The Medical Humanists

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The Scientific Revolution is generally thought of as the great transformation of the physical sciences that occurred during the sixteenth and seventeenth centuries, and is primarily associated with Nicolaus Copernicus (1472-1543), Johannes Kepler (1571-1630), Galileo Galilei (1564-1642), and Isaac Newton (1642-1727). Some scholars have tried to explore the problem of why the Scientific Revolution occurred in Europe in the seventeenth century, rather than in China or Islamic areas, which reached a sophisticated level in science and technology centuries earlier. Other scholars have dealt with the questions by arguing that there was no such thing as a European Scientific Revolution. After all, during the alleged Scientific Revolution, interest in astrology, alchemy, magic, religion, and theory persisted. Yet other scholars see the Scientific Revolution are a valid metaphor for the transition from a pre-modern to a modern worldview, in which science is at the very core of life and thought. Writers who lived through the era traditionally called the Renaissance often expressed an awed awareness of changing ideas, such as the Copernican Theory. John Donne (1572-1631), English poet and clergyman, thought that the sun-centered image of the cosmos might well be true, but he lamented that the new philosophy ''calls all in doubt.'' Truly, the world had lost its traditional ''coherence.'' Men no longer knew where to find the sun, the earth, and the planets. Yet poets and the human mind can eventually adjust even to the displacement of earth and sun. Alexander Pope (1688-1744), in his Essay on Man (1734), saw the new vision as exciting rather than frightening, and hoped new ideas about the universe might tell us ''why Heaven has made us as we are.''

Thus, just as the Renaissance transformed the arts, the Scientific Revolution ultimately transformed ideas about the nature of the universe and the nature of man. During the period from about 1450 to 1700, medieval scholasticism was replaced by a new approach to understanding the natural world. Applying this new mode of thought to anatomy, physiology, and medical education would have been impossible without the work of the humanist scholars. Like the scholastics of the Middle Ages, the humanists were devoted to words and books and the difficult task of integrating experience and practice with classical learning. While the intellectual ferment and scholarly enthusiasms of this period were unique, religion still permeated Renaissance life and the way in which scholars, artists, explorers, and natural philosophers saw the world, even the New World. Even if humanism was indicative of a new state of mind, half of the books printed during this era dealt with religious subject matter.

A good case can be made that humanism and humanists at universities throughout Western Europe played a key role in transforming the scholastic medieval curriculum. University faculties fought about funding, arrogant celebrity scholars, full-time and adjunct positions, pensions, and dress codes, and complained about town and gown tensions, while students attempted to censure professors for what they considered inadequate teaching. In other words, much about the academic environment has remained the same. Despite the persistence of many aspects of the medieval intellectual tradition, humanist scholars, especially those at Italian universities, fomented a real intellectual revolution. But, for many reasons, the Italian universities were in decline in the seventeenth century as universities in other regions offered strong competition for students and faculty.

While the humanist scholars were generally more concerned with art and literature than science, their new perspective served the needs of the medical sciences as well. As staunch supporters of the newly purified Galenic texts, humanist scholars rejected corrupt medieval translations. Nevertheless, their excessive respect for ancient authorities made them skeptical of attempts to create a new medical science that would be independent of the ancient Greeks. The work of Thomas Linacre (14607-1524) and John Caius (1510-1573), outstanding English medical humanists, exemplifies the nature of scholarship and medical education during this period.

Thomas Linacre studied Greek in Florence and Rome before receiving the degree of Doctor of Medicine from the University of Padua in 1496. In addition to his scholarly work, he maintained a lucrative private medical practice, taught Greek, and served as personal physician to King Henry VII. Linacre edited and translated Galen's writings on hygiene, therapeutics, disease symptoms, the pulse, and so forth. He was also highly regarded as a grammarian. His last book, a study of Latin syntax, was published posthumously. As founder and guiding light of the College of Physicians, Linacre helped to mold the character of the English medical profession. He and other elite English physicians gained the power to determine who could legally practice medicine in the Greater London area. The Royal College of Physicians had the power to fine and imprison unlicensed medical practitioners. Graduates of Cambridge and Oxford, which Linacre himself had attended, were exempted from these harsh penalties. Under the leadership of Linacre's devoted disciple John Caius, the College of Physicians grew in power and prestige, taking control of medical licensing away from religious authorities, and using strict regulations to enhance the status of approved physicians. Nevertheless, Caius was troubled by what he saw as a decline in English medical humanism.

In terms of the development of institutions of higher learning, England lagged behind the universities and professional schools of the continent. Thus, like other English scholars, Caius had to pursue his studies abroad. After abandoning his theological studies, Caius became a medical student at the University of Padua, where he met Andreas Vesalius (1514-1564), the rising star of Renaissance anatomy. Both men were involved in editing and publishing new Latin versions of Galenic texts, but their reactions to discrepancies between Galenic anatomy and the human cadaver were quite different. While Vesalius insisted on returning to the ''true book of the human body,'' Caius was confident that once all the writings of Galen were critically edited, medical knowledge would be virtually complete.

In 1546, Caius was appointed anatomical demonstrator to the United Company of Barbers and Surgeons. Since 1540, the Company of Barbers and Surgeons had been allotted the bodies of four convicted felons per year for anatomical demonstrations. After considerable lobbying by Caius and other elite physicians, the College of Physicians received a similar bequest in 1565. Whereas other presidents of the College of Physicians had generally ignored unqualified practitioners, especially outside London, Caius wanted to control medical licensing for all of England. Although his goal of raising standards for medical education and practice was laudable, efforts to limit the number of practitioners by dictating their credentials had adverse effects, especially for women and the poor. Obviously, the needs of the common people could not be met by the small numbers of physicians who belonged to the medical aristocracy, which was not necessarily a meritocracy. Because women were not admitted to the universities, female practitioners were easy targets for licensing reforms. In addition to his campaigns against unlicensed practitioners, quackery, witchcraft, and superstition, Caius challenged those who dared to criticize Galen.

Respect for the ancients did not blunt Caius' ability to observe and describe new phenomena, as shown in his account of an illness known as the English sweating sickness. His remarkable Bake or Counseill against the Disease Called the Sweate (1522) was the first original description of disease to be written in England in English. In all probability, Caius would be distressed to know that his vernacular description of the ''sweats'' is now regarded as his most important medical work. At least five severe outbreaks of Sudor Britanica, or sudor anglicus, apparently occurred between 1480 and 1580. The disease was characterized by copious sweat, fever, nausea, headache, cramps, pain in the back and extremities, delirium, hallucinations, and a profound stupor. Within about 24 hours the disease reached a critical stage, when either the disease or the patient came to an abrupt end. Even among strong, healthy men, the mortality rate was extremely high. Many victims lapsed into coma and died within 24 to 48 hours. Moreover, the disease seemed to seek out Englishmen even if potential Scottish, Irish, and Welsh victims were available.

According to Caius, a stricken town was fortunate if only half of all souls were claimed by the disease. After carefully evaluating the clinical pattern and natural history of the disease, he concluded that the sweating sickness was a new disease. Some historians believe that the disease was brought to London in 1485 when Henry Vll's mercenaries returned from France and Flanders. The disease might have been a virulent form of influenza, ergotism (a reaction to fungal toxins), food poisoning, or a totally unknown and extinct disease, but the exact nature of these epidemics and the reason for their peculiar geographical distribution are still obscure.

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