Medical Humanists of the Renaissance.
Elizabeth Pahk Cressman MD, PhD.

The word Humanist was used in late Quattrocento Italy to describe a teacher of the humanities. The medical humanists of the Renaissance that I shall discuss this evening are medical doctors whose focus was on the study of Humanism. Among many powerful humanists, there were number of medical doctors. They were called Homo Universale, universal men with broad interests in all aspects of culture. I will examine their work, their influence on the course of medical history, and I will summarize their work inthe context of the Renaissance culture.

The word Renaissance originally was used conceptually, meaning a revival of antiquity, but from Jacob Burkhardt, the 19th century Renaissance scholar onward, it also describes the certain historical period, usually, from the time of Petrarch (1304 to 1374) to the death of Erasmus in 1536. The medical humanists that I shall discuss belonged to approximately this historical period.

Philosophical humanism started in the late Middle Ages in "Studia Humanitatis", the studies of humanities in the newly founded universities. During the early middle ages, man thought himself as a part of the universal order of things represented by the church. But with the rise of humanism, this perspective was radically changed. Human values, human dignity, and welfare of human affairs became the center of consciousness. No longer were humanists satisfied with the church dogma, which dominated the medieval world. Arid, rigid Scholasticism of the middle age was waning. The emphasis was on the realism, naturalism, and individualism. The ultimate goal of humanism was the betterment of the lives of mankind on earth. The Oration "On the Dignity of Man" by Pico Della Mirandola, a Neoplatonist and a giant humanist of the time, most forcefully expressed the ideals of Quatrocento Italy. In his oration, Pico places attention on the free will of mankind and human perspective. Man was the elan of Gods purpose.

The 16th century French political philosopher Jean Bodin claimed that reading could cure illness of the mind and body and to prove his belief, Bodin gave examples. Alfonso V and Ferdinand 1 of Aragon, Livy, and his contemporary, Quintus Curtius, described similar examples. In this modern age, it may sound rather strange, but what I am trying to say is that from very early history, the art of healing, the culture of medicine was placed in the realm of intellectual speculation and medical humanists continued this tradition.

Most of the medical humanists of Renaissance received some of their medical training in Italy, such as universities of Padua, Bologna, Ferrara and Pisa for two reasons; First, Italy was far more advanced in medicine than other countries, second, after the fall of Constantinople in 1453, many Greek scholars poured into Italy with their rich cultural background. Until this time, Arab medicine was invincible, but this occasion became the beginning of the decline of Arab medicine. For physicians, a new exciting era had arrived.

There were number of humanists who formed the golden age of the Quattrocento Italian Renaissance, and Florence was its leader. A great humanist, Leonardo Bruni, said, "Florence harbors the greatest mind, whatever they undertake, they easily surpass other men". The champion of this movement was a great poet, Francesco Petrarch. He claimed, "After the darkness has been dispelled, our grandsons will be able to walk back into the pure radiance of the past. In order to forget my own time, I have constantly striven to place myself in other ages." The Humanists yearned for the ideals and glory of the past. Petrarch's sonnet for his lover Laura and his imaginary conversation with St. Augustine in his book titled "Secret" exemplifies the essence and the energy behind the Italian Renaissance. Religious idealization of untouchable ladies in courtly love of the middle age seemed rather unreal. Contrast to this, Petrarch's portrayal of Laura was of a real human being, a natural individual with blood and flesh.In "Secret" the conflict between new ideas of Petrarch and St. Augustine is vividly shown. Petrarch concluded that despite the importance of the next world to come, the world of here-and-now held many delights, which must not be shunned. One of the maxims, Lorenzo the Magnificent had inscribed in his villa reads "Flee troubles, be happy in the present". These were some of the ideas behind the Florentine Renaissance.

The humanists were bibliophiles and passionately collected Greek and Latin manuscripts and feverishly corrected mistakes. Many humanists were grammarians and philologists, such as Lorenzo Valla, Poliziano, and Barbaro. As a result, ancient manuscripts were impeccably translated. Medical humanists followed the path parallel to other humanists. These doctors corrected inaccurately translated, Arabized Hippocrates, Galen, Dioscorides, and Pliny. Dioscorides' De Materia Medica was used for 1500 years. Medical humanists essentially did total reevaluation of classical medicine and gave their new perspective.

Prevailing philosophy of the time was Platonism and Neo-Platonism. A Byzantine scholar, Gemistus Pletho, who lectured at the Council of Union in Florence in 1439, was a Platonist. Cosimo de Medici (1380-1464) was very impressed by his talk and decided to form Platonic Academy. A Greek scholar, Argyropoulos, set foundation for this event. Marsilio Ficino, (1433-1499), the head of the Plato's academy, was of course a Platonist. He is credited with producing a complete version of Plato's work. The most illustrious Greek humanist, Archbishop Basilius Bessarion who came to Italy 1438 to attend the Council of Ferrara-Florence, became cardinal in Italy. He was also a Platonist. His vast collection of Greek and Latin manuscripts became the major part of the library of St. Marks in Venice. Within this intellectual ambiance, Aristotelianism was waning. Humanists and medical humanists were all gravitated toward Plato. Incidentally, Marsilio Ficino's father was the physician for Cosimo, and Ruggiero the elder was the physician for Lorenzo. Ruggiero the elder was the most learned man of the time.

I chose two medical humanists from Italy, Nicolo Leoniceno (1428-1524) and Girolamo Fracastoro (1484-1553). Nicolo taught medicine at Padua, Bologna, and Ferrara. He was a philologist and the famous translator of the aphorisms of Hippocrates, and he was asked to translate Galen. The translation was impeccable. In many Arab translations of old Greek texts, some names of diseases and drugs were incomprehensible. To eliminate these problems, physicians had to refer to two books, "Synonima Medicinae" by the Genoese physician Sirnon and "Pandectaea" by Matthaeus Sylvaticus (died 1342). Both books were arranged in alphabetical order and meant to give clear correct names for various illnesses and medicines. Nicolo was one of the early Renaissance physicians to write on syphilis. Nicolo also had a great interest in botany and read the "Natural history" of Pliny. To his amazement, he found that Pliny made many mistakes. colo published a text titled "Errors of Pliny". One had to be intellectually honest and brave to writes such a text, because there were many Pliny worshipers at that time. There were storms of criticism from powerful humanists who were non-botanists. Without Nicolo, Materia Medica could have contained many inaccurate scientific descriptions. Nicolo had many intellectual friends and he was a good friend of Thomas Linacre, the uppermost English humanist physician.

The other medical humanist Girolamo Fracastoro (1484-1553) was a genius from Verona. He was a poet, physicist astronomer; was particularly keen in pathology and about the cause of syphilis. It was he who gave the name syphilis. The types of illness during 15th and 16th centuries were different from the Middle Ages due to the changes in the ecology of pathogens, as a result of the discovery of New World, changing Socio-economic demography. Leprosy still existed, but less prevalent, but plague, influenza and syphilis became dominant illnesses. Syphilis was indeed a scourge of Renaissance and remained so throughout Europe for several centuries. 18th century French writer said that nowadays, everyone has Syphilis more or less. Girolamo's humorous poems "Syphilis sive Mobrus Gallicus", Syphilis, French disease published in Venice in 1530 made him very famous. He knew syphilis as a contagious disease. In his treatise, "De Contagione" published during 1546, he wrote that infection was caused by microorganisms and described an epidemic of foot and mouth disease. This was a very modern idea at that time. To place this in proper context, during the Middle Ages, people believed that the disease was sin made visible by God. Plaque was the result of communal sins. Girolamo was also a geologist. It is said that he and Leonardo da Vinci were the first geologist to see fossil remains under true light. Never in the history of mankind, artists and medical doctors came so close together. Together they brought medicine to uncompromising realism. During the 16th century, there were artist-physician associations. The most famous was that of Michelangelo and Matteo Realdo Colombo (1515-1559). Toward the end of the 15th century, Pico, Politian and Barbaro all died in succession. No one of their caliber was available to replace them. In the meantime, humanist scholarship spread to other parts of the continent. Even though Valla, Barbaro, and Poliziano have been the teachers of humanism in Europe, humanism in northern countries was very different from that of Italy and had a widely varying spiritual aspiration with a clearly revolutionary tone. Medical humanists of the north approached medicine also with revolutionary zeal. In contrast to escapisms and revival of antiquities, humanists of northern countries faced up to the reality of the time and tried to foster ideal human being and to create utopian society.

Two 15th century French humanists were Jaque Lefevre d'Etaples and Guillaume Bude. Jacque Lefevre went to Florence and brought back the principle of humanism. Guillaume Bude (1456-1540) was a bibliophile and fostered the study of Greek. Jacque Lefevre and Bude encouraged the King Francis 1 to establish the college of France. The library of this school became the future Bibliotheque National. Montaigne was a humanist during the late part of the 16th century (1533-1592). He must never be forgotten. Montaigne emphasized the importance of man developing according to the potential within him. Montaigne developed his own literary form and called it an essay. In his 94 essays, he expressed personal views on many subjects and condemned the ill of society and also saw the shortcomings of humanism. In his final essay titled "Of Experience" prophesized the triumph of science in upcoming age. Montaigne was a courtier to King Charles IX. The Renaissance of France was in much broader scope than that of ItalyIt placed a great emphasis on the education, a wide awareness of what was going on abroad in the cultural sphere and changes in the pattern of social life.

I will talk about two medical humanists from France, Symphorien Champier (1472-1539) and Francois Rabelais (1490-1553). Champier was from Lyon, an intellectual city at that time. Champiere was private physician to Charles VIII, Louis XIth and the Duke of Lorraine. Champier compiled Hippocrates, Galen, Celsus (Aulus Cornelius Celsus) 1st century ace Roman encyclopedist who wrote 8 volumes on medicine. Champier also wrote medical history in 1508 and this was regarded as the best history book of medicine at that time.

Francois Rabelais (1490-1553) is a quintessential medical humanist of French Renaissance. Rabelais was born at Chinon, and then went to Lyon. He was a monk and an attorney. He studied medicine at the University of Montpellier. During the 16th century, the University of Montpellier was known for its excellence in medicine, the University of Paris was for theology and University of Bologna was for law. Rabelais lectured medicine at Montpelliere. Rabelais translated aphorism of Hippocrates in Lyon in 1532, but Rabelais is best known for his "Gargantua and Pentagruel". Even though both were humorous satire, they were powerful social critiques with clear revolutionary tones. Through Gargantua, he criticized every aspect of social ills, especially monasticism that was against nature. His stress was moving away from an obsession with salvation to awareness of the fully lived lives on this earth. Since Rabelais was a physician, Gargantua was filled with medical erudition. For incidence, he stated that those doctors who studied Galenic medicine knew only half of medicine that Gargantua knew. It is interesting to note that Sorbonne University, which was under the domination of the church censored Rabelais' work, whereas the Renaissance King, Francis I liked the work of Rabelais and praised it. For education, Rabelais was vehemently against the prevailing mode, which depended strictly on book learning, but he encouraged the Greek way of teaching of youth, which offered a broader horizon, such as gymnastic, social issues, and social science. As I already said, emphasis on education was the hallmark of French Renaissance and in this Rabelais played an important role. Rabelais was also highly critical of how people knew so little about other parts of the world. 20th century a towering intellectual, Anthropologist, Livy Strauss said the same thing, 400 years after Rabelais. Clearly, Rabelais was a medical humanist with very modern ideas.

In England, the Renaissance arrived later than in the other European countries. John Cole, a leading humanist theologian, was the founder of St. Paul's School and influenced such leading humanists as Sir Thomas More (1478-1536) and his famous friend Erasmus. More's "Utopia" reveals the harsh condition of life in England and describes the ideal state, "Utopia". "Utopia" was a powerful source of the English Renaissance. More's refusal to accept the Supremacy act of Henry VIII led to his eventual execution in 1535.

Thomas Linacre (1460-1524) was the most outstanding medical humanist during the 15th and the 16th centuries in England. He studied Greek in Florence and Rome, before he became a physician. An eminent grammarian and laid foundation for lectures on medicine in Oxford and Cambridge. He faithfully translated Galen's treatises, which widely circulated throughout the continent. He received his medical education at Padua and Oxford. Linacre was a physician to Henry VII and Henry VIII. He had a profound influence on education in England, and established the foundation of English medical practice with his disciple, John Caius. Thomas Fuller, a 17th century English clergyman who wrote "The Worthies of England", called Linacre the "Restorer of learning". John Caius and Linacre worked very closely together, and it is impossible to separate their contributions.

Caius studied medicine at Padua and met Andreas Vesalius. With the help of Linacre, he became very active at the College of Physicians. Caius was instrumental in making the College of Physicians the prestigious and powerful institution. There was also a group called the United Company of Barbers and Surgeons. Toward the end of the 15th century, Pope Sixtus IV (1414-1484) authorized the study of anatomy with cadavers and Pope Clement VII further confirmed this. This facilitated the study of anatomy. Since 1540, four condemned criminals were allotted to the United Company of Barbers and Surgeons annually, and Caius was appointed a demonstrator of dissection. Caius was also involved in obtaining an equal number of cadavers for the College of Physicians in 1565. Caius is best remembered for his description of the outbreak of "English Sweating Disease" in his text "Counseille Against Disease Called The Sweat". On the continent, the idea of granting medical licenses and legislating it first appeared in Sicily shortly before the 12th century. In England, it was Caius who wanted to control medical licensing for all of England. It is hard to believe, but until then, no one investigated the credentials of so-called medical practitioners. Obviously Caius's goal was to raise the standard of medical practice, but unfortunately, it had an adverse effect. It was an impractical approach. There were only small numbers of practitioners who could meet the demand of the licensing board. As a result women and the poor were unable to obtain medical service. John Caius, however, and Thomas Linacre have to be credited with founding the basis of medical practice in England.

Before 1450, in Germany, there was hardly any sign that the idea of Italian Renaissance would cross the Alps. Travelers from Italy to Germanic countries were shocked by their poverty, filth, and the ignorance of the people. Humanism north of the Alps eventually depended much more upon institutions, schools and Universities than in Italy where individual intellectuals led the Renaissance movement. The cultural achievement of the Italian renaissance reached its zenith in the 15th century, but in the Germanic countries, it stretched over the 16th into the 17th century.

Philip Melanchthon (1497-1560) was an outstanding humanist of Germany and a religious reformer. He was educated in theology at Tubingen, and was the professor of Greek and Hebrew at Wittenberg University. His mastery of theology and his approach to moderation led him to reconcile Catholicism and Protestantism. He helped drafting the Augsburg Confession and moderated Luther's vehemence. He was a good friend of the reformer Zwingli. In his treatise, published in 1521, "Loci Communes Rerum Theologicarum", meaning common texts of theological matters, he wrote about the relationship between God and man and between fellow human beings.

A Dutch priest, Desiderius Erasmus was the greatest humanist scholar in northern Europe. He was the most important figure in the formation of Northern Renaissance. Erasmus lived from 1466 to 1536, traveled extensively throughout Europe and disseminated humanism. His "The Praise of Folly" that written in 1511 was a widely read book among intellectuals all over Europe. Printing played an important role in this. Erasmus was repelled by all things that were wrong in the life of his time. In contrast to Italian classical humanism, that is to say the revival of antiquity, Erasmus's sharp criticism became a powerful force for reform. It aroused the social and religious consciousness of the people.

Among many northern artists, Albrecht Durer must be mentioned. His treatise "De simmetria," on human proportion published in Nuremburg, in 1532 added the naturalism to the study of human anatomy.

It is impossible to speak about northern medical humanists without mentioning the reformation led by Martin Luther. The atmosphere of the north was anything but peaceful. It was a restless time with the feeling of revolution everywhere. In 1525, in Germany, there was a revolt led by farmers. Medical humanists also expressed this spirit and energy.

Most outstanding of these were Andreas Vesalius and Paracelsus. They were not exactly Homo universale, but they were men of letters. These two doctors changed the course of medical history in the most vivid fashion.

I consider Vesalius (1514-64) as the most important figure after Gelan and before Harvey Cushing. The most important contributions during the Renaissance by medical humanists were in the field of anatomy, and botany, anatomy by Vesalius, botany by Thomas Linacre.

Ambrois Pare's contribution to surgery during the Renaissance will always occupy the important chapter in the history of medicine, but I cannot call Pare a medical humanist; he was not a man of letters.

Vesalius led a romantic life. He was born in Belgium. He studied medicine in Louvain and later in Paris under Jacob Sylvius. Sylvius was the anatomist. He named the jugular, subclavian, renal, popliteal, and other blood vessels. In his "Isagorge", published in Venice in 1556, Sylvius first mentioned the Sylvian aqueduct and valves in veins. But unfortunately, Sylvius was an extremely conservative Galenist. It is hard to imagine, but Sylvius supposedly has said that, Galen did not make mistakes, but it was the human body that changed since the time of Galen. Vesalius was an intellectually honest, free thinker who did not compromise with Sylvius nor Galen's mistakes. The animosity between the two became such that Vesalius decided to escape to Padua where the atmosphere was more conducive to him. At that time the University of best for the study of anatomy. Cushing began his experiment of anatomy at Padua. Vesalius taught anatomy for 5 years at Padua and had a student called Gabriele Fallopio, a famous future anatomist. Vesalius published his "De Fabrica Humani Corporis" in 1543. The year 1543 was a significant in the history of medicine. At last, anatomy broke from the yoke of Galenism. Vesalius, after leaving Padua, accepted a post as a court physician to none other than Charles V, the King of Spain, and the Emperor of the Holy Roman Empire. By this time Vesalius' name was well known throughout the continent. Life in the court was lucrative, but Vesalius soon found that life under Charles V was even more intolerable. He had to give up the study of Anatomy completely and dissection was out of the question. It was a dark moment in his life. Meanwhile the popularity of Fallopio became such that the rumor began to circulate that Vesalius was becoming a mere shadow of Fallopio. Fallopio discovered the Chorda Tympani, the semicircular canals, sphenoid sinus, trigeminal, auditory and glossopharyngeal nerves and described all these structures. He also named ovaries, until then, they were called female testicles. Fallopian tube was named after him. Vesalius meanwhile, accidentally performed human vivisection. For penance, he set out on a pilgrimage to Jerusalem. In 1564, on the way back, he was invited by the University of Padua to fill the vacant post of Fallopio who died recently. But with an unknown malady, Vesalius died before reaching Padua. "De Fabrica Humani Corporis", published in June 1543, was the first book on human anatomy with beautiful typography done by his friend Oporinus of Basel. If one compares pre-Vesalian medical illustrations with those of Vesalius, the difference is remarkable. Titian's pupil Kalkar sumptuously illustrated a facsimile of Fabrica. Harvey Cushing has edited this beautiful book since. Beside Fabrica, other principal works of Vesalius include six anatomic plates printed in Venice in 1538. Printing press in Venice, such as Aldine press played an important role in spread of anatomy and all sphere of knowledge.

During the 11th century, Avicenna's Canon was the most important anatomy text in Europe, until the text of Mondino de Liuzzi, which appeared almost two centuries later. Throughout the continent Mondino's text was used until Fabrica appeared. Vesalius saw the human body in its exactitude in a natural, realistic way. It was a moment of revolution in the history of human anatomy. William Osler saw the Fabrica as "The greatest book ever written, from which modern medicine dates."

Paracelsus born in Switzland (1493-1541) was the most revolutionary original medical thinker of the 16th century. Revolutionary in a sense that he looked upon the human body as a chemical laboratory and by experiment, he added chemical substances, such as mercury, sulphur and reduced salt for the treatment of diseases, such as Syphilis. I consider Paracelsus the forerunner of pharmacology. Paracelsus had an insatiable curiosity about many things. Friends in his circle were often among the humble strata of society, such as barbers, gypsies, fortunetellers and bathkeepers. In spite of his aristocratic upbringing, with his democratic ideas and in order to learn folk medicine, he tried to think and tried to speak like those commoners. He was appointed as a professor of medicine and city physician at Basel. Being trained under Nicolo Leonicenus, whom I talked about already, he developed a life long respect for Hippocrates, but he rejected the work of Galen and Avicenna. With his violent temper, in Salzburg, he died from a wound in a tavern quarrel. Paracelsus developed so-called "Spagyric" drugs. The word "Spagyric" is derived from the Greek word meaning "to separate" and "to assemble." He rejected the idea of anatomical research to understand human illness, but was convinced that the internal force of alchemy, which he named "Archaeus", controls the profound question of life and illness. This concept was well accepted by many physicians, especially in Germany. They formed so-called Paracelsianism, which continued to the 17th century. King Rudolf II became an ardent supporter of Paracelsianism. Among Paracelsianists, there were many court physicians. Paracelsianism parallels the birth of Protestantism. Paracelsus's complete work was sponsored by elector Ernst von Wittelsbach, who was a vigorous supporter of the Reformation. The court physician, Johann Huser collected 141 volumes of manuscripts pertaining to Paracelsianism.

A towering renaissance scholar, Jacob Addington Symonds, a physician from Bristol in the 19th century defined the Renaissance said this "a just perception of the dignity of man as a rational, volitional and sentient being, born upon this earth with a right to use it and enjoy it".

To summarize my talk, I find that the work of the medical humanists of Italy, that is their reviving old medicine and purifying it, so it belongs precisely to the pattern of Italian Renaissance culture. The work of Northern medical humanists, they are exploring, confronting on past establishment and creating new medicine also belongs to the revolutionary from of the northern Renaissance culture. Even though their approach to medicine varied widely, they never deviated from the central issue of the Renaissance, "Humanus" man "Homo" mankind. Medical humanists made a Renaissance a time of special importance for medicine and made significant contribution to the history of medicine. Medical humanist of the Renaissance fully participated in the formation of Renaissance culture.