Return to Classical Ideas
- Renaissance is the name given to the changes which started in the cities of Northern Italy during the 14th century and spread throughout Europe over the next 200 years.
- It started by embracing the close study of classical texts. It was critical of old translations.
- There was an interest in how the human body worked based on direct observation and dissection.
- There was less superstition involved with medicine. The Royal Society (Britain's most prestigious scientific body) was founded in 1660 and had patronage from King Charles II so it had high status.
- Renaissance Man - the idea that a well educated person would be proficient in science and art. Leonardo da Vinci was good at both. Artists attended dissections of human corpses and wrote on scientific objects using illustrations.
- The return of the Greek texts by people like Hippocrates and Galen led to renewed faith in the four humours theory and treatment by opposites.
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Changes in the Church
- In the 16th century some religious thinkers felt that the Catholic Church had become corrupt and got too far away from the teachings of the Bible.
- Men like Martin Luther wanted the Church to be reformed and for the Bible to be translated into modern languages so that more people can understand it.
- This movement became known as the Reformation. Protestant Churches spread across Europe.
- The Reformation was a time when traditional religious authority was challenged and knowledge spread to a greater range of people - this ethos influenced the wider world and had an impact on the development of medicine.
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Reactions to the New Ideas
- There was resistance to the new ideas of the Renaissance and the Reformation. Galileo Galilei was persecuted by the Inquisition (a Catholic organisation set up to root out unorthodox beliefs) in 1633.
- 'Renaissance Man' Paracelsus began his lecturing career in Basel in 1527 by burning one of Galen's books an calling him a liar and Avicenna a kitchen master. He also rejected the four humours theory. He gave his lectures in German rather than the academic language of Latin and opened them to anyone that wanted to attend.
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War's Effect on Public Health
- The Renaissance was a very violent period and religious differences led to many wars. Large mercenary armies fought in long inconclusive wars.
- Populations were beginning to increase in the towns and cities which placed more strain on the available clean water supplies and sewage disposal systems.
- Warfare gobbled up resources, destroyed crops and bottled people up in besieged towns without enough food. Starvation, camp fever (typhoid), plague and sexually transmitted diseases followed the armies around the continent.
- Homelessness and those permanently disabled by war put unsustainable pressures on parish structures intended for poor relief.
- Naval power and the science of navigation improved worldwide communication. However, communication was sometimes a negative factor. Diseases common in Europe lke smallpox, measles and syphilis were spread to North and South America, while cholera was on its way to Europe from the East.
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The Great Plague
- This was the worst of the not infrequent reappearances of the Black Death.
- The death toll in London was about 100000 and many fled from the city.
- Some efforts were made to control the spread of the disease. Affected households were locked in and red crosses were drawn on their doors with the words, 'Lord have mercy upon us.' Carts organised by the authorities roamed the city to the cry of, 'Bring out your dead!' collecting corpses for mass burial in 'plague pits'.
- Such measures showed that people realised that the disease was contagious but, they still didn't understand about germs.
- Doctors, chemists and priests were worse affected than average because the sick went to them for help.
- The Great Fire of London in 1666 effectively sterilised large parts of London, killing the plague bacteria.
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- Johann Gutenberg introduced printing to Europe in 1454. This invention accelerated the rate of progress in medicine and everything else. It made it much easier for ideas to spread and be debated widely. William Caxton set up the first British printing press in 1476 in Westminster Abbey.
- Making a single copy of a book by hand could take many months or even years for a copyist so books were very rare and precious before printing. New ideas would have to be thoroughly accepted before anyone would go to the bother of copying them by hand.
- Between 1500 and 1531 more complete copies of Galen's works ame out of the East, were translated into Latin and published by use of the printing press.
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Vesalius' Anatomy Books
- Vesalius was born in 1514 and studied anatomy in Louvain and Paris. He was allowed to perform dissections, but not to boil up bodies to get skeletons. He pinched a rather ripe body from a gibbet - dirty job but someone's got to do it.
- He became professor of surgery and anatomy at Padua.
- He did his own dissections rather than employing a menial demonstrator and he wrote books based on his observations using accurate diagrams to illustrate his work. The most important were 'Tabulae Sex' (1538) and 'The Fabric of the Human Body' (1543).
- His illustrations were carefully annotated so that he could refer to specific parts in the text. He oversaw all stages in the production.
- His work served to point out some of Galen's mistakes. In the second edition of 'The Fabric' Vesalius said there were no holes in the septum of the heart - and his successor, Colombo, said (1559) that blood went from one side of the heart to the other via the lungs. This was 300 years after Ibn al-Nafis.
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- He was a barber-surgeon born in 1510. Surgery was still a low status profession. Pare worked for a public hospital, then became an army surgeon.
- At this time the severed blood vessels left by amputation were sealed by burning their ends using a red hot iron (cauterisation). This caused extreme discomfort for the already stressed patient. Pare invented the method of tying off vessels with threads (ligatures). He also designed quite sophisticated artificial legs.
- Gunshot wounds caused infection more often than arrow or blade wounds. We now know this is because a bullet carries soiled cloth and skin into the wound and produces a great deal of dead tissue encouraging infection. At the time people thought that bullets were poisoned by the gunpowder. The standard treatment was to use the hot iron again or pouring boiling oil which may have worked in some cases but would have caused more harm than good.
- During one battle Pare ran out of oil and resorted, by chance, to a simple cool salve instead. To his surprise the patients treated that way did better than the ones scalded with the oil.
- Eventually he became surgeon to the King of France, but his ideas were resisted by doctors who thought that a lowly surgeon should not be listened to. It took the King's support to gain his ideas some acceptance.
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- He was born in 1578 and studied medicine and anatomy at Padus. He then worked in London as a doctor and a lecturer at the Royal College of Surgeons, before becoming Royal Physician to James I and Charles I.
- He did comparative studies on animals and humans. He realised that he could observe living animal hearts in action and his findings would also apply to humans.
- Galen had thought that the blood was formed, carried to the tissues and then consumed. Harvey realised this was wrong. His logic for suggesting circulation was that too much blood was being pumped out of the heart for it to be continually formed and consumed so it must be going round and round.
- He also identified the difference between arteries and veins which built on the discoveries of Erasistratus (250BC) and he noticed that blood changes colour as it passes through the lungs.
- Although Harvey's work was very important and a turning point in anatomy, it didn't radically change the practice of surgery. Bleeding continued to be performed and blood transfusions were not generally successful until the discovery of blood groups in 1900.
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