Chapter XXVI: Appendix: IV

CHURCH DECREES RELATING TO MEDICINE.

Besides the Papal documents referred to in the body of this book and quoted in the original in the Appendix to the first edition immediately preceding this, there is a series of decrees of Councils and Synods of the Church which are sometimes referred to as representing a distinct policy of opposition on the part of the Church to science and particularly medical and surgical practice, as if their purpose had been to force people to have recourse to prayers and relics and pilgrimages and masses rather than to take advantage of medical knowledge and surgical experience for the relief of their ills. The Papal documents quoted and discussed in the previous edition of this book proved to have no such meaning as was attributed to them and the history of the medical sciences as traced, shows that these Church regulations were not misconstrued either in their own or subsequent generations in such a way as to have the effect of interfering with the development of medical science or medical education as has been claimed. Their citation in support of the thesis of Church opposition to science, theoretic or applied, is entirely without justification.

Exactly this same thing is true with regard to the other documents that are referred to as having a parallel and confirmatory significance of Church opposition to medical science, or medical or surgical practice, or medical teaching. It requires no lengthy explanation to see that the decrees referred to are simply ecclesiastical disciplinary regulations, aimed at putting an end to certain abuses that had arisen in religious matters, and well calculated to prevent their further occurrence. The Church authorities recognized as will anyone who understands the circumstances that men who had devoted their lives in religious orders exclusively to the work of religion, should not be permitted to neglect their religious vocations because of devotion to some secular profession. They were forbidden to practice and to study medicine, but the practice of law was forbidden to them quite as well and for the same reason. There was no question of limiting the number of persons who might take up medical study, but all those who had bound themselves for life to religious duties must not withdraw from these to take up secular occupations. The case against the Church as opposed to science, and above all medicine and surgery, must indeed be weak {425} when it has to be bolstered up by recondite references to documents such as these, the purport of which is so clear and the good sense of which is as evident now as it was when they were issued.

Everyone recognizes that absorbing professional occupations such as the practice of medicine or of law keeps men from devoting themselves to the intellectual or the spiritual life. The opposite is also felt to be the case and there is still a profound distrust of the lawyer or the physician who devotes himself to literature or to any intellectual avocation, for the feeling is that he cannot be practically successful at his profession. This feeling is often a mere prejudice and great lawyers and great physicians have often been litterateurs of distinction, but as a rule there is incompatibility between the two modes of occupation. In the medieval period it was felt that there was the same incompatibility between proper devotion to the spiritual life and the professions, and as members of religious orders had given up worldly affairs and interests in order to devote themselves to other-worldliness and had taken vows of poverty, chastity and obedience for that purpose, it was sincerely felt that they should not engage in gainful occupations and professional work that distracted them from the religious profession which they had taken up. Hence these decrees.

The only way to make perfectly clear the meaning of these decrees in their proper place in history both as regards education in general and medical education, is to give the text of the documents in the accompanying translation. I owe the text of them to Father Corbett of the Seminary of St. Charles Borromeo at Overbrook, Pa., who supplied me with the similar documents for the first edition of this work. The translations are made from the recognized authoritative edition of the decrees of the Church councils and synods issued at Paris in 1671, the title page of which reads as follows: "Sacrosancta concilia ad regiam editionem exacta quae nunc quarta parte prodit auctior studio Philip. Labaei et Gab. Cossartii, Soc. Jesu Prebyterorum, Tomus Decimus, 1053--1197, Lutetiae Parisiorum 1671." [Footnote 49]

[Footnote 49: I feel that I should say that when there was question of publishing these documents I consulted Dr. Garrison, the Assistant Librarian of the Surgeon General's Library at Washington and the author of the best history or medicine in English, as to the Church decrees that ought to be published in their entirety in order to make their meaning perfectly clear. I have followed the list suggested by him.]

_The Council of Rheims held under Pope Innocent II, A.D. 1131,_ Canon VI, forbidding monks or regular canons to study law or medicine for the sake of gain.

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"An evil custom as we consider it and detestable has grown up by
which monks and regular canons after having received the habit and
made their profession, spurning the rule of their blessed masters
Benedict and Augustine, learn secular law and medicine for the sake
of temporal gain. Inflamed by the fire of avarice they make
themselves the patrons of causes [that is the attorneys of legal
proceedings] and when they ought to be devoting themselves to
psalmody and hymns, confiding in the support of a fine voice and the
variety of their pleas, they confound justice and injustice, right
and wrong. Imperial constitutions attest that it is absurd, nay even
an opprobrium, for members of the clerical order to wish to be
skilled in forensic disputation. We decree that violators of the
religious life of this kind should fall under the severe judgment of
the apostolical authority, for as they have neglected the cure of
souls and in no way attend to the purpose of their order, promising
health for filthy lucre, they make themselves guardians of human
bodies. And since an impure eye is the index of an impure heart and
since religion ought not to deal with those things even to talk
about which brings the blush of shame to the cheek of honesty, in
order therefore that the monastic and canonical order should be
preserved inviolably pleasing to God in its holy purpose, we
interdict by the apostolical authority that any such proceeding
should be allowed hereafter. Bishops therefore and abbots and priors
who consent to such an enormity shall be deprived of their own
dignities."

_The Council of Tours held under Pope Alexander III, A.D. 1163,_ Canon VIII. That religious should avoid secular studies.

"Not only does the envy of the old enemy of mankind bring him to
labor greatly to destroy the infirm members of the Church, but he
also puts his hand to securing the desirable members of the Church
and strives even to supplant the elect according to the saying of
the Scriptures 'for the elect are his food.' He plumes himself if he
can bring about the fall of many, but especially if he can bring
down some more distinguished member of the Church by making him
lukewarm. Hence it is that he knows how to transfigure himself after
his usual fashion into an angel of light, so that under the pretext
of caring for the health of ailing brethren and more faithfully
carrying out ecclesiastical business he leads members of the regular
religious orders to the study of law and of physical problems which
have to be given attention outside of the cloister. For this reason,
so that spiritual men under the pretext of science may not again
become involved in mundane affairs and themselves lose their
interior life while they are thinking to provide for others in the
exterior, we have decreed by the assent of the present council in
the endeavor to meet this evil, that no one at all after taking the
vows of religion or the making of religious profession should be
allowed to absent himself from the cloister for the study of
medicine and physic. If however he has already absented himself and
shall not have returned to his cloister within the space of two
months he is to be avoided by all as excommunicate, and if he should
presume to try the effect of patronage in no case should {427} he be
heard. On his return to the cloister he must always be the last of
the brothers in the choir and unless by the special indult or
permission of the Holy See must lose hope of all promotion."

_The Council of Paris, A.D. 1212,_ Second Part, Canon XX.

"Since certain of the members of the regular orders under the pretense of caring for the bodies of ailing brother members and of more faithfully managing ecclesiastical affairs, to use the words of the Lateran Council, have not hesitated to go out of their cloisters to learn mundane law and give themselves to the study of physical problems in order to give their time to jurisprudence and medicine and on account of that are lacking in the interior life because they are devoting themselves to care for external things, we walking closely in the footsteps of that council decree that unless within the space of two months such students of law and medicine return to their cloisters, in spite of the permission of their abbot, which he is not empowered to give, they are to be excommunicated and avoided by all; and in no case if they should endeavor to use patronage to aid them are they to be admitted.

"We prohibit also anyone who enters the cloister for the sake of religion to go out of it in order to go to school; whatever a student may wish he should learn in the cloister. Those who are now in the schools should within two months return to the cloister."

_Decree of the Council of Montpellier held under Pope Alexander III, 1162._

Since the proceedings of this Council are not extant the records of it are preserved in two monuments. One an Epistle of Pope Alexander to the Bishop of Verona and the other the decrees of the Council of Montpellier held in 1195 which enacted similar legislation.

Cap. 15. "The Council prohibited besides under the full severity of
ecclesiastical discipline any monk or canon regular or other member
of a religious order to take up the study of secular laws or
medicine. Anyone violating this statute must be canonically
published by the diocesan Bishops according to the decree
promulgated in this matter under Pope Alexander in the Council of
Montpellier."

It has been suggested that this exclusion of monks and religious from the study of medicine by Church ordinance practically shut out all the clerics, that is, all the educated men of the medieval period, from the medical profession. Any such idea, however, could only have occurred to one who does not realize that at any given time there are only a comparatively few religious and a great many secular clergymen. Practically all those who could read and write in the Middle Ages were known as clerks, that is clerics, and were under the protection of the Church, most of them indeed receiving minor orders, and if all the clergy were to have been excluded {428} from the medical profession this contention would be true. So far is it from the truth, however, that a number of the great physicians and surgeons of the thirteenth and fourteenth centuries belonged to the clerical orders, not a few of them were priests and some of the greatest of them, like Theodoric, were actually bishops. It was only the religious, that is the men who had specially devoted their lives to monasticism, who were forbidden to take up the study of medicine because it did not comport with their monastic vocation.

A second series of ecclesiastical decrees that are often referred to in the history of medicine are those which concern the relations of the physician and his patient whenever there is danger of death. The Church's duty was to secure the proper dispositions on the part of those who were in danger of death. Physicians sometimes did not let patients and their friends know how serious the illness was and as a consequence patients died without the sacraments and rites of the Church. In order to prevent this the Church regulation was promulgated that a physician was bound to have a patient take care of his soul at the same time that his body was being treated. Physicians of the present day, even when they are not themselves Catholics, know how much of good, even physical good, is done to patients almost without exception by the consolations of religion. Instead of being perturbed as is sometimes thought by those who have not had experience with the custom, exactly the opposite effect is produced, and patients often drop their anxieties and solicitudes and begin to improve immediately after the reception of the sacraments. They usually submit themselves to whatever Providence has in store for them, put off their worries, and this factor of itself is eminently therapeutic.

Many a non-Catholic physician obeys these decrees of the Church with regard to the summoning of a priest to an ailing Catholic patient without knowing anything about them. He does it because of his experience that his patients are benefited by the consolations of religion. The wisdom of the Church in the decrees is seen very well by the paragraph in which it is suggested that the reason for having the physician always advise the calling in of a priest is that if this advice is given only when there is serious danger of death many patients knowing this will be thrown into a state of depression very harmful to them when the suggestion is made.

How such decrees could be thought in any way to interfere with medicine or its practice, or with the physician and his duties, or, above all, represent any effort on the part of the Church to hamper medical science or discourage patients from having physicians, I {429} cannot for the life of me imagine. The idea sometimes suggested that the real reason for this legislation was that the Church did not want patients to die before priests were given an opportunity to secure money for services in the administration of the last rites or for masses for the recovery of the patient and the like, would only enter into the mind of someone who not only did not understand the Church and had no experience of Catholics and Catholic life, but who had no proper recognition of the place of religion in life as a great source of consolation and strength in the face of the mystery of death and the hereafter.

Those who think religion a mere hypocrisy imposed on people by designing clergy are so lacking in the knowledge that would enable them to judge of the meaning of such decrees that their opinion is not worth while considering. It must not be forgotten that these decrees are still binding on a Catholic physician, and far from resenting them we welcome them as helps in securing the aid of the consolations of religion for our patients. Many a worried business man suffering from some severe disease like pneumonia or typhoid fever, goes on to develop a much more favorable mental attitude toward himself and his affection after he has seen the priest. The last paragraph of the first decree also emphasizes the wisdom of the Church and shows how much of an aid her legislation was in the support of ethical standards, for it forbids under the severest penalties that a physician should ever advise a patient to anything contrary to his conscience. This paragraph is also still binding on Catholic physicians.

_The Fourth Lateran Council held under Pope Innocent III, A.D. 1215,_ Canon XII. That the sick should rather provide for the soul than the body.

"Since bodily infirmity sometimes proceeds from sin, the Lord
himself saying to the ailing man whom he had cured 'Go now and sin
no more lest something worse should happen to you,' we declare by
the present decree and distinctly impose upon physicians of the body
that whenever it shall happen that they are called to ailing
persons, they must before all warn and persuade the ailing that they
should call in physicians of the soul so that after the spiritual
safety of the sick has been provided for he may proceed more
healthfully to the remedy of corporeal medicine, since the cause
ceasing the effect shall also cease.

"This among other things gave cause for this edict that certain
people lying on a bed of sickness when persuaded by physicians that
they should dispose things for the safety of their souls fall into a
condition of despair whence the more easily they incur the danger of
death.

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"If any one of the physicians after this constitution of ours shall
have been published should transgress it he should be kept from
entrance to the Church until he shall have satisfied competently for
the transgression.

"Besides, since the soul is by far more precious than the body, we
prohibit under dire anathema that any physician should ever advise a
patient to do anything for his corporal welfare that would bring him
into danger of losing his soul."

_The Synodal Statutes of the Church of Mans (the chief town of the Province of Main), A.D. 1247._

On Communion for the Sick.

"It was decreed in the general session and distinctly enjoined on
physicians of the body that when they happen to be called to the
ailing they must before everything else warn and persuade their
patients to call physicians of the soul, in order that after the
spiritual safety of the sick one may be provided for they may
proceed with more assurance to the remedy of corporal ills. If any
physician should transgress this constitution let him be kept from
entrance to the Church until he shall have made competent
satisfaction.

"Besides since the soul is much more important than the body it is
prohibited under anathema that any physician should advise a patient
anything for his bodily health which might bring his soul into
peril."

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