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    Words to live by

    Dr. McDonnell

    John of Garland, writing some 900 years ago, provided excellent advice to the young persons of his time—advice that we ophthalmologists today would be wise to heed. He begins with the importance of good nutrition and moderation in eating and drinking:

    “Polite diners pause over their cup, but gluttons, who live like mules and weevils (sic), empty it with one draught. Always serve two pieces of bread. He who takes a walk or a brief nap after dinner preserves his health. If you wish to regain your strength as a convalescent, and keep your health when you are well, drink moderately. All Epicureans live impure lives; they lose their eyesight; they are rude, unclean and are doomed to die a sudden death . . . ”

    The observation that excessive eating will specifically cause blindness, made so long ago, is an interesting one. It is the only specific medical problem mentioned by the author, who was a philologist and university professor (not a physician). John of Garland was probably born around 1190 and taught at the University of Toulouse in 1229.

    Merits of good diet and exercise

    Apparently, John of Garland had never studied medicine, but nonetheless seemed to appreciate the relationship between gluttony and visual loss, presumably the result of obesity-related diabetes mellitus, centuries before that disease was “discovered.”

    Unfortunately, despite at least 1,000 years of warnings about overeating, we humans still fail to take this advice to heart. Fortunately (for him) John of Garland did not live to observe my glutinous behavior in the restaurants of “The Big Easy,” whose Cajun cuisine I have never been able to enjoy in moderation.

    Sadly, it seems to me, educating people about the health benefits of a good diet and the dangers of overeating has failed to keep our species from suffering an epidemic of obesity. Some political leaders, like New York’s Mayor Michael Bloomberg, believe the solution lies in laws limiting the sizes of servings. His efforts to ban the “Big Gulp” in New York were derided by some as a nanny-state tactic, before being ultimately blocked by the courts.

    The recommendation of a walk after dinner is one that makes good sense to me, and I know many people who make a habit of this.

    Why John of Garland believed that a postprandial nap is just as good as a walk is a mystery to me. He goes on to say: “When you walk after dinner keep on frequented streets.” When walking at night in unfamiliar cities, such as when attending ophthalmology meetings, ophthalmologists should probably take this advice.

    Money matters

    On financial matters, this advisor from medieval times does not subscribe to the “neither-a-borrower-or-lender-be” school of thought.

    Rather, said John of G: “Hasten to help a needy friend, give him money if you can. Be a good debtor and hasten to pay your debts lest you be condemned by your burden of sin and by the peasant bewailing his losses.”

    I am also pretty sure John of Garland had ophthalmology meetings in mind with his next bits of wisdom: “Avoid insincere speeches. Unless you wish to be considered a fool, learn to keep your mouth shut in season.”

    Finally, offers John: “Stand and sit upright, do not scratch yourself.”

    Words to live by.


    • How the student should behave. John of Garland. In: The Medieval Reader. Viking Press, New York, 1949.


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    Peter J. McDonnell, MD
    He is director of The Wilmer Eye Institute, The Johns Hopkins University School of Medicine, Baltimore, and chief medical editor of ...

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