FIFTEENTH-CENTURY MEDICINE

FIFTEENTH-CENTURY MEDICINE

The thirteenth and fourteenth centuries had seen some slight

advancement in the science of medicine; at least, certain

surgeons and physicians, if not the generality, had made

advances; but it was not until the fifteenth century that the

general revival of medical learning became assured. In this

movement, naturally, the printing-press played an all-important

part. Medical books, hitherto practically inaccessible to the

great mass of physicians, now beca 18418e421s me common, and this output of

reprints of Greek and Arabic treatises revealed the fact that

many of the supposed true copies were spurious. These discoveries

very naturally aroused all manner of doubt and criticism, which

in turn helped in the development of independent thought.

A certain manuscript of the great Cornelius Celsus, the De

Medicine, which had been lost for many centuries, was found in

the church of St. Ambrose, at Milan, in 1443, and was at once put

into print. The effect of the publication of this book, which had

lain in hiding for so many centuries, was a revelation, showing

the medical profession how far most of their supposed true copies

of Celsus had drifted away from the original. The indisputable

authenticity of this manuscript, discovered and vouched for by

the man who shortly after became Pope Nicholas V., made its

publication the more impressive. The output in book form of other

authorities followed rapidly, and the manifest discrepancies

between such teachers as Celsus, Hippocrates, Galen, and Pliny

heightened still more the growing spirit of criticism.

These doubts resulted in great controversies as to the proper

treatment of certain diseases, some physicians following

Hippocrates, others Galen or Celsus, still others the Arabian

masters. One of the most bitter of these contests was over the

question of "revulsion," and "derivation"--that is, whether in

cases of pleurisy treated by bleeding, the venesection should be

made at a point distant from the seat of the disease, as held by

the "revulsionists," or at a point nearer and on the same side of

the body, as practised by the "derivationists." That any great

point for discussion could be raised in the fifteenth or

sixteenth centuries on so simple a matter as it seems to-day

shows how necessary to the progress of medicine was the discovery

of the circulation of the blood made by Harvey two centuries

later. After Harvey's discovery no such discussion could have

been possible, because this discovery made it evident that as far

as the general effect upon the circulation is concerned, it made

little difference whether the bleeding was done near a diseased

part or remote from it. But in the sixteenth century this

question was the all-absorbing one among the doctors. At one time

the faculty of Paris condemned "derivation"; but the supporters

of this method carried the war still higher, and Emperor Charles

V. himself was appealed to. He reversed the decision of the Paris

faculty, and decided in favor of "derivation." His decision was

further supported by Pope Clement VII., although the discussion

dragged on until cut short by Harvey's discovery.

But a new form of injury now claimed the attention of the

surgeons, something that could be decided by neither Greek nor

Arabian authors, as the treatment of gun-shot wounds was, for

obvious reasons, not given in their writings. About this time,

also, came the great epidemics, "the sweating sickness" and

scurvy; and upon these subjects, also, the Greeks and Arabians

were silent. John of Vigo, in his book, the Practica Copiosa,

published in 1514, and repeated in many editions, became the

standard authority on all these subjects, and thus supplanted the

works of the ancient writers.

According to Vigo, gun-shot wounds differed from the wounds made

by ordinary weapons--that is, spear, arrow, sword, or axe--in

that the bullet, being round, bruised rather than cut its way

through the tissues; it burned the flesh; and, worst of all, it

poisoned it. Vigo laid especial stress upon treating this last

condition, recommending the use of the cautery or the oil of

elder, boiling hot. It is little wonder that gun-shot wounds were

so likely to prove fatal. Yet, after all, here was the germ of

the idea of antisepsis.