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250 BC present in the Hippocratic Corpus passed on by Galen
1) Blood [air and infancy];
2) Yellow Bile [fire and youth];
3) Black Bile (melancholy) was a harmful if essential humour [earth and adulthood]; and
4) Phlegm [water and old age].
Two fluids or humours most often associated with illness: bile and phlegm (present in the body, but flowed in quantity in sickness)—winter colds due to phlegm and summer diarrhoea and vomiting due to bile; mania due to bile boiling in brain.
the body was viewed as stable until an illness subverted it. Imbalance was often noted by the concentration of fluid in a particular body zone or part. Egs: i) A flow of humours to the feet would produce gout; or ii) Phlegm from the head to the lungs would be the cause of a cough. A healer’s job was to preserve balance, or to restore it when an illness was present.
Significant because everyone believed that Galen knew everything and therefore didn't question him for hundreds of years. Influenced medicine long after galen's death.
Humorism, or humoralism, is a now discredited theory of the makeup and workings of the human body, adopted by Greek and Roman physicians and philosophers, positing that an excess or deficiency of any of four distinct bodily fluids in a person directly influences their temperament and health. From Hippocrates onward, the humoral theory was adopted by Greek, Roman and Islamic physicians, and became the most commonly held view of the human body among European physicians until the advent of modern medical research in the nineteenth century.
The four humors of Hippocratic medicine are black bile (Gk. melan chole), yellow bile (Gk. chole), phlegm (Gk. phlegma), and blood (L. sanguis), and each corresponds to one of the traditional four temperaments. A humor is also referred to as a cambium (pl. cambia or cambiums). |
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| the God of Medicine and Healing in ancient Greek religion. Asclepius represents the healing aspect of the medical arts; his daughters are Hygieia ("Hygiene"), Iaso ("Medicine"), Aceso ("Healing"), Aglæa/Ægle ("Healthy Glow"), and Panacea ("Universal Remedy"). The rod of Asclepius, a snake-entwined staff, remains a symbol of medicine today, sometimes the caduceus, or staff with two snakes and wings represents medicine, this is commonly used in American culture. He was associated with the Roman/Etruscan god Vediovis. |
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| was an ancient Greek physician of the Age of Pericles (Classical Athens), and is considered one of the most outstanding figures in the history of medicine. He is referred to as the father of Western medicine in recognition of his lasting contributions to the field as the founder of the Hippocratic School of Medicine. This intellectual school revolutionized medicine in ancient Greece, establishing it as a discipline distinct from other fields that it had traditionally been associated with (notably theurgy and philosophy), thus establishing medicine as a profession. |
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City of Alexandria near mouth of the Nile River was capital of the Ptolemy royal family and its library and museum were key sites of learning in ancient world—linked the Greek world to Egypt and its rich history. Archimedes and Euclid taught there, and the library contained more than 700,000 books and had its own observatory, zoological gardens, lecture halls, and research rooms. Due to Alexander’s conquest, the Hellenistic world stretched from Sicily to Persian Gulf (with much knowledge of Central Asia and northern India). Thus, a broad geographic area of knowledge or animals, plants, drugs, minerals and medical techniques.
The Royal Library of Alexandria, or Ancient Library of Alexandria, in Alexandria, Egypt, was the largest and most significant[1] great library of the ancient world. It flourished under the patronage of the Ptolemaic dynasty and functioned as a major center of scholarship from its construction in the 3rd century BC until the Roman conquest of Egypt in 30 BC. The library was conceived and opened either during the reign of Ptolemy I Soter (323–283 BC) or during the reign of his son Ptolemy II (283–246 BC). |
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a prominent Roman (of Greek ethnicity) physician, surgeon and philosopher.[2][3][4] Arguably the most accomplished of all medical researchers of antiquity, Galen contributed greatly to the understanding of numerous scientific disciplines, including anatomy,[5] physiology, pathology,[6] pharmacology,[7] and neurology, as well as philosophy[8] and logic.
The son of Aelius Nicon, a wealthy architect with scholarly interests, Galen received a comprehensive education that prepared him for a successful career as a physician and philosopher. He traveled extensively, exposing himself to a wide variety of medical theories and discoveries before settling in Rome, where he served prominent members of Roman society and eventually was given the position of personal physician to several emperors.
Galen's understanding of anatomy and medicine was principally influenced by the then-current theory of humorism, as advanced by many ancient Greek physicians such as Hippocrates. His theories dominated and influenced Western medical science for nearly two millennia. His anatomical reports, based mainly on dissection of monkeys and pigs, remained uncontested until 1543, when printed descriptions and illustrations of human dissections were published in the seminal work De humani corporis fabrica by Andreas Vesalius[9][10] where Galen's physiological theory was accommodated to these new observations.[11] Galen's theory of the physiology of the circulatory system endured until 1628, when William Harvey published his treatise entitled De motu cordis, in which he established that blood circulates, with the heart acting as a pump.[12][13] Medical students continued to study Galen's writings until well into the 19th century. Galen conducted many nerve ligation experiments that supported the theory, which is still believed today, that the brain controls all the motions of the muscles by means of the cranial and peripheral nervous systems. |
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Andreas Vesalius (31 December 1514 – 15 October 1564) was a Flemish anatomist, physician, and author of one of the most influential books on human anatomy, De humani corporis fabrica (On the Structure of the Human Body). Vesalius is often referred to as the founder of modern human anatomy.
On graduation he was immediately offered the chair of Surgery and Anatomy (explicator chirurgiae) at Padua. He also guest lectured at Bologna and Pisa. Previously these topics had been taught primarily from reading classic texts, mainly Galen, followed by an animal dissection by a barber-surgeon whose work was directed by the lecturer. No attempt was made to actually check Galen's claims; these were considered unassailable. Vesalius, on the other hand, carried out dissection as the primary teaching tool, handling the actual work himself while his students clustered around the table. Hands-on direct observation was considered the only reliable resource, a huge break with medieval practice.
He kept meticulous drawings of his work for his students in the form of six large illustrated anatomical tables. When he found that some of these were being widely copied, he published them all in 1538 under the title Tabulae Anatomicae Sex. He followed this in 1539 with an updated version of Galen's anatomical handbook, Institutiones Anatomicae. When this reached Paris one of his former professors published an attack on this version. |
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commonly known as Ibn Sīnā or by his Latinized name Avicenna, was a Persian polymath, who wrote almost 450 treatises on a wide range of subjects, of which around 240 have survived. In particular, 150 of his surviving treatises concentrate on philosophy and 40 of them concentrate on medicine.
His most famous works are The Book of Healing, a vast philosophical and scientific encyclopaedia, and The Canon of Medicine, which was a standard medical text at many medieval universities. The Canon of Medicine was used as a text-book in the universities of Montpellier and Leuven as late as 1650. Ibn Sīnā's Canon of Medicine provides a complete system of medicine according to the principles of Galen (and Hippocrates).
. Practicing medicine by the age of sixteen, Avicenna was the ideal of the philosopher-physician in the Islamic world. During his life he was a jurist, philosophy teacher, administrator, and physician at various courts. He wrote more than 270 works during his life including two huge encyclopedias on science and medicine. His Kitah al-Qanun (‘Canon of Medicine’) detailed the legacies of Hippocrates, Galen, the Alexandria school of medicine, and contemporary Arab physicians. Its five books detailed diseases, anatomy, hygiene, physiology, drugs and their preparation, and various diagnoses and treatments. His Canon became the authoritative medical text in both the Islamic world and also Christian Europe during the Middle Ages. He was often referred to as the ‘Galen of Islam’. |
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| Maimonides spent ten years in the Spanish centre of learning before moving on to Cairo. He was one of the most famous doctors in the Arab empire, and in 1174 was actually appointed court physician to Saladin—the sultan of the provinces of Egypt and Syria. He, like many Islamic intellectuals, was a polymath—learned in philosophy, logic, theology, astronomy and medicine. He is famous in the last field due to ten medical texts—one of which was a translation of Galen, and another on the works of the Greeks. While he did criticize Galen, his writings were examples of the continuation of the writings and ‘wisdom’ of the Classical age by ‘outsiders’. His most famous work was the Regimen of Health, which provided basic advice on diet. His vast literary output earned him both respect and a legacy in that later Western physicians such as Henri de Mondeville and Guy de Chauliac cited him often. |
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| These were large city hospitals, which in medieval times had provided hospitality and medical assistance. As the Middle Ages came to a close, they became more medicalized, and employed surgeons and often had an attending physicians. The sick poor could use the Hotel Dieu, but syphilitics and infectious patients were banned. By the 17th century, the Hotel Dieu in Paris had a terrible reputation and was viewed by many physicians as little more than a hotbed of infection—it was over-crowded with beggars, orphans, vagabonds and prostitutes, and the sick poor of all types. |
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Born in Acquapendente, Latium, Fabricius studied at the University of Padua, receiving a Doctor of Medicine degree in 1559 under the guidance of Gabriele Falloppio. He was a private teacher of anatomy in Padua, 1562–1565,[1] and in 1565, became professor of surgery and anatomy at the university, succeeding Falloppio.
: A pupil of the great anatomist at Padua, Gabriele Falloppia (1523-1563), Hieronymus Farbricius (1533-1619), was not interested in structural architecture of the body (as had been Vesalius), but with a comparative approach which stressed description, action and use of body parts. His major work was De venarum ostiolis (On the Valves of the Veins) (1603)—and this work was to be crucial in Harvey’s later work on the circulation of blood. Fabricius, while Chair of Anatomy at Padua, also wrote on the egg, generation of the chick, and foetal growth.
While the anatomists of this generation noted errors in the works of the ancients (Galen in particular) they continued to support the works of antiquity by constantly referring to them. They did, however, forever improve the status of anatomy within medical education and the humanist medical movement. After the Renaissance, the separation between anatomy (as a field of learning for physicians) and surgery (work with one’s hands) was closing. Surgery as a distinct discipline, however, did not advance very far during this period, and overall was not much influenced by the new anatomical knowledge. |
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attended Caius College, Cambridge, and then studied at Padua under Fabricius. He returned to England in 1602, was elected a Fellow of the College of Physicians in 1607, and 1609 became a physician at St. Bartholomew’s Hospital, six years later becoming a college lecture in anatomy, and then in 1618 was named royal physician.
He used the scientific method, but did not use the new invention the microscope to discover the capillaries (links between the arteries and veins), but used logic to deduce their presence.
Harvey, an English physician, published his famous book, On the Motion of the Heart in 1628.
In Padua he had studied the valves in the veins with anatomy teachers who had known of Vesalius—therefore he knew that blood in the veins flowed toward the heart. Also, using mathematics and pulse and stroke volume, he calculated that if blood did not circulate that the liver would have to manufacture 1,800 litres of blood each day—more than could ever be made based on food intact. Harvey was also influenced by philosophical notions of cycles in nature, and by the new mechanical pumps and fire engines in the cities of Europe.
Harvey’s experiments on animals confirmed this reasoning, but he delayed publishing his ideas for a decade. Why? His ideas were radical, challenged ancient wisdom, and were based on anatomical observations and calculations. |
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The greatest epidemic to hit Europe, the Black Death killed 20 million people in 3 years in the mid 14th century. Probably originating in China, the disease crossed Central Asia to the Black Sea where it struck the city of Kaffa—where Italian merchants were besieged by the Tatars. The Tatars sent diseased bodies raining into the city, and the Christians then took the disease into the Mediterranean (Messina, Genoa, and then into the rest of Europe—killing ¼ of the population between 1347 and 1349.
The plague was of the bubonic form caused by the bacillus Yersinia pestis passing from rats to humans via fleas. After a six-day incubation, the victim suffers chest pains, coughing, vomiting of blood, trouble breathing, high fever, dark skin blotches (internal bleeding), and hard, painful egg-sized swellings (buboes) in the lymph nodes in the armpits, groin and neck. Due to the speed by which it spread, it is also likely that there was human-to-human transmission.
Medical responses: 1) Believed that it was punishment from God—prayers, flagellants, persecution of Jews; 2) few believed in contagion (continued belief in Greek idea that constitution was the key factor), but doctors did use beaks and posies of herbs and scents, and some towns did enact quarantine and mandatory burials—this growing political involvement in public health (leprosaria, burials, health boards and inspectors) was the plague’s legacy. |
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Born in Switzerland, Paracelsus received his early education from his father (a physician) who taught him botany, medicine and natural philosophy. At the age of 20 he went to Italy to study medicine, but soon quit, only to become a wandering student, who picked up knowledge from a variety of sources (artisans, miners, “tramps, butchers and barbers”). As he did not have a classical, university education based on the old canonical texts, he was able, and in fact eager to repudiate Galenism and the works of antiquity and the Arabs. (“I tell you, one hair on my neck knows more than all you authors, and my shoe-buckles contain more wisdom than both Galen and Avicenna”
: Swiss doctor who had studied in Italy—he challenged Galenism and believed that nature was the key—contemptuous of medical authorities. In 1526 was appointed professor of medicine in Basel and lectured not in Latin, but German; he also refused to teach Hippocrates or Galen, and he publicly burned Avicenna’s Canon. Bases his natural philosophy on chemical principles—salt, sulfur and mercury. Also ridiculed anatomy as ‘dead’ as it could teach nothing about the living |
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| , a Scottish navel surgeon protested against the poor conditions on board British naval vessels (cramped quarters, rancid food, foul water). In the mid 1700s, the British Navy was plagued by a number of illnesses during the lengthy sea voyages. For example in a round-the-world expedition in the 1740s, of the 1955 men who left England, 320 died of fevers and dysentery, and a staggering 997 died of scurvy by the time the fleet returned after its 4 year voyage. Scurvy, the scourge of the fleet, involved swollen, spongy, bloody gums, bruises, swollen joints, lassitude, heart failure, and death. Lind wrote a treatise on the disease in which he relied on his own experiences, and proved that citrus fruits were effective in preventing the deadly disease. However, Lind’s ideas were not quickly adopted by the Navy—although by the 1790s fresh vegetables, fruits, vinegar, and better ventilation and hygiene were common on most ships. |
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constructed a total of 247 simple (single lens) microscopes, which despite their tiny size (2mm in width) were extremely powerful (+250X). His lens grinding techniques were not matched until the 20th century.
A religious man, he hoped that his work would counter atheistic arguments for spontaneous generation (in dew, mud, putrefaction). A tradesman without formal education he studied a wide variety of materials and animal structures, including: the texture of wood, cells of planes, red blood corpuscles and blood capillaries, the crystals associated with gout, organization of nerves, muscles, bones, teeth and hair. His most important discovery was the observation of the animalcules in fluids—first person to see spirogyra, hydra, protozoa, bacteria and human spermatozoa. He estimated population densities of these animals at more than 1 million per drop of water. |
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The miasma theory (also called the miasmatic theory) held that diseases such as cholera, chlamydia or the Black Death were caused by a miasma (Μίασμα, ancient Greek: "pollution"), a noxious form of "bad air".
The miasma theory was accepted from ancient times in Europe, India and China. The theory was eventually displaced in the 19th century by the discovery of germs and the germ theory of disease. |
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Dynasty of University Heads all of the same name and family.
Edinburgh emerged as the leading medical school in Britain during the 18th century. Its founding dates to the appointment of Alexander Monro I in 1726 as professor of anatomy. Monro was followed by his son and grandson, and thus the family controlled this chair of anatomy for 120 years. The school also boasted famous instructors in chemistry, practical medicine (surgery and anatomy), as well as philosophy and human sciences. By the late 1700s more than 200 students enrolled every year at Edinburgh, and by 1820 the number had grown to 400.
Edinburgh also pioneered infirmary-based teaching, however only 1/3 of its students registered in clinical lectures and rounds. Although famous for anatomical studies, the school was always short on bodies and this resulted in the famous Burke and Hare murder scandal of the early 1800s. |
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| In England during the Georgian period, there was an explosion in the founding of new hospitals. While prior to 1700, London could boast of only St. Thomas’s, St. Bartholomew’s and Bethlem Hospital, during the early 18th century five new major general hospitals were constructed (the two most famous being Guy’s [1724] and London [1740]). Similar growth occurred in outlying regions with the cities of Edinburgh, York, Bristol, Bath and other centres also founding general hospitals. By 1800 a total of 28 British cities had a general, secular hospital to serve its poorer citizens. Many cities (Manchester, Liverpool and York) also had philanthropically supported lunatic asylums, and in London the Lock Hospital was established to treat venereal diseases. Another creation of this period was the ‘lying-in’, or maternity hospital that provided a few days rest to poor women. By 1800, London’s hospitals were treating over 20,000 patients a year. |
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| Need to come back to this one |
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Muhammad ibn Zakariya al-Razi (Rhazes) (865-925) was a Persian physician who wrote more than 200 medical treatises. After practicing medicine in Baghdad, al-Razi returned to the Persian city of Rayy, near Teheran, to be the head of its hospital. In his ten volume medical manual, he detailed anatomy, physiology, materia medica, diagnosis, surgery, pathologies of diseases. After becoming famous for his knowledge, al-Razi moved to Baghdad to head its new al-Mu’tadidi hospital in his later years. His works emphasized observation and reason, not slavish authorities of the past (although he cited Galen’s case studies). Key to his medical philosophy was the idea that experience must be the touchstone of truth.
Like Galen, he believed that nobles should receive special medical attention (making their drugs more pleasing to drink), but like many Islamic physicians he also emphasized care of the poor.
As with many of the major Islamic doctors and writers, al-Razi’s works were translated into Latin and widely circulated throughout Europe during the Middle Ages. |
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