Law of the Emperor Frederick II. (1194-1250) regulating the practice of Medicine.[18]

“While we are bent on making regulations for the common weal of our loyal subjects we keep ever under our observation the health of the individual. In consideration of the serious damage and the irreparable suffering which may occur as a consequence of the inexperience of physicians, we decree that in future no one who claims the title of physician shall exercise the art of healing or dare to treat the ailing, except such as have beforehand in our University of Salerno passed a public examination under a regular teacher of medicine and been given a certificate, not only by the professor of medicine, but also by one of our civil officials, which declares his trustworthiness of character and sufficiency of knowledge. This document must be presented to us, or in our absence from the kingdom, to the person who remains behind in our stead in the kingdom, and must be followed by the obtaining of a licence to practise medicine either from us or from our representative aforesaid. Violation of this law is to be punished by confiscation of goods and a year in prison for all those who in future dare to practise medicine without such permission from our authority.

“Since the students cannot be expected to learn medical science unless they have previously been grounded in logic, we further decree that no one be permitted to take up the study of medical science without beforehand having devoted at least three full years to the study of logic.[19] After three years devoted to these studies he (the student) may, if he will, proceed to the study of medicine, provided always that during the prescribed time he devotes himself also to surgery, which is a part of medicine. After this, and not before, will he be given the licence to practise, provided he has passed an examination, in legal form, as well as obtained a certificate from his teacher as to his studies in the preceding time. After having spent five years in study he shall not practise medicine until he has during a full year devoted himself to medical practice with advice and under the direction of an experienced physician. In the medical schools the professors shall during these five years devote themselves to the recognized books, both those of Hippocrates as well as those of Galen, and shall teach not only theoretic but also practical medicine.

“We also decree as a measure intended for the furtherance of public health that no surgeon shall be allowed to practise, unless he has a written certificate, which he must present to the professor in the medical faculty, stating that he has spent at least a year at that part of medicine which is necessary as a guide to the practice of surgery, and that, above all, he has learned the anatomy of the human body at the medical school, and is fully equipped in this department of medicine, without which neither operations of any kind can be undertaken with success nor fractures be properly treated.

“In every province of our kingdom which is under our legal authority, we decree that two prudent and trustworthy men, whose names must be sent to our court, shall be appointed and bound by formal oath, under whose inspection electuaries and syrups and other medicines be prepared according to law and be sold only after such inspection. In Salerno in particular we decree that this inspectorship shall be limited to those who have taken their degree as masters in physic.“We also decree by the present law that no one in the kingdom except in Salerno or in Naples [in which were the two universities of the kingdom] shall undertake to give lectures on medicine or surgery, or presume to assume the name of teacher, unless he shall have been very thoroughly examined in the presence of a government official and of a professor in the art of medicine. [No setting up of medical schools without the proper authority.]

“Every physician given a licence to practise must take an oath that he shall faithfully fulfil all the requirements of the law, and in addition that whenever it comes to his knowledge that any apothecary has for sale drugs that are of less than normal strength, he shall report him to the court, and besides that he shall give his advice to the poor without asking for any compensation. A physician shall visit his patient at least twice a day and at the wish of his patient once also at night, and shall charge him, in case the visit does not require him to go out of the village or beyond the walls of the city, not more than one-half tarrene in gold for each day’s service.[20] From a patient whom he visits outside of the village or the wall of the town, he has a right to demand for a day’s service not more than three tarrenes, to which may be added, however, his expenses, provided that he does not demand more than four tarrenes altogether.

“He (the regularly licensed physician) must not enter into any business relations with the apothecary nor must he take any of them under his protection nor incur any money obligations in their regard. Nor must any licensed physician keep an apothecary’s shop himself. Apothecaries must conduct their business with a certificate from a physician according to the regulations and on their own credit and responsibility, and they shall not be permitted to sell their products without having taken an oath that all their drugs have been prepared in the prescribed form, without any fraud. The apothecary may derive the following profits from his sales: Such extracts and simples as he need not keep in stock for more than a year, before they may be employed, may be charged for at the rate of three tarrenes an ounce. Other medicines, however, which in consequence of the special conditions required for their preparation or for any other reason, the apothecary has to have in stock for more than a year, he may charge for at the rate of six tarrenes an ounce. Stations for the preparation of medicines may not be located anywhere but only in certain communities in the kingdom as we prescribe below.

“We decree also that the growers of plants meant for medical purpose shall be bound by a solemn oath that they shall prepare their medicines conscientiously according to the rules of their art, and so far as it is humanly possible that they shall prepare them in the presence of the inspectors. Violations of this law shall be punished by the confiscation of their movable goods. If the inspectors, however, to whose fidelity to duty the keeping of the regulations is committed, should allow any fraud in the matters that are entrusted to them, they shall be condemned to punishment by death.”