Renaissance medicine

Medicine of the Renaissance era in Europe, from around 1400 to around 1750. The Renaissance marked a change of direction for medical knowledge and practice following the stagnation of medieval medicine in the preceding period. A rebirth of interest in the pursuit of new knowledge and scientific enquiry began, similar to that found in ancient Greek medicine. The known world expanded for Europeans, as they discovered the Americas and explored the continents of Asia and Africa, making contact with new peoples and civilizations. New medicinal plants and treatments were brought back to Europe and new technologies such as the microscope emerged, influencing medical development. The spirit of discovery encouraged scientific research that overturned the traditional practices of the Middle Ages, which had been based on the classical teachings of Egypt, Greece, and Rome.

The questioning of classical traditions
At the beginning of the Renaissance the theories of Galen, a Greek physician of the 2nd century AD, were still accepted as fact by most doctors. The Catholic Church in Europe continued to promote Galen's anatomical ideas as infallible, and its control over medical practice and training in the universities remained strong, hindering progress. However, as the Renaissance in learning took hold in Europe, and inventions such as the microscope appeared, leading doctors began to investigate the anatomy and physiology of the body. Classical theories were put to the test of thorough investigation for the first time.

The ideas of Galen, however, were hard to overturn. His theories had been the accepted wisdom of the medical world for over a thousand years. Even when Galen appeared to be wrong, doctors would defend his writings by stating that they had been mistranslated or that crucial parts had been lost.

Dissection and anatomical discovery
In 1531 Johannes Guinter published a Latin translation of Galen's On Anatomical Procedures, in which Galen stressed the need to dissect the human body to learn about anatomy. Galen's understanding of human anatomy had been deduced from dissections of animals such as the barbary ape, leading to numerous errors. His previously unknown approval of human dissection, and his recognition that his work on the human body had been hindered, challenged the ban on dissection imposed by the Catholic Church, and made proper investigation of the human body more acceptable. Doctors such as Andreas Vesalius, Matteo Realdo Colombo, Geronimo Fabricius, and William Harvey all used dissection, observation, and experimentation to come up with new discoveries and theories of human anatomy. Vesalius demonstrated that many of Galen's anatomical theories, such as the number of bones in the human jaw and the existence of holes in the septum between the left and right sides of the heart, were incorrect. Although his ideas were not universally accepted, he set in motion a series of discoveries at Padua University that eventually led to William Harvey's discovery of the circulation of blood, described in 1628.

Vesalius successfully challenged the general ban on dissection by the church, which had arisen from the religious belief that to cut up a dead body was sacrilegious. The only dissections that had been permissible were those undertaken on the corpses of criminals as part of their punishment, and these had been carried out purely to support Galen's theories. By the 16th century the main pressure to maintain the ban on dissection came from senior university professors, who were afraid that the ideas of Galen would be challenged by new discoveries. Vesalius, who distrusted the teachings of Galen, decided to make his own observations when he became professor of surgery at the University of Padua in 1537. He began to teach his students using the dissection of human corpses to illustrate anatomical facts. The tradition that dissection should only be done while a professor read aloud the theories of Galen was dropped. In the pioneering atmosphere of the Renaissance, dissection was accepted as a means to develop new ideas and explain these to students.

New methods
Instead of applying traditional treatments without question, doctors came up with new practices based on experimentation. Ambroise Paré, a French military surgeon, introduced modern principles to the treatment of wounds. He rejected the old method of treating gunshot wounds or amputations by cauterization (sealing with heat) as unnecessarily painful and likely to lead to infection or death. Paré developed the use of ligatures, in which he sealed wounds by sewing up the veins with silk thread rather than applying boiling oil or a hot iron. Paré also used a mixture of rose oil, egg yolk, and turpentine to soothe and heal exposed flesh wounds. Paré's new treatments resulted from his rational approach to the fact that many patients were killed or scarred by the old methods. Paré's La Méthode de traicter les playes faites par les arquebuses et aultres bastons á feu/Method of Treating Wounds Inflicted by Arquebuses and Other Guns (1545) eventually became a standard work for army surgeons in Europe. He published other works, including Cinq livres de chirugie/Five Books of Surgery (1572) and a defence of his ideas in Apology and Treatise of Ambroise Paré (1585). Paré's methods were not instantly adopted, even in the enlightened mood of the Renaissance, but the recording of his theories, experiments, and observations in books enabled the spread of his ideas. As doctors became more receptive to new ideas, much of Paré's work was accepted.

The printing revolution
Paré's ideas spread far more rapidly than they would have done in previous centuries because of the introduction of the printing press to Europe by Johannes Gutenberg in the 1450s. Books had previously been extremely expensive, as each page had to be hand written. This slowed down the spread of new ideas and encouraged doctors to carry on using the information in texts that were already available. The introduction of the printing press meant that books could be produced more quickly and less expensively. It enabled the rapid spread of new ideas, encouraging doctors to try out new methods.

At the same time, the greater naturalism in Renaissance art and interest in human anatomy and perspective, led by artists such as Leonardo da Vinci, resulted in more accurate illustrations of the human body. It was now possible to include detailed anatomical drawings with labels in the books published by doctors. Readers were able to gain a greater understanding of the theories and explanations in the books. Vesalius's celebrated De humani corporis fabrica/On the Structure of the Human Body, published in 1543, contained the most accurate anatomical illustrations used to that date. William Harvey also used detailed illustrations in his De motu cordis/On the Motion of the Heart and the Blood in Animals (1628) to explain his discovery of circulation. Printing made new medical books widely available; without the printing press their revolutionary new ideas would not have spread so rapidly.

Continuity of traditional medicine
The medical discoveries and advances of the Renaissance only affected a small portion of the population of Europe. For most the practice of medicine remained unchanged, the only available and affordable treatments being the traditional methods of herbal and spiritual healing. People in villages and towns continued to visit local men and women, who practised medical skills and cures handed down by example and word of mouth through the ages. Treatments bought from travelling fairs were still used without any reference to the work of medical pioneers such as Paré or Harvey. It would take decades before the anatomical and medical knowledge of the Renaissance filtered down to the poor.

Even the richest and most powerful people in Europe were still being treated using traditional classical and medieval methods well into the Renaissance. King Charles II, who died in 1685 at the age of 55 (possibly of a stroke and subsequent brain haemorrhage), had the most educated and respected doctors in Britain to treat him. However, the methods they used included bleeding and laxatives, remedies used by the ancient Greek doctor Hippocrates in the theory of humours, the four body fluids, blood, phlegm, yellow bile, and black bile, that had to be kept in balance. The day before the king died he was given a potion including bezoar stone, traditionally believed to treat any poison in the body, even though Paré had proved that bezoar stone was an ineffective remedy over a hundred years before. Although new discoveries were made in the Renaissance, their impact was often not felt for many years.