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In medieval Europe, physicians analysed symptoms, examined excreta, and made their diagnoses. Medical therapies included diet, rest, sleep, exercise, or baths, or administration of emetics, purgatives or bleeding to get rid of the “bad substances / airs”. Surgeons treated fractures, dislocations, hernias and could perform amputation.
Religion and medicine were inseparable. Hospitals were established and infirmaries were attached to abbeys, monasteries, priories, and convents. Doctors and nurses in these institutions were members of religious orders and combined spiritual with physical healing. Learning was static, no major advancements were made, Dissection was prohibited and looked down upon.
Renaissance: Period between 14th to 16th Centuries AD
Historians identify period between 14th and 16th centuries in Europe, as one of “reawakening” or “rebirth” or “renaissance” when enormous growth took place in arts, humanities, philosophy, and science. Medical practice was also not left untouched by these changes. Various established centers of medical learning were to rediscover knowledge, such as in Salerno & Bologna (11th century), Queen Mary, Montpellier (12th century) Oxford, Padua, Siena, Coimbra (13th century) and Florence, Perugia, Pisa, Prague, Vienna, Heidelberg, and Liepzig (14th Century).
Renaissance was borne out of a medical calamity
Calamities are often considered as divine retributions, and so was Great Famine of 1315-17. Many lives were lost, and this event reduced authority of the church due to perceived “ineffective prayers”. A few years later in 1345, Europe was struck by another epidemic of bubonic plague. Later described as “Black-Death“, this epidemic consumed about 200 million individuals, about half of entire population. Authority of the church dwindled further, and people began to question if previous “prayer-based” preventive methods were any good. Ancient medical texts, were retrieved from Persia, and were read again, questioned and re-interpreted. Florence in Tuscany, Italy was at the centre of these developments. First printing press was established by Gutenberg in 1440, and it became simpler to produce texts for a wider distribution.
Leonardo-da-Vinci (1452-1519)
Leonardo was an Italian painter, inventor, and an engineer. He had a deep interest in human anatomy. He drew many 3-D sketches of human foetus, bones, heart and nervous system. These sketches were commissioned for new texts of human anatomy, which Leonardo drew directly from dissected cadavers. He lived for 67 years, and many of his illustrations were discovered years after his death. Human dissection, which was looked down upon became common across centres of learning, and our understanding of Anatomy increased.
From a handful of hospitals till 1400s, more were being established. One of the new hospitals was Hospise de beaune in Burgundy France, which was opened by chancellor Nicholas Rolin for medical care of poor and destitute in 1443. A postage stamp from France commemorated its 500 years is shown in a following panel.
Trials by fire: Paracelsus (1493-1541) and Miguel Servet (1509-1553)
Paracelsus (real name Theophrastus von Hohenheim) was a rebel, and he publicly burned Avicenna’s test “Cannon of medicine” an indisputable medical text of the day, way back in 1527. Initially taught by his physician-father he obtained formal medical education in 1516. In search of knowledge, he wandered to various centres of learning in Europe. His unconventional ways (such as using German instead of Latin in academic lectures, and having discourses with non-academic providers) were not taken kindly by the academia. Shunned by many of his peers for his queer and temperamental ways, he wrote various detailed texts in medicine and philosophy. His critical writings about ineffective prevalent treatments (such as for syphilis) were banned. He pioneered use of chemicals, rather than plants for cure. He is known as “father of toxicology” for his detailed study of substances.
Miguel Servet, born in Spain was not so lucky. He initially studied law, followed by theology, and later medicine. As a student of medicine, his views on astrology and theology were not accepted kindly. He had to shift medical schools to complete his education. He settled in Vienna, and later France for medical practice, and he is most famous for his work documenting pulmonary circulation. His critical views on established religious catholic practices enraged clergy. On 27th October 1553, he was immolated to death in Geneva, on a pyre made of his own books. A memorial for Servetus could be erected only in 2011 in Geneva, due to conflicts with various religious groups.
Astronomers and Mathematicians, and their link to Medicine
Nicholas copernicus (1473-1543) and Galileo Galilei (1564-1642) would have never met each other, but have many common linkages. Both studied medicine, Nicholas later in his career so as to get a stable earning from the church and Galileo early in career when he abandoned lucrative medicine for astronomy and mathematics. Both propagated the fact that Sun, and not Earth is at the centre of universe. Both were condemned by the church, as their notions were contrary to what was written in the Bible. Nicholas continued to practice medicine, delayed formal publication of his work, and was buried in an unmarked grave. Galileo was house-arrested eight years before his death, and became blind four years prior to his death. Nicholas established a medical library and remained a physician to various bishops. Galileo had abandoned medicine, but developed “thermoscope” which became a precursor of modern thermometers.
Ambroise Parre (1510-1590) and William Harvey (1578-1657)
Ambroise Pare was a French surgeon, and is known today as “father of modern surgery”. He designed various surgical instruments, propagated forensic pathology, especially related to battlefield injuries. He described various ligatures, techniques to stop bleeding, and established midwifery schools. He also designed limb and ocular prosthesis. He was appointed as a surgeon to the King of France.
William Harvey was an English physician, who described circulation. Before him, entire circulatory pathway and functions of various organs were conflicting. His work changed the ancient circulatory beliefs perpetuated by Galen, and ushered an era of factual understanding. He worked at St Bartholomew’s hospital, oldest running hospital till date. His famous text “De Motu Cordis” runs into 17 chapters. He gave experimental proofs about circulation, and believed that entire arterial blood is picked up by the veins. He was yet unaware about existence of capillary network, as microscope was still a few years away.
Established notions were challenges, and the period of 14-16th century allowed scientists to question and seek new answers. This would change the practice and knowledge of medicine in subsequent centuries.