Restoring Organs to Premodern Medicine: Clinical-Anatomical Medicine Before the Paris Hospital Medicine
The dominant historical narrative of the shift from pre-modern to modern medicine turns on a supposed shift from humoral to organ-based pathological and therapeutic thinking. In this narrative, pre-modern Galenic and Hippocratic medical thinking and practice mostly ignored the organs and other solid parts of the body, conceiving of health in terms of a proper balance of the four humors, and disease as imbalance of the four humors. As the story goes, around 1800 modern medicine emerged in and around the Paris hospitals and French political reforms. Only then did physicians situate diseases in the organs rather than the humors, and for the first time used the conjunction of bedside examination, regular hospital teaching, and routine post-mortem dissections to track the hidden causes of diseases and then reveal them after death, and so generate new pathological knowledge and make important discoveries. I will argue that this dominant narrative seriously misconstrues Galenic medical thinking, practice, and teaching, and that even standard early modern medical textbooks and professors relied on the interrelation of regular hospital teaching and examinations, organ-based pathology, and post-mortem dissections to generate new knowledge about disease and treatments. To focus my talk, I will provide evidence from ancient, medieval, and modern sources, but concentrate mainly on one medical school at Leiden University, from about 1575 to the 1670s. It's past time we followed the overwhelming evidence from pre-modern sources and gave pre-modern patients and physicians their diseased organs back.
Originally published at reilly.nd.edu.