A medical renaissance?

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Nevertheless, life expectancy remained low and diseases, notably plague, were still rife. Conditions may, in fact, have been worse than the medieval era at times, due to the growth of cities, where sanitation was poor. Voyages of discovery brought new remedies to Europe but transported infectious diseases like smallpox to the New World, creating huge mortality in populations unfamiliar with these diseases.

New world plants like sarsaparilla and snakeroot were brought back to Europe and eager adopted. Tobacco, too, was brought from the New World to the Old, initially as a kind of cure-all for any number of ailments. Quickly it left medicine behind to become the recreational substance we know today.

The theory of the humours continued to shape learned medicine’s approach to healing. Bloodletting and purges were the mainstays of therapy. Prayers and charms remained regular preventative measures to keep disease and death at bay, and some people turned to the monarch rather than medical professionals for healthcare.

The ‘king’s touch’ was a much-vaunted ceremony in France and England, where it was believed that a monarch laying their hands on the sick would cure them of the ‘king’s evil’, or scrofula (a form of tuberculosis that could go away on its own). Charles II of England is thought to have performed the touch on as many as 90,000 people. Ordinary folk who might not be able to afford a university-educated physician relied on domestic medicine. Many ailments get better on their own, and careful nursing at home helped many people survive episodes of illness.

Quacks and questioning

Trained and trustworthy physicians were expensive so only the wealthy could benefit from their wisdom. Most people got medicine and medical advice at the apothecary’s shop, or made their own medicines with herbs gathered locally or purchased at the market. However, new kinds of commercial practitioners also began vying for custom. They sold new and exciting remedies, already packaged up, sometimes with pamphlets of information for the users. Such practitioners were often labelled “quacks” by the learned physicians who did not like the competition; Britain did not pass comprehensive laws to control who could hand out medical advice until the mid-19th century.

At the same time as the so-called quacks, however, more people than ever were showing an interest in scientific understanding thanks to the advent of the printing press. This enabled medical texts to spread quickly across Europe. Professor Mary Fissell suggests that with access to more texts came the initiative to be more questioning. “Physicians began to get critical about what they were reading, and more sophisticated with it,” she says. “For the first time, people were saying, ‘This classical authority isn’t quite right for where I am.’”

For centuries, dissecting the human body was viewed as a desecration. Although, Fissell points out that the idea the Catholic Church banned it was a myth: “It came from surgeons and anatomists wanting to portray themselves as heroic battlers against superstition. A pope decreed something in 1215, which has been misread again and again as the church being against dissection,” she says. “The church didn’t like surgeons sneaking into graveyards at night and digging up bodies. That was desecration, after all. The problem was with how they got the bodies, not with the practice of dissection itself.”

Physicians became more curious and willing to study inside the human body and, in 1543, the anatomist Andreas Vesalius published his epochal work, De Humani Corporis Fabrica (‘On the Fabric of the Human Body’). He advocated the need for dissection and was able to prove that some long-held beliefs about the body – going back to the time of Galen – were wrong.

Another graduate of Padua University in Italy, William Harvey, made another anatomical breakthrough almost a century later by accurately describing the circulation of blood around the body by the heart. This disproved once and for all another aspect of Galenic medicine. Then, in 1761, another professor at Padua, Italian physician Giovanni Battista Morgagni, published De sedibus et causis morborum per anatomen indagatis (‘The Seats and Causes of Diseases Investigated by Anatomy’) containing more than 60 years of work on the causes of disease. By conducting post-mortem examinations, he developed the science of pathological anatomy.

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In the 17th century, scientific and medical men began to investigate the unseen world by using the new invention of the microscope. The English polymath Robert Hooke published images of what he saw under the microscope, coining the word “cell” to describe the structure of cork. The Dutchman Antoine van Leeuwenhoek had used magnifying glasses to inspect the quality of fabrics he bought and sold, and then developed a new kind of microscope, seeing little wiggling “animalcules” (bacteria) and spermatozoa for the first time.

In the field of surgery, the French battlefield barber surgeon Ambroise Paré made innovations in treating wounds and invented instruments in the 16th century, earning him the nickname, ‘the father of modern surgery’. He was a modest man who often claimed that “I bandaged him and God healed him”.

Curing the Plague

For all the advancements, though, the early modern period continued to experience devastating mortality from the plague. From 1665 to 1666, the Great Plague ravaged London, killing an estimated 100,000 people, and the medical world was largely powerless to help.

The miasma theory led people to carry bottles of perfume, burn sweet-scented herbs in one’s home, or light fires in the streets to purify the air. Continued belief in humoural theory meant that bloodletting was still being regularly prescribed to restore the balance of the fluids in the body. Other ways to ward off plague were to carry lucky charms, such as a hare’s foot, or rubbing the plague sores with a live chicken. Houses were fumigated or, if those inside were already ill, closed off and marked with a cross.

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As cities experiences waves of plague, they instituted increasingly effective quarantine measures, and not just for people. It was understood that clothing and fabric might also be a vector for the disease, so trading was also regulated to help diminish the risk of transmission.

Eventually such measures succeeded; the last epidemic of plague in Western Europe occurred in Marseille in 1720-21. Thousands died, but the epidemic did not spread to the rest of Europe; it was limited to the city and its environs. And it was the last European plague; quarantine worked.

While miasma, or bad air, continued to be blamed for outbreaks of plague, the nature of contagious diseases began to be explored. Syphilis arrived in Europe in 1495, in the midst of the siege of Naples, and it was immediately recognised as a brand-new disease. There was no point looking to Hippocrates or Galen; new medical knowledge had to be made. It was quickly recognised that the disease was sexually transmitted, although often women were blamed far more than men for its spread. New drugs like mercury and the New-World guaiac wood quickly became the remedies of choice for this new ailment.

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Physicians may have failed to tackle the Great Plague effectively, but they did develop a greater understanding of contagions. “People began to see the way plague spread and reacted with quarantining measures,” Fissell explains. “The advent of the French pox, what we call syphilis, was also understood as a sexually transmitted disease early on. In the early modern period, we begin to see more articulated ideas and practices, such as increasing development of quarantines or locking people in their house when they have the plague to prevent contagion.”

This article was first published in the February 2021 edition of BBC History Revealed