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In the Islamic world and the West, all books were in manuscript until the introduction of movable type printing in about 1450.
Manuscripts using all upper case letters are called majuscule, those using all lower case are called minuscule.
In India, the palm leaf manuscript, with a distinctive long rectangular shape, was used from ancient times until the 19th century.
Paper spread from China via the Islamic world to Europe by the 14th century, and by the late 15th century had largely replaced parchment for many purposes.
Inside the letter is a picture of a master in cathedra expounding on the Aphorisms of Hippocrates. Inside the letter is a picture of a master on bench pointing at a raised flask while lecturing on the "Book on urines" of Theophilus. On its very bottom is an illuminated letter "U" - initial of "Urina ergo est colamentum sanguinis" (Urine is the filtrate of the blood).
Initial "V" rendered as "U" of "Vita brevis, ars vero longa", or "Life is short, but the art is long". Inside the letter is a picture of a master holding up a flask while explaining the diagnostic significance of urine to a student or a patient. Ironically, the manuscripts that were being most carefully preserved in the libraries of antiquity are virtually all lost.