The Renaissance
brought an intense focus on scholarship to Christian Europe. A major effort to
translate the Arabic and Greek scientific works into Latin emerged. Europeans
gradually became experts not only in the ancient writings of the Romans and
Greeks, but in the contemporary writings of Islamic scientists. During the
later centuries of the Renaissance came an increase in experimental
investigation, particularly in the field of dissection and body examination,
thus advancing our knowledge of human anatomy.
The development
of modern neurology began in
the 16th century in Italy and France with Niccolò Massa, Jean Fernel, Jacques Dubois and Andreas Vesalius.
Vesalius described in detail the anatomy of the brain and other organs; he had
little knowledge of the brain's function, thinking that it resided mainly in
the ventricles. Over his lifetime he corrected over 200 of Galen's mistakes. Understanding of medical sciences and
diagnosis improved, but with little direct benefit to health care. Few
effective drugs existed, beyond opium and quinine. Folklore cures
and potentially poisonous metal-based compounds were popular treatments.
Independently from Ibn al-Nafis, Michael Servetus rediscovered
the pulmonary circulation, but this discovery did not reach the public because it
was written down for the first time in the "Manuscript of
Paris" in 1546, and later published in the theological work which he
paid with his life in 1553. Later this was perfected by Renaldus Columbus and Andrea Cesalpino.
Later William Harvey correctly described the circulatory system. The most useful tomes in medicine used both by students
and expert physicians were De Materia Medica and Pharmacopoeia.
Bacteria and protists were first observed with a microscope by Antonie van Leeuwenhoek in
1676, initiating the scientific field of microbiology.
Paracelsus (1493–1541),
was an erratic and abusive innovator who rejected Galen and bookish knowledge,
calling for experimental research, with heavy doses of mysticism, alchemy and
magic mixed in. He rejected sacred magic (miracles) under Church auspisces and
looked for cures in nature. He preached but he also pioneered the use of
chemicals and minerals in medicine. His hermetical views
were that sickness and health in the body relied on the harmony of man (microcosm) and Nature (macrocosm). He took an
approach different from those before him, using this analogy not in the manner
of soul-purification but in the manner that humans must have certain balances
of minerals in their bodies, and that certain illnesses of the body had
chemical remedies that could cure them. Most of his influence came after
his death. Paracelsus is a highly controversial figure in the history of
medicine, with most experts hailing him as a Father of Modern Medicine for
shaking off religious orthodoxy and inspiring many researchers; others say he
was a mystic more than a scientist and downplay his importance.
The University of Padua was founded about 1220 by walkouts from the University of Bologna, and began teaching medicine in 1222. It played a
leading role in the identification and treatment of diseases and ailments,
specializing in autopsies and the inner workings of the body. Starting in
1595, Padua's famous anatomical theatre drew artists and scientists studying
the human body during public dissections. The intensive study of Galen led to
critiques of Galen modeled on his own writing, as in the first book of
Vesalius's De humani corporis fabrica. Andreas Vesalius held
the chair of Surgery and Anatomy (explicator chirurgiae) and in 1543
published his anatomical discoveries in De Humani Corporis Fabrica. He portrayed the human body as an interdependent system
of organ groupings. The book triggered great public interest in dissections and
caused many other European cities to establish anatomical theatres.
At the University of Bologna the training of physicians began in 1219. The
Italian city attracted students from across Europe. Taddeo Alderotti built a
tradition of medical education that established the characteristic features of
Italian learned medicine and was copied by medical schools elsewhere. Turisanus (d. 1320) was his student. The
curriculum was revised and strengthened in 1560–1590. A representative professor
was Julius Caesar Aranzi(Arantius) (1530–89). He became Professor of Anatomy and
Surgery at the University of Bologna in 1556, where he established anatomy as a
major branch of medicine for the first time. Aranzi combined anatomy with a
description of pathological processes, based largely on his own research,
Galen, and the work of his contemporary Italians. Aranzi discovered the
'Nodules of Aranzio' in the semilunar valves of the heart and wrote the first
description of the superior levator palpebral and the coracobrachialis muscles.
His books (in Latin) covered surgical techniques for many conditions,
including hydrocephalus, nasal polyp, goitre and tumours to phimosis, ascites, haemorrhoids, anal abscessand fistulae.
Catholic women
played large roles in health and healing in medieval and early modern
Europe. A life as a nun was a prestigious role; wealthy families provided
dowries for their daughters, and these funded the convents, while the nuns
provided free nursing care for the poor.
The Catholic
elites provided hospital services because of their theology of salvation that
good works were the route to heaven. The Protestant reformers rejected the
notion that rich men could gain God's grace through good works and thereby
escape purgatory by providing cash endowments to charitable institutions. They
also rejected the Catholic idea that the poor patients earned grace and
salvation through their suffering. Protestants generally closed all the
convents and most of the hospitals, sending women home to become
housewives, often against their will. On the other hand, local officials
recognized the public value of hospitals, and some were continued in Protestant
lands, but without monks or nuns and in the control of local governments.
In London, the
crown allowed two hospitals to continue their charitable work, under
nonreligious control of city officials. The convents were all shut down
but Harkness finds that women, some of them former nuns, were part of a new
system that delivered essential medical services to people outside their
family. They were employed by parishes and hospitals, as well as by private
families, and provided nursing care as well as some medical, pharmaceutical,
and surgical services.
Meanwhile, in
Catholic lands such as France, rich families continued to fund convents and
monasteries, and enrolled their daughters as nuns who provided free health
services to the poor. Nursing was a religious role for the nurse, and there was
little call for science.
During
the Age of Enlightenment, the 18th-century, science was held in high esteem and
physicians upgraded their social status by becoming more scientific. The health
field was crowded with self-trained barber-surgeons, apothecaries, midwives,
drug peddlers, and charlatans.
Across Europe
medical schools relied primarily on lectures and readings. The final year
student would have limited clinical experience by trailing the professor through
the wards. Laboratory work was uncommon, and dissections were rarely done
because of legal restrictions on cadavers. Most schools were small, and only
Edinburgh, Scotland, with 11,000 alumni, produced large numbers of graduates.
In Britain,
there were but three small hospitals after 1550. Pelling and Webster estimate
that in London in the 1580 to 1600 period, out of a population of nearly
200,000 people, there were about 500 medical practitioners. Nurses and midwives
are not included. There were about 50 physicians, 100 licensed surgeons, 100
apothecaries, and 250 additional unlicensed practitioners. In the last category
about 25% were women. All across Britain—and indeed all of the world—the
vast majority of the people in city, town or countryside depended for medical
care on local amateurs with no professional training but with a reputation as
wise healers who could diagnose problems and advise sick people what to do—and
perhaps set broken bones, pull a tooth, give some traditional herbs or brews or
perform a little magic to cure what ailed them.
The London
Dispensary opened in 1696, the first clinic in the British Empire to dispense
medicines to poor sick people. The innovation was slow to catch on, but new
dispensaries were open in the 1770s. In the colonies, small hospitals opened in
Philadelphia in 1752, New York in 1771, and Boston (Massachusetts
General Hospital) in 1811.
Guy's Hospital, the first
great British hospital opened in 1721 in London, with funding from
businessman Thomas Guy. In 1821 a bequest of £200,000 by William Hunt in 1829
funded expansion for an additional hundred beds. Samuel Sharp (1709–78), a surgeon at Guy's Hospital, from 1733
to 1757, was internationally famous; his A Treatise on the Operations
of Surgery (1st ed., 1739), was the first British study focused
exclusively on operative technique.
English
physician Thomas Percival (1740–1804)
wrote a comprehensive system of medical conduct, Medical Ethics, or a
Code of Institutes and Precepts, Adapted to the Professional Conduct of Physicians
and Surgeons(1803) that set the standard for many textbooks.
In the Spanish Empire, the
viceregal capital of Mexico City was a site of medical training for physicians
and the creation of hospitals. Epidemic disease had decimated indigenous
populations starting with the early sixteenth-century Spanish
conquest of the Aztec empire, when a
black auxiliary in the armed forces of conqueror Hernán Cortés,
with an active case of smallpox, set off a
virgin land epidemic among indigenous peoples, Spanish allies and enemies
alike. Aztec emperor Cuitlahuac died of
smallpox. Disease was a significant factor in the Spanish conquest
elsewhere as well.
Medical
education instituted at the Royal and
Pontifical University of Mexico chiefly served the needs
of urban elites. Male and female curanderos or lay
practitioners, attended to the ills of the popular classes. The Spanish crown
began regulating the medical profession just a few years after the conquest, setting
up the Royal Tribunal of the Protomedicato, a board for licensing medical
personnel in 1527. Licensing became more systematic after 1646 with physicians,
druggists, surgeons, and bleeders requiring a license before they could
publicly practice. Crown regulation of medical practice became more
general in the Spanish empire.
Elites and the
popular classes alike called on divine intervention in personal and
society-wide health crises, such as the epidemic of 1737. The intervention of
the Virgin of Guadalupe was depicted in a scene of dead and dying Indians,
with elites on their knees praying for her aid. In the late eighteenth century,
the crown began implementing secularizing policies on the Iberian peninsula and
its overseas empire to control disease more systematically and scientifically.
Comments
Medicine didn’t
advance much during the Renascence from 1400 to 1800, despite the fact that the
other sciences advanced rapidly. Physicians finally had tools like the
microscope, but made little progress. Physicians had developed pain killers,
but they spent most of their time just keeping patients comfortable until they
died. They had become entrapped in their own bureaucracy.
Norb Leahy,
Dunwoody GA Tea Party Leader
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