Topic 2 - The Beginnings of Change

• Much of early Modern Britain’s era is also known as the Renaissance, this means rebirth in French. In general, it was a period of interest in the Greek and Roman era. This included their literature, scientific interests and architecture. It‘s had a profound impact on medicine as new ideas, technologies and scientific discoveries were created.
• New ideas and discoveries were made following the revival of the Greek passion for enquiry. Individuals began to ask questions and challenge existing ideas and theories.
• In 1660, the Royal Society came into being in Britain. It was formed as a meeting place for educated people who were interested in different aspects of science. It could even boast King Charles II as an interested attendee.
• Subject areas of the Royal Society included physics, astronomy, botany and medicine.
• The Royal Society also produced a journal, which meant that others could learn about new medical and scientific ideas. This greatly aided in the transmission of ideas and supported further study.
• Many began to find that some of the foundations of their work were inaccurate. Questions were raised about leading authorities working on medicine and the role of the Church, which had restricted certain types of research but promoted others.
• Galen, one of the key medical researchers of the time, began to be critiqued and challenged.
• Through dissection, Andreas Versalius revealed that Galen’s work on the human anatomy was wrong. He proved that the church and its insistence upon studying Galen was hindering any real progress in medicine.
• Thomas Sydenham also questioned the existing beliefs of the time. He argued in favour of practical hands on experience rather than learning from a book. He used this practical work to develop the concept of species and type in illnesses. He felt that most illnesses held a type, similar to the types of animal and vegetable species, this allowed him to improve diagnosis.
• The growing change in attitude, particularly towards religion, was not made by everyone. Religion was at the centre of people’s lives, it influenced them greatly. Conservative thinkers found it very hard to accept the new ideas and methods of investigation.
• As a consequence, a battle broke out between people defending traditional theories and those fighting for new ideas.
• New technologies also aided research. New mechanisms such as water pumps and clocks changed the way people viewed the body. They began to see the body as a type of machine. The creation of the microscope allowed scientists to see things more clearly and allowed a more detailed understanding of the body.
• Johannes Gutenberg created the printing press around 1440 and introduced it to Europe commercially from the 1450s. It revolutionised how ideas were shared. For the first time, books could be quickly and cheaply printed and distributed. Thousands of copies of a single text could be handed out. This stripped the church of its control over new research and text.
• Until this point, the only way of transcribing information was through handwritten manuscripts. They were very few in number and easy to control.
• Although there were significant changes during this period, very little improved in treating illnesses. For example, almost all the treatments used to treat the victims of the Great Plague in 1665, were the same as those used in the 1348 Black Death epidemic.
• Change was slow and subtle. Gradually, science and superstition started to separate. Enquiry led to science rather than the Church.
• At the start of the Renaissance era, around the early fifteenth century, the 3 main challenges for surgeons were pain, infection and bleeding management.
• The most effective thing they could offer a patient was surgical speed, which could save them from dying of shock or blood loss. However, this did nothing to prevent the infections that often killed patients following surgery.
• Surgeons actually increased the likelihood of infection by using instruments that had not been cleaned or sterilised.
• As a result, surgeons mainly performed simple surgeries on complaints such as broken limbs and wounds. Occasionally, they might do something deemed more risky, such as removing a kidney stone from a bladder. This was successfully performed on the famous diarist Samuel Pepys.
• By the 16th century, surgeons were having to deal with gunshot wounds on the battlefield, which no previous experience had prepared them for. Lead bullets ripped apart flesh and shattered bones as they drove deep into the body.
• From 1536 onwards, Ambroise Paré, a French barber surgeon, gained extensive battlefield experience. He was a talented surgeon who, when writing about his work, stated ”There are 5 duties of surgery: to remove what is superfluous, to restore what has been dislocated, to separate what has grown together, to reunite what has been divided, and to redress the defects of nature”.
• Paré originally studied as an apprentice to his brother before becoming a surgeon in Paris and then on the battlefield. He grew disillusioned with the effectiveness of an order method of treating gunshot wounds with boiling oil. This was, in part, because of the pain it caused to the patient.
• When Paré ran out of oil during the Siege of Turin, he turned to an old Roman concoction made of egg yolk, rose oil and turpentine. He had once read about this concoction.
• Although Paré was concerned during the night that the mixture wouldn’t work, when he inspected the wounds the next day, he found that those treated with the ointment did not suffer from fever or inflammation like those treated with boiling oil.
• Additionally, the soldiers were in much less pain. In comparison, those who were treated with boiling oil were either dead, dying or in significant pain.
• Paré published these findings in a book about gunshot wounds, which persuaded many other surgeons to turn against the boiling oil treatment.
• Paré‘s 2nd great contribution to survey was his reintroduction of the ligature in 1552 to stop bleeding after amputation. This meant that individual silk threads were tied around the open arteries to stop the blood without afflicting too much pain.
• The ligature’s principle was founded by Hippocrates and Galen. Paré reintroduced it over a millennia and a half later.
• The traditional method of Pare’s time was to seal the wound using hot irons, but this often caused the patient to die from shock.
• Paré also designed the crow’s beak instrument, to aid with the ligature process. The crow’s beak is the predecessor to the modern hemostat. It was a curved instrument that was used to clamp a bleeding vessel before it was secured with a ligature.
• While fewer patients now died of shock, they often died of infection carried into their wounds by the ligatures. Doctors were still unaware of germ theory and there were no forms of antiseptics.
• It wouldn’t be until the 1870s that the threat of infection was abated with the use of sterilised sutures, the threads used to close the wound.
• Paré’s work also had a slow impact upon medicine. Ligatures were slow to stitch and in the chaos of war, the surgery was difficult to perform. Doctors also initially viewed them with suspicion.
• It wasn’t until Paré became well known and acknowledged God’s role in his discovery, that his views became more mainstream.
• In 1628, William Harvey, an English physician, published the book ‘An Anatomical Disputation concerning the Movement of the Heart and Blood in Living Creatures’. The book described accurately for the first time, how blood was pumped around the body by the heart.
• It disproved Galen’s ideas regarding blood which had, until that point, been widely accepted for over 1500 years. It was fundamental to understanding the heart’s role in the body.
• In his study of Harvey, Thomas Wright claimed that his work “was arguably as great as Darwin’s theory of evolution and Newton’s theory of gravity”.
• Galen, an Ancient Greek physician, had made two significant claims about blood and the heart. Firstly, he stated that new blood was replaced after it was burnt up. Secondly, he suggested that there were invisible holes in the septum of the heart.
• However, the Renaissance period, which took place during the 16th and 17th century, saw many longstanding ideas being challenged. Galen’s work was no exception. Citizens across Europe were now better educated than ever before, they no longer had to rely on church figures interpreting the contents of books.