Medicine Still Bound to the Ancients
Despite the advances of anatomy, the science and art of medicine were still subject to the opinions and sayings of the great Greeks and Arabs. The testimony of the senses could hardly stand against the word of Galen and Avicenna; even Vesalius, after refuting Galen by his own dissections, said, "I could hardly trust my own eyes." Editions and translations of Galen and Hippocrates, while spreading old knowledge, also closed the road to new experience, much as the efforts of Petrarch and Ronsard to compose epics in Virgil's style diverted or frustrated their natural genius. When Thomas Linacre founded the institution later called the Royal College of Physicians (1518), the basic texts taught there were translations he had himself made of Galen.
New Drugs and Old Filth
Therapy drew on drugs newly arriving in Europe: cinchona, ipecac and rhubarb from America; ginger and benzoin from Sumatra; cloves from the Spice Islands; aloes from Cochin; camphor and cinnabar from China. This progress also encouraged wider use of native herbs. Valerius Cordus wrote the first pharmacopoeia in German (1546). The treatment of syphilis with an infusion of guaiacum wood, a plant brought to Europe from the West Indies, became so popular that the Fugger family could double its fortune by holding a monopoly of its sale throughout the realm of its debtor, Charles V. The poverty and uncleanliness of the common people always kept diseases ahead and cures behind.
Heaps of dung from draft animals poisoned the air and sometimes fouled the streets. Paris had sewers whose outlets Henry II proposed to open into the Seine, but the municipal authorities dissuaded him, explaining that the Seine was the only source of drinking water for half the inhabitants. In 1532 England commissioned bodies to study the building of sewers for the country's towns; but as late as 1844 only two English towns included the cost of collecting refuse from poor districts in public expenses. Epidemics were less frequent than in the Middle Ages, but what occurred from time to time, together with deadly childbed fever and infant mortality, was enough to keep Europe's population nearly stationary and block its growth. Between 1500 and 1568 plague repeatedly struck Germany and France. Typhus spread by lice broke out in England in several years of the period (the source's dates are inconsistent). The "sweating sickness," perhaps a kind of influenza, swept England in 1528, 1529, 1551 and 1578, Germany in 1543-1545, and France in 1550 and 1551. By report, its toll in each of the cities of Hamburg and Aachen reached a thousand in a few days. Influenza was blamed on celestial influences, and the name itself means as much. Bubonic plague appeared again in Germany in 1562 and killed 9,000 of Nuremberg's 40,000 inhabitants, though all plague statistics must be considered somewhat exaggerated. A brighter side of the picture was the gradual disappearance of leprosy and of nervous disorders known as "St. Vitus's dance."
Practitioners
Practical medicine advanced much more slowly than theory. Itinerant quack drug sellers were still plentiful, and despite some prohibiting laws it was still easy to practice medicine without an official degree. Most children came into the world at the hands of midwives. Specialization had not yet taken shape. Dentistry was not separate from medicine and surgery; barber-surgeons pulled teeth and set an ivory piece in the empty place. Nearly all physicians, Vesalius being an exception, left ordinary surgery to these barbers; but most of them were not mere barbers but trained, experienced men.
Ambroise Pare
Ambroise Pare began as a barber's apprentice and rose to be surgeon to kings. Born at Bourg-Hersent in Maine (1517), he made his way to Paris and set up his small shop on the Place Saint-Michel. In the war of 1536 he was taken on as regimental surgeon. In treating soldiers he accepted the prevailing theory that all gunshot wounds are poisoned and, like Vesalius, followed the usual treatment of cauterizing the wound with boiling elder oil, a treatment that turned pain into convulsive agony. One night the oil ran out, and Pare was forced to dress the soldiers' wounds with a salve of egg yolk, oil of roses and turpentine. The next day he wrote:
That night, he says, he could not sleep for the constant press of thoughts about the soldiers whose wounds he had been unable to cauterize; he expected to find them all dead. So he rose early to visit them, and to his great astonishment found that those he had treated with the salve felt very little pain in their wounds, with no swelling at all, and had spent a restful night. But the others, whose wounds had been treated with boiling oil, had severe fever, and their wounds were swollen and extremely painful. From then on he resolved never again to burn the poor wounded men with that cruel and painful method.
Though he had no higher education, Pare published in 1545 a small book on the treatment of wounds that is still counted among the classics of medicine. In the war of 1552 he proved that in amputation, tying the arteries to stop bleeding is better than cauterizing the stump. Captured by the enemy, he bought his freedom by performing life-saving operations. On returning to Paris he was appointed head of the surgical department of the College of Saint-Come, which horrified the Sorbonne, where a teacher without Latin was counted among the monsters of biology. Even so he became surgeon to Henry II, then Francis II, then Charles IX; and although a Huguenot, he came to no harm in the St. Bartholomew massacre, by the king's order.
His two surgical books (1573) added nothing to surgical theory but did great service to practice. He invented new instruments, made the use of artificial limbs common, introduced the truss for hernia, corrected the position of a baby born feet-first during delivery, was first to reduce a dislocated elbow, described poisoning by charcoal fumes, and declared that the fly carries disease. His reply to the congratulations showered on him after a difficult operation has become famous in medical history: "I treated him, and God healed him." Pare died in 1590 at seventy-three, having raised the standing of surgeons considerably and brought France to a level in surgery at which it kept its lead for several centuries.
Paracelsus and the Doctors
In every generation there appear people who, out of disgust with the reactionary and conservative ways of the medical profession, claim they can make wonderful cures by unusual means. They accuse physicians of laziness and cruelty, heal some patients miraculously, and then bury their names in a dark cloud of exaggeration, despair and isolation. It is not useless that such gadflies appear now and then to keep medical thought awake, and it is a good reason for medicine to treat every hasty novelty that touches human life with caution. Here as in politics and philosophy, the revolutionary young and the reactionary old, without knowing it, cooperate in that balance between change and heredity which is nature's principal method of every kind of evolution.
Philippus Theophrastus Bombastus von Hohenheim called himself Aureolus to convey his brilliance, and also Paracelsus, perhaps a Latinization of the name Hohenheim. His father, Wilhelm Bombast von Hohenheim, was the illegitimate son of a hot-tempered Swabian noble. Forced to work for his living from youth, Wilhelm practiced medicine among the poor peasants near Einsiedeln in Switzerland, and married Elsa Ochsner, an innkeeper's daughter who worked as a nurse's assistant. The family was unsettled, and this double inheritance surely had a direct effect on the formation of Philippus's unstable character and his hatred of an environment that had distorted his talents. He was born in 1493, grew up among his father's patients, and became used to the unrestrained life of inns. A doubtful report of an injury in childhood is omitted here as unreliable. His mother died when he was nine; probably for that reason father and son moved to Villach in Tyrol (the source's location). There, as the story goes, Wilhelm taught at a mining school and made alchemy his pastime. There were certainly mines in that region and a refinery, and probably little Philippus first became acquainted there with chemistry, the acquaintance on which he was later to base a revolution in medical treatment.
At fourteen Philippus went to Heidelberg to study. His restlessness shows in the way he changed universities in a short time: Freiburg, Ingolstadt, Cologne, Tubingen, Vienna, Erfurt and, in 1513-1515, Ferrara, although such academic wandering was common in the Middle Ages. In 1515, without having obtained a degree, Philippus, who now called himself Paracelsus, entered the army of Charles I of Spain as a barber-surgeon. After the war he resumed his unsettled life. If we believe his own words, he practiced in Granada, Lisbon, England, Denmark, Prussia, Poland, Lithuania, Hungary and "other lands." At the time of the Peasants' War in 1525 he was in Salzburg, treating wounded peasants and sympathizing with their sufferings and hopes. Paracelsus was drawn to socialist ceremonies and ideas; he rejected capital, interest and merchants and preached a communal system of landholding and trade and equal reward for all. In his first work, The Supreme Wisdom (1525, title as the source gives it), he set theology aside and held practical experience to be valid.