THE SIGNIFICANCE OF GILBERTUS ANGLICUS

Little is known about Gilbertus Anglicus (Gilbert of England, sometimes ‘Gilbert Eagle’) – where he was born, lived or died. We know that he was active in the first half of the 13th century. He studied at the medical school in Salerno, travelled widely, and was for a time physician to the Archbishop of Canterbury.

He is known chiefly for his Compendium of Medicine (Compendium Medicinæ) – “an attempt at a comprehensive overview of the best practice in pharmacology, medicine, and surgery at the time” (Wikipedia).

The Compendium is typical of the medical books of the time: a huge amalgam of copying and paraphrasing of known knowledge – notably Hippocrates, Galen, Avicenna and the Salerno School – on everything from physiology to physiognomy ("He who has large ears is calm and long-lived") along with literally thousands of medical remedies and advice on matters such as hair and personal hygiene. The book has a significant section on surgery, most of which was copied from the works of his teacher, Roger of Parma.

This, of course, added to the huge medieval muddle of different, even contradictory, ideas and cures, but Gilbert offers us an insight into medieval thinking on this:

"But our custom is to gather the best from the sayings of the best, and where there is doubt, to scatter different opinions; so that each one may choose for himself which he wishes to retain."

Gilbert, however, was quite capable of adding ideas of his own, and the medical writer Henry Handerson (1918) claimed that Gilbert showed “an acuteness and a common sense quite unexpected” and that – although he did include superstition, charms, folk cures and disgusting remedies – they “are often introduced with a sort of apology, implying his slight belief in their efficacy”. Thus a list cures for gout which included tying a frog’s foot, or a magnet, or the heel of a donkey, or the right foot of a tortoise to the affected limb is introduced as follows:

“Although I decline to these matters a little, it is still good to write in our book, so that the treatise may not remain without what the ancients said…”

The remedies in the Compendium are typical of medieval medicine at the time. Gilbert believed that “Hippocrates elegantly gave the method of treatment”: diseases are defined as hot, cold, moist, or dry, and the vast range of comfortatives, laxatives, diuretics, fumigations, enemas, electuaries and suppositories Gilbert offers was directed toward helping the body to heal itself by the use of opposites:

“Medicine is only a helper, and the principal actor is the part that is sick."

So a hot headache – symptoms: a red forehead, fast pulse, red urine, and an aversion to hot things – was treated by cold remedies, and by avoiding too much thinking, staying awake, bathing, or sexual excitement. Equally, for a ‘cold’ illness, “hot medicines can dissolve the matter of the sickness just as the heat of the sun dissolves ice or snow into water”.

IMPACT: SOME POSITIVES

  •   The Compendium is the earliest complete treatise on general medicine by an English author.

  •   It was practical, systematic, comprehensive and – when it was written – up-to-date. Handerson criticised those writers who “select from the Compendium a charm or two and a few silly statements … and draw therefrom the easy conclusion that the book is a mass of crass superstition and absurd nonsense”. He suggested that the Compendium perfectly fulfilled the task of a compendium – to accurately present a comprehensive selection from the best authorities available at the time. And he points out that Gilbert was “possessed of exceptional education in the science of his day, a man of wide reading, broadened by extensive travel and endowed with the knowledge acquired by a long experience”.

  •   The Compendium was cited and copied extensively in England and Europe in the 13th and 14th centuries, and continued to be referenced into the 15th; the medical historian Faye Marie Getz (1991) gave examples from medieval medicine of physicians using the herbs suggested by Gilbert.

  •   Gilbert gets a mention in Chaucer’s (1380) list of famous physicians:

“... Bernard and Gatesden and Gilbertyn.”

  •   Parts of the Compendium (mostly the remedies) were translated into Middle English c.1400, which gave it a wider exposure – Getz suggested that the Compendium was popular to rank-and-file physicians because it offered a ‘quick fix’ for doctors faced with impatient patients. However, its translation into English suggests also that it made its way to a degree beyond medical professionals, into the everyday medicine of wealthy households.

  •   In the 15th century, the gynaecological and obstetrical portions of the English translation of the Compendium were excerpted (and added to) and circulated widely as The Sekenesse of Wymmen, which remained a key text on women’s medicine – especially for barber-surgeons and midwives – into the 16th century.

  •   It was one of the first medical texts in the west to examine the teachings of Islamic physicians, whose works were beginning to be translated from Arabic into Latin – for instance, Gilbert included knowledge from the Muslim surgeon Albucasis in his sections on surgery.

  •   Handerson pointed especially to the 50 chapters on surgery, and how remarkable they are given that Gilbert was writing at a time when the Pope had forbidden surgery (1215).

IMPACT: SOME LIMITATIONS

  •  The Compendium was not groundbreaking or inventive. It did not challenge Galenic orthodoxy or introduce any new medical methods (but it was never intended to be).

  •  Although some English versions existed, most of his work remained in Latin manuscripts, limiting access to it to elite male physicians and clerics.

  •  There is no evidence that the Compendium significantly influenced medical institutions (eg hospitals, licensing bodies or universities). Although copies were kept for reference in some college libraries, it was not a core text at Oxford or Cambridge Universities, or included as required reading for student debates.

  •  Its influence as a medical reference was waning by the 15th century.

  •  Handerson commented that “we have no historical facts which demonstrate that Gilbert's Compendium exercised any considerable influence upon the development of surgery in England”; it was quickly superseded by the Surgery of Theodoric (c. 1260) and Guy de Chauliac’s Chirurgia Magna (1363).