Story

In the XIV-XV centuries. In the social and cultural life of Western Europe, and above all in Italy, great changes took place. In the depths of the feudal socio-economic formation, a new capitalist mode of production was born. He demanded a new flow of knowledge, and scientists turned to the study of nature. In opposition to medieval scholasticism, with its reliance on authorities, an experimental method in science began to be established. Preference was given to observation and accurate counting. Mathematics became the queen of wauc: “There is nothing more convincing than number, measure and weight, if they are correct,” wrote the English doctor William Petty (see p. 309). During this period, measuring instruments and tools were invented and improved. Galileo Galilei designed a telescope and created the first thermoscope (a prototype of the thermometer). Nicolaus Copernicus developed the heliocentric theory. Poets and artists sought to reflect in their work the world around them and the person as they were in reality (Fig. 87). They sought support in the realistic art of the ancients, especially the Greeks. That is why this period of the late Middle Ages in Western Europe was called the “Renaissance” (the revival of ancient culture).

In the Renaissance, science began to take an international character. The extensive development of navigation in search of new lands made the end of the 15th - beginning of the 16th centuries a time of great geographical discoveries. In 1492, Christopher Columbus (1451-1506) discovered the American continent for Europeans. In 1498, Vasco da Gama (1460-1524), having rounded Africa, for the first time passed by sea from Europe to India. In the years 1519-1521. Fernan Magellan (1480-1521) organized the first world tour. With the discovery of new lands, the world has become several times larger, the framework of national isolation has been broken, and with them the medieval isolation in the economy, culture and thinking.

The ideological content of the Rennebur-João culture of the Renaissance was humanism (from the Latin. Humanus - human). In the center of the humanists' worldview was a man. Culture and science gradually acquired a secular character.

“It was the greatest progressive revolution of all that had been experienced by mankind until that time, an era that needed titans, and which gave rise to titans by the power of thought, passion, and character, by versatility and scholarship. The people who founded the modern domination of the bourgeoisie, were ... fanned by the spirit of daring adventurers characteristic of that time. Then there was almost no single man who would not make long journeys, would not speak four or five languages, would not shine in several areas of creativity, * wrote F. Engels about the outstanding representatives of this mighty era. Among them are Dante Aligh-yeri and Francesco Petrarch, Giovanni Boccaccio and Rafael Santi, Micheland-jello Buonarroti and Leonardo da Vinci, Paracelsus and Girolamo of the Fraca-storo, Andreas Vesalius and Francis Bacon.

The formation of anatomy as a science

In the Renaissance, the main features of natural science became: the assertion of the experimental method in science, the development of mathematics and mechanics, metaphysical thinking, which was a step forward compared with the scholastic thinking of the classical Middle Ages.

All these features clearly manifested during the formation of anatomy as a science. One of its founders was the brilliant Italian artist and scientist Leonardo da Vinci (Leonardo da Vinci, 1452-1519). He owned valuable technical inventions in the field of military engineering and hydraulic engineering; his discoveries he enriched physics, geometry, mechanics, astronomy, geology, botany, anatomy. Claiming an experimental method in science, Leonardo da Vinci was one of the first in Europe to uncover human corpses and systematically study their structure, introducing new research methods (washing the organs with running water, injecting wax into the ventricles of the brain and blood vessels, cutting bones and uterus.

The works of Leonardo da Vinci were half a century ahead of the research of the founder of modern scientific anatomy, Andreas Vezalia, but remained unknown to contemporaries. After his death, all the manuscripts of about seven thousand sheets were inherited by his pupil, friend and companion Francesco Melzi, who systematized only what had to do with art. The rest, in various ways, fell into private collections and libraries of Italy and other Western European countries and was not published for a long time. Over time, Leonardo’s manuscripts were collected in the second half of the 18th century. 13 books were compiled from his notes and drawings. Among them: “The Book of Animals”, “On the Flight of Birds”, “Anatomical Notebooks” (“Quaderni d'Anatomia”), and others. Thus, the works of Leonardo da Vinci became famous for anatomy only in the XVIII century. (after the publication of the fundamental work of Vesalius), and published even later (Turin, 1901).

Andreas Vesalius (Vesalius, Andreas, 1514–1564) studied at three universities: in Louvain (Flanders) in the humanities course, in Montpellier and Paris, where he studied medicine. In 1537, at the age of 23 in Padua, he received a doctorate in medicine and soon, at the invitation of the Republic of Venice, became a professor at Padua University, an advanced scientific center of that time.

Vesalius knew well the works of Galen, whom he treated with great respect, translated his books and even prepared them for publication. Anatomy of human corpses, Vesalius was convinced that Galen’s views on the structure of the human body, which had dominated Europe for 14 centuries, are largely erroneous, since they are based on studying the anatomy of monkeys and other animals. Vesalius corrected more than 200 errors; Galen correctly described the human skeleton, its muscles, and many internal organs; established the absence of holes in the cardiac septum, through which, according to Galen, the blood had to penetrate from the right ventricle to the left and contact with pneuma; described the valves of the heart and thus created the prerequisites for the subsequent justification of the circular movement of blood.

Vesalius set forth his observations in Anatomical Tables (Tabulae sex, 1538), which included six engravings made by Titan's talented student Johann Stefan van Kalkar, who illustrated all the books of Vesalius. Improving the teaching of anatomy, Vesalius published a short anatomy textbook "Extract" ("Epitome", 1543) - an abbreviated anatomy for students in the anatomical theater. In the same year, the main work of Vesalius “On the Structure of the Human Body” was published in seven books (“De humani corporis fabrica”) in the publication of I. Oporin. It not only summarized the achievements in the field of anatomy over the preceding centuries, - Vesalius enriched science with his own reliable data obtained as a result of numerous autopsies of the human body; corrected a large number of mistakes of his predecessors and, most importantly, for the first time brought all this knowledge into the system, that is, made science from anatomy.

The first volume of his work is devoted to the study of bones and joints, the second to muscle anatomy, the third to blood vessels, the fourth to the peripheral nervous system, the fifth to the abdominal organs, the sixth to the structure of the heart and lungs, the seventh anatomy of the brain and sensory organs. The text is accompanied by 250 drawings, brilliantly executed by Y.S. van Kalkar. The frontispiece (fig. 89) depicts the moment of anatomy: in the center of the group - A. Vesalius, around - outstanding scientists and public figures of that time, numerous students, like-minded people and opponents.

The experimentally valid conclusions of A. Vesalius dealt a powerful blow to medieval scholasticism.

The teacher Vesalius at the University of Paris. The scholar and the galenist J. Silvius (Sylvius, Jacobus, 1478–1555) called his pupil insane (lat. Veasanus) and publicly spoke out against him, publishing the work “Denial of a certain madman slandering the Hippocrates and Galen anatomy ” ( "Ve-asani cuiusdam calumniarum in Hip-pocratis Galenique rem anatomicam ...", 1555). In the face of irrefutable facts, he was more likely to admit that in the 14 centuries the anatomy of the human body had changed, than to admit that the great Galen could be wrong. In 1546, Vesalius was expelled from the progressive University of Padua. The chair of anatomy was taken by his successor, Realdo Colombo (Colombo, Realdo, 1516–1559), one of the creators of the “golden age” of anatomy. At that time, inquisition fires were blazing in Europe: the church physically cracked down on dissidents. Vesalius was accused of encroaching on the authority of Galen, canonized by the church, and sentenced to death; this sentence was later replaced by pilgrimage to Jerusalem, where, according to legend, the coffin of the founder of the Christian religion (the Lord’s coffin) is located. On the way back as a result of the shipwreck, Vesalius was on Fr. Zante, where he died in his prime and talent.

With the work of Vesalius, a golden age is revealed in the history of anatomy. In 1545, Charles Étienne (Etienne, Charles, 1503–1564) published a beautifully designed anatomy textbook “On the dissection of human body parts” (“De dissectione partium corporis hu-mani”) with numerous drawings of the organs of the abdominal cavity, chest, head, and extremities. In 1553, the Spanish philosopher-theologian and physician Miguel Cereth (Servet, Michael, 1509–1553), for the first time in Europe, described the small circle of blood circulation in his book “The Restoration of Christianity” (“Christianism restitutio ...”, 1553). Many of the philosophical and natural-scientific positions of this work were in contradiction with the tenets of the church. To confirm his philosophical views, CepiBeT used modern achievements of natural science. The book was declared heretical. At the insistence of Calvin, its author was put to cruel death: burning alive at the stake along with his book. F. Engels wrote about this: “... the study of nature was then made in the setting of a general revolution ... it gave its martyrs for fires and dungeons of the Inquisition. ... Calvin burned Serveta when he came close to the opening of blood circulation, and at the same time made him fry for two hours alive ... ".

Inquisition in Europe existed since the end of the XIII century. until the beginning of the XIX century. The number of its victims (according to the archives of the "sacred tribunal") was in the hundreds of thousands, among them tens of thousands of women recognized by the inquisitors as "witches." In the Middle Ages, “the title of a scientist,” wrote A. I. Herzen, “rather led to the stake than to the Academy. And they walked, inspired by the truth. "

Unfortunately, in the system of the Inquisition, an important place was occupied by doctors. The inquisitor physician was essentially the assistant of the executioner. The results of the investigation depended on his “art” of torturing the defendant. At the same time, he ensured that the defendant did not die before the trial. After torture, doctors healed their wounds - after all, the heretic was supposed to be erected on a fire unharmed. Here it is impossible not to cite the words of an outstanding doctor of the era. Revival of Paracelsus: "The doctor does not dare to be either a torturer, or an executioner, or a servant of the executioner."

After Servet, studies on the movement of blood continued unabated. R. Colombo studied the movement of blood in the lungs and described his observations in the work “On Anatomy in 15 Books” (“De re anatomica libri XV”, 1559). Jerome Fabrizius (Fabricius, Hiero-nymus, 1533–1619) —the disciple of Fallotus and the teacher of Harvey — described and first demonstrated (1603) venous valves, thereby proving one-way blood flow through the veins — only towards the heart

Anatomical studies in the Renaissance were not limited to the study of blood circulation and affected many body systems. ” So, Bartholomew Eustachius (Eustachio, Bartolomeo, 1510–1574) in 1563 for the first time gave a detailed description of the organ of hearing in humans, including the auditory tube, named after him, and Gabriel Fallopy (Fallopio, Gab-riele, 1523–1562) studied the structure reproductive organs, the development of the human embryo and its vascular system, first described the structure and function of the fallopian tubes.

Thus, the efforts of many scientists - titans of the Renaissance - laid the foundation for scientific anatomy. On its basis, physiology, therapy, and surgery developed.

The formation of physiology as a science

The birth of physiology as a science is associated with the name of the eminent English physician, physiologist and embryologist William Garvey. (Harvey, Wilii-am, 1578-1657) (Fig. 90), who is credited with creating a coherent theory of blood circulation.

At the age of 2 years, U. Garvey graduated from the University of Cambridge. In 24 years in Padua, he became a doctor of medicine. Returning home, Harvey became a professor at the Department of Anatomy, Physiology and Surgery in London,

Based on the achievements of their predecessors - Galen, Vesa-li, Colombo, Fabrizia - Harvey mathematically calculated and experimentally substantiated the theory of blood circulation, according to which blood returns to the heart in small and large circles. Due to the fact that he did not use a microscope in physiology during the life of Harvey, he could not see the capillaries, - they were discovered by Mar-chello Malpighi (Malpighi, Marcello, 1628-1644) four years after Harvey's death. According to Harvey, the blood was coming from. arteries in the veins. by anastomoses and through the pores of tissues.

After many years of testing in an experiment, U. Garvey expounded his theory in his fundamental essay “Anatomical Research on the Movement of the Heart and Blood in Animals” (“Exercitatio anatomica de motu cor-dis et sangvinis in animalibus”, 1628) and immediately underwent fierce attacks from churches and many scholars. The first theory of Harvey recognized R. Descartes, then G. Galileo, S. Santorio, A. Borelli. I.P.Pavlov defined it as not only “a rare value the fruit of his mind, but also the feat of his courage and selflessness”.

The great influence on the development of natural science (and physiology in particular) was exerted by the activities of the eminent English philosopher Francis Bacon (Bacon, Francis, 1561-1626). Not being a doctor, Bacon largely determined the path of further development of medicine. In his work “On the Dignity and Improvement of Sciences,” he formulated three main objectives of medicine: “the first is to preserve health, the second is to cure 'diseases, the third is to continue life”. Being engaged in experimental work in the field of physiology, Bacon raised several specific questions for medicine: about studying the anatomy of not only healthy but also a sick body, about the introduction of anesthesia, about the use of natural factors in the treatment of diseases and the development of balneology. The solution of these and many other tasks put forward by F. Bacon, took centuries.

Francis Bacon’s contemporary, the outstanding French scientist Rene Descartes (Descartes, Rene, 1596–1650), in a simple form, developed a reflex arc. He divided all the nerves into centripetal, along which signals come to the brain, and centrifugal, along which signals from the brain move to organs. Descartes believed that life actions have a reflex nature and are subject to mechanical laws.

Descartes was a typical representative of I t r o f and h and and - trends in the natural sciences and medicine, which is considered the wildlife from the standpoint of physics. Compared with medieval scholasticism, the metaphysical thinking of the seventeenth century. was a progressive phenomenon, and the mechanistic views of Descartes had a positive impact on the further development of philosophy and science in the era of the new time. However, along with the materialist understanding of the world, Descartes interpreted phenomena idealistically on a number of issues. So, he believed that thinking is the ability of the soul, not the body.

Another direction in the natural sciences was the mechanics. Its main provisions are clearly stated in the essay “On the movement of animals” (Fig. 91) by the Italian anatomist and physiologist Giovanni Alfonso Borelli (Borelli, Giovanni Alfonso, 1608–1679) —one of the founders of biomechanics. From the standpoint of yatromechanics, a living organism is like a machine in which all processes can be explained with the help of mathematics and mechanics.

Among the outstanding achievements of the Renaissance, related to both physics and medicine - the invention at the end of the XVI century. thermometer (more precisely, air thermoscope). Its author is the Italian scientist Galileo Galilei (Galilei, Galileo, 1564 - 1642), one of the titans of the Renaissance, who confirmed and developed the heliocentric theory of N. Copernicus (1543). Many of his precious manuscripts were burned by the Inquisition. But in those that survived, they found: drawings of the first thermoscope. In contrast to the modern thermometer, the air expanded instead of mercury. Almost simultaneously with Galileo, a professor at Padua University Santorio (Santorius, 1561-1636), a physician, anatomist and physiologist, created his own device with which he measured the warmth of the human body (Fig. 92). The device was rather cumbersome. Santorio installed it in the courtyard of your home for everyone to see. The heat of various parts of the body was determined during ten pulse strokes at changes in the level of fluid in the tube, the scale of which was arbitrary.

At the beginning of the XVII century. in Europe, many original thermometers were made. The first thermometer, whose testimony did not depend on changes in atmospheric pressure, was created in 1641 at the court of Ferdinand I, the emperor of the Holy Roman Empire, who not only was known as a patron of the arts, but also was the author of a number of physical instruments. With his participation, amusing thermometers shaped like small frogs were created. They were designed to measure the heat of the human body and are easily attached to the skin with a plaster. The “frog” cavity was filled with a liquid in which colored balls of various density floated. When the liquid warmed, its volume increased, and the density decreased, and some of the harnesses sank to the bottom of the device. The patient's body heat was determined according to the number of multi-colored balls remaining on the surface: the smaller they are, the higher the subject's body heat.

The development of a single scale of degrees stretched for a century. The last word in this question belongs to the Swedish astronomer and physicist Andes Ölsus Celsius (Celsius, Anders, 1701-1744), who in 1742 proposed the centigrade scale: for 0 ° he took the boiling point of water, and the melting point of ice corresponded to 100 ° Subsequently, this scale was turned upside down, making the 0 ° a melting point of ice and a reference point. In this form, the Celsius scale has reached our days, having won the widest popularity.

In medical practice, thermometry began to be applied much later - only in the second half of the nineteenth century. The active implementation of this method in Russia in 1860 is associated with the name of the outstanding Russian clinician S. P. Botkin (see p. 270).

Yatrochemistry and medicine

Along with jatrophysics and jatro-mechanics in the Renaissance, iatrochemistry was widely developed - a medical direction related to the progress of chemistry. Yatrochemists believed that the processes taking place in the body are chemical, therefore, the study of these processes and the treatment of diseases should be associated with chemistry.

One of the founders of yatro-chemistry is Philippe Aureol, an eminent physician and chemist of early Renaissance, Bombast von Haugengame-game, known in history under the pseudonym Paracelsus (Hohenheim, Philip-pus Aureolus Theophrastus Bombastus von - Paracelsus, 1493–1541). A Swiss by birth, he was educated at the University of Ferrara (Italy) and subsequently lectured at the University of Basel in his native German language instead of the Latin accepted in the scientific world. 190

Paracelsus was one of the founders of the experimental method in science. “The theory of the doctor is experience. No one can become a doctor without science and experience, ”he argued.

At the time of Paracelsus, surgery in Europe was not considered a field of medicine and was not taught at universities (artisans were involved), and Paracelsus insisted on combining surgery and medicine (that is, therapy) into one science, because they both come from the same root. He himself proudly called himself "the doctor of both medicine." His books Small Surgery (Chirurgia minor, 1528), Big Surgery (Chirurgia magna, 1536), and others were very popular (Fig. 93).

With Paracelsus, a radical restructuring of chemistry begins in its application to medicine: from the search for ways to produce gold — to the preparation of medicines. According to Paracelsus, health is connected with the normal content in the human body of three natures: sulfur, mercury and salt; violation of their correct ratios leads to illness. That is why doctors and pharmacists of the Renaissance attached great importance to drugs containing sulfur, mercury and various salts, and often smelted them from natural ores. Paracelsus wrote with pride that he and his students "have a rest in the laboratory, they put fingers into the coals and garbage and put all kinds of dirt, not gold rings, and are blackened as blacksmiths and charcoal-burners." In his writings, he also wrote about the diseases of miners and foundry workers associated with sulfur, lead, mercury, and antimony poisonings, and thus laid the foundation for the future science of occupational diseases. A contemporary of Paracelsus, Georg Bauer, known under the pseudonym Agracola (Agricola, Ge-org, 1493–1541), also wrote about the miners' diseases and their warnings in his essay "On Mining and Metallurgy" ("Re metallica ...", 1556) .

The development of medical chemistry in the Renaissance led to the expansion of pharmacy. Pharmacy as an independent institution emerged in the second half of the VIII century. in the middle east. (The first pharmacy in the Middle East was opened in 754 in the capital of the Caliphate, Baghdad.) In Europe, the first pharmacies appeared in the XI century. in the Spanish cities of Toledo and Cordoba. K XV century. they spread widely across the continent.

In the Renaissance, the size of pharmacy shops increased significantly: from simple shops of the period of the developed Middle Ages, when the entire pharmacy was located in one room, they turned into large pharmaceutical laboratories, which included a reception room, storerooms where medicines and syrye were crushed and stored , and the laboratory itself with a furnace and a distillation apparatus (Fig. 94).

Starting from the XV century. Pharmaceutical botanical gardens were cultivated with special diligence; they were also called gardens of health - Hortus sanitatis. From this Latin name came the Russian — the vernograd (i.e., garden, flower garden). In the XVI — XVII centuries. vertogradady widely spread in Russia. Mineral substances and animal parts were also used as medicinal raw materials. Of great importance were overseas travel, from which foreign medicines were brought.

Ideas about the therapeutic effect of many medicines at that time were often far from the truth. Thus, for almost two millennia (from the 1st to the 20th century), it was believed that teriak is a universal remedy against all diseases. It was made by the doctors themselves with a large gathering of more than 70 components, and then kept for six months: moreover, the teriak made in Venice was of particular fame.

Renaissance pharmacists, like other professionals, have made a great contribution to shaping the culture of their time. They occupied a high position in society, but their activities were regulated by the state. In the middle of the XVI century. The first pharmacopoeias began to appear, in which the medicines used in a given city or state were listed, their composition, use and cost. That was the beginning of the official regulation of the price of medicines in Europe.

Epidemics and the study of contagion

The history of epidemics in the Renaissance is characterized by two factors: on the one hand, there is some weakening of the "old" diseases - leprosy and plague, and on the other - new diseases appear (syphilis, English sweat fever, typhus).

At the end of the XV - the beginning of the XVI century. The epidemic of syphilis has spread across Europe. At the beginning of the 16th century, J. Fracastoro, A. Paray, Paracelsus, G. Fallopius, and other scholars wrote about him. By sea and land trade routes, syphilis has spread beyond the European continent. Public baths, which were widely recommended at that time for hygienic and medicinal purposes, were closed due to the epidemic of syphilis.

The causes of this powerful epidemic are not well understood. Some scientists believe that syphilis was introduced to Europe after the discovery of America. As a proof, the description (1537) of the Spanish doctor Diaz de Isla, who treated people from the crew of Columbus, arrived from about. Haiti. According to most other scientists, syphilis has existed among the peoples of Europe since ancient times. Proof of this version are descriptions of ancient authors, medieval physicians and the results of archaeological excavations of burial grounds in various regions of Europe and Asia. In all likelihood, syphilis has long existed in Europe, Asia and America, and a sudden epidemic of the end of the 15th century. in Europe was due to long wars, mass movements of people, and possibly the emergence of a new strain of the pathogen, imported from the Americas.

At the same time, in the process of conquest, new, previously unknown diseases were brought to America. Connect them - smallpox. Before the introduction of smallpox according to the method of E. Jenner (1796), only 10 million people in Europe each year were infected with smallpox, of which between 25 and 40% died. In order to exterminate the aborigines, the conquistadors distributed contaminated clothing among them. Millions of indigenous people died in this brutal bacteriological war; many areas of America completely depopulated.

The causes of epidemics in the Middle Ages were not yet known. The enormous size of the disasters they bring (Fig. 95) and the helplessness of man caused the greatest confusion and superstitious horror.

“Sometimes you have to see how the soil suddenly fluctuates under peaceful cities and buildings collapse on the heads of residents,” wrote the French medical historian E. Littre. “So suddenly and the deadly infection comes out of unknown depth and cuts human generations with its disastrous breath, as a reaper cuts off ears of corn. The causes are unknown, the action is terrible, the spread is immeasurable: nothing can cause more severe anxiety. It is a wonder that mortality will be limitless, devastation will be endless and that the fire, once flashed, will stop only due to lack of food ... "

Some scientists linked the epidemic with earthquakes, which, as claimed by the German medical historian G. Gezer, "at all times coincided with devastation from widespread diseases." According to others (and most of them), epidemics are caused by “miasms” - “contagious fumes”, which “are caused by the rotting that takes place underground” and is carried out to the surface during volcanic eruptions. Still others thought that the development of epidemics was directed by the special position of the stars, so sometimes people left the affected cities in search of an astrologically more favorable place, which in any case reduced the risk of their infection.

The first scientifically based concept of the spread of contagious diseases was put forward by Girolamo Fracastoro (Frac'astoro, Girolamo, 1478-1553) - an Italian scientist - doctor, physicist, astronomer and poet, one of the most prominent representatives of the Renaissance

Fracastoro received his medical education at the advanced University of Padua, the “Patavinian Academy”, with which fate is related. Galileo and Santorio, Vesalius and Phallolia, Copernicus and Harvey. At this university, the first Russian medical doctors Francis Georgy Skorina from Polotsk (1512), a contemporary of Frakastoro and Copernicus, received their diplomas, and P. Posnikov from Moscow (1695) — Peter I.

Being already a professor at Padua University, J. Frakastoro wrote his basic work “On contagion, contagious diseases and treatment” (“De contagione et contagio-sis morbis et curation libri tres”, 1546) in three books. The first one contains general theoretical propositions and a systematic generalization of the views of the predecessors of Frakastoro - Hippocrates and Thucydides, Aristotle and Lucretia Cara, Pliny the Elder and Galen, Ar-Razi and Ibn Sina. The second is devoted to the description of infectious diseases (smallpox, measles, plague, malaria, rabies, English sweat, leprosy). The third - at the time known methods of their treatment. In his work, J. Fracastoro outlined the fundamentals of the theory of "contagion" - a lively breeding infectious principle secreted by a sick organism, and thus significantly shaken the previously existing notions of "miasma". Even then, Fracastoro was convinced of the specificity of the "seeds" of infection (that is, the pathogen). According to his teaching, there are three ways of transmitting the infectious principle: with direct contact with a sick person, through infected objects and through the air at a distance. Moreover, Fracastoro believed that not all diseases are transmitted at a distance, but through contact - everything. The term infection he entered (Latin in-fectio from inficere - to infiltrate, poison) meant “introduction”, “penetration”, “damage”. From it came the name "infectious diseases", subsequently introduced by the German physician K. Hufeland (Hufeland K., 1762–1836). The term disinfection is also suggested by Fracastoro.

However, at the time of Frakastoro there could not yet be effective, scientifically grounded methods of fighting general-purpose diseases, their pathogens then remained invisible and unknown, and the science of them was still in its infancy. D. S. Samoilovich and E. Jenner, L. Pasteur, and I. I. Mechnikov later became its worthy representatives.

The discovery of pathogens of infectious diseases, which began at the end of the last century, and their scientific study today led to the elimination of many infectious diseases across countries, regions, continents, and sometimes the entire globe. A striking example of this is the elimination of smallpox on our planet according to the program proposed by the USSR delegation at the XI Assembly of the World Health Organization in 1958 and implemented in the 1980s by the joint efforts of the peoples of all countries of the world.

Development of surgery

As already noted, in the Middle Ages in Western Europe there was a distinction between doctors (or doctors) who received medical education at universities. They were only engaged in the treatment of internal diseases, and surgeons who did not have scientific education, were not considered doctors and were allowed. According to the guild organization of the medieval city, surgeons were considered artisans and united in their professional corporations. So, for example, in Paris, where the antagonism between doctors and surgeons was expressed most clearly, the hiourgists united in the “Brotherhood of St. Cosmas ”, while doctors entered the Medical Corporation at the University of Paris and very jealously guarded their rights and interests.

There was a relentless struggle between the military and the surgeons. Doctors represented the official medicine of that time, which still continued to follow the blind memorization of texts and was still far from clinical observations and understanding of the processes occurring in a healthy or diseased body.

Craftsmen surgeons, in contrast, had a wealth of practical experience. Their profession required specific knowledge and energetic actions in the treatment of fractures and dislocations, the extraction of foreign bodies or the treatment of wounded on the battlefield during numerous wars and crusades.

Among the surgeons there was a professional graduation. The so-called "long-sex" surgeons, who differed in their long clothing, occupied a higher position. They had the right to perform the most complex operations, such as stone-cutting or hernia repair. Surgeons of the second category ("short-sex") were mainly barbers and were engaged in "minor" surgery: bleeding (fig. 97), removal of teeth, etc.

The lowest position was occupied by the representatives of the third category of surgeons - bath attendants, who performed the simplest manipulations, for example, the removal of corns. There was also a constant struggle between the various categories of surgeons.

Official medicine stubbornly_to resisted the recognition of the equality of surgeons: they were forbidden to overstep the bounds of their craft, perform medical manipulations, and write prescriptions. Surgeons were not allowed into universities. Education surgery took place inside the workshop (corporation), first on the principles of apprenticeship. Then they began to open surgical-. scy school Their reputation grew, and in 1731 (already in the period of new history) in Paris, in spite of the desperate resistance of the medical faculty of the University of Paris, the King opened the first surgical academy. In 1743 she was equated to the medical faculty. At the end of the XVIII century, when, as a result of the French bourgeois revolution, the reactionary University of Paris was closed,. It was surgical schools that became the basis on which higher medical schools of a new type were created.

Thus ended in Western Europe, the age-old struggle between scholastic medicine and innovative surgery, which grew out of practical experience. (Note that the medicine of the peoples of the East and ancient medicine did not know such a separation.)

Surgery in Western Europe did not have scientific methods of anesthesia until the middle of the XIX century. All operations in the Middle Ages inflicted severe tortures on patients (Fig. 98). There was also no correct understanding of wound infection and methods of wound disinfection. Therefore, the majority of opeations in medieval Europe (up to 95%) resulted in the death of a patient as a result of sepsis.

With the advent of firearms in Europe in the XIV century. the nature of the injuries has changed a lot: the open wound surface has increased (especially with artillery wounds), wound suppuration has increased, common complications have become frequent. All this began to be associated with the penetration into the body of a wounded “powder poison”. The Italian surgeon Johannes de Vigo (Vigo, Johannes de, 1450–1545) wrote about this in his book The Art of Surgery (Arte Chirurgica, 1514), which was published in more than 50 editions in various world languages. De Vigo believed that the best way to heal gunshot wounds is to destroy the remains of gunpowder by burning the wound surface with a red-hot iron (see Fig. 100) or by boiling the resinous substance (yo avoiding the spread of “powder poison”

throughout the body). In the absence of ozozbolivaniya such a cruel method of treating wounds caused much more torment than the injury itself.

The upheaval of these and many other established concepts in surgery is associated with the name of the French surgeon and obstetrician Ambroise Pare (Pare, Ambroise, 1510 — d590). He did not have a medical degree. He studied surgery at the Paris-based Hotel-uieu Hospital, where he was a barber apprentice. In 1536, A. Pare began serving in the army as a barber-hi-rug.

The first work of A. Pare on military surgery "A way to heal gunshot wounds, as well as wounds caused by arrows, spears, etc." was published in 1545 in spoken French (he did not know Latin) and already in 1552 has been reprinted.

In 1549, Pare published the “Guide for the extraction of babies, both living and dead, from the womb of the mother”. Being one of the most famous surgeons of his time, Ambroise Pare was the first surgeon and obstetrician at the court of the kings Henry I, Francis II, Charles IX, Henry III and the chief surgeon of the Hotel deux, where he once studied the surgical craft.

Pare's outstanding merit is his contribution to the teaching of the treatment of gunshot wounds. In 1536, during a campaign in Northern Italy, the young army barber Ambrois Pare did not have enough hot resinous substances that were to be filled with wounds. Having nothing else at hand, he applied a wound digestive of egg yolk, pink and terrestrial oils, and covered them with clean dressings. “I could not sleep all night,” Pare wrote in his diary, “I was afraid to catch my wounded, whom I had not burned down, dead from poisoning. To my amazement, early in the morning I found these wounded vigorous, well slept, with non-inflamed wounds and not swollen. At the same time, others, whose wounds were filled with boiling oil, I found feverish, with severe pains and swollen edges of the wounds. Then I decided never again so cruelly to burn the unfortunate wounded. " That was the beginning of a new, humane method of treating wounds. Ambroise Pare significantly improved the technique of many surgical operations, re-described the rotation of the fetus on the leg, (the ancient Indian method, forgotten in the Middle Ages), applied ligation of the vessels instead of twisting and cauterization, designed a number of new surgical instruments, orthopedic devices, including artificial limbs and joints. Many of them were created after the death of Ambroise Pare according to the detailed drawings left by him and played an important role in the development of orthopedics.

At the same time, along with brilliant works on orthopedics, surgery, obstetrics, Paray wrote an essay “On Freaks and Monsters”, in which he cited many medieval legends about the existence of people-animals, people-fish, devils, etc. This indicates contradictions in the views of outstanding figures of the most difficult transitional Renaissance era.

Ambroise Pare's activities largely determined the emergence of surgery as a science and contributed to the transformation of the artisan-surgeon. a full-fledged specialist doctor. The transformation of surgery associated with his name was continued by his numerous followers and successors in different countries.

The Middle Ages, which was recently considered barbaric, made a significant contribution to the cultural history of mankind. And this is not only the early culture of the Italian Renaissance and the humanistic worldview of Western Europe of the XVI century. This, as D. Likhachev noted, is also “Byzantine music and iconography, African sculpture, Hellenistic novel, Fayum portrait, Persian miniature, Inca art and much, much more. "

Nowadays, when humanity returns to understanding the importance of the priority of universal human values, a study of the historical and cultural heritage of the Middle Ages makes it possible to see how the cultural horizons of the world began to expand in the Renaissance, how scholastic authorities threw down the limits of national limitation at risk to life; exploring nature, they served primarily truth and humanism, and therefore - science in the only possible sense of the word.