The origin & history of medicine

With the bloody crusades the art and science of medicine began

Thousands of crusaders where killed and even more where injured during the Middle Ages crusades in the middle east. Although, because of this the crusades revolutionised European medicine.

Christianity was during the Middle Ages against autopsy, however the Muslim faith allowed it, the Muslim physicians where therefore not controlled by the strict rules Christian rules. The church during most of the Middle Ages avidly opposed physicians or others dissecting human corpses. The reason being that Christianity built on the fact that they body would resurrect after death, which according to the understanding of that time was not possible if the corpse had been cut into pieces.

It was not until the 1300’s that dissection of the dead was recognized as custom in Europe, whereas in the middle east one had been performing dissections since the 100-1100’s. Procedures are described in historical middle eastern texts, in Europe however it was not yet as widespread. During the 1400’s the church finally gave up its opposition towards dissections.

Thus, the contact with physicians and medical services in the middle east offered European physicians, pharmacists and other medical staff invaluable knowledge during these bloody crusades.

Furthermore practical experience from the many bloody battles which where fought and the existence of foreign diseases, contributed to the vast development of the art of medicine in Europe.

The Middle Ages Muslim physicians were far more knowledgeable than the Christian and had, among others, texts describing how the cranium could be opened in order to drain fluid from the head and a series of surgical procedures were documented, for instance several examples of how one surgically could set the bones of broken legs.

Wounds were cleaned as much as possible, sutured and then treated with herbs and ointments. Before penicillin, which was discovered in 1928, the risk for serious infections was large.

The Middle Age physicians also possessed the knowledge of anaesthesia. Opium was popularly used to ease the patients’ pain, but it was not always available and thus most surgeries were performed without anaesthetic.

During the 1180’s the first mobile hospitals were developed, the knights of the Johanniter order – known as the Johannites – established a mobile hospital near the battle field. The wounded were given first aid and if they required additional care they were sent to the orders main hospital in Jerusalem.

The European hospitals were up until the beginning of the 1200’s not principally a place where one treated the sick but rather a combination of lodging and hospice. Here travellers and pilgrims could spend the night and the old and weak received care, but there was seldom a physician on call to offer aid if someone fell ill. Medical procedures were mostly performed in the monastery, even if the monks themselves often took care of their own. Treatment was also less important than prayer and penance for the sins one assumed lay as the cause of the disease. It was these treatments that the Europeans first brought to the middle east. A few decades later, after the first crusade ended with the conquering of Jerusalem year 1099, the European hospitals in the area began to change.

The Johannit Order was the first to adopt the new methods when founding their large hospital in Jerusalem. Around year 1180 the hospitals in the area had developed so that they could now treat and care for the sick on a larger scale, by that they were far ahead of most hospitals back home in Europe. During the 1400’s several medicine handbooks where published in Europe, for instance a German book with information and a drawing of a physicians operating table and instruments.

The need for care and different treatments has certainly been an underlying factor for this development. But also the presence of advanced hospitals in the nearby Muslim and Byzantine kingdoms played an important role. Not until the 1200’s did one start to see similar development in Europe’s medical services. In this period many crusaders and physicians had returned home – full of experience and knowledge.

Listen to the patient, Antoine Fourcroy leads an ambitious group of physicians and moves teaching to the hospital ward. They are to use their own senses in order to understand what is happening in the patient’s body, assisted by the stethoscope – invented by the French physician René Laennec in 1816.

New knowledge from animals. In the late 1800’s we find a new type of physician – the laboratory scientists. They discover a whole new discipline by performing tests on animals in a controlled environment and threaten the hospital physicians’ authority. Only when the Canadian physician William Osier establishes laboratories at the University Hospital does one manage to combine patient contact and research.

Looking at the skeleton. In 1895 the German physicist Wilhelm Röntgen experiments with electricity in a vacuum tube. The tube radiated, a then unknown, radiation which can go straight through certain materials and leave a print on paper treated with barium and platinacyanid. Two weeks later he takes a picture of his wife’s hand. Medical science quickly recognizes the possibilities and begins using x-rays to diagnose fractures.

Vaccine protects. Since the 1700’s physicians know that humans develop resistance against certain diseases if the body has once been infected. In 1870 Louis Pasteur carries out tests on animals that show if an animal is infected with a mild variety of a disease, it becomes immune against tougher varieties of the same disease.

The use of soap. In 1847 the Hungarian physician Ignaz Semmelweis persuades his obstetrician colleagues to wash their hands often and carefully. The mortality rate among delivering mothers decreases from 20 percent to less than one percent. However, medical science does not care about Semmelweis discovery since no one can explain the connection. It takes decades before cleanliness is taken seriously and influences the hospitals.

The bodys atlas. Autopsies have been performed in secrecy for hundreds of years. The catholic church proclaimed that a cut up body would not resurrect on the last day and thus forbade autopsies. Not until the 1800’s were physicians allowed to perform post-mortems on the poor who had died at the hospital and on executed criminals. For the first time one could systematically examine a vast amount of corpses and map the body’s organs and functions. Medical science makes a breakthrough in diagnosing many diseases.

Airborne bacteria. Louis Pasteurs research during the 1860’s shows that mould does not originate on its own. In a very simple experiment he pours stock into clean bowls. Some bowls are left without a lid, others are sealed. Mould only forms in the open bowls. Pasteur concludes that dust particles in the air can carry fungi pores. The new discovery within bacteria research leads to radical breakthroughs, since one has for thousands of years thought that disease originates in the body on its own.

Painless. For many hundreds of years surgery was very painful because physicians did not have any anaesthetic. During the 1800’s great progress is made within chemistry and one discovers, among others, substances that relieve the patients pain. First is the Scottish physician James Simpson who uses ether to numb patients. However, ether proves to give troubles after awakening and James Simpson tried instead to use chloroform – with great success. Chloroform quickly becomes a common anaesthetic.

The nurse. During the Crimean War (1853-56) the nurse Florence Nightingale revolutionises patient care. She manages, through cleanliness and care, to decrease mortality within the British field hospitals from 40 percent to less than 3 percent. One handed she manages to change nurses’ work from being a job for uneducated maids to a respectable profession. From around 1860 nurses are an important part of modern medical service.

Take ones temperature. The connection between fever and disease has always been known. But not until the 1800’s do physicians realize that the bodily temperature is a key to diagnosing many diseases. In 1886 the German physician Carl Wunderlich documented that 32 diseases can be diagnosed by taking the patients temperature twice a day. Temperature taking can be performed by both nurses and relatives and thus the thermometer becomes a popular aid for both hospitals and homes.

Source: Bonniers World History, nr 6, 2007 [ Världens historia nr 6 2007].