Cancer: Medieval Medicine: Greece and Rome Revisited

by National Cancer Institute

(Page 2 of 9)

1110 - 1478

AFTER THE FALL OF ROME, Constantinople became the intellectual storehouse of civilization. From there, in Arabic translations, classic Greek and Roman texts made their way back through Europe. While the Church emphasized the healing powers of faith, medical arts and philosophy remained rooted in Aristotle and Galen. The rise of universities and medical schools in the Middle Ages heralded the explosive genius of dawning Renaissance.

Medical Practice in the East

The ancient teachings of Galen continued to inspire physicians in Constantinople, Cairo, Alexandria, Athens and Antioch in a time when magic spells and myths dominated the West. Islamic scholars translated Greek and Roman works, spreading knowledge west to Spain and east to Persia and Baghdad. Despite the Church's bias against science, Constantinople served as a vital crossroads in the preservation and dispersal of medical wisdom.

Medieval Views of Disease

Sin, Satan, astrology and the ancient Greek theory of the four bodily humors-blood, phlegm, yellow bile and black bile-were variously invoked to explain human illness. Uroscopy charts depicted shades and conditions of urine samples, and indicated what diseases might be the cause. Cancer continued to be explained as the result of an excess of black bile, curable only in its earliest stages.

Death by Epidemic: The Black Plague

In 1347 bubonic plague carried by infected Crusaders struck Italy and spread through Europe. Helpless, doctors could only watch as the plague claimed over 42 million lives, a quarter of the population, in six years. Jews were blamed for the plague and were hanged or burned alive. Despair, chaos and economic upheaval caused a profound loss of faith in society's institutions and accelerated the decline of feudalism.

Research and Creativity
Rediscovered In The Renaissance

1517 - 1590

WITH THE FALL OF CONSTANTINOPLE, invention of the printing press, and voyages of discovery to the New World, the medieval world ended and the modern world began. In every discipline dogma was discarded, replaced by the humanist spirit of individual dignity and spiritual freedom expressed in such acts as Martin Luther's religious revolt and Paracelsus' burning of the works of Galen. Science and surgery advanced as physicians returned to direct observation of the human body.

Ambroise Paré, Surgeon of the Age

An unschooled barber-surgeon, Ambroise Paré became the greatest surgeon and surgical writer of the Renaissance. Rejected by medical schools, he was educated by the army on the battlefields, and saved thousands of lives by ending the use of burning oil to cleanse wounds. He abandoned cautery and taught the use of ligatures in amputations. Paré recommended surgery for cancer only if the cancer could be totally removed.

The Art of Anatomy

The most significant medical discoveries of the 16th century were in anatomy. Antonio Benivieni published his observations of autopsies in 1507, and Leonardo da Vinci, Michelangelo and Albrecht Dürer participated in dissections. The greatest anatomist was Andreas Vesalius. At 28 he revolutionized anatomy with De Humani Corporis Fabrica, describing and illustrating bones, muscles, blood vessels, nerves and internal organs.

Contemporary Views on Cancer

The theory that cancer was caused by an excess of black bile (one of the so-called four bodily humors: blood, phlegm, yellow bile and black bile) continued to prevail in the 16th century. Cancer was considered incurable, although a wide variety of pastes containing arsenic were compounded to treat its manifestations.

Syphilis and Early Theories of Infection

Syphilis was epidemic in the 16th century, the unhappy legacy of armies and navies on the move. The French called it "the disease of Naples"; the Neapolitans, "the French disease"; and priests called it a plague sent down from heaven. Girolamo Fracastoro (1483-1553) was the first to ascribe the spread of syphilis to living organisms. In De Contagione he stated the modern theory of infection by invisible germs and modes of disease transmission.

Experimental Medicine's Beginning In The 17th Century

1609 - 1665

THE FOUNDATIONS OF MODERN SCIENCE were laid in the 17th century. Scientists asked "how" rathen than "why," aided by the microscope and other new instruments. Galileo's telescope and Newton's laws of gravitation advanced understanding of the physical universe, and William Harvey described the continuous circulation of the blood. With the humoral theory of disease discarded, and cancer no longer attributed to bile, researchers looked for answers elsewhere.

Cancer Surgery in the 17th Century

While techniques improved, lack of anesthesia and antiseptic conditions made surgery a risky choice. A renowned German surgeon, Fabricius Hildanus, removed enlarged lymph nodes in breast cancer operations, made amputations at the thigh, and devised a tourniquet to control bleeding. Johann Scultetus performed total mastectomies, and Marco Severinus' illustrated book on surgical pathology was a landmark in the field.

17th Century Theories on the Causes of Cancer

The old theory of disease based on bodily humors was discarded in the 17th century. Discovery by Gaspare Aselli of the vessels of the lymphatic system suggested abnormalities of lymph as the primary cause of cancer. Attention was focused on lymph nodes, which now were more frequently removed when enlarged and near the tumor site. Lymphatic drainage became the key factor in developing more extensive surgical removal of cancer.

Discovery of Circulation by Experiment

William Harvey's brilliant proof of the continuous circulation of the blood in a contained system was the 17th century's most significant achievement in medicine and physiology. Harvey's contemporary Aselli discovered the lymphatic vessels through experiments on animals, leading to a theory attributing cancer to lymph abnormalities.

The Beginnings of Medical Demography

The gathering of statistics to improve health care was the inspiration not of a doctor, but of an English tradesman and ward politician, John Graunt. He was the first to analyze data from weekly parish records of christenings, marriages and burials. The spirit of quantification pervading scientific thought helped others to see the importance of Graunt's work, and he was made a fellow of the Royal Society.

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