Medicine

Throughout the Renaissance medical diagnosis was grounded in the belief that the human body comprises four humors: black bile, yellow bile, phlegm, and blood, associated with the four primal qualities of cold, dry, wet, and hot, and with the four elements of earth, air, water, and fire. Each person was thought to have some of all four humors, with one humor dominating the others and thus forming the individual’s body type and personality. Allopathic medicine treated an illness with the “other” (the meaning of allopathic). A person who had an excess of heat, for example, a sanguine type, would be

Science and Medicine

10.5 Example of a patient in full-body traction. New medical knowledge gained by the study of ancient Greek texts and of practical anatomy led to innovative treatments such as that depicted here. The patient probably suffered an injury to the back. Woodcut in Guido Guidi, Chirurgia (Surgery, 1544). (Photograph courtesy of Sotheby’s, Inc., © 2003)

Treated with a medication having the property of cold. Special diets, not very different from today’s diets according to blood type, were recommended for each predominant humor. Each new drug discovered in the Americas or Asia was adapted to the humoral system, which prevailed into the 17th century. Humors were conceptualized as actual physical components of the body, which could be damaged or putrefied and become life threatening. Although their logic was fallible, Renaissance physicians realized that pain or discomfort in one part of the body could be caused by problems in another part. Redistributing or repairing the humors was thought to be one possible cure.

Renaissance physicians were university men, and most of them were scholars for whom ancient medical texts of Hippocrates and Galen were as important as new works published by their colleagues. Paracelsus stood outside this model, vehemently criticizing Galenic medicine. Even though many of his ideas about medicine were bizarre, even for the time, he may have foreseen why vaccinations are effective. Paracelsus suggested that a mild case of a disease might prevent a more serious case of the same malady. He also recommended homeopathic treatment, in which the plant from which a medication was derived had a similarity, visual or otherwise, to the organ or other body part being treated. His major contribution to medicine were chemical remedies, especially compounds of salts, minerals, and metals. The principles of effervescence and fermentation used in iatrochemistry were later applied to basic human physiological functions. Iatrochem-istry was used to treat the new disease called syphilis. Introduced to Europe from the Americas, syphilis became the scourge of the 16th century. The ailment was treated chiefly by mercury, which slowly poisoned the patient and rotted the bones. Fortunately for Europe, the virulent strain that killed thousands during the 16th century evolved into a less deadly form of the disease. Girolamo Fracastoro (1478-1553), a Veronese physician, wrote a famous Latin poem entitled Syphilis, sive morbus Gallicus (Syphilis, or the French sickness, 1530), in which he discussed several possible treatments, as well as the gruesome symptoms.

Barber-surgeons could perform minor procedures, such as bloodletting with leeches or cupping. The latter procedure involved heating the inside of a glass cup and quickly sliding it over the skin, usually on the back. The slight vacuum would then break minor capillaries. Phlebotomy was sometimes done by barber-surgeons, even though cutting into a vein was supposed to be the job of an actual surgeon. A basic knowledge of anatomy was necessary to prevent cutting into an artery and risking the patient’s bleeding to death, or into a nerve and causing partial paralysis. Veins in the arms were normally used for

Handbook to Life in Renaissance Europe

Bloodletting, unless the specific condition called for release of bad humors from another part of the body. Physicians argued about whether blood should be released from the side of the body that had a problem, or from the opposite side to draw the illness away from its location. Physicians also debated the amount of blood to release; some argued for small amounts over time and others advised a gush of blood until the patient fainted. Phlebotomy was practiced as holistic medicine; the procedure was planned around the patient’s diet, routine, humors, and specific illness, with attention paid to the season of the year and phases of the Moon. In spite of advances in anatomy and general medical knowledge, such treatments continued well past the Renaissance.

Considering the simple knives, razors, and lancets available to Renaissance surgeons, they accomplished amazing feats of healing. Surgeons knew how to couch cataracts (displacing the lens into the vitreous part of the eye), remove kidney stones, diagnose and excise malignant breast cancer, and even perform trepanation (rarely undertaken). Although many Renaissance procedures had been known since ancient times, surgical knowledge during the later 15th and 16th centuries benefited from the severe wounds resulting from firearms used in warfare. Ambroise Pare (1510-90), a field surgeon in the French army, improved the treatment of infection by dealing with gunshot wounds. He also made significant advances in the procedures for amputation, previously a major cause of death because of bleeding and shock (see chapter 7). Pare published several surgical manuals, including Deux livres de chirurgie (Two books of surgery, 1572), which explained his method of turning a breech baby in the womb. In recognition of his expertise, he was appointed surgeon to the king of France, Henry II (1519-59). During a jousting tournament, the tip of a wooden lance pierced the king’s temple and lodged in his brain. Although both Pare and Vesalius were at his bedside and treated him, not even their best efforts could save him.

MIDWIFERY

Pregnancy was not considered an illness, though many women died in childbirth or occasionally afterward as a result of infection. (Childbed fever was not a serious problem until much later, when more children were born in hospitals and with the aid of unsterilized instruments.) Though physicians treated gynecological problems, they were not obstetricians. Not until the 18 th century did male surgeons routinely attend normal births. In the Renaissance babies were delivered at home by midwives, older women in the community who usually had learned their skills from women in their family. Midwives did not have professional organizations or apprenticeships in guilds, and for most of them midwifery supplied only part of their income, because many were married to artisans or farmers.

The midwife was called as soon as a woman began labor. Examining the patient with her hand in the birth canal, the midwife would determine the dilation of the cervix by using her fingers. If birth seemed likely to occur within a few hours, she would stay with the patient, encouraging her and helping to keep her in good spirits. During this time the patient’s entire family was likely to be in the room with her. A positive mental attitude and family support were considered important for a successful birth. Midwives knew how to straighten twisted limbs in the birth canal during delivery, and some midwives knew how to turn a breech baby in the uterus. After delivery the midwife tied the umbilical cord, helped the mother deliver the placenta, and cleaned and inspected the baby. She also knew how to dress vaginal abrasions and stitch tears. The midwife advised a mother who was giving birth to her first child about breast-feeding. Although midwives were not permitted to administer drugs to women during or after childbirth, many had their own recipes for soothing potions and aids for sleeping.