LECTURE 4
Renaissance
Medicine
 What
is the Renaissance?
 Philosophical, scientific and artistic
concepts of Renaissance
 Anatomy during Renaissance
 Surgery in Renaissance
 Pathology in Renaissance
 Representative medical personalities of
Renaissance
Renaissance Medicine
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The Renaissance represents a period of humanistic revival of classical
influence in Europe from the fourteenth to the seventeenth century,
expressed in a flowering of the arts and literature and by the beginnings
of modern science. Giorgio Vasari (1511-1574), a Florentin artist,
architect and man of letters called the period a "rinascita", or rebirth,
because of the belief that there was a return to the cultural priorities of
ancient Rome and Greece.
The Turkish capture of Constantinopole in 1453 led to an influx of
Greek refugee scholars into Italy, greater than to any other country. The
universities of northern Italy, especially of Bologna, Padua and Ferrara
attracted students and scholars from all over Europe. Thus, in the second
half of the fifteenth century, the social, economic and political
conditions in northern Italy encouraged a veritable explosion of
intellectual and creative activity.
Renaissance Medicine
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Art and science were allied more closely in the Renaissance than during
any other period in the history of humanity.
During the medieval period earlier anatomic illustrations were accepted
and copied. In general, the ability of copyist was limited and they often
introduced errors of understanding as well as of technique.
The first examples of printed anatomical illustrations remained in the
medieval manuscript tradition. The "Fasciculus medicinae" was a
collection of contemporary writings for practicing physicians. In the first
edition, in 1491, the woodcut was first used for an anatomical figure. The
illustrations contained large figures showing the location of appropriate
bloodletting sites. The dissections were primitively and nonrealistically
drawn.
The Renaissance artists of the fifteenth century became increasingly
interested in the human form and the study of human anatomy.
Leonardo da Vinci (1452-1519) was the first artist interested in human
anatomy. Leonardo made anatomical preparations from which he
produced drawings representing the skeletal, muscular, nervous and
vascular systems.
Renaissance Medicine
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Albrecht Durer (1471-1528) wrote treatises on mathematics, chemistry,
hydraulics and anatomy. His treatise on human proportions was
published after his death, but his concern for anatomy was entirely
esthetic.
Andreas Vesalius (van Wesel) was the most celebrated of the anatomists.
Born in Brussels, he studied in Louvain and Paris, and became professor
of anatomy at Padua at the age of 23.
After several preliminary works, at the age of twenty-eight, he
published at Basle his masterpiece "De humani corporis fabrica"
which revolutionized not only anatomy but also scientific teaching in
general. This work is said to be the first modern treatise in any science.
The treatise was a turning-point for all branches of medicine.Vesalius set
himself two tasks: first to make anatomy the foundation of all medicine
and second to correct Galen's anatomical‘ errors.
The book has 7 volumes, describing (I) bones, (II) muscles, (III) blood
vessels, (IV) nerves, (V) abdominal organs, (VI) heart and lungs, (VII)
brain. Each of the major systems was discussed and depicted separately.
The various parts of each organ system were considered both together
and isolated, as well as the relationships of all these structures.
Renaissance Medicine
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Vesalius founded a dynasty of brilliant anatomists. Among them were
Bartolommeo Eusttachio (15242-1574), Matteo Realdo Colombo (151521559), GabrieHo Fallopio (1523-1562) and Girolamo Fabrizio
d'Acquapendente (1537-1619).
Realdo Colombo was a pupil and successor of Vesalius. He was
professor of anatomy and surgery at Padua between 1 544 and 1 559. His
text-book "De re anatomica" repairs some of the great teacher's
omissions. He was the first to describe the lens towards the front of the
eye and not at the centre. Colombo showed that arteries expand when
the heart contracts and he recognized the function of the valve at root
of the pulmonary artery in preventing reflux of blood into the heart.
Andrea Cesalpino (1524-1603), pupil of Colombo, was professor of
botany at Pisa. He observed that blood in the veins flowed towards the
heart. But he did not recognize that the heart was a pump, or that the
blood flowed continuously.
Renaissance Medicine
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One of the great medical personalities who violently attacked the
classical fortresses was Philipp Theophrastus Bombastus von
Hohenheim, also called Paracelsus (1493-1541).
He was also interested in chemistry, theology, alchemy, astrology and the
occult sciences.
Paracelsus set himself to reform the whole of medicine but converted
nobody and changed nothing. His greatest opportunity came in 1526
when he was appointed town physician and professor in Basle.
Paracelsus intended to "purify medicine of errors" by accepting only
rules that had been proved by experiment. Unfortunately he demolished
the old, unproven theories, only to replace them with fantasies of his
own. He broke with tradition by writing not in Latin but in his native
dialect. When he was short of a word he invented one, often without
defining it.
Renaissance Medicine
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Some of Paracelsus's discoveries were acceptable in the sixteenth century.
He was the first man to describe miner's lung (pneumoconiosis). This
represents a group of occupational diseases caused by inhaling noxious
dusts at work.
Paracelsus also noticed the relation of cretinism to goitre (enlargement
of the thyroid gland). He introduced chemistry to medicine with
compounds of lead, iron, copper and mercury, and he was the first to use
sulphur and antimony as drugs. Paracelsus believed in simple, clean
dressings for wounds.
He insisted that anatomy should be studied and taught in relation to the
living body. He detested polypharmacy, the giving of half a dozen
remedies in the hope that one would work. Paracelsus said that talking to
a patient and letting him talk might be the best treatment.
Jean Fernel (1497-1558), professor of medicine in Paris was the author
of a treatise on medical practice that was a standard work of reference
for two centuries.
Renaissance Medicine
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In his writing entitled "A Universal Medicine" he for the first time
divided the study of medicine into three parts: physiology, pathology and
treatment, in the manner of a modern text-book. Pathology - the nature
of disease - was his special study. He summarized current views and
added many observations of his own, including one of the few
descriptions of appendicitis before the nineteenth century.
The first major epidemic of syphilis occurred among the sailors
returning from Columbus's first voyage to the New World. In short time
the disease spread from the Mediterranean across Europe. The disease
finally reached the French troops of Charles VIII who had forced Naples
to surrender. As Charles's army returned north, the Italian peninsula was
inundated with syphilis, which became known as "morbo gallico", or
French disease.
Fernel was the first to suggest that gonorrhea and syphilis were quite
separate illness, sharing only a common mode of transmission.
Renaissance Medicine
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Syphilis was first named in 1530 by Girolamo Fracastoro of Verona
(1478-1553), a poet, physicist, geologist, astronomer besides being a
physician. In his poem written in Latin "Syphilis sive Morbus Gallicus"
he not only gave the "French disease" its more general name but also
suggested its venereal spread.
His later treatise, "De Contagione" (1546), stated the modern theory of
infection by invisible germs, which he called "seminaria", except that he
may not have viewed these contagious elements as living organisms.
Clinical surgery during Renaissance owed much to Ambroise Pare (15101590). Inspired by the anatomical work of Vesalius, he more than anyone
else led surgery out of the Middle Ages.
Giovanni da Vigo (1460-1525) had written in his "Practica copiosa in arte
chirurgica" (1514) that gunshot wounds were poisonous. Based on the
pseudo-Hippocrate doctrine that "wounds which are not curable by knife
are curable by fire" Vigo and others concluded that gunshot wounds
should be first dressed with boiling oil.
Renaissance Medicine
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Epidemic diseases of the sixteenth century were quite different from
those of the preceding century. Syphilis was common and the favoured
treatment was with mercury and guaiac. Gonorrhea became even more
common. These two venereal diseases were responsible for the
suppression of communal baths. In many areas this meant a loss of the
only means of personal hygiene, since adequate water was still
unavailable to most of the population.
Other epidemic diseases became inexplicably more common in the
sixteenth century. Among them were typhus, diphtheria, smallpox and
measles.
Hospitals continued to be established and supported by
municipalities. Many new universities were founded in the sixteenth
century, especially in Germany and in central and eastern
Europe.
In the medieval schools, the mainstays remained the works of
Avicenna, Galen, Hippocrates and Dioscorides.