Francis Bacon (1561-1639), England's premier philosopher of science and Lord High Chancellor, said that if we considered the ''force, effect, and consequences'' of all the products of human ingenuity, the three most important inventions were printing, gunpowder, and the compass. It was especially significant, Bacon noted, that the three inventions that had changed the appearance and state of the world were unknown to the ancients.
The first European book printed with movable type appeared in 1454, which was about four years after printing began in Europe. The establishment of printing presses throughout Europe in the 1460s launched a communications revolution that might, at least in part, account for the permanence of the Renaissance. Texts printed with movable type before 1501 are known as incunabula, a term coming from the Latin word for cradle, to indicate that such texts represent the infancy of the printed book.
The print revolution accelerated the trend towards literacy, the diffusion of ideas, and the establishment of a vernacular literature, and transformed a scribal and image culture into a print culture. Interest in educational problems was not limited to higher learning and university curricula, but included reform programs for elementary education. In contrast to centuries of laboriously hand-copied manuscripts, within a few decades, millions of books had been reproduced. By the end of the fifteenth century, printing presses had been established in some three hundred European cities and towns. While scholars praised printing as ''the art that preserved all other arts,'' advocates of literacy could say ''shame on those who cannot read.'' Censorship rules were a serious threat to printers in many countries, because publishing heretical materials could be punished by imprisonment or death.
The role of the printing press in the Renaissance and the Scientific Revolution has, however, been a matter of debate among scholars. Theological, legal, and classical texts generally preceded works on science and medicine. Jean Charlier de Gerson's writings on self-abuse, De pollutione nocturna, printed in Cologne about 1466, may have been the first printed medical book. Some historians emphasize the importance of the printing press in standardizing and preserving texts, as well as increasing the numbers of texts available. Of course, careless and ignorant printers could introduce errors and multiply errors more rapidly than scribes could corrupt hand-made books. But copy editors, proofreaders (''correctors''), and skillful editors understood the danger of introducing errors. Errors in the text or the illustrations and captions could be particularly dangerous in medical and surgical books. When editing medical texts for a printer in Lyon, the French humanist Francois Rabelais (14907-1553), who is best known for his satirical attacks on superstition and scholasticism, allegedly said: ''One wrong word may now kill thousands of men!''
An avalanche of advice literature, especially texts dealing with health and diet, was a major product of the print revolution. Popular texts in the vernacular told people what foods, drugs, and spices were ''good'' or ''bad'' for their health, explaining proper food choices in terms of humoral and medical theories. Advice on hygiene still discussed the Galenic rules of health or regimen in terms of the six non-naturals: food and drink, air or the environment, exercise and rest, sleep and waking, evacuation and repletion, and the passions of the soul or the emotions. Similar formats were adopted by texts that gave advice to wealthy readers about sex, clothing, cosmetics, health, family life, managing pregnancy and childbirth, wet-nursing, child rearing, and so forth. Medical writers had to find ways of adapting medical theories to New World plants—such as tomatoes, potatoes, and tobacco—that were being used as foods and drugs. Written advice could get very detailed without causing embarrassment to the advisor or the patient. Of course, the advice literature was probably consulted more often by those who were ill than by those who might learn to preserve their health by actually following lifestyle advice. The authors of advice literature often complained that people only worried about diet and proper regimen when they were already sick.
Despite the inevitable grumbling about the vulgarity of printed books as compared to manuscripts and the fear that an excess of literacy might be subversive, scholars and an increasingly literate populace were generally more concerned with acquiring the new treasures than in complaining about the end of scribal culture. Once in print, a text could speak to students directly, rather than through the professor or keeper of manuscripts. The mass-produced book made it possible for the young to study, and perhaps even learn, by reading on their own. Without the art of papermaking, which originated in China, the knowledge revolution launched by the printing press would have been impossible. Johannes Gutenberg's Bible, one of the few early books to be printed on parchment, required the skins of three hundred sheep. Europeans would have run out of sheep before printers ran out of orders for books. Although printed books were not as difficult to obtain as manuscripts, they were still very expensive and had to be chained to library shelves to discourage theft.
Gunpowder weapons have an important place in the history of medicine because they forced surgeons to deal with problems unknown to Hippocrates and Galen. The Chinese probably invented gunpowder and the compass, but others have claimed prior or independent invention. As Europeans followed the compass around the world, they brought back new plants, animals, and remedies and left in their wake a series of ecological and demographic catastrophes that transformed the world.
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