 A. D.), during the reign of Henry IV., this institution remained under the control of the Church. Its functions--so far at least as medicine was concerned--were limited to the bestowing of degrees, for it possessed at that time no organization of instructors and no permanent quarters in which the teaching might be carried on systematically; a church (see Fig. 10) or the Dean’s residence serving as the locality in which the lectures were commonly delivered. During the middle part of the thirteenth century and for a long time afterward, the practice of surgery, which was then of a rather primitive type, was entirely in the hands of two classes of men--the barbers and the so-called surgeons.[65] As time went on, the surgeons began to feel the necessity of securing better protection for their material interests, which were being more and more encroached upon by the barbers--a class of men who were not privileged by the authorities to include in their field of activities anything beyond hair-cutting, shaving, cupping, the extraction of teeth, the application of leeches, the incision of boils and perhaps one or two other simple operations. For this reason, therefore, and also probably because they too felt in some measure the effects of the Renaissance spirit which was then abroad in the land, they organized themselves (1254 A. D.) into an association which bore the name of “College of Saint Cosmas” (_Collège de St. Côme_).[66] One of the early acts of this association was to establish the rule that all applicants for membership should pass successfully an examination as to their fitness before they could be admitted. Very little is known about the doings of the organization during the early years of its existence. Later, as we shall see, it played a very important part in the history of medicine in France. [Illustration: FIG. 10. THE MANNER OF GIVING PUBLIC INSTRUCTION IN MEDICINE DURING THE MIDDLE AGES. (From Meaux Saint-Marc’s _L’École de Salerne_.) The present cut is evidently a modern copy of a much earlier original.]