He was the earliest special writer on surgery in Italy.[771] His later editor ROLANDO exhibits an acquaintance with surgery, which shows that, although the art had not been previously written upon in Italy, it was very well understood at Salerno. De Renzi says that some of the operations described are trephining, the removal of polypi from the nose, resection of the lower jaw, the operation for hernia and lithotomy. Malignant tumours of the rectum and uterus are referred to.[772] Salerno was the first school in Europe in which regular diplomas in medicine were granted to students who had been duly instructed and had passed an examination in accordance with the requirements of the legal authorities. The great patron of Salerno, Frederick II., in the year 1240 confirmed the law of King Roger, passed in the year 1137, or as some say in 1140, with reference to licences to practise medicine. That ancient enactment was that, “Whoever from this time forth desires to practise medicine must present himself before our officials and judges, and be subject to their decision. Any one audacious enough to neglect this shall be punished by imprisonment and confiscation of goods. This decree has for its object the protection of the subjects of our kingdom from the dangers arising from the ignorance of practitioners.”[773] Frederick’s law was: “Since it is possible for a man to understand medical science, only if he has previously learnt something of logic, we ordain that no one shall be permitted to study medicine until he has given his attention to logic for three years. After these three years he may, if he wishes, proceed to the study of medicine. In this study he must spend five years, during which period he must also acquire a knowledge of surgery, for this forms a part of medicine. After this, but not before, permission may be given him to practise, provided that he passes the examination prescribed by the authorities and at the same time produces a certificate showing that he has studied for the period required by the law.” “The teachers must, during this period of five years, expound in their lectures the genuine writings of Hippocrates and Galen on the theory and practice of medicine.” “But even when the prescribed five years of medical study are passed, the doctor should not forthwith practise on his own account, but, for a full year more he should habitually consult an older experienced practitioner in the exercise of his profession.”