PART III. Medicine During the Renaissance

MEDICINE DURING THE RENAISSANCE

CHAPTER XXVI

IMPORTANT EVENTS THAT PRECEDED THE RENAISSANCE--EARLY ATTEMPTS TO DISSECT THE HUMAN BODY

Important Events Immediately Preceding the Renaissance.--Three hundred years before the Christian era Erasistratus and Herophilus made, at Alexandria, Egypt, an attempt to develop a correct knowledge of anatomy by means of dissections of human corpses, but the political and religious conditions at that time were not favorable to scientific work, and therefore the success attained was of a very restricted character. Then, during the succeeding three or four centuries, this early movement gradually died out, and no further contributions to our knowledge of human anatomy were made until toward the end of the second century of the present era, at which time Claudius Galen, a man of giant intellect and tireless energy, did his best to supply the anatomical knowledge so urgently needed. But the deeply rooted prejudices of that age against dissections of the human body lay like an insurmountable barrier across his path and forced him to confine his efforts to the dissection of those animals whose bodily construction resembled more or less closely that of man. Galen believed that the anatomy which he thus evolved for the guidance of his professional brethren would satisfy all their legitimate wants of this nature, and he proceeded to build upon this faulty and unstable foundation an equally faulty physiology. History records the extraordinary fact that Galen’s belief in the sufficiency of his anatomy and physiology for all the reasonable needs of physicians and surgeons was so well grounded that during the following thirteen or fourteen centuries nobody dared to cast the slightest suspicion upon the trustworthiness of these foundations of the science of medicine. Then followed, during the fourteenth and fifteenth centuries, an awakening which seemed to affect all departments of human activity. This movement, which is commonly termed the “Renaissance,” developed at first very slowly, and reached a noteworthy degree of momentum only toward the middle of the fifteenth century, about which time there occurred several events that contributed greatly to strengthen and perpetuate the movement. Such were, for example, the employment of gunpowder in the wars of Western Europe; the invention of a method of manufacturing paper--a discovery which led to the abandonment of the much more expensive parchment, and prepared the way for the invention of printing in its different forms; the taking of Constantinople by the Turks in 1453; the discovery of America in 1492; and, finally, the Reformation inaugurated by Martin Luther. Let us pass in review very briefly each of these events, in order that we may the better appreciate how the science of medicine, in the short space of time represented by a couple of centuries, made a greater advance than it had previously made in the course of several hundred years.

The employment of gunpowder in warfare robbed the knight of the protection which he had previously enjoyed from the wearing of metal armor, and thenceforward his life was as much imperiled in battle as was that of the foot-soldier, who was not permitted to protect his person in this manner. Thus were the two upper classes of the community, the nobles and the bourgeois, in any conflict which might arise between them, placed more nearly upon a footing of equality. The ultimate result showed itself in an increased importance, an increased prosperity, of the middle class or bourgeoisie, from which the physicians chiefly came. Indeed, feudalism from this time forward rapidly ceased to exist.

The discovery of paper, an excellent and relatively cheap substitute for parchment, facilitated wonderfully the spread of knowledge. Parchment, the material upon which books were written, was expensive and was at times difficult to obtain; both of which circumstances rendered books so costly that only a few physicians were able to become the owners of the important standard medical works of that period--such, for example, as the Hippocratic writings, Galen’s treatises, the surgical manuals of de Mondeville and Guy de Chauliac, the pharmacopoeia of Dioscorides, and still other books of lesser value. And, if a satisfactory method of manufacturing paper had not first been discovered, the benefits growing out of the invention of printing in 1467 would have been far less than they actually proved to be. Some idea of the magnitude of these benefits may be formed from the following statement of facts. The demand for books, after the invention of printing, became so great that the presses were kept almost constantly busy. At first, according to the record furnished by Haeser, Venice and Rome took the lead in supplying this great demand for books; the former city printing 2978 and the latter 972 volumes between the years 1467 and 1560; but, during a later period (1500–1536), Paris outstripped Venice with a total of 3056 volumes, and Strassburg advanced to the second place with a showing of 1021 volumes printed during the same period of time. Thanks to the great diminution in the market price of books that resulted from the two inventions named--the manufacture of paper and the introduction of printing--almost every physician in fairly prosperous circumstances was able at that period to purchase the relatively few medical treatises which issued from the presses; and, besides, new authors were thenceforth stimulated to put their experiences into print.

Among the very first medical books printed the following deserve to be mentioned:--

(In Germany.) Buch der Bündth-Erznei, by Heinrich von Volsprundt, 1460.--Das buch der wund Artzeny. Handwirckung der Cirurgia von Jyeronimo brunschwick, 1508.--Das Feldtbuch der Wundtartzney, by Hans von Gerssdorff, 1517.

(In Italy.) Avicennae opera, arabice, 1473.--Guillelmi de Saliceto cyrurgia, 1475. (A French translation was published at Lyons in 1492.)--Celsi de medicina liber, etc., 1478.--Guidonis de Cauliaco cyrurgia, 1490. (A French version was printed in Lyons in 1498.)

(In France.) Christophori de Barzizus de febribum cognitione et cura, 1494.--Bernard de Gourdon, traduction de son “Lilium medicinae,” 1495.

When Constantinople fell into the hands of the Turks in 1453, many of its Greek inhabitants, and particularly those belonging to the more highly educated classes, fled to Western Europe in order to escape from the tyranny of the invaders. Not a few of these refugees brought with them to Italy and France copies of the works of the classical Greek authors, and on this account, as well as because of their willingness to give instruction in their native tongue, they met with a cordial welcome wherever they took up their new abodes. Their arrival in Italy happened at a most propitious time, for the interest in Greek literature was at that period just beginning to develop among Italian scholars. Previously, Greek had been an almost unknown tongue in Italy. Petrarch, for example, is reported to have said in 1360 that he did not know of ten educated men in that country who understood Greek; and there is no evidence to show that the number of such men increased between 1360 and the time when the refugees from Constantinople arrived. Many of the works of greatest importance to physicians--such, for example, as the writings of Hippocrates, of Galen, of Rufus of Ephesus, of Oribasius, of Alexander of Tralles, and of several other classical medical authors of antiquity--were accessible (in the original) only to those who were familiar with the Greek tongue. Consequently the arrival of these refugees from Constantinople constituted a most important event in the history of European medicine.

The discovery of America by Christopher Columbus in 1492 owed its origin in part to the restless spirit of adventure which was abroad in Spain and Italy at that time, and also, in perhaps still larger measure, to the hope of gain which might be expected to follow the discovery of a shorter and more direct route to India. As regards the attainment of the latter object, the great explorer failed, but his discovery of a new continent resulted eventually in bringing great wealth to the rulers of Spain, in stimulating maritime commerce, and in broadening men’s views with regard to every phase of human activity. The addition of a few new drugs to the pharmacopoeia was a further result of some importance. Luther’s efforts to reform the government and doctrines of the Church undoubtedly gave a great impetus to the Renaissance and therefore to the growth of the science of medicine. Men learned to use their reasoning powers with greater freedom, and as a result our knowledge of the structure of the human body (anatomy) and of the working of its complicated machinery, both in health (physiology) and in disease (pathology), made astounding advances. And it is to the consideration of these fundamental branches of medical knowledge that we must now turn our attention.

Early Attempts to Dissect the Human Body.--Already as early as during the first half of the fourteenth century physicians began to appreciate the fact that further progress in the knowledge of medicine was not to be attained otherwise than by a more profound study of human anatomy than had been made up to that time; and they realized that it was only by means of actual dissections that this more profound study might be made. Various influences, however, co-operated to hinder such study. In the first place, the people at large were thoroughly imbued with the idea that dissecting a human corpse was an act of desecration, and consequently it was by no means safe for a physician to do any work of this character except in the most secret manner. Then, in addition, it was commonly believed-and this belief persisted even up to a comparatively recent date--that the bull which Pope Boniface VIII. issued in 1300--and which declared that whoever dared to cut up a human body or to boil it, would fall under the ban of the church--was intended to cover dissections for purposes of anatomical study. The recent investigations of Corradi, however, show (Haeser, p. 736 of the third edition) that this bull was not intended to apply to dissections for scientific purposes, but simply to put an end to the practice of cutting up human corpses and boiling the separate sections in order to obtain the bony framework in a condition suitable for transportation from Palestine to Europe,--a practice which had grown to be very common among the Crusaders.

Mondinus’ “Anatomy,” which was published in 1314, reveals the fact that, during the early part of the fourteenth century, several private dissections were made. As might be expected, from the primitive character of the illustrations that accompany the text of Mondinus’ work, these dissections were carried out in a very imperfect manner, for--to mention only a single example--this author admits that he made no attempt to investigate the deeper structures of the ear, as such an examination would necessitate the employment of violent measures, “which would be a sinful act.”

The archives of the Bolognese School of Medicine contain an item which reveals the active interest taken in anatomy by the students of that day. It reads as follows: “At Bologna, in 1319, several of the Masters stole from a grave the corpse of a woman who had been buried two days before, and then turned it over to Master Albertus to dissect in the presence of a large number of students.” At the Medical School of Montpellier, in the south of France, the Faculty obtained permission in 1376 to dissect the corpse of an executed criminal once every year; and the records show that the school actually availed itself of this privilege in the years 1377, 1396 and 1446. Felix Platter, who afterward became one of the most distinguished physicians of Basel, Switzerland, pursued his early medical studies at the latter university during the years 1552–1557; and, in the diary which he faithfully kept during this period, he reveals in an interesting manner what difficulties as well as dangers he experienced, first, in reaching Montpellier from his home in the eastern part of Switzerland, and, second, in obtaining greater opportunities for acquiring a genuine knowledge of anatomy than the school itself afforded in its official course. Although, owing to lack of space, I shall not be able to quote in full the appropriate portions of this most interesting narrative, I will furnish an abridged English translation of the story as it appears in Platter’s journal or diary. In all its more important details the account reads as follows:--

Our little party was composed of three persons, viz., Thomas Schoepfius, the schoolmaster of St. Pierre; a Parisian by the name of Robert who happened to be passing then through Basel on his way to Geneva; and myself, a lad of sixteen. We traveled on horseback and all three of us were armed with rapiers. My outfit, which was handed to me by my father shortly before our departure, consisted of two extra shirts and a few pocket-handkerchiefs, wrapped up in a piece of waxed cloth. In the matter of funds for the journey I received from my father three crowns in silver and four gold pieces which, for further security, he sewed into my vest. In addition, he presented me with a rare piece of silver money which had been issued by the Cardinal Mathieu Schiner, of the Canton de Valais, who personally commanded the Swiss soldiers in their successful combat with the troops of Louis the Twelfth, at Marignan. It was a coin, therefore, which possessed considerable historical value. My mother also bestowed upon me a gold coin (a couronne). As a last injunction my father begged me not to forget that, in order to procure the money which he had just placed in my hands, as well as that which he had already paid for my horse, he had been obliged to mortgage his property.

We left the city at nine o’clock on the morning of Oct. 10th, 1552, and at the same moment the news reached us that the Plague had made its appearance in Basel. This was a most depressing piece of intelligence, especially as we were already in great fear that the army of the Emperor Charles the Fifth, which was at that time on its way to the siege of Metz, would utterly destroy our city.

We arrived at Berne early on the morning of Oct. 12th, and, after leaving our horses at the inn, The Falcon, lost no time in visiting the objects of interest in that ancient city, not forgetting the bear pit, in which there were at that time six of these creatures. In the afternoon we resumed our journey toward Fribourg, and very soon overtook a newly married couple. As they were traveling on horseback like ourselves, and were following the same route for a certain distance, we all agreed to keep together. While passing along a shady part of the road the bride’s dress became so firmly entangled in the branches of an apple tree that, failing to stop the horse, she was left suspended in the air by her skirts. I immediately dismounted and helped her to regain her feet, to adjust her disordered dress, and to resume her seat in the saddle. On arriving at Fribourg we put up at the inn called La Croix Blanche, and soon discovered that almost everybody in the town spoke French, a language with which Thomas and I, who were Germans, were not familiar; but, thanks to our companion Robert, the Parisian, we experienced no difficulty whatever in making all our wants known and in securing all the information that we desired.

On the following day, Oct. 13th, it was raining hard when we left Fribourg, and we were soon wet to the skin. After passing through several small villages we stopped for refreshment at an inn in the picturesque town of Romont, and at the same time availed ourselves of the opportunity to have our clothes dried. Then, having satisfied our appetites, we resumed our journey in the direction of Lausanne; but we did not get very far on our way before we discovered that Thomas had disappeared. We were of course obliged to wait for him, and, by the time he had rejoined the party, darkness and a thick fog combined to render further progress very difficult, and we soon realized that we had lost our way. We wandered up and down for some time without encountering a barn or building of any kind in which we might find shelter from the rain and secure a measure of protection from the robbers who, according to common report, infested that part of the country. Finally, however, we discovered a small village; but, when we applied for a night’s lodging, not one of the householders was willing to receive us. So we engaged the services of a young peasant to act as our guide, and with his assistance we finally reached a mean-looking inn in a village called Mézières, which was composed of a few widely scattered houses. We entered the tavern and found several Savoyard peasants and some beggars seated at the long table of the bar-room; they were engaged in eating roasted chestnuts and black bread, which they washed down with copious draughts of a liquor called piquette. They unceremoniously examined our weapons and acted with great rudeness toward us in other respects. The woman who kept the house said she had no other room which she could place at our disposal, and our first impulse therefore was to resume our journey immediately after we had finished our meal of black bread and chestnuts; but, after careful reflection, we came to the conclusion that such a course might prove fraught with considerable danger. So we decided to remain awake and watch for an opportunity to make our escape. Very soon afterward these half-intoxicated men lay down on the floor before the fire in the adjoining hall-way or vestibule and fell into a sound sleep. Our guide then confessed to us that, while at work in the stable, he had heard them planning to waylay us on the highway at an early hour of the following day. As soon, therefore, as we heard them all snoring lustily we very quietly slipped out of the house. Our score having already been paid earlier in the evening, and our horses having been left saddled and bridled in the stable, we mounted and took our departure by a road which led at first in a direction different from that in which we were supposed to be traveling. We experienced no further trouble on this part of our journey and in due time reached Lausanne. When we told the people at the inn about our experience at Mézières they replied that we might consider ourselves most fortunate, as almost every day there occurred, in the forest through which we had passed (la Forêt du Jorat), a murder or some other deed of violence. It was plain, therefore, that we had had a narrow escape from death.

In the further course of our journey along the north shore of the lake we reached the city of Geneva on Oct. 15th. When I called upon John Calvin, to whom my father had given me a letter of introduction, he said to me: “My Felix, you arrive at the right moment, for I am now able to give you an excellent traveling companion for the remainder of your journey--to wit, Dr. Michel Heronard, a native of Montpellier.” This Dr. Heronard, as I learned subsequently, was a Protestant who played a prominent part in the religious disorders which, a few years later, greatly disturbed the peace of that city.

On the 30th of October--just twenty days after we set out from Basel--we entered the city of Montpellier, and I lost no time in hunting up Laurent Catalan, the apothecary, at whose house I expected to reside during my stay in that city.

Platter had now, after a long and dangerous journey, reached one of the three greatest medical schools of that period, and it was his hope and expectation that he would here be able to acquire a correct and intimate knowledge of human anatomy. He was already aware that this knowledge could be satisfactorily obtained in only one way--that is, by dissecting the human body; and accordingly he availed himself of every possible opportunity, during the five years which he spent at Montpellier, to accomplish this purpose. From the somewhat superficial examination which I have made of the record furnished by the diary, it appears that only five or six official lessons or demonstrations were given by the professor of anatomy during the period of time named; but--as every student of medicine knows--instruction of this character is of relatively small value; and Platter himself seems to have realized fully the truth of this statement, for during the second year of his stay at Montpellier he joined a secret band of nocturnal grave-robbers who were determined at all hazards to obtain the material needed for self-instruction. The following brief description of one of the raids made by this band of eager searchers after knowledge will convey a good idea of the manner in which the work was conducted:--

Our first excursion of this kind was made on Dec. 11th, 1554. As soon as it was really dark our fellow student Gallotus guided us, along the road that leads to Nîmes, to the Augustinian Monastery, which is situated about half-way between Castelnau and the Verdanson brook. Here we were received by a monk called Brother Bernard, a bold and determined fellow, who had disguised himself for the business in hand. At midnight, after we had partaken of food and drink, we started out, sword in hand, for the cemetery which is located close to the church of Saint Denis. Here we dug up with our hands a corpse which had been interred that very day; and, having lifted it out of the pit by means of ropes, and wrapped our cloaks around it, we carried the body on two canes as far as Montpellier. Then, having concealed our load close to the postern, alongside the city gateway, we summoned the keeper and begged him to get us some wine, as we were dying of thirst and very tired. While he was absent in search of the wine three of our party slipped in through the passage and carried the corpse safely to Gallotus’ house, which was only a short distance from the gate. The gate-keeper returned in due time with the wine, and did not appear to have the slightest suspicion of the trick that we had played upon him. It was now three o’clock in the morning.

The control exercised by the authorities over the practice of dissecting human corpses differed very appreciably at different dates in different parts of Europe. Thus, for example, orders were issued to the Italian bishops during the latter part of the fourteenth century to put a stop to further dissections, and for a period of over one hundred years these orders accomplished the purpose desired. On the other hand, the Emperor Charles the Fourth adopted a more liberal course: from the year 1348 on he permitted dissections of human corpses to be made without hindrance in Prague, Bohemia, but his liberality in this particular appears to have been of little use, for there is no evidence to show that the knowledge of anatomy made any appreciable advance anywhere in Europe until after the beginning of the sixteenth century.

Gabriel Zerbi of Verona (1468–1505) published at Venice in 1502 the first modern treatise on human anatomy that deserves to receive special mention. Pagel speaks of it as containing fairly good descriptions of different parts of the body. Zerbi held the Chair of Medicine, Logic and Philosophy in the University of Padua, and lectured first in that city, next at Bologna, and finally at Rome. One incident in his career may prove of interest to the reader as showing the fearful risks to which a practicing physician in those days was sometimes exposed. The incident was of this nature:--

A wealthy pacha in Constantinople, failing to obtain relief from his malady at the hands of the native Turkish doctors, summoned an Italian physician from Venice. Zerbi, whom the ruling Doge invited to accept the summons, sailed immediately for Constantinople in company with his two sons who were mere lads. The treatment which he inaugurated proved promptly successful, and Zerbi, having been handsomely remunerated for his services, was already on his way back to Venice when his ship was overhauled by a swift-sailing caique on board of which were the sons of his recent patient, who--as the story goes--had celebrated his recovery by eating and drinking to excess. This debauch promptly caused his death--probably by cerebral apoplexy; but the sons were convinced that it was the result of poison administered by Zerbi, and accordingly they lost no time in starting out to capture the supposed murderer. Their first act, on reaching the vessel which they were pursuing, was to kill the younger of the two sons, in the presence of the father, by sawing his body in two lengthwise. Then they killed Zerbi himself in the same manner.

Tiraboschi, the first historian of Italian literature (1731–1794), is mentioned by Dezeimeris as his authority for this terrible tale. The events here narrated occurred in 1505.

At the beginning of the sixteenth century--the period with which our history now has to deal--the only available knowledge of anatomy was that which had been supplied by Galen in the third century of the Christian era, and which had been handed down through all the intervening centuries as something absolutely correct and not to be challenged. But the time had arrived when men were no longer willing to accept as truth the teachings of any individual until they had subjected them afresh to the most searching investigations; and thus it came about that a group of remarkably able men devoted all their energies, during the greater part of the sixteenth century, to a very critical study of human anatomy. As the work accomplished by these men constitutes a very important chapter--perhaps the most important chapter--in the history of medicine, I may be pardoned if I devote a disproportionately large amount of space to the consideration of the careers of the more prominent of these founders of modern anatomy, and to an enumeration of the details of the work which they accomplished, and which furnished the most complete verification of the truth stated by Francis Bacon, Lord Verulam (1561–1626), in the following words (translation):--

Man has no other means of getting at and revealing the truth than by induction coupled with a never-tiring, unprejudiced observation of nature and an imitation of her operations. Actual facts must first be collected, and not created by a process of speculation.

One of the earliest and most thorough students of human anatomy was Marc Antonio della Torre (1473–1506), who belonged to an honorable family of Verona, several members of which had attained distinction as physicians. He planned to publish a treatise on anatomy, and, with this object in view, secured the assistance of Leonardo da Vinci (1452–1515), the celebrated painter, architect and civil engineer, to make life-size pictures of the parts which he had dissected with such care. But, after the latter had completed many of the drawings which were intended to serve as illustrations for the projected treatise, Della Torre unexpectedly died, and the book was never finished. Quite a number of the drawings, however, found their way to England, and for many years past they have been carefully treasured at Windsor Castle and in certain private collections. If Della Torre’s life had been spared it is highly probable that his treatise on anatomy, equipped with illustrations copied from this great artist’s drawings, would have constituted a formidable rival of Vesalius’ famous work.

Not long after this event it became the rule, among the leading painters and sculptors of the Renaissance period, to pay a great deal of attention to the study of human anatomy. The museums of Central and Southern Italy contain quite a large number of anatomical drawings that were made by Michael Angelo, by Raphael and by other great masters of that period. Doubtless many of my readers recall seeing, in the Cathedral of Milan, Marco Agrate’s (1562) extraordinary masterpiece, in the form of a life-size black marble statue which represents Saint Bartholomew standing erect, and carrying on one arm the folded skin of his entire body. In this statue all the muscles and bony prominences are modeled with perfect accuracy. It is a remarkable work of art.