history medicine 17th-19th century

• After the Reformation in the mid-16th century, the power of the Church declined. Science began to play a more influential role in learning. Some scientists and doctors began to challenge the old ideas by asking questions and seeking evidence themselves.
• There was much continuity during these centuries regarding popular beliefs about the causes of disease and illness. For most people, the methods of diagnosis, the prevention of disease and treatments for those who were sick remained very similar.
• Causes of disease and illness that people still believed in


  • An imbalance of the four humours
  • Bad air, or miasma
• As a result of the change towards a more scientific approach to learning, there were new medical ideas and discoveries.
• New medical ideas and discoveries


  • Small seeds spread in the air were observed using newly invented microscopes
  • Factors outside the human body (eg temperature), rather than the four humours inside the body
  • 'Animalcules' - tiny animals that could only be seen using a microscope
• However, these ideas had little impact. The general public continued to believe that illness was caused by an imbalance of the four humours.
• The world's first printing press was invented in the 15th century. As a result, books could be printed, rather than written out by hand. As it was now easier to create books, more of them appeared, and more people could access them. This meant that new ideas could be spread more easily.
• The invention of the printing press also meant that the Church no longer had control over what was written in books. Therefore, it could not control medical education. Physicians and scientists were now able to publish ideas that challenged people like Galen.
• The Royal Society


  Founded in 1660 in London to support scientists in carrying out experiments, debating new ideas and sharing new discoveries
• The Royal Society was supported by Charles II, which increased the popularity and credibility of the organisation. In 1665, the society began to issue its scientific journal. In the 21st century, The Royal Society continues to publish scientific journals and carries out its mission across the UK and globally.
• Andreas Vesalius


  • Improved the existing understanding of anatomy
  • His contribution to medicine shows a significant change in the importance of scientific methods, especially observation
  • The ideas of the ancient Greek physician Galen began to be challenged
• Vesalius


  The most famous anatomist of the Renaissance
• Dissection had previously been viewed as extremely indecent and blasphemous, but it was no longer banned because the power of the Church was decreasing. It was difficult to get a steady supply of corpses. However, Vesalius was able to carry out a large number of dissections because a local magistrate allowed him to use the bodies of executed criminals.
• Vesalius noticed that Galen had made some incorrect assumptions about the human body, as Galen had been unable to dissect human corpses. Galen had based his ideas about the human body on his dissections of animals such as monkeys, dogs and pigs. By dissecting humans, Vesalius was able to improve on Galen's previous work.
• Discoveries made by Vesalius


  • The human jaw has one bone, not two
  • The human breastbone has three parts, not seven
  • Blood does not flow into the heart through invisible holes in the septum (the wall dividing the ventricles of the heart) but is 'diffused' through it
• In 1543, Vesalius published the details of his dissections in a book called On the Fabric of the Human Body. Vesalius' discoveries led to an improved understanding of the human body.
• His book was used to train physicians across Europe, including in England. Doctors were encouraged to carry out dissections themselves and carefully observe the human body rather than relying on old books.
• Humanism


  A new way of thinking that recognised the importance of the individual in discovering the truth around them. Humanist ideas represented a challenge to the old ideas and encouraged experimentation to find the truth. They rejected the religious idea that God controlled everything.
• Thomas Sydenham


  • Encouraged physicians to move away from the classical ideas of Galen and Hippocrates towards the new scientific ideas of observation
  • Believed that to diagnose a patient's illness, a doctor needed to closely observe the symptoms and treat the disease that was causing them
  • Refused to rely solely on medical books
• Sydenham's approach


  • Observe a patient carefully
  • Record a description of their symptoms
  • Prescribe a remedy that would treat the disease
• Sydenham became known as the 'English Hippocrates' because of how important he believed it was for doctors to observe their patients. He believed that each disease was different and that doctors needed to identify the exact disease before recommending a cure. He was able to identify that scarlet fever and measles (both very dangerous diseases at the time) were different.
• Sydenham published his ideas about disease in a book called Observationes Medicae (Medical Observations) in 1676. His work led to a more scientific approach to medicine after the 18th century.
• Despite the innovations and discoveries of people such as Andreas Vesalius and Thomas Sydenham, some ideas from the medieval period about the causes of disease and illness continued to be accepted. This meant that there was a continuation in the methods generally used to care for and treat the sick.
• For most of the Renaissance, doctors continued to learn from the books of Galen and Hippocrates at university. However, the printing press meant different ideas were starting to become available in more accessible printed books. Towards the end of the Renaissance, there were changes as the ideas of Galen were challenged by individuals such as Vesalius, Sydenham and William Harvey.
• The training of physicians took a more scientific approach, encouraging observation and experimentation. Doctors had the opportunity to dissect bodies and learn using new technology, such as the microscope.
• Rich people continued to pay for a doctor or nurse to look after them at home. However, most people continued to seek cheaper remedies from an apothecary, and women continued to play an important role in the care of the sick. The first person to treat sickness was normally the patient's wife or mother. In some villages, wealthy women provided charity and care for families.
• After the Reformation, when Henry VIII closed the monasteries, the hospitals were taken over by local authorities. Hospitals were now funded by charity and run by physicians. In London, St Bartholomew's was kept open in this way. Some hospitals were beginning to concentrate on treating the sick, aiming to deal with patients' symptoms and illnesses. However, most hospitals continued to provide care in the form of food and warmth rather than medical cures.
• Treatments for illness that continued to be used


  • Bloodletting and purging
  • Herbal remedies
  • Superstition and religious beliefs
• William Harvey


  • Studied medicine at the University of Cambridge and at a famous medical school in Padua, Italy
  • Became a lecturer in anatomy and was a doctor to Charles I
  • Interested in how blood flowed around the body
• Harvey proved that Galen's ideas about how blood flows around the body were wrong.
• Harvey's experiments


  1. Dissecting human corpses and carefully observing the heart

  2. Dissecting cold-blooded animals, such as frogs, because they had a slower heartbeat and this enabled the movement of blood to be observed

  3. Measuring blood flow to show that the same blood is pumped around the body repeatedly by the heart
• Soon after his death, Marcello Malpighi, who used one of the first effective microscopes, discovered tiny blood vessels that carry blood from the arteries to the veins. We call these vessels capillaries.
• Microscopes were a key technological development in the Renaissance that transformed medical knowledge.
• In 1665, the plague returned to England and killed thousands of people. Plague had appeared several times since the Black Death in the 14th century. However, there had been very little change in medical understanding of it.
• Ideas about the cause of the plague


  • God controlled everything and sent the plague as a punishment for sin
  • An unusual alignment of the planets had caused bad air - miasma theory
  • Rotten waste had caused miasma
  • The disease was spread from person to person
• Treatments for the plague


  • Prayers for the sick
  • Wearing of magical or religious charms
  • Herbal remedies such as posies (bunches of sweet-smelling flowers and herbs)
  • Bloodletting and purging
• Attempts to prevent the spread of the plague

  • Place strong-smelling herbs and flowers over doorways and windows to prevent bad air from entering
  • Hold posies to their nose when they walked in the streets
  • Chew tobacco, which was new to England, hoping that the strong smell would fight off any bad air carrying the plague
  • Stay at home to prevent contact with others
  • Soak coins in vinegar to avoid passing on plague when buying food
• During the Great Plague, Charles II and his government ordered days of public prayer and fasting to allow people to confess their sins. This was because they believed that God could have sent the illness. The mayor of London also tried to prevent the spread with the following orders:
• Government actions to prevent the spread of the plague


  • Victims and their families were shut in their homes for 40 days and prevented from leaving so that they could not spread the illness by human contact. This was known as quarantine.
  • Barrels of tar and bonfires were lit in the streets to clean the air.
  • Animals were banned inside the city as it was thought they could spread the illness.
  • Events that attracted large crowds, such as plays and games, were banned to prevent the illness spreading through human contact.
• However, these rules were difficult to enforce because there were very few authorities in London to check, and punish, the behaviour of individuals. This was before a police force was introduced in England. The mayor of London had to rely on people to follow his orders.