Renaissance Medicine

The book that was wrong for 1,400 years

Galen, a Greek physician working in Rome in the second century, wrote the books on which every European doctor was trained until the sixteenth. He had dissected pigs, apes and dogs, because Roman law forbade the cutting of human bodies, and had described the human body from what he found in them. The Church approved him, because he wrote that the body was designed by a creator, and the universities taught him by reading his text aloud while a barber cut and a demonstrator pointed. Nobody looked to see whether the text was right. Andreas Vesalius looked. Professor at Padua at 23, he dissected the bodies of executed criminals himself and in 1543 published the Fabrica, seven volumes with woodcut illustrations that showed, among some 200 corrections, that the human jaw is one bone not two, the breastbone three parts not seven, and the wall between the two sides of the heart solid, without the holes Galen had needed to explain how blood passed through. In 1537 the French army surgeon Ambroise Pare, treating gunshot wounds at Turin, ran out of the boiling oil the textbooks prescribed and dressed the rest with egg yolk, rose oil and turpentine; the men he had not burned were the ones who recovered. In 1628 William Harvey, physician to Charles I, published proof that the blood circulates, pumped by the heart around the body and back, which no one had known. And yet in 1700 a sick Englishman was still bled, purged and treated by the four humours, as in 1400. AQA asks what these three changed, why the change stopped at knowledge and did not reach treatment, and why so many educated people resisted it for reasons that made sense to them. This module gives you the evidence and the four question shapes.

Five words the examiners use

Each definition ends with the moment it mattered, because a bare definition earns nothing in an 8-mark answer.

The beginnings of change, in order

Put these six events in the order they happened.

• Galen describes the human body from the dissection of animals, and his books become the medical textbooks of Europe
• Pare runs out of boiling oil at Turin and treats gunshot wounds with a soothing dressing instead
• Vesalius publishes the Fabrica, correcting Galen from his own dissections
• Pare uses ligatures instead of the cautery to seal amputations
• Harvey publishes De Motu Cordis and proves that the blood circulates
• Malpighi sees the capillaries through a microscope and closes the gap in the theory of Harvey

Why did the challenge to Galen come when it did?

Galen had been unchallenged for fourteen centuries. Which explanation best accounts for the challenge coming in the sixteenth and seventeenth centuries?

• The Renaissance taught scholars to go back to the original Greek texts and then to the original body, and the humanist habit of questioning authority reached medicine through the universities of Italy; the printing press let Vesalius send accurate woodcuts across Europe from 1543, which no manuscript could; the Reformation weakened the Church that had guaranteed Galen; and individuals of unusual nerve, Vesalius stealing bodies from the gallows and Harvey dissecting live animals, were willing to look where the text said not to.
• The microscope let doctors see germs for the first time.
• The Church ordered doctors to correct Galen.
• The plague forced doctors to find new cures.

What changed, and what did not

The significance question asks what a discovery changed at the time and over the longer term. Put what the three men changed beside what stayed the same, and the answer to why is on the right.

Question 1: how useful is a source?

Source A: a description of the woodcut title page of the Fabrica, printed in Basel in 1543. In the centre a corpse lies on a table with its abdomen opened; Vesalius himself stands beside it with his hand inside the body, looking out at the viewer. Around them a crowd of students, scholars and townspeople press in to see; a skeleton is mounted above the table; a dog and a monkey are drawn at the sides; under the table the barber-surgeons who used to do the cutting sit idle, sharpening their razors. AQA Question 1 asks how useful the source is to a historian studying the challenge to medical authority in the Renaissance. Tap the TWO details a top-level answer would use to show what had changed.

• Vesalius has his own hand inside the body, showing that the professor now dissected himself instead of reading Galen while a barber cut.
• A skeleton is mounted above the table.
• A dog and a monkey are drawn at the sides while the barber-surgeons sit idle beneath, showing that the animals Galen had dissected and the men who had done the cutting have both been pushed to the margins by the human body on the table.
• A large crowd has gathered to watch.
• The book was printed in Basel.

Why opposition persisted

Select the THREE statements that correctly explain why the new ideas were resisted, as the grade-9 note requires, rather than dismissing the opposition as ignorance.

• The Church had endorsed Galen because he described a body made by a creator, and it restricted dissection to a few executed criminals a year, so that to question Galen was to question the Church at the moment of the Reformation when the Church was least able to allow it.
• Physicians had spent years learning Galen at university and were licensed by the College of Physicians on that learning, so that accepting Vesalius or Harvey meant admitting their training was wrong and their fees unearned; Paris taught Galen into the 1670s for that reason.
• The discoveries changed no treatment: Harvey could not say why the blood circulated or what to do about it, could not see the capillaries until Malpighi did in 1661, and lost patients after 1628 because his ideas made his cures no better, so that a doctor who rejected him lost nothing in practice.
• Doctors were too stupid to understand the new books.
• The Fabrica was banned and all copies burned.
• Parliament made it illegal to teach the circulation of the blood.

Which factor mattered most, c1500 to c1700?

The 16-mark question names one factor and asks whether it was the main one across a period. For the beginnings of change the strong answer weighs the factors with dated evidence and notices which factor was missing, because its absence is why knowledge grew and treatment did not. Communication carried every discovery: the printing press turned the Fabrica into a European textbook within a decade, Pare wrote in French so that surgeons could read him, and De Motu Cordis was argued over from Padua to Paris because it could be bought. The individual did the looking: Vesalius, Pare and Harvey each broke a rule that everyone else kept. Science and technology supplied the woodcut, the printing press and, at the end, the microscope of 1661 that closed the gap in Harvey. Religion worked both ways, the Reformation loosening the grip of the Church while the Church itself still restricted dissection. Chance gave Pare an empty oil pot at Turin. War gave him the wounds. Government did nothing, and there was no germ theory, which is why none of it cured anyone. This meant that the factors that drove the beginnings of change were communication and the individual together, and a judgement that says which was necessary first, and shows with dates that a discovery nobody could read would have died with its discoverer, reaches the top level.

In the shoes of the three men

Four decisions between 1537 and 1628. Choose what was actually done, and notice what each choice cost or won.

• 1537, the siege of Turin. You are Pare, a young army surgeon. The textbooks say gunshot wounds are poisoned and must be cauterised with boiling oil, and tonight the oil has run out with wounded men still waiting. What do you do?
• 1540. You are Vesalius, professor of surgery at Padua, aged 25. The custom is to lecture from Galen while a barber cuts. You have noticed that what the barber uncovers does not match the text. What do you do?
• 1616. You are Harvey, lecturing at the College of Physicians in London. You have seen the valves in the veins and know they only let blood flow towards the heart, which Galen cannot explain. What do you do?
• 1630. You are Harvey. Physicians are calling you Circulator, a word for a quack, your practice is shrinking, and Paris will not teach your book. The one thing you cannot show is how blood gets from the arteries to the veins. What do you do?

From cause to consequence

Because Roman law had forbidden human dissection, _____ described the human body from apes and pigs, and his errors stood for fourteen centuries. Because Renaissance scholars went back to the original texts and then to the original body, Vesalius dissected criminals at Padua and printed the _____ in 1543 with woodcuts that showed what he found. Because Pare ran out of boiling oil at Turin in _____, he discovered that a soothing dressing healed gunshot wounds better than burning. Because Harvey could prove that the blood circulates but not why, or what to do about it, his ideas changed no _____ in his lifetime. And because there was no theory linking the new anatomy to disease, a patient in 1700 was still treated by the four _____.

The arithmetic of Harvey

Harvey estimated that the heart pushes out about 2 ounces of blood with every beat, and counted about 72 beats a minute. How many ounces of blood does that put through the heart in one minute?

Question 3: in what ways were they similar?

AQA Question 3 might read: Compare the work of Vesalius and the work of Harvey. In what ways were they similar? Explain your answer with reference to both. It is marked on similarities explained with support from both, for 8 marks. Which answer scores in the top level?

• Both overturned Galen by looking rather than reading: Vesalius dissected executed criminals at Padua and showed in 1543 that the jaw was one bone and the septum of the heart solid, and Harvey dissected and experimented for twelve years before showing in 1628 that blood circulates through a heart that pumps. Both also changed knowledge without changing treatment and were resisted for it: the Fabrica was attacked by Galenists who said the body must have changed since Galen, and Harvey was called Circulator and lost patients, because neither discovery offered a doctor a new cure.
• Both were famous doctors who made important discoveries.
• Vesalius corrected 200 errors in Galen and published the Fabrica with beautiful woodcuts.
• They were different because Vesalius studied structure and Harvey studied function.

Question 2: significance, marked

Question 2: Explain the significance of the work of Vesalius in the development of medicine. The significance of Vesalius at the time was that he made anatomy a matter of evidence. By dissecting human bodies himself at Padua, rather than lecturing from Galen while a barber cut, he found that Galen had described animals, and in the Fabrica of 1543 he printed the corrections with woodcuts accurate enough to be checked: the jaw one bone, the breastbone three parts, and a solid wall in the heart where Galen had needed holes. This meant that the authority of a text could now be tested against the body, and within a generation anatomists across Europe were working from dissection, which the printing press made possible by carrying the same pictures to every university. The longer significance is what his method made possible rather than what he found: Harvey used dissection and the solid septum to prove the circulation in 1628, and every later advance in surgery depended on knowing where the vessels ran. His limit is equally significant: he changed what doctors knew and nothing that they did, because without a theory of disease there was no way to turn a correct anatomy into a cure, and patients were treated by the humours for another two centuries. What earned the marks: significance explained at the time (a method and a book, with dated support); the link phrase this meant that; significance explained over the longer term (what the method made possible); and the limit stated as part of the significance rather than as an afterthought. Both timescales, tied together, are what reach the top level of the 8-mark significance question.

Question 4: the 16-mark factors judgement

Has communication been the main factor in the development of medicine in Britain in the years c1500 to c1700? Explain your answer with reference to communication and other factors.

• One paragraph on communication, with at least three dated examples: the printing of the Fabrica in 1543, Pare writing in French, De Motu Cordis in 1628 and the argument it started across Europe
• At least two paragraphs on other factors from the AQA list, each with dated support: the role of the individual, science and technology (the woodcut, the microscope of 1661), religion working both ways, chance and war for Pare

Question 4: the judgement, tested

A student has argued that communication was the main factor in the beginnings of change. Which is the strongest point to set AGAINST that judgement, in the way the top level of Question 4 requires?

• Printing spread the discoveries but did not make them: Galen was printed too, in far larger numbers, and stayed the textbook at Paris into the 1670s, so what the press carried depended on what individuals had first been willing to see, Vesalius with a knife in a criminal in 1540, Pare with an empty oil pot in 1537, Harvey with twelve years of experiments before 1628; communication was the main factor in the spread of change and the individual the main factor in its origin, and a judgement should give each its stage rather than one the whole.
• Nothing really changed before 1700, so no factor was the main one.
• Religion was the main factor because the Church controlled everything.
• The printing press was invented in the 1450s, so communication must be the main factor.