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==Mediaeval Science in the West==
{{Template:AHoS Williams}}
=Mediaeval Science in the West=
We have previously referred to the influence of the Byzantine civilization in transmitting the learning of antiquity across the abysm of the dark age. It must be admitted, however, that the importance of that civilization did not extend much beyond the task of the common carrier. There were no great creative scientists in the later Roman empire of the East any more than in the corresponding empire of the West. There was, however, one field in which the Byzantine made respectable progress and regarding which their efforts require a few words of special comment. This was the field of medicine.
We have previously referred to the influence of the Byzantine civilization in transmitting the learning of antiquity across the abysm of the dark age. It must be admitted, however, that the importance of that civilization did not extend much beyond the task of the common carrier. There were no great creative scientists in the later Roman empire of the East any more than in the corresponding empire of the West. There was, however, one field in which the Byzantine made respectable progress and regarding which their efforts require a few words of special comment. This was the field of medicine.


The Byzantines of this time could boast of two great medical men, Aetius of Amida (about 502-575 A.D.) and Paul of Aegina (about 620-690). The works of Aetius were of value largely because they recorded the teachings of many of his eminent predecessors, but he was not entirely lacking in originality, and was perhaps the first physician to mention diphtheria, with an allusion to some observations of the paralysis of the palate which sometimes follows this disease.
The Byzantines of this time could boast of two great medical men, Aetius of Amida (about 502-575 A.D.) and Paul of Aegina (about 620-690). The works of Aetius were of value largely because they recorded the teachings of many of his eminent predecessors, but he was not entirely lacking in originality, and was perhaps the first physician to mention diphtheria, with an allusion to some observations of the paralysis of the palate which sometimes follows this disease.


Paul of Aegina, who came from the Alexandrian school about a century later, was one of those remarkable men whose ideas are centuries ahead of their time. This was particularly true of Paul in regard to surgery, and his attitude towards the supernatural in the causation and treatment of diseases. He was essentially a surgeon, being particularly familiar with military surgery, and some of his descriptions of complicated and difficult operations have been little improved upon even in modern times. In his books he describes such operations as the removal of foreign bodies from the nose, ear, and esophagus; and he recognizes foreign growths such as polypi in the air-passages, and gives the method of their removal. Such operations as tracheotomy, tonsellotomy, bronchotomy, staphylotomy, etc., were performed by him, and he even advocated and described puncture of the abdominal cavity, giving careful directions as to the location in which such punctures should be made. He advocated amputation of the breast for the cure of cancer, and described extirpation of the uterus. Just how successful this last operation may have been as performed by him does not appear; but he would hardly have recommended it if it had not been sometimes, at least, successful. That he mentions it at all, however, is significant, as this difficult operation is considered one of the great triumphs of modern surgery.
Paul of Aegina, who came from the Alexandrian school about a century later, was one of those remarkable men whose ideas are centuries ahead of their time. This was particularly true of Paul in regard to surgery, and his attitude towards the supernatural in the causation and treatment of diseases. He was essentially a surgeon, being particularly familiar with military surgery, and some of his descriptions of complicated and difficult operations have been little improved upon even in modern times. In his books he describes such operations as the removal of foreign bodies from the nose, ear, and esophagus; and he recognizes foreign growths such as polypi in the air-passages, and gives the method of their removal. Such operations as tracheotomy, tonsellotomy, bronchotomy, staphylotomy, etc., were performed by him, and he even advocated and described puncture of the abdominal cavity, giving careful directions as to the location in which such punctures should be made. He advocated amputation of the breast for the cure of cancer, and described extirpation of the uterus. Just how successful this last operation may have been as performed by him does not appear; but he would hardly have recommended it if it had not been sometimes, at least, successful. That he mentions it at all, however, is significant, as this difficult operation is considered one of the great triumphs of modern surgery.


But Paul of Aegina is a striking exception to the rule among Byzantine surgeons, and as he was their greatest, so he was also their last important surgeon. The energies of all Byzantium were so expended in religious controversies that medicine, like the other sciences, was soon relegated to a place among the other superstitions, and the influence of the Byzantine school was presently replaced by that of the conquering Arabians.
But Paul of Aegina is a striking exception to the rule among Byzantine surgeons, and as he was their greatest, so he was also their last important surgeon. The energies of all Byzantium were so expended in religious controversies that medicine, like the other sciences, was soon relegated to a place among the other superstitions, and the influence of the Byzantine school was presently replaced by that of the conquering Arabians.


'''THIRTEENTH-CENTURY MEDICINE '''
==Thirteenth-Century Medicine==


The thirteenth century marks the beginning of a gradual change in medicine, and a tendency to leave the time-worn rut of superstitious dogmas that so long retarded the progress of science. It is thought that the great epidemics which raged during the Middle Ages acted powerfully in diverting the medical thought of the times into new and entirely different channels. It will be remembered that the teachings of Galen were handed through mediaeval times as the highest and best authority on the subject of all diseases. When, however, the great epidemics made their appearance, the medical men appealed to the works of Galen in vain for enlightenment, as these works, having been written several centuries before the time of the plagues, naturally contained no information concerning them. It was evident, therefore, that on this subject, at least, Galen was not infallible; and it would naturally follow that, one fallible point having been revealed, others would be sought for. In other words, scepticism in regard to accepted methods would be aroused, and would lead naturally, as such scepticism usually does, to progress. The devastating effects of these plagues, despite prayers and incantations, would arouse doubt in the minds of many as to the efficacy of superstitious rites and ceremonies in curing diseases. They had seen thousands and tens of thousands of their fellow-beings swept away by these awful scourges. They had seen the ravages of these epidemics continue for months or even years, notwithstanding the fact that multitudes of God-fearing people prayed hourly that such ravages might be checked. And they must have observed also that when even very simple rules of cleanliness and hygiene were followed there was a diminution in the ravages of the plague, even without the aid of incantations. Such observations as these would have a tendency to awaken a suspicion in the minds of many of the physicians that disease was not a manifestation of the supernatural, but a natural phenomenon, to be treated by natural methods.
The thirteenth century marks the beginning of a gradual change in medicine, and a tendency to leave the time-worn rut of superstitious dogmas that so long retarded the progress of science. It is thought that the great epidemics which raged during the Middle Ages acted powerfully in diverting the medical thought of the times into new and entirely different channels. It will be remembered that the teachings of Galen were handed through mediaeval times as the highest and best authority on the subject of all diseases. When, however, the great epidemics made their appearance, the medical men appealed to the works of Galen in vain for enlightenment, as these works, having been written several centuries before the time of the plagues, naturally contained no information concerning them. It was evident, therefore, that on this subject, at least, Galen was not infallible; and it would naturally follow that, one fallible point having been revealed, others would be sought for. In other words, scepticism in regard to accepted methods would be aroused, and would lead naturally, as such scepticism usually does, to progress. The devastating effects of these plagues, despite prayers and incantations, would arouse doubt in the minds of many as to the efficacy of superstitious rites and ceremonies in curing diseases. They had seen thousands and tens of thousands of their fellow-beings swept away by these awful scourges. They had seen the ravages of these epidemics continue for months or even years, notwithstanding the fact that multitudes of God-fearing people prayed hourly that such ravages might be checked. And they must have observed also that when even very simple rules of cleanliness and hygiene were followed there was a diminution in the ravages of the plague, even without the aid of incantations. Such observations as these would have a tendency to awaken a suspicion in the minds of many of the physicians that disease was not a manifestation of the supernatural, but a natural phenomenon, to be treated by natural methods.


But, be the causes what they may, it is a fact that the thirteenth century marks a turning-point, or the beginning of an attitude of mind which resulted in bringing medicine to a much more rational position. Among the thirteenth-century physicians, two men are deserving of special mention. These are Arnald of Villanova (1235-1312) and Peter of Abano (1250-1315). Both these men suffered persecution for expressing their belief in natural, as against the supernatural, causes of disease, and at one time Arnald was obliged to flee from Barcelona for declaring that the "bulls" of popes were human works, and that "acts of charity were dearer to God than hecatombs." He was also accused of alchemy. Fleeing from persecution, he finally perished by shipwreck.
But, be the causes what they may, it is a fact that the thirteenth century marks a turning-point, or the beginning of an attitude of mind which resulted in bringing medicine to a much more rational position. Among the thirteenth-century physicians, two men are deserving of special mention. These are Arnald of Villanova (1235-1312) and Peter of Abano (1250-1315). Both these men suffered persecution for expressing their belief in natural, as against the supernatural, causes of disease, and at one time Arnald was obliged to flee from Barcelona for declaring that the "bulls" of popes were human works, and that "acts of charity were dearer to God than hecatombs." He was also accused of alchemy. Fleeing from persecution, he finally perished by shipwreck.


Arnald was the first great representative of the school of Montpellier. He devoted much time to the study of chemicals, and was active in attempting to re-establish the teachings of Hippocrates and Galen. He was one of the first of a long line of alchemists who, for several succeeding centuries, expended so much time and energy in attempting to find the "elixir of life." The Arab discovery of alcohol first deluded him into the belief that the "elixir" had at last been found; but later he discarded it and made extensive experiments with brandy, employing it in the treatment of certain diseases--the first record of the administration of this liquor as a medicine. Arnald also revived the search for some anaesthetic that would produce insensibility to pain in surgical operations. This idea was not original with him, for since very early times physicians had attempted to discover such an anaesthetic, and even so early a writer as Herodotus tells how the Scythians, by inhalation of the vapors of some kind of hemp, produced complete insensibility. It may have been these writings that stimulated Arnald to search for such an anaesthetic. In a book usually credited to him, medicines are named and methods of administration described which will make the patient insensible to pain, so that "he may be cut and feel nothing, as though he were dead." For this purpose a mixture of opium, mandragora, and henbane is to be used. This mixture was held at the patient's nostrils much as ether and chloroform are administered by the modern surgeon. The method was modified by Hugo of Lucca (died in 1252 or 1268), who added certain other narcotics, such as hemlock, to the mixture, and boiled a new sponge in this decoction. After boiling for a certain time, this sponge was dried, and when wanted for use was dipped in hot water and applied to the nostrils.
Arnald was the first great representative of the school of Montpellier. He devoted much time to the study of chemicals, and was active in attempting to re-establish the teachings of Hippocrates and Galen. He was one of the first of a long line of alchemists who, for several succeeding centuries, expended so much time and energy in attempting to find the "elixir of life." The Arab discovery of alcohol first deluded him into the belief that the "elixir" had at last been found; but later he discarded it and made extensive experiments with brandy, employing it in the treatment of certain diseases--the first record of the administration of this liquor as a medicine. Arnald also revived the search for some anaesthetic that would produce insensibility to pain in surgical operations. This idea was not original with him, for since very early times physicians had attempted to discover such an anaesthetic, and even so early a writer as Herodotus tells how the Scythians, by inhalation of the vapors of some kind of hemp, produced complete insensibility. It may have been these writings that stimulated Arnald to search for such an anaesthetic. In a book usually credited to him, medicines are named and methods of administration described which will make the patient insensible to pain, so that "he may be cut and feel nothing, as though he were dead." For this purpose a mixture of opium, mandragora, and henbane is to be used. This mixture was held at the patient's nostrils much as ether and chloroform are administered by the modern surgeon. The method was modified by Hugo of Lucca (died in 1252 or 1268), who added certain other narcotics, such as hemlock, to the mixture, and boiled a new sponge in this decoction. After boiling for a certain time, this sponge was dried, and when wanted for use was dipped in hot water and applied to the nostrils.


Just how frequently patients recovered from the administration of such a combination of powerful poisons does not appear, but the percentage of deaths must have been very high, as the practice was generally condemned. Insensibility could have been produced only by swallowing large quantities of the liquid, which dripped into the nose and mouth when the sponge was applied, and a lethal quantity might thus be swallowed. The method was revived, with various modifications, from time to time, but as often fell into disuse. As late as 1782 it was sometimes attempted, and in that year the King of Poland is said to have been completely anaesthetized and to have recovered, after a painless amputation had been performed by the surgeons.
Just how frequently patients recovered from the administration of such a combination of powerful poisons does not appear, but the percentage of deaths must have been very high, as the practice was generally condemned. Insensibility could have been produced only by swallowing large quantities of the liquid, which dripped into the nose and mouth when the sponge was applied, and a lethal quantity might thus be swallowed. The method was revived, with various modifications, from time to time, but as often fell into disuse. As late as 1782 it was sometimes attempted, and in that year the King of Poland is said to have been completely anaesthetized and to have recovered, after a painless amputation had been performed by the surgeons.


Peter of Abano was one of the first great men produced by the University of Padua. His fate would have been even more tragic than that of the shipwrecked Arnald had he not cheated the purifying fagots of the church by dying opportunely on the eve of his execution for heresy. But if his spirit had cheated the fanatics, his body could not, and his bones were burned for his heresy. He had dared to deny the existence of a devil, and had suggested that the case of a patient who lay in a trance for three days might help to explain some miracles, like the raising of Lazarus.
Peter of Abano was one of the first great men produced by the University of Padua. His fate would have been even more tragic than that of the shipwrecked Arnald had he not cheated the purifying fagots of the church by dying opportunely on the eve of his execution for heresy. But if his spirit had cheated the fanatics, his body could not, and his bones were burned for his heresy. He had dared to deny the existence of a devil, and had suggested that the case of a patient who lay in a trance for three days might help to explain some miracles, like the raising of Lazarus.


His great work was Conciliator Differentiarum, an attempt to reconcile physicians and philosophers. But his researches were not confined to medicine, for he seems to have had an inkling of the hitherto unknown fact that air possesses weight, and his calculation of the length of the year at three hundred and sixty-five days, six hours, and four minutes, is exceptionally accurate for the age in which he lived. He was probably the first of the Western writers to teach that the brain is the source of the nerves, and the heart the source of the vessels. From this it is seen that he was groping in the direction of an explanation of the circulation of the blood, as demonstrated by Harvey three centuries later.
His great work was Conciliator Differentiarum, an attempt to reconcile physicians and philosophers. But his researches were not confined to medicine, for he seems to have had an inkling of the hitherto unknown fact that air possesses weight, and his calculation of the length of the year at three hundred and sixty-five days, six hours, and four minutes, is exceptionally accurate for the age in which he lived. He was probably the first of the Western writers to teach that the brain is the source of the nerves, and the heart the source of the vessels. From this it is seen that he was groping in the direction of an explanation of the circulation of the blood, as demonstrated by Harvey three centuries later.


The work of Arnald and Peter of Abano in "reviving" medicine was continued actively by Mondino (1276-1326) of Bologna, the "restorer of anatomy," and by Guy of Chauliac: (born about 1300), the "restorer of surgery." All through the early Middle Ages dissections of human bodies had been forbidden, and even dissection of the lower animals gradually fell into disrepute because physicians detected in such practices were sometimes accused of sorcery. Before the close of the thirteenth century, however, a reaction had begun, physicians were protected, and dissections were occasionally sanctioned by the ruling monarch. Thus Emperor Frederick H. (1194-1250 A.D.)--whose services to science we have already had occasion to mention--ordered that at least one human body should be dissected by physicians in his kingdom every five years. By the time of Mondino dissections were becoming more frequent, and he himself is known to have dissected and demonstrated several bodies. His writings on anatomy have been called merely plagiarisms of Galen, but in all probability be made many discoveries independently, and on the whole, his work may be taken as more advanced than Galen's. His description of the heart is particularly accurate, and he seems to have come nearer to determining the course of the blood in its circulation than any of his predecessors. In this quest he was greatly handicapped by the prevailing belief in the idea that blood-vessels must contain air as well as blood, and this led him to assume that one of the cavities of the heart contained "spirits," or air. It is probable, however, that his accurate observations, so far as they went, were helpful stepping-stones to Harvey in his discovery of the circulation.
The work of Arnald and Peter of Abano in "reviving" medicine was continued actively by Mondino (1276-1326) of Bologna, the "restorer of anatomy," and by Guy of Chauliac: (born about 1300), the "restorer of surgery." All through the early Middle Ages dissections of human bodies had been forbidden, and even dissection of the lower animals gradually fell into disrepute because physicians detected in such practices were sometimes accused of sorcery. Before the close of the thirteenth century, however, a reaction had begun, physicians were protected, and dissections were occasionally sanctioned by the ruling monarch. Thus Emperor Frederick H. (1194-1250 A.D.)--whose services to science we have already had occasion to mention--ordered that at least one human body should be dissected by physicians in his kingdom every five years. By the time of Mondino dissections were becoming more frequent, and he himself is known to have dissected and demonstrated several bodies. His writings on anatomy have been called merely plagiarisms of Galen, but in all probability be made many discoveries independently, and on the whole, his work may be taken as more advanced than Galen's. His description of the heart is particularly accurate, and he seems to have come nearer to determining the course of the blood in its circulation than any of his predecessors. In this quest he was greatly handicapped by the prevailing belief in the idea that blood-vessels must contain air as well as blood, and this led him to assume that one of the cavities of the heart contained "spirits," or air. It is probable, however, that his accurate observations, so far as they went, were helpful stepping-stones to Harvey in his discovery of the circulation.


Guy of Chauliac, whose innovations in surgery reestablished that science on a firm basis, was not only one of the most cultured, but also the most practical surgeon of his time. He had great reverence for the works of Galen, Albucasis, and others of his noted predecessors; but this reverence did not blind him to their mistakes nor prevent him from using rational methods of treatment far in advance of theirs. His practicality is shown in some of his simple but useful inventions for the sick-room, such as the device of a rope, suspended from the ceiling over the bed, by which a patient may move himself about more easily; and in some of his improvements in surgical dressings, such as stiffening bandages by dipping them in the white of an egg so that they are held firmly. He treated broken limbs in the suspended cradle still in use, and introduced the method of making "traction" on a broken limb by means of a weight and pulley, to prevent deformity through shortening of the member. He was one of the first physicians to recognize the utility of spectacles, and recommended them in cases not amenable to treatment with lotions and eye-waters. In some of his surgical operations, such as trephining for fracture of the skull, his technique has been little improved upon even in modern times. In one of these operations he successfully removed a portion of a man's brain.
Guy of Chauliac, whose innovations in surgery reestablished that science on a firm basis, was not only one of the most cultured, but also the most practical surgeon of his time. He had great reverence for the works of Galen, Albucasis, and others of his noted predecessors; but this reverence did not blind him to their mistakes nor prevent him from using rational methods of treatment far in advance of theirs. His practicality is shown in some of his simple but useful inventions for the sick-room, such as the device of a rope, suspended from the ceiling over the bed, by which a patient may move himself about more easily; and in some of his improvements in surgical dressings, such as stiffening bandages by dipping them in the white of an egg so that they are held firmly. He treated broken limbs in the suspended cradle still in use, and introduced the method of making "traction" on a broken limb by means of a weight and pulley, to prevent deformity through shortening of the member. He was one of the first physicians to recognize the utility of spectacles, and recommended them in cases not amenable to treatment with lotions and eye-waters. In some of his surgical operations, such as trephining for fracture of the skull, his technique has been little improved upon even in modern times. In one of these operations he successfully removed a portion of a man's brain.


Surgery was undoubtedly stimulated greatly at this period by the constant wars. Lay physicians, as a class, had been looked down upon during the Dark Ages; but with the beginning of the return to rationalism, the services of surgeons on the battle-field, to remove missiles from wounds, and to care for wounds and apply dressings, came to be more fully appreciated. In return for his labors the surgeon was thus afforded better opportunities for observing wounds and diseases, which led naturally to a gradual improvement in surgical methods.
Surgery was undoubtedly stimulated greatly at this period by the constant wars. Lay physicians, as a class, had been looked down upon during the Dark Ages; but with the beginning of the return to rationalism, the services of surgeons on the battle-field, to remove missiles from wounds, and to care for wounds and apply dressings, came to be more fully appreciated. In return for his labors the surgeon was thus afforded better opportunities for observing wounds and diseases, which led naturally to a gradual improvement in surgical methods.


'''FIFTEENTH-CENTURY MEDICINE'''
==Fifteenth-Century Medicine==


The thirteenth and fourteenth centuries had seen some slight advancement in the science of medicine; at least, certain surgeons and physicians, if not the generality, had made advances; but it was not until the fifteenth century that the general revival of medical learning became assured. In this movement, naturally, the printing-press played an all-important part. Medical books, hitherto practically inaccessible to the great mass of physicians, now became common, and this output of reprints of Greek and Arabic treatises revealed the fact that many of the supposed true copies were spurious. These discoveries very naturally aroused all manner of doubt and criticism, which in turn helped in the development of independent thought.
The thirteenth and fourteenth centuries had seen some slight advancement in the science of medicine; at least, certain surgeons and physicians, if not the generality, had made advances; but it was not until the fifteenth century that the general revival of medical learning became assured. In this movement, naturally, the printing-press played an all-important part. Medical books, hitherto practically inaccessible to the great mass of physicians, now became common, and this output of reprints of Greek and Arabic treatises revealed the fact that many of the supposed true copies were spurious. These discoveries very naturally aroused all manner of doubt and criticism, which in turn helped in the development of independent thought.


A certain manuscript of the great Cornelius Celsus, the De Medicine, which had been lost for many centuries, was found in the church of St. Ambrose, at Milan, in 1443, and was at once put into print. The effect of the publication of this book, which had lain in hiding for so many centuries, was a revelation, showing the medical profession how far most of their supposed true copies of Celsus had drifted away from the original. The indisputable authenticity of this manuscript, discovered and vouched for by the man who shortly after became Pope Nicholas V., made its publication the more impressive. The output in book form of other authorities followed rapidly, and the manifest discrepancies between such teachers as Celsus, Hippocrates, Galen, and Pliny heightened still more the growing spirit of criticism.
A certain manuscript of the great Cornelius Celsus, the De Medicine, which had been lost for many centuries, was found in the church of St. Ambrose, at Milan, in 1443, and was at once put into print. The effect of the publication of this book, which had lain in hiding for so many centuries, was a revelation, showing the medical profession how far most of their supposed true copies of Celsus had drifted away from the original. The indisputable authenticity of this manuscript, discovered and vouched for by the man who shortly after became Pope Nicholas V., made its publication the more impressive. The output in book form of other authorities followed rapidly, and the manifest discrepancies between such teachers as Celsus, Hippocrates, Galen, and Pliny heightened still more the growing spirit of criticism.


These doubts resulted in great controversies as to the proper treatment of certain diseases, some physicians following Hippocrates, others Galen or Celsus, still others the Arabian masters. One of the most bitter of these contests was over the question of "revulsion," and "derivation"--that is, whether in cases of pleurisy treated by bleeding, the venesection should be made at a point distant from the seat of the disease, as held by the "revulsionists," or at a point nearer and on the same side of the body, as practised by the "derivationists." That any great point for discussion could be raised in the fifteenth or sixteenth centuries on so simple a matter as it seems to-day shows how necessary to the progress of medicine was the discovery of the circulation of the blood made by Harvey two centuries later. After Harvey's discovery no such discussion could have been possible, because this discovery made it evident that as far as the general effect upon the circulation is concerned, it made little difference whether the bleeding was done near a diseased part or remote from it. But in the sixteenth century this question was the all-absorbing one among the doctors. At one time the faculty of Paris condemned "derivation"; but the supporters of this method carried the war still higher, and Emperor Charles V. himself was appealed to. He reversed the decision of the Paris faculty, and decided in favor of "derivation." His decision was further supported by Pope Clement VII., although the discussion dragged on until cut short by Harvey's discovery.
These doubts resulted in great controversies as to the proper treatment of certain diseases, some physicians following Hippocrates, others Galen or Celsus, still others the Arabian masters. One of the most bitter of these contests was over the question of "revulsion," and "derivation"--that is, whether in cases of pleurisy treated by bleeding, the venesection should be made at a point distant from the seat of the disease, as held by the "revulsionists," or at a point nearer and on the same side of the body, as practised by the "derivationists." That any great point for discussion could be raised in the fifteenth or sixteenth centuries on so simple a matter as it seems to-day shows how necessary to the progress of medicine was the discovery of the circulation of the blood made by Harvey two centuries later. After Harvey's discovery no such discussion could have been possible, because this discovery made it evident that as far as the general effect upon the circulation is concerned, it made little difference whether the bleeding was done near a diseased part or remote from it. But in the sixteenth century this question was the all-absorbing one among the doctors. At one time the faculty of Paris condemned "derivation"; but the supporters of this method carried the war still higher, and Emperor Charles V. himself was appealed to. He reversed the decision of the Paris faculty, and decided in favor of "derivation." His decision was further supported by Pope Clement VII., although the discussion dragged on until cut short by Harvey's discovery.


But a new form of injury now claimed the attention of the surgeons, something that could be decided by neither Greek nor Arabian authors, as the treatment of gun-shot wounds was, for obvious reasons, not given in their writings. About this time, also, came the great epidemics, "the sweating sickness" and scurvy; and upon these subjects, also, the Greeks and Arabians were silent. John of Vigo, in his book, the Practica Copiosa, published in 1514, and repeated in many editions, became the standard authority on all these subjects, and thus supplanted the works of the ancient writers.
But a new form of injury now claimed the attention of the surgeons, something that could be decided by neither Greek nor Arabian authors, as the treatment of gun-shot wounds was, for obvious reasons, not given in their writings. About this time, also, came the great epidemics, "the sweating sickness" and scurvy; and upon these subjects, also, the Greeks and Arabians were silent. John of Vigo, in his book, the Practica Copiosa, published in 1514, and repeated in many editions, became the standard authority on all these subjects, and thus supplanted the works of the ancient writers.


According to Vigo, gun-shot wounds differed from the wounds made by ordinary weapons--that is, spear, arrow, sword, or axe--in that the bullet, being round, bruised rather than cut its way through the tissues; it burned the flesh; and, worst of all, it poisoned it. Vigo laid especial stress upon treating this last condition, recommending the use of the cautery or the oil of elder, boiling hot. It is little wonder that gun-shot wounds were so likely to prove fatal. Yet, after all, here was the germ of the idea of antisepsis.
According to Vigo, gun-shot wounds differed from the wounds made by ordinary weapons--that is, spear, arrow, sword, or axe--in that the bullet, being round, bruised rather than cut its way through the tissues; it burned the flesh; and, worst of all, it poisoned it. Vigo laid especial stress upon treating this last condition, recommending the use of the cautery or the oil of elder, boiling hot. It is little wonder that gun-shot wounds were so likely to prove fatal. Yet, after all, here was the germ of the idea of antisepsis.


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Williams HS. A History of Science. (1904) Harper and Bros. New York.

A History of Science: Arabian Medicine | Mediaeval Science in the West | The Great Anatomists | The coming of Harvey | Leeuwenhoek Discovers Bacteria | Medicine in the 16th and 17th Century | Philosopher-Scientists and new Institutions | 18th Century Anatomy and Physiology Part 1 | 18th Century Anatomy and Physiology Part 2 | 18th Century Anatomy and Physiology Part 3 | 19th Century Anatomy and Physiology Part 1 | 19th Century Anatomy and Physiology Part 2 | 19th Century Anatomy and Physiology Part 3 | Theories Of Evolution Part 1 | Theories Of Evolution Part 2 | 18th Century Medicine | 19th Century Medicine Part 1 | 19th Century Medicine Part 2 | Brain and Mind | Brain Structure | Embryology History
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Mediaeval Science in the West

We have previously referred to the influence of the Byzantine civilization in transmitting the learning of antiquity across the abysm of the dark age. It must be admitted, however, that the importance of that civilization did not extend much beyond the task of the common carrier. There were no great creative scientists in the later Roman empire of the East any more than in the corresponding empire of the West. There was, however, one field in which the Byzantine made respectable progress and regarding which their efforts require a few words of special comment. This was the field of medicine.


The Byzantines of this time could boast of two great medical men, Aetius of Amida (about 502-575 A.D.) and Paul of Aegina (about 620-690). The works of Aetius were of value largely because they recorded the teachings of many of his eminent predecessors, but he was not entirely lacking in originality, and was perhaps the first physician to mention diphtheria, with an allusion to some observations of the paralysis of the palate which sometimes follows this disease.


Paul of Aegina, who came from the Alexandrian school about a century later, was one of those remarkable men whose ideas are centuries ahead of their time. This was particularly true of Paul in regard to surgery, and his attitude towards the supernatural in the causation and treatment of diseases. He was essentially a surgeon, being particularly familiar with military surgery, and some of his descriptions of complicated and difficult operations have been little improved upon even in modern times. In his books he describes such operations as the removal of foreign bodies from the nose, ear, and esophagus; and he recognizes foreign growths such as polypi in the air-passages, and gives the method of their removal. Such operations as tracheotomy, tonsellotomy, bronchotomy, staphylotomy, etc., were performed by him, and he even advocated and described puncture of the abdominal cavity, giving careful directions as to the location in which such punctures should be made. He advocated amputation of the breast for the cure of cancer, and described extirpation of the uterus. Just how successful this last operation may have been as performed by him does not appear; but he would hardly have recommended it if it had not been sometimes, at least, successful. That he mentions it at all, however, is significant, as this difficult operation is considered one of the great triumphs of modern surgery.


But Paul of Aegina is a striking exception to the rule among Byzantine surgeons, and as he was their greatest, so he was also their last important surgeon. The energies of all Byzantium were so expended in religious controversies that medicine, like the other sciences, was soon relegated to a place among the other superstitions, and the influence of the Byzantine school was presently replaced by that of the conquering Arabians.

Thirteenth-Century Medicine

The thirteenth century marks the beginning of a gradual change in medicine, and a tendency to leave the time-worn rut of superstitious dogmas that so long retarded the progress of science. It is thought that the great epidemics which raged during the Middle Ages acted powerfully in diverting the medical thought of the times into new and entirely different channels. It will be remembered that the teachings of Galen were handed through mediaeval times as the highest and best authority on the subject of all diseases. When, however, the great epidemics made their appearance, the medical men appealed to the works of Galen in vain for enlightenment, as these works, having been written several centuries before the time of the plagues, naturally contained no information concerning them. It was evident, therefore, that on this subject, at least, Galen was not infallible; and it would naturally follow that, one fallible point having been revealed, others would be sought for. In other words, scepticism in regard to accepted methods would be aroused, and would lead naturally, as such scepticism usually does, to progress. The devastating effects of these plagues, despite prayers and incantations, would arouse doubt in the minds of many as to the efficacy of superstitious rites and ceremonies in curing diseases. They had seen thousands and tens of thousands of their fellow-beings swept away by these awful scourges. They had seen the ravages of these epidemics continue for months or even years, notwithstanding the fact that multitudes of God-fearing people prayed hourly that such ravages might be checked. And they must have observed also that when even very simple rules of cleanliness and hygiene were followed there was a diminution in the ravages of the plague, even without the aid of incantations. Such observations as these would have a tendency to awaken a suspicion in the minds of many of the physicians that disease was not a manifestation of the supernatural, but a natural phenomenon, to be treated by natural methods.


But, be the causes what they may, it is a fact that the thirteenth century marks a turning-point, or the beginning of an attitude of mind which resulted in bringing medicine to a much more rational position. Among the thirteenth-century physicians, two men are deserving of special mention. These are Arnald of Villanova (1235-1312) and Peter of Abano (1250-1315). Both these men suffered persecution for expressing their belief in natural, as against the supernatural, causes of disease, and at one time Arnald was obliged to flee from Barcelona for declaring that the "bulls" of popes were human works, and that "acts of charity were dearer to God than hecatombs." He was also accused of alchemy. Fleeing from persecution, he finally perished by shipwreck.


Arnald was the first great representative of the school of Montpellier. He devoted much time to the study of chemicals, and was active in attempting to re-establish the teachings of Hippocrates and Galen. He was one of the first of a long line of alchemists who, for several succeeding centuries, expended so much time and energy in attempting to find the "elixir of life." The Arab discovery of alcohol first deluded him into the belief that the "elixir" had at last been found; but later he discarded it and made extensive experiments with brandy, employing it in the treatment of certain diseases--the first record of the administration of this liquor as a medicine. Arnald also revived the search for some anaesthetic that would produce insensibility to pain in surgical operations. This idea was not original with him, for since very early times physicians had attempted to discover such an anaesthetic, and even so early a writer as Herodotus tells how the Scythians, by inhalation of the vapors of some kind of hemp, produced complete insensibility. It may have been these writings that stimulated Arnald to search for such an anaesthetic. In a book usually credited to him, medicines are named and methods of administration described which will make the patient insensible to pain, so that "he may be cut and feel nothing, as though he were dead." For this purpose a mixture of opium, mandragora, and henbane is to be used. This mixture was held at the patient's nostrils much as ether and chloroform are administered by the modern surgeon. The method was modified by Hugo of Lucca (died in 1252 or 1268), who added certain other narcotics, such as hemlock, to the mixture, and boiled a new sponge in this decoction. After boiling for a certain time, this sponge was dried, and when wanted for use was dipped in hot water and applied to the nostrils.


Just how frequently patients recovered from the administration of such a combination of powerful poisons does not appear, but the percentage of deaths must have been very high, as the practice was generally condemned. Insensibility could have been produced only by swallowing large quantities of the liquid, which dripped into the nose and mouth when the sponge was applied, and a lethal quantity might thus be swallowed. The method was revived, with various modifications, from time to time, but as often fell into disuse. As late as 1782 it was sometimes attempted, and in that year the King of Poland is said to have been completely anaesthetized and to have recovered, after a painless amputation had been performed by the surgeons.


Peter of Abano was one of the first great men produced by the University of Padua. His fate would have been even more tragic than that of the shipwrecked Arnald had he not cheated the purifying fagots of the church by dying opportunely on the eve of his execution for heresy. But if his spirit had cheated the fanatics, his body could not, and his bones were burned for his heresy. He had dared to deny the existence of a devil, and had suggested that the case of a patient who lay in a trance for three days might help to explain some miracles, like the raising of Lazarus.


His great work was Conciliator Differentiarum, an attempt to reconcile physicians and philosophers. But his researches were not confined to medicine, for he seems to have had an inkling of the hitherto unknown fact that air possesses weight, and his calculation of the length of the year at three hundred and sixty-five days, six hours, and four minutes, is exceptionally accurate for the age in which he lived. He was probably the first of the Western writers to teach that the brain is the source of the nerves, and the heart the source of the vessels. From this it is seen that he was groping in the direction of an explanation of the circulation of the blood, as demonstrated by Harvey three centuries later.


The work of Arnald and Peter of Abano in "reviving" medicine was continued actively by Mondino (1276-1326) of Bologna, the "restorer of anatomy," and by Guy of Chauliac: (born about 1300), the "restorer of surgery." All through the early Middle Ages dissections of human bodies had been forbidden, and even dissection of the lower animals gradually fell into disrepute because physicians detected in such practices were sometimes accused of sorcery. Before the close of the thirteenth century, however, a reaction had begun, physicians were protected, and dissections were occasionally sanctioned by the ruling monarch. Thus Emperor Frederick H. (1194-1250 A.D.)--whose services to science we have already had occasion to mention--ordered that at least one human body should be dissected by physicians in his kingdom every five years. By the time of Mondino dissections were becoming more frequent, and he himself is known to have dissected and demonstrated several bodies. His writings on anatomy have been called merely plagiarisms of Galen, but in all probability be made many discoveries independently, and on the whole, his work may be taken as more advanced than Galen's. His description of the heart is particularly accurate, and he seems to have come nearer to determining the course of the blood in its circulation than any of his predecessors. In this quest he was greatly handicapped by the prevailing belief in the idea that blood-vessels must contain air as well as blood, and this led him to assume that one of the cavities of the heart contained "spirits," or air. It is probable, however, that his accurate observations, so far as they went, were helpful stepping-stones to Harvey in his discovery of the circulation.


Guy of Chauliac, whose innovations in surgery reestablished that science on a firm basis, was not only one of the most cultured, but also the most practical surgeon of his time. He had great reverence for the works of Galen, Albucasis, and others of his noted predecessors; but this reverence did not blind him to their mistakes nor prevent him from using rational methods of treatment far in advance of theirs. His practicality is shown in some of his simple but useful inventions for the sick-room, such as the device of a rope, suspended from the ceiling over the bed, by which a patient may move himself about more easily; and in some of his improvements in surgical dressings, such as stiffening bandages by dipping them in the white of an egg so that they are held firmly. He treated broken limbs in the suspended cradle still in use, and introduced the method of making "traction" on a broken limb by means of a weight and pulley, to prevent deformity through shortening of the member. He was one of the first physicians to recognize the utility of spectacles, and recommended them in cases not amenable to treatment with lotions and eye-waters. In some of his surgical operations, such as trephining for fracture of the skull, his technique has been little improved upon even in modern times. In one of these operations he successfully removed a portion of a man's brain.


Surgery was undoubtedly stimulated greatly at this period by the constant wars. Lay physicians, as a class, had been looked down upon during the Dark Ages; but with the beginning of the return to rationalism, the services of surgeons on the battle-field, to remove missiles from wounds, and to care for wounds and apply dressings, came to be more fully appreciated. In return for his labors the surgeon was thus afforded better opportunities for observing wounds and diseases, which led naturally to a gradual improvement in surgical methods.

Fifteenth-Century Medicine

The thirteenth and fourteenth centuries had seen some slight advancement in the science of medicine; at least, certain surgeons and physicians, if not the generality, had made advances; but it was not until the fifteenth century that the general revival of medical learning became assured. In this movement, naturally, the printing-press played an all-important part. Medical books, hitherto practically inaccessible to the great mass of physicians, now became common, and this output of reprints of Greek and Arabic treatises revealed the fact that many of the supposed true copies were spurious. These discoveries very naturally aroused all manner of doubt and criticism, which in turn helped in the development of independent thought.


A certain manuscript of the great Cornelius Celsus, the De Medicine, which had been lost for many centuries, was found in the church of St. Ambrose, at Milan, in 1443, and was at once put into print. The effect of the publication of this book, which had lain in hiding for so many centuries, was a revelation, showing the medical profession how far most of their supposed true copies of Celsus had drifted away from the original. The indisputable authenticity of this manuscript, discovered and vouched for by the man who shortly after became Pope Nicholas V., made its publication the more impressive. The output in book form of other authorities followed rapidly, and the manifest discrepancies between such teachers as Celsus, Hippocrates, Galen, and Pliny heightened still more the growing spirit of criticism.


These doubts resulted in great controversies as to the proper treatment of certain diseases, some physicians following Hippocrates, others Galen or Celsus, still others the Arabian masters. One of the most bitter of these contests was over the question of "revulsion," and "derivation"--that is, whether in cases of pleurisy treated by bleeding, the venesection should be made at a point distant from the seat of the disease, as held by the "revulsionists," or at a point nearer and on the same side of the body, as practised by the "derivationists." That any great point for discussion could be raised in the fifteenth or sixteenth centuries on so simple a matter as it seems to-day shows how necessary to the progress of medicine was the discovery of the circulation of the blood made by Harvey two centuries later. After Harvey's discovery no such discussion could have been possible, because this discovery made it evident that as far as the general effect upon the circulation is concerned, it made little difference whether the bleeding was done near a diseased part or remote from it. But in the sixteenth century this question was the all-absorbing one among the doctors. At one time the faculty of Paris condemned "derivation"; but the supporters of this method carried the war still higher, and Emperor Charles V. himself was appealed to. He reversed the decision of the Paris faculty, and decided in favor of "derivation." His decision was further supported by Pope Clement VII., although the discussion dragged on until cut short by Harvey's discovery.


But a new form of injury now claimed the attention of the surgeons, something that could be decided by neither Greek nor Arabian authors, as the treatment of gun-shot wounds was, for obvious reasons, not given in their writings. About this time, also, came the great epidemics, "the sweating sickness" and scurvy; and upon these subjects, also, the Greeks and Arabians were silent. John of Vigo, in his book, the Practica Copiosa, published in 1514, and repeated in many editions, became the standard authority on all these subjects, and thus supplanted the works of the ancient writers.


According to Vigo, gun-shot wounds differed from the wounds made by ordinary weapons--that is, spear, arrow, sword, or axe--in that the bullet, being round, bruised rather than cut its way through the tissues; it burned the flesh; and, worst of all, it poisoned it. Vigo laid especial stress upon treating this last condition, recommending the use of the cautery or the oil of elder, boiling hot. It is little wonder that gun-shot wounds were so likely to prove fatal. Yet, after all, here was the germ of the idea of antisepsis.


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The Great Anatomists


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Williams HS. A History of Science. (1904) Harper and Bros. New York.

A History of Science: Arabian Medicine | Mediaeval Science in the West | The Great Anatomists | The coming of Harvey | Leeuwenhoek Discovers Bacteria | Medicine in the 16th and 17th Century | Philosopher-Scientists and new Institutions | 18th Century Anatomy and Physiology Part 1 | 18th Century Anatomy and Physiology Part 2 | 18th Century Anatomy and Physiology Part 3 | 19th Century Anatomy and Physiology Part 1 | 19th Century Anatomy and Physiology Part 2 | 19th Century Anatomy and Physiology Part 3 | Theories Of Evolution Part 1 | Theories Of Evolution Part 2 | 18th Century Medicine | 19th Century Medicine Part 1 | 19th Century Medicine Part 2 | Brain and Mind | Brain Structure | Embryology History
Historic Disclaimer - information about historic embryology pages 
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Pages where the terms "Historic" (textbooks, papers, people, recommendations) appear on this site, and sections within pages where this disclaimer appears, indicate that the content and scientific understanding are specific to the time of publication. This means that while some scientific descriptions are still accurate, the terminology and interpretation of the developmental mechanisms reflect the understanding at the time of original publication and those of the preceding periods, these terms, interpretations and recommendations may not reflect our current scientific understanding.     (More? Embryology History | Historic Embryology Papers)

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Cite this page: Hill, M.A. (2024, March 28) Embryology Book - A History of Science 2. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Book_-_A_History_of_Science_2

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