The Middle Ages covers an enormous period ranging from the Roman Emperor Constantine’s conversion to Christianity in 313 C.E., through the early medieval period known as the Dark Ages, to Martin Luther’s launching of the Protestant Reformation in 1517.
Advances in the Muslim world
Abuclasis-The father of Modern SurgeryAbu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi (936 - 1013), also known in the West as Abulcasis, was an Andalusian-Arab physician, surgeon, chemist, cosmetologist, and scientist.
He is considered the father of modern surgery, and as Islam's greatest medieval surgeon, whose comprehensive medical texts shaped both Islamic and European surgical procedures up until the Renaissance. His greatest contribution to history is the Kitab al-Tasrif, a thirty-volume encyclopedia of medical practices.
Abu al-Qasim Khalaf ibn al-Abbas Al-Zahrawi (936 - 1013), also known in the West as Abulcasis, was an Andalusian-Arab physician, surgeon, chemist, cosmetologist, and scientist.
He is considered the father of modern surgery, and as Islam's greatest medieval surgeon, whose comprehensive medical texts shaped both Islamic and European surgical procedures up until the Renaissance. His greatest contribution to history is the Kitab al-Tasrif, a thirty-volume encyclopedia of medical practices.
Abu al-Qasim was born in the city of El Zahra, six miles northwest of Córdoba, Spain. He was descended from the Ansar Arab tribe who settled earlier in Spain.
Abu al-Qasim was a court physician to the Andalusian caliph Al-Hakam II. He devoted his entire life and genius to the advancement of medicine as a whole and surgery in particular. His best work was the Kitab al-Tasrif. It is a medical encyclopaedia spanning 30 volumes which included sections on surgery, medicine, orthopaedics, ophthalmology, pharmacology, nutrition etc.
In the 14th century, French surgeon Guy de Chauliac quoted al-Tasrif over 200 times. Pietro Argallata (d. 1453) described Abu al-Qasim as "without doubt the chief of all surgeons".
In an earlier work, he is credited to be the first to describe ectopic pregnancy in 963, in those days a fatal affliction. Abu Al-Qasim's influence continued for at least five centuries, extending into the Renaissance, evidenced by al-Tasrif's frequent reference by French surgeon Jaques Delechamps (1513-1588).
In his Al-Tasrif (The Method of Medicine), he introduced his famous collection of over 200 surgical instruments. Many of these instruments were never used before by any previous surgeons. He was in Cordona,Spain and so this was a favorite haunt for people from all over Europe traveling requiring treatment.
Another great doctor of Córdoba, born in the 12th century, just as the sun of Arabian culture was setting, was the Jewish philosopher Maimonides Banished from the city because he would not become a Muslim, he eventually went to Cairo, where the law was more lenient and where he acquired a reputation so high that he became physician to Saladin, the Saracen leader. (He was the original of El Hakim in Sir Walter Scott's Talisman.) A few of his works, written in Hebrew, were eventually translated into Latin and printed.
Advances in Europe
It is sometimes stated that the earlyChristian Church had an adverse effect upon medical progress. Disease was regarded as a punishment for sin, and such chastening demanded only prayer and repentance. Moreover, the human body was held sacred and dissection was forbidden. But the infinite care and nursing bestowed upon the sick under Christian auspices must outweigh any intolerance shown toward medicine in the early days.
Perhaps the greatest service rendered to medicine by the church was the preservation and transcription of the classical Greek medical manuscripts. These were translated into Latin in many medieval monasteries, and the Neostorin Christians (an Eastern church) established a school of translators to render the Greek texts into Arabic. This famous school, and also a great hospital, were located at Jundi Shāhpūr in southwest Persia, where the chief physician was Jurjīs ibn Bukhtīshūʿ, the first of a dynasty of translators and physicians that lasted for six generations. A later translator of great renown was Johannitus (born ad 809), whose translations were said to be worth their weight in gold.
About this time there appeared a number of saints whose names were associated with miraculous cures. Among the earliest of these were twin brothers, Cosmas and Damian, who suffered martyrdom (c. ad 303) and who became the patron saints of medicine. Other saints were invoked as powerful healers of certain diseases, such as St. Vitus for chorea (or St. Vitus' dance) and St. Anthony for erysipelas (or St. Anthony's fire). The cult of these saints was widespread in medieval times, and a later cult, that of St. Roch for plague, was widespread during the plague-ridden years of the 14th century.
At about the same time that Arabian Medicine flourished, the first organized medical school in Europe was established at Salerno, in southern Italy. Although the school of Salerno produced no brilliant genius and no startling discovery, it was the outstanding medical institution of its time and the parent of the great medieval schools soon to be founded at Montpellier and Paris, in France, and at Bologna and Padua, in Italy. Salerno drew scholars from near and far. Remarkably liberal in some of its views, Salerno admitted women as medical students. The school owed much to the enlightened Holy Roman emperor Frederick II, who decreed in 1221 that no one should practice medicine until he had been publicly approved by the masters of Salerno.
The Salernitan school also produced a literature of its own; the best-known work, of uncertain date and of composite authorship, was the Regimen Sanitatis Salernitanum ("Salernitan Guide to Health"). Written in verse, it has appeared in numerous editions and has been translated into many languages. Among its oft-quoted couplets is the following:
Use three physicians still, first Doctor Quiet,
Next Doctor Merryman, and Doctor diet.
Salerno yielded its place as the premier medical school of Europe to Monteplier in about 1200. John of Gaddesden, the model for the "doctour of physick" in Chaucer's Canterbury tales, was one of the English students there. That he relied upon astrology and upon the doctrine of the humours is evident from Chaucer's description:
Well could he guess the ascending of the star
Wherein his patient's fortunes settled were.
He knew the course of every malady,
Were it of cold or heat or moist or dry.
Medieval physicians analyzed symptoms, examined excreta, and made their diagnoses. Then they might prescribe diet, rest, sleep, exercise, or baths; or they could administer emetics and purgatives or bleed the patient. Surgeons could treat fractures and dislocations, repair hernias, and perform amputations and a few other operations. Some of them prescribed opium, mandragora, or alcohol to deaden pain. Childbirth was left to midwives, who relied on folklore and tradition.
Great hospitals were established during the Middle Ages by religious foundations, and infirmaries were attached to abbeys, monasteries, priories, and convents. Doctors and nurses in these institutions were members of religious orders and combined spiritual with physical healing.
Among the teachers of medicine in the medieval universities there were many who clung to the past, but there were not a few who determined to explore new lines of thought. The new learning of the Renaissance, born in Italy, grew and expanded slowly. Two great 13th-century scholars who influenced medicine were Roger Bacon, an active observer and tireless experimenter, and Albertus Magnus, a distinguished philosopher and scientific writer.
About this time Monedinnio de Luccio taught at Bologna. Prohibitions against human dissection were slowly lifting, and Mondino performed his own dissections rather than following the customary procedure of entrusting the task to a menial. Although he perpetuated the errors of Galen, his Anothomia, published in 1316, was the first practical manual of anatomy. Foremost among the surgeons of the day was Guy De a physician to three popes at Avignon. His Chigurgia magna ("Great Surgery"), based on observation and experience, had a profound influence upon the progress of surgery.
The Renaissance in the 14th, 15th, and 16th centuries was much more than just a reviving of interest in Greek and Roman culture; it was rather a change of outlook, an eagerness for discovery, a desire to escape from the limitations of tradition and to explore new fields of thought and action. In medicine, it was perhaps natural that anatomy and physiology, the knowledge of the human body and its workings, should be the first aspects of medical learning to receive attention from those who realized the need for reform.
It was in 1543 that Andreas Vesalius, a young Belgian professor of anatomy at the University of Padua, published De humani corporis fabrica ("On the Structure of the Human Body"). Based on his own dissections, this seminal work corrected many of Galen's errors. By his scientific observations and methods, Vesalius showed that Galen could no longer be regarded as the final authority. His work at Padua was continued by Gabriel Fallopius and, later, byHieronymus Hieronymus Fabricius ab Aquapendente; it was his work on the valves in the veins, De venarum ostiolis (1603), that suggested to his pupil William Harvey his revolutionary theory of the circulation of the blood, one of the great medical discoveries.
Ambrose Pare-Father of modern surgerySurgery profited from the new outlook in anatomy, and the great reformer Ambrose Pare dominated the field in the 16th century. Paré was surgeon to four kings of France, and he has deservedly been called the father of modern surgery. In his autobiography, written after he had retired from 30 years of service as an army surgeon, Paré described how he had abolished the painful practice of cautery to stop bleeding and used ligatures and dressings instead. His favourite expression, "I dressed him; God healed him," is characteristic of this humane and careful doctor.
In Britain during this period surgery, which was performed by barber-surgeons, was becoming regulated and organized under royal charters. Companies were thus formed that eventually became the royal colleges of surgeons in Scotland and England. Physicians and surgeons united in a joint organization in Glasgow, and a college of physicians was founded in London.
The 16th-century medical scene was enlivened by the enigmatic physician and alchemist who called himself Paracelsus . Born in Switzerland, he traveled extensively throughout Europe, gaining medical skills and practicing and teaching as he went. In the tradition of Hippocrates, Paracelsus stressed the power of nature to heal; but unlike Hippocrates he believed also in the power of supernatural forces, and he violently attacked the medical treatments of his day. Eager for reform, he allowed his intolerance to outweigh his discretion, as when he prefaced his lectures at Basel by publicly burning the works of Avicenna and Galen. The authorities and medical men were understandably outraged. Widely famous in his time, Paracelsus remains a controversial figure to this day. Despite his turbulent career, however, he did attempt to bring a more rational approach to diagnosis and treatment, and he introduced the use of chemical drugs in place of herbal remedies.
A contemporary of Paracelsus,Girolamo Fracastoro of Italy was a scholar cast from a very different mold. His account of the disease syphilis, entitled Syphilis sive morbus Gallicus (1530; "Syphilis or the French Disease"), was written in verse. Although Fracastoro called syphilis the French disease, others called it the Neapolitan disease, for it was said to have been brought to Naples from America by the sailors of Christopher Columbus. Its origin is still questioned, however. Fracastoro was interested in epidemic infection, and he offered the first scientific explanation of disease transmission. In his great work, De contagione et contagiosis morbis (1546), he theorized that the seeds of certain diseases are imperceptible particles transmitted by air or by contact.
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