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Renaissance & Medicine

INTRODUCTION

The term Renaissance designates the rebirth


of the arts and sciences that accompanied
the complex and often painful economic, social,
political, and intellectual transformations that
took place in Europe between about 1300 and
1650.
The Renaissance was a new age of
exploration of the word, the world, the
mind, and the human body. The Renaissance
era may have ultimately transformed European
culture in a profound and permanent way that
led to the modern world, but it was also a
period in which superstition, mysticism,
intolerance,
and
epidemic
disease
flourished.
During this period, Europe experienced the
disintegration of medieval economic, social, and
religious patterns, the expansion of commerce,
cities, and trade, and the growth of the modern
state. While such a profound transformation
might seem to imply a sharp break with the
past, in many ways the Renaissance was the
natural culmination of the Middle Ages.
Scholars have argued that the Renaissance
was not yet an age of individualism, as
indicated by the importance of kinship ties and
the growth of religious and professional
associations. For the most part, towns and cities
were urban islands surrounded by traditional
rural life. Moreover, medievalists have argued
that the outlines of modern society were already
being formed between the late tenth century
and the early thirteenth.
As an era of scientific and philosophical
interest, if not therapeutic advances, the
Renaissance
is
a
time
of
special
importance for medicine. The death rate circa
1500 was about three times the present level,
and life expectancy was perhaps half that of
modern Europe. War, famine, and epidemic
disease appeared so often that fears of the
imminent end of the world were widespread.
However, the exact relationship between the
Renaissance and the renaissance of medicine is
extremely complicated.
It is possible to speak of a long medical
renaissance that began in the twelfth

century, a distinct medical renaissance of


the sixteenth century, and a medical
revolution of the seventeenth century.

INVENTIONS THAT CHANGED THE WORLD

Francis Bacon (15611639), Englands premier


philosopher of science and Lord High Chancellor,
said that if we considered the force, effect, and
consequences of all the products of human
ingenuity, the three most important inventions
were printing, gunpowder, and the compass.
PRINTING
The establishment of printing presses
throughout Europe in the 1460s launched a
communications revolution that might, at least
in part, account for the permanence of the
Renaissance.
Jean Charlier de Gersons writings on selfabuse, De pollutione nocturna, printed in
Cologne about 1466, may have been the first
printed medical book.
Some historians emphasize the importance of
the printing press in standardizing and
preserving texts, as well as increasing the
numbers of texts available. Of course, careless
and ignorant printers could introduce errors and
multiply errors more rapidly than scribes could
corrupt hand-made books. But copy editors,
proofreaders (correctors), and skillful editors
understood the danger of introducing errors.
Errors in the text or the illustrations and captions
could be particularly dangerous in medical and
surgical books. When editing medical texts for a
printer in Lyon, the French humanist Francois
Rabelais (1490?1553), who is best known for
his satirical attacks on superstition and
scholasticism, allegedly said: One wrong word
may now kill thousands of men!
An avalanche of advice literature,
especially texts dealing with health and
diet, was a major product of the print
revolution. Popular texts in the vernacular told
people what foods, drugs, and spices were
good or bad for their health, explaining

proper food choices in terms of humoral and


medical theories. Advice on hygiene still
discussed the Galenic rules of health or regimen
in terms of the six non-naturals: food and drink,
air or the environment, exercise and rest, sleep
and waking, evacuation and repletion, and the
passions of the soul or the emotions. Similar
formats were adopted by texts that gave advice
to wealthy readers about sex, clothing,
cosmetics, health, family life,
managing
pregnancy and childbirth, wet-nursing, child
rearing, and so forth.
Medical writers had to find ways of adapting
medical theories to New World plantssuch as
tomatoes, potatoes, and tobaccothat were
being used as foods and drugs. Written advice
could get very detailed without causing
embarrassment to the advisor or the patient. Of
course, the advice literature was probably
consulted more often by those who were ill than
by those who might learn to preserve their
health by actually following lifestyle advice. The
authors of advice literature often complained
that people only worried about diet and proper
regimen when they were already sick.
Despite the inevitable grumbling about the
vulgarity of printed books as compared to
manuscripts and the fear that an excess of
literacy might be subversive, scholars and an
increasingly literate populace were generally
more concerned with acquiring the new
treasures than in complaining about the end of
scribal culture. Once in print, a text could speak
to students directly, rather than through the
professor or keeper of manuscripts. The massproduced book made it possible for the young to
study, and perhaps even learn, by reading on
their own. Without the art of papermaking, which
originated in China, the knowledge revolution
launched by the printing press would have been
impossible.
GUNPOWDER
Gunpowder weapons have an important place
in the history of medicine because they forced
surgeons to deal with problems unknown to
Hippocrates and Galen.
COMPASS
The Chinese probably invented gunpowder and
the compass, but others have claimed prior or
independent invention.
As Europeans followed the compass around the
world, they brought back new plants, animals,
and remedies and left in their wake a series of
ecological and demographic catastrophes that

THE MEDICAL HUMANISTS

transformed the world.


The work of Thomas Linacre (1460?1524) and
John Caius (15101573), outstanding English
medical humanists, exemplifies the nature of
scholarship and medical education during the
Renaissance period.
University of Padua began teaching medicine
in 1222 and played a leading role in the
identification and treatment of diseases and
ailments, specializing in autopsies and the inner
workings of the body. Thomas Linacre studied
Greek in Florence and Rome before receiving the
degree of Doctor of Medicine from the University
of Padua in 1496. In addition to his scholarly
work, he maintained a lucrative private medical
practice, taught Greek, and served as personal
physician to King Henry VII. Linacre edited and
translated
Galens
writings
on
hygiene,
therapeutics, disease symptoms, the pulse, and
so forth. As founder and guiding light of the
College of Physicians, Linacre helped to mold the
character of the English medical profession. He
and other elite English physicians gained the
power to determine who could legally practice
medicine in the Greater London area. The Royal
College of Physicians had the power to fine and
imprison unlicensed medical practitioners.
Graduates of Cambridge and Oxford, which
Linacre himself had attended, were exempted
from these harsh penalties.
Under the leadership of Linacres devoted
disciple John Caius, the College of Physicians
grew in power and prestige, taking control of
medical
licensing
away
from
religious
authorities, and using strict regulations to
enhance the status of approved physicians.
Nevertheless, Caius was troubled by what he
saw as a decline in English medical humanism.
In terms of the development of institutions of
higher learning,
England lagged behind the universities and
professional schools of the continent. Thus, like
other English scholars, Caius had to pursue his
studies abroad. After abandoning his theological
studies, Caius became a medical student at the
University of Padua, where he met Andreas
Vesalius (1514 1564), the rising star of
Renaissance anatomy. Both men were involved
in editing and publishing new Latin versions of
Galenic
texts,
but
their
reactions
to
discrepancies between Galenic anatomy and the
human cadaver were quite different. While
Vesalius insisted on returning to the true book
of the human body, Caius was confident that
once all the writings of Galen were critically

edited, medical knowledge would be virtually


complete.
In 1546, Caius was appointed anatomical
demonstrator to the
United Company of Barbers and Surgeons. Since
1540, the Company of Barbers and Surgeons
had been allotted the bodies of four convicted
felons per year for anatomical demonstrations.
After considerable lobbying by Caius and other
elite physicians, the College of Physicians
received a similar bequest in 1565. Whereas
other presidents of the
College of Physicians had generally ignored
unqualified practitioners, especially outside
London, Caius wanted to control medical
licensing for all of England. Although his goal of
raising standards for medical education and
practice was laudable, efforts to limit the
number of practitioners by dictating their
credentials had adverse effects, especially for
women and the poor. Obviously, the needs of the
common people could not be met by the small
numbers of physicians who belonged to the
medical aristocracy, which was not necessarily a
meritocracy. Because women were not admitted
to the universities, female practitioners were
easy targets for licensing reforms. In addition to
his campaigns against unlicensed practitioners,
quackery, witchcraft, and superstition, Caius
challenged those who dared to criticize Galen.
Respect for the ancients did not blunt Caius
ability to observe and describe new phenomena,
as shown in his account of an illness known as
the English sweating sickness. His remarkable
Boke or Counseill against the Disease Called the
Sweate (1522) was the first original description
of disease to be written in England in English. In
all probability, Caius
would be distressed to know that his vernacular
description of the sweats is now regarded as
his most important medical work. At least five
severe outbreaks of Sudor Britanica, or sudor
anglicus, apparently occurred between 1480 and
1580. The disease was characterized by copious
sweat, fever, nausea, headache, cramps, pain in
the back and
extremities, delirium, hallucinations, and a
profound stupor. Within about 24 hours the
disease reached a critical stage, when either the
disease or the patient came to an abrupt end.
Even among strong, healthy men, the mortality
rate was extremely high. Many victims lapsed
into coma and died within 24 to 48 hours.
Moreover, the disease seemed to seek out
Englishmen even if potential Scottish, Irish, and
Welsh victims were available. According to

Caius, a stricken town was fortunate if only half


of all souls were claimed by the disease. After
carefully evaluating the clinical pattern and
natural history of the disease, he concluded that
the sweating sickness was a new disease. Some
historians believe that the disease was brought
to London in 1485 when Henry VIIs mercenaries
returned from France and Flanders. The disease
might have been a virulent form of influenza,
ergotism (a reaction to fungal toxins), food
poisoning, or a totally unknown and extinct
disease, but the exact nature of these epidemics
and the reason for their peculiar geographical
distribution are still obscure.
AUTOPSIES, ART, AND ANATOMY
ANDREAS VESALIUS ON THE FABRIC OF THE
HUMAN BODY
MEDICINE AND SURGERY
AMBROISE PARE AND THE ART OF SURGERY
THE OCCULT SCIENCES: ASTROLOGY AND
ALCHEMY
SYPHILIS, THE SCOURGE OF THE RENAISSANCE
SYPHILIS AND HUMAN EXPERIMENTATION
THE DISCOVERY OF THE CIRCULATION OF BLOOD
WILLIAM HARVEY AND THE CIRCULATION OF
BLOOD
HARVEYS PARADOXICAL INFLUENCE: THERAPY
BY LEECH AND LANCET
BLOOD TRANSFUSION
NEW HEARTS FOR OLD
SANTORIO SANTORIO AND THE QUANTITATIVE
METHOD