Medicine of Ironfire
derives from man’s iniquity and is the means by which the Lord punishes
idolatry and the profanation of His gospel. The principal antidote against
the plague is conversion...."
Though it was
the age of reason, such ideas were far from extinct.
Medical schools still taught the Canon of Medicine by Avicenna,
a Persian doctor who had been dead for four hundred years, and the works of
Galen, a Greek physician whose views had been the standard for more
than a thousand. Human
believed to require an equilibrium between the four main bodily fluids, or
humors -- blood, yellow bile, black bile, and phlegm. Each humor was built
up from the four elements and displayed two of the four primary qualities:
hot, cold, wet, and dry.
Doctors were reluctant to trust their own direct
observations whenever they conflicted with ancient wisdom. Out of
religious concern for the sanctity of the human body, dissections were still
chiefly restricted to animals, and strict laws prohibited the practice. Dogs
and pigs provided most of the raw material for study. By the mid 16th
century, medical faculties were reluctantly beginning to adopt the study of
corpses, mostly those of executed criminals. There were never enough, and
bright medical students, undeterred by fear of punishment, often took
matters into their own hands. By night those who could not afford the
services of grave-robbers wielded a shovel themselves, digging up fresh
corpses for clandestine study.
Most physicians rarely deigned to touch a patient, save for taking a
pulse or checking a fever, relying instead upon the examination of excreta
in order to render a diagnosis and prescribe treatment. Samples were probed
for consistency, odor, and shade. Urine was swirled, sniffed, and held up to
the light. An accomplished physician could identify more than a score of
different colors and densities, and describe the significance of each.
There were five shades of yellow, four of red, and five of green (from
pistachio to rainbow to verdigris to emerald to leek). There were two
shades near black; one translucent; and another the white of milk or
parchment, each shade carrying a specific implication. There were infinite
subtleties. Urine might smell fetid, sweet, or putrid, and display
variations due to sex, age, and mental state. The liquid might be
oleaginous, or ruddy, or resemble raw meat washings. It might remind one of
poor wine or chick-pea water. It might be thick or thin, turbid or clear,
musty or semen-like. Even the sediment could be broken into ten distinct
types, from flaky to fleshy to mucoid. To the seasoned eye and nose, such
nuances might indicate dispersion of vitality, the presence of an
atrabilious humour, deficient digestive power, or—when white or slightly
reddish—even herald the advent of dropsy.
Humors and Vapors
Doctors consulted not only medical texts but also books on astrology and
numbers--and, of course, the Bible. Hippocrates’ Epidemics was
essential in interpreting the length of time between significant stages of
disease, which could help predict the outcome. A physician would carefully
calculate where in the “medical month” (precisely twenty-six days and
twenty-two hours) a patient’s symptoms and subsequent fevers or other crises
had occurred. Every effort would be dedicated to striking the proper
balance between the all-important humors—hot and dry, cold and
moist—that kept the body well, or, when out of balance, made it ill.
After making a diagnosis, the doctor would prescribe medication, diet, or
surgery. Patients were cautioned not to eat fruit after salad, the mixture
of which could overload one’s humours with deadly results. Strenuous sex
must be avoided, for it might induce seizures. Apothecaries prepared
purgatives for syphilis, emetics for poison, and tinctures of lead and
mercury to cure the vapors, those exhalations of the liver and
stomach that produced hysteria and depression.
was primitive and most often not used at all. A surgeon's ability was
measured by the time he took to operate. A patient's hands and feet were
bound to the table while amputations or other procedures were performed.
Various methods were tried. The hammer stroke involved encasing the
patient’s head in a leather helmet that guided the surgeon as he delivered a solid blow
to the skull with a wooden hammer, rendering the patient either unconscious
or dead. Narcotic sponges were soaked in mandrake and
belladonna and pressed over the mouth of the patient, who sucked the
solution and either fell into a deep sleep or died.
Shock and sepsis killed most of
those who survived the blade.
Dried ground boar penis could cure pleurisy, while pigeon dung
was helpful for eye irritations. Grease was applied to burns, and verbena
was prescribed for the bite of a rabid dog.
was the most common treatment for alleviating symptoms of disease and for
releasing malignant humors. One palette of blood—precisely three ounces—was
let for pleurisy, and was drawn from the elbow of the arm opposite the
affected side. Two to four palettes were drawn from the chest to cure
peripneumonia. The basilic vein was bled for difficulties of the liver or
spleen, while the temporal vein was tapped for melancholy or migraine.
Every malady had its vein, and every vein its malady.
were cleaned and washed with salted water as a first aid measure.
Splinting and traction
were employed in the treatment of fractures. Broken skull bones were treated
by elevation of the depressed fragments, while trephining was resorted to
when necessary. Wounds involving soft tissues were sutured & severed
blood vessels were ligatured as the tying up of bleeding arteries & veins
had begun to replace the cautery as haemostatic. The wound was then dressed
with tow or wool. In injuries of the mouth which rendered the intake of
food difficult or impossible, nourishment administered by means of nutrient
The Medical History of Malta, Paul Cassar,
a Protestant, wanted to build a new science of medicine on the study of
nature. He insisted—radically—that physicians should rely on their eyes and
ears rather than the words of the ancients, an idea which did not find great
favor. He justified the use of a wide variety of folk cures (scorned, at
least in theory, by many physicians)
Andreas Vesalius (1514
-1564), a battlefield surgeon, supervised artists (including Titian) who
drew more accurate illustrations based upon direct observation: a blasphemy
that was not easily forgiven by the Church.
(1510-90), was self-taught, serving as an army surgeon and surgeon to the
king. He devised new surgical instruments, introduced the use of artificial
limbs and eyes, suspected flies of carrying disease, and even attempted the
implantation of artificial teeth. His most important contribution was the
development of successful techniques for battlefield amputations. He
reintroduced the old Roman practice of employing ligature prior to
amputation, which greatly reduced bleeding and shock. He abandoned the
brutal technique of plunging the limb into boiling elder oil mixed with
treacle. Having run out of oil on one occasion, he treated the raw limb with a
mixture of egg yolk, oil of roses, and turpentine. The results were
remarkable. He tried similar poultices on gunshot wounds, and noticed a
reduction in infection. From this he reached the radical conclusion that
gunshot wounds were not by themselves poisonous, theorizing that somehow
infection was introduced into the wound from outside. He used wine as an
antiseptic, and taught the repeated debridement of wounds. His use of
adhesive bandages also promoted healing. Pare's ideas, though
demonstrably effective, did not take hold in a medical culture afraid of
change. The practice of treating traumatic amputation with cautery and boiling
oil survived another 300 years.
man of science, Pare believed in witches and devils, and of course in the miraculous
cures of God, whom he never failed to credit for his successes..
medical wisdom of the 16th century:
the soul in the embryo forty days after conception. The soul
controlled growth and nutrition, sensation and motion, and all
liver created blood, which was used by the brain to create invisible
nervous spirits which flowed through the nervous system and were vectors of
sensation and motion.
nothing more than imperfect versions of men.
were either sanguine (hot and moist), choleric (hot and dry),
phlegmatic (cold and moist) or melancholic (cold and dry) according to
their predominant temperaments.
when one or more parts of the body became disturbed by an external
cause. According to Hippocratic tradition, there were six
non-naturals, whose good or bad management maintained the body in a
state of health or provoked disease. These were air, food, and drink,
exercise (including sex) and rest, sleep and wakefulness, bodily
evacuations, and the passions of the soul.
over-exercise, anger, and sexual athleticism were the sure harbingers
of disease. Hunting to excess could raise the body’s temperature,
overheat the heart, and launch a fever.
could be made from the nature of excrement, and tint of skin. A
lemon-yellow color suggested a blockage of the liver; a brown
complexion an obstruction of the spleen; a black tongue, an ardent
fever; hooked nails, phthisis, red cheeks, peripneumonia.
--from The Medical World of Early Modern France
Laurence Brockliss & Colin Jones.
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