THE HISTORY OF MEDICINE

1. EUROPIAN MEDICINE DURING RENAISSANCE THE HISTORY OF MEDICINE

2. BY GROUP-2 • LAKSHMY V.P

3. 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.

4. THE DEVELOPMENT OF  THE SCIENTIFIC SPIRIT • Medicine practiced prior to renaissance period was more an art than a science . Though some jewels of real scientific lusture are witnessed in the writings of Galen and Hippocrates, their followers could not develop the real scientific attitude of mind . The practice of medicine degenerated into a medley of some positive scientific facts and multitude of fads and fancies unwarranted assumptions, imperfect and biased observations, hasty generalizations, false conclusions and most absurd and often torturesome therapeutic practices. Reason came to be overshadowed by strange traditional beliefs and superstitions; authority claimed a superior and often implicit allegiance from the medical profession. But a new spirit was awakened in the European mind during the renaissance period- which goes by the name of the scientific spirit – which had its repercussions in every field of human knowledge.  This period is rightly called the age of reasons and medicine also came under its way

5. MEDICAL RESEARCH • Medicine remained dominated by the teachings of the church but physicians began to learn more about the human body. They read books translated from Arabic medical texts and began to study anatomy in scientific and systematic way. AndreasVesalius and Leonardo Da Vinci dissected human bodies and made the first anatomical drawings. These helped in understanding the organs and systems of the human body. The church did not permit the dissection of 'God fearing bodies' so it was often the bodies of criminals or 'sinners' that were used. Doctors learned about anatomy from watching these dissections. Sometimes the criminal was alive at the start of proceedings as part of their punishment.During the Renaissance, the human body was regarded as a creation of God and the ancient Greek view of the four humors prevailed. • Sickness was due to an imbalance in these humors and treatments, such as bleeding the patient or inducing vomiting, were aimed at restoring the balance of these four humors. In 1628, William Harvey published his new theory that the heart acts as a muscular pump which circulates blood around the body in the blood vessels. Discoveries during the Renaissance laid the foundations for a change in thinking

6. 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.

7. New knowledge and inventions improved medicine • A flurry of new knowledge and inventions helped to advance medicine quickly, during the Renaissance. There were no instruments yet to observe bacteria, and thus create a need for cheap urbane scrubs. However, diagrams of the human body and the printing press both had a huge influence on the world of medicine. Thus, doctors had a better comprehension of how the human body functioned, than during any previous era in Europe's history.

8. Galen was no longer king • During the previous Middle Ages, the medical world considered Galen's writings to be infallible. Galen was an ancient Greek living in Rome, who had developed the concepts of Hippocrates, "The Father of Medicine." • However, during the Renaissance, doctors took a more practical and academic approach to training in their profession. Medical students studied from books with realistic diagrams of humans. In addition to better books, doctors-in-training also had access to more of them, thanks to the invention of the printing press. In fact, universities even permitted students to dissect humans, towards the end of the Renaissance. This practice had previously been limited to animals.

9. Science began to supersede spirituality • During the Renaissance, people still held to some spiritual reasoning regarding diseases. For instance, people were unaware that bacteria existed, and could spread from person-to-person. However, logic became king, due to a new wealth of knowledge available, and an efficient way to distribute it faster-the printing press. In addition, the training for surgical procedures greatly improved. Apprentices would learn surgical techniques, from an active surgeon. Interestingly, universities themselves failed to supply doctors-in-training with these skills. Nevertheless, the improvements in textbooks about human anatomy significantly boosted the complexity of the surgeries that doctors did.

10. Many did not embrace advances in medicine • While the Renaissance ushered in a new era of medical knowledge and skills, not everyone was impressed. During the Renaissance, home remedies remained a vital aspect of medical treatment, for many people. In fact, some people still sought treatments from local shaman who lacked formal training in the medical profession. Also, many "old-school" doctors and the Catholic Church still adhered to the teachings of Galen. However, within time, medical advances during the Renaissance would revolutionize the whole professional. • The Renaissance was clearly an era of enlightenment and developments. Besides the fantastic output in the arts, the medical profession flourished as well. While doctors were yet unaware of bacteria or the need to wear scrubs during surgeries, they were nonetheless learning. Essentially starting with the Renaissance, spiritual doctors were becoming scientific doctors!

11. 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 thebarbary 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, MatteoRealdoColombo, 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.

15. HOSPITALS AND HEALTHCARE • The majority of people were too poor to be treated by trained doctors. Major cities had hospitals. For example, the Santa Maria Nuova in Florence, treated wealthy patients. These hospitals were amongst the first medical schools in Europe to start teaching medicine. Surgery improved and techniques such as tying wounds to stop bleeding began to be used.Previously, bleeding was stopped by cauterizing, or burning, the wound with red hot metal.Surgical instruments remained basic. A surgeon would perform operations with the most basic set of instruments: a drill, a saw, forceps and pliers for removing teeth. If a trained surgeon was not available,it was usually the local barber who performed operations and removed teeth.

16. IMPORTANT  PERSONALITIES IN THE FIELD OF MEDICINE DURING RENAISSANCE PERIOD

17. LEONARDO DA VINCI(1452-1592) He was originally a god gifted artist. His appreciation of naturalism &deep insightmade him to contribute remarkable drawing of human anatomical pictures.he was first to demonstrate the ventricles of brain by wax injection and to depict correctly the foetus and its membrane within the uterus. Originally he engaged to study the bones muscles in relation to art &persued his investigation to study the deeper parts of the body, viscera, brain blood vessels and more specially the heart

18. VERSALIUS • 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.

19. PARACELSUS • 'In the 16th  century the most disputed person of the time was PARACELSUS. While still a youth Paracelsus became aware of many of the conflicting currents of his age. His father was a physician in Einsiedeln and he practiced in a number of mining towns. The boy surely learned some practical medicine at home through observing his father. It is likely that he learned some folk medicine as well. He also picked up some alchemy from his father who had an interest in the subject. And in mining towns he would have observed metallurgical practices as well as the diseases that afflicted the men who worked the mines • Traditionally it has been said that Paracelsus was taught by several bishops and the occultist abbot of Sponheim, Johannes Trithemius. At the age of fourteen the boy left home to begin a long period of wandering. He apparently visited a number of universities, but there is no proof that he ever took a medical degree. As an adult, however, he picked up practical medical knowledge by working as a surgeon in a number of the mercenary armies that ravaged Europe in the seemingly endless wars of the period. He wrote that he visited most of the countries of Central, Northern, and Eastern Europe.

20. others still  remembered • Among many  others still  remembered.Ambroise Pare  for his surgical attempts. • Pierre Franco was first person to perform a subpubiclithotomy.wrote an article on hernia. He had great success on operation on cataract. Free Jacques&Frere Jean who practised surgery.Amongthe many anatomist two names Gabriel Fallopius (1526-62) for his discovery of AQUEDUCT and tubes which bear his name BartolomeusEustachius who was head of the Department of Anatomy at Rome is remembered for accurate illustration of THORACIC DUCT , CILLARY MUSCLES , details of FASCIAL MUSCLES, LARNYX, KIDNEY.ThomasVicary was the first master of the united company of Barber’s Surgeon and rapidly became the chief to the king Henry VIII.his book is titled as ‘A TREASURE FOR ENGLISH MEN’, containing the anatomic of man’s body.

21. 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'sLa Méthode de traicter les playesfaites par les arquebuses et aultresbastons 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 Cinqlivres 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.

22. Circulation: a major breakthrough • In 1628, William Harvey published his new theory that the heart acts as a muscular pump which circulates blood around the body in the blood vessels. Discoveries during the Renaissance laid the foundations for a change in thinking leading to the view that the body is made up of specialised systems that work together; the basis of medical knowledge that we still see today..

23. 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 humanicorporisfabrica/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 motucordis/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.

24. CONCLUSION • 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.