For 1,500 years, medical practice in the Western and Arab worlds, such as it was, was dominated by the doctrines of two ancient Greeks: Hippocrates and Galen, who explained the inner workings of the body with the theory of the four humors.
But in his book, The Invention of Surgery: A History of Modern Medicine: From the Renaissance to the Implant Revolution, surgeon David Schneider observed that the exalted position of these teachings was undeserved. He said, “Even the savants of the Renaissance, who were forced to contemplate the function of the body in a world without science, were powerless to resist the allure of Hippocratic musings. Because the philosophical foundation was a fraud, medicine was ineffectual, even lethal. The Hippocratics provided much explanation for why the therapies worked: it never occurred to them that they did not.”
Schneider defined the fifteenth century as the beginning of “modern medicine” in part because “so little had changed from the time of Hippocrates to the 15th century,” but when the scientific methods of the Renaissance belatedly began to be applied to medicine, the understanding of the human body and the ability to treat it began to grow.
In a new environment of discovery, “the invention of surgery was crafted by tinkerers, oddballs, lonely geniuses, inspiring mentors, and stubborn misfits,” according to Schneider. Over centuries, a series of remarkable men used empirical observation and analysis to make insights we now take for granted:
- Andreas Vesalius—In the late 1530s, Vesalius was one of the first to learn from his own anatomical dissections, and he showed that Galen was not infallible. His book, De humani corporis fabrica (“On the Structure of the Human Body”), was “a visually stunning, didactic tour de force that…challenged 1,500 years of [Galen’s] authority.” Moreover, De fabrica “was not simply a book about the body…[but] an instruction manual for physicians.”
- William Harvey—In the seventeenth century, Harvey correctly explained the function of the heart when he declared that ”movement of the blood occurs constantly in a circular manner and is the result of the beating of the heart.” He followed Vesalius’s devotion to first-hand examination of the body, but applied his own background in physics to posit that the body operated as a machine with each organ performing a specific function that worked in relation to other organs in the body.
- “Giovanni Battista Morgagni—In the late eighteenth century, Morgagni first connected symptoms with anatomical conditions and initiated modern medical diagnosis. His work, De Sedibus et causis morborum per anatomem indagatis (“Of the seats and causes of diseases investigated through anatomy”) “made pathological anatomy a science, and diverted the course of medicine into new channels of exactness or precision.”
- John Dalton—Though he did not work in medicine, when Dalton formalized the atomic theory at the turn of the nineteenth century—explaining how atoms combine together to form chemical compounds—he prompted the rapid rise of chemistry and the ability to synthesize drugs; for the first time man could make chemicals that had “genuine and powerful effects on the human body.”
- Carl von Rokitansky and Rudolf Virchow—performed organ-based and cellular-oriented autopsies, thus furthering the understanding of morbidity. Schneider said, it was Virchow and his successors who “fathomed the significance of the cellular basis of life—forever destroying the ancient, mystical speculations about vital spirits, humors, and life forces.”
In the twentieth century, according to Schneider, “The antibiotic revolution [of the 1940s], building on the breakthroughs of the understanding of the organ and cellular basis of disease, and the founding of bacteriology meant for the first time ever that it was worth going to a doctor when you were sick.”
Nowadays, a child rightly learns to trust that, when something is wrong, the doctor can likely make you better. Knowing that that was not always the case and that we owe our well-placed modern confidence in healthcare professionals to centuries of research, discovery and diagnosis provides reassurance and comfort in times of crisis.
The Truth is in the Middle 