Durants' SoC
Vol V The Renaissance
Pages 533-537
Medicine
Public sanitation was improving. As Doge of Venice (1343-1354), Andrea Dandolo established the first known municipal commission of public health; other Italian cities followed the example. These ‘magistrati della sanita’ tested all foods and drugs offered for sale, and isolated the victims of some contagious diseases. As a result of the Black Death, Venice in 1374 excluded from her port all ships carrying persons or goods suspected of infection. Hospitals were multiplying under the zeal of both laity and clergy. Siena built in 1305 a hospital famous for its size and services, and Francesco Sforza founded the Ospedale Maggiore in Milan (1456). Florence in the fifteenth century had thirty-five hospitals. These establishments were generously supported by public and private donations. Luther, who was so shocked by the immorality that he found in Italy in 1511, was also impressed by its charitable and medical institutions. He described the hospitals in his ‘Table Talk’:
“In Italy the hospitals are handsomely built, and admirably provided with excellent food and drink, careful attendants, and learned physicians. The beds and bedding are clean, and the walls are covered with paintings. When a patient is brought in, his clothes are removed in the presence of a notary who makes a faithful inventory of them, and they are kept safely. A white smock is put on him, and he is laid on a comfortable bed, with clean linen. Presently, two doctors come to him, and servants bring him food and drink in clean vessels.... Many ladies take turns to visit the hospitals and tend the sick, keeping their faces veiled, so that no one knows who they are; each remains a few days and returns home, another taking her place... Equally excellent are the foundling asylums of Florence, where the children are well fed and taught, suitably clothed in a uniform, and altogether admirably cared for.”
It is often the fatality of medicine that its heroic advances in therapy are balanced -- almost pursued-- by new diseases. Smallpox and measles, hardly known in Europe before the sixteenth century, now come to the fore; Europe experienced its first recorded influenza epidemic in 1510; and epidemics of typhus- a disease not mentioned before 1477 -- swept Italy in 1505 and 1528. But it was the sudden appearance and rapid dissemination of syphilis in Italy and France toward the end of the fifteenth century that constituted the most startling phenomenon and test of Renaissance medicine. Whether syphilis existed in Europe before 1493, or was brought from America by the return of Columbus in that year, is a matter still debated by the well informed, and not to be settled here.
In any case the new disease spread with terrifying speed. Caesar Borgia apparently contracted it in France. Many cardinals, and Julius II himself, were infected, but we must allow the possibility, in such instances, of infection by innocent contact with persons or objects bearing the active germ. The Church preached chastity as the one prophylaxis needed, and many churchmen practised it.
The name syphilis was first applied to the disease by Girolamo Fracastoro, one of the most varied and yet best integrated characters of the Renaissance. He had a good start: he was born in Verona (1483 )of a patrician family that had already produced outstanding physicians. At Padua he studied almost everything. He had Copernicus as a fellow student, and Pomponazzi and Achillini to teach him philosophy and anatomy; at twenty-four he was himself professor of logic. Soon he retired to devote himself to scientific, above all medical, research, tempered with fond study of classic literature. The association of science and letters produced a rounded personality, and a remarkable poem, written in Latin on the model of Virgil’s ‘Georgics’ and entitled ‘Syphilis, sive de morbo gallico’ (1521). Italians since Lucretius have excelled in writing poetical didactic poetry, but who would have supposed that the undulant spirochete would lend itself to fluent verse? Syphilis, in ancient mythology was a shepherd who decided to worship not the gods, whom he could not see, but the king, the only visible lord of the flock; whereupon angry Apollo infected the air with noxious vapors, from which Syphilis contracted a disease fouled with ulcerous eruptions over his body; this is essentially the story of Job. Fracastoro proposed to trace the first appearance, epidemic spread, causes, and therapy of “a fierce and rare sickness never before seen for centuries past, which ravished all of Europe and the flourishing cities of Asia and Libya, and invaded Italy in that unfortunate war whence from the Gauls it has its name”. He doubted that the ailment came from America, for it appeared almost simultaneously in many European countries far apart.
The poem goes on to discuss treatment by mercury or by guaiac-- a “holy wood” used by the American Indians. In a later work, ‘ De contagione,” Frascastoro dealt in prose with various contagious diseases --syphilis, typhus, tuberculosis-- and the modes of contagion by which they could be spread. In 1545 he was called by Paul II to be head physician for the council of Trent. Verona raised a noble monument to his memory, and Giovanni dal Cavino graved his likeness on a medallion which is one of the finest works of its kind.
Before 1500 it was usual to class all contagious diseases together under the indiscriminate name of the “ Plague “. It was one measure of the progress of medicine that it now clearly distinguished and diagnosed the specific character of an epidemic, and was prepared to deal with so sudden and virulent an eruption as syphilis. Mere reliance on Hippocrates and Galen could never have sufficed in such a crisis; it was because the medical profession had learned the necessity of ever fresh and detailed study of symptoms, causes, and cures, in an ever widening and intercommunicated experience, that it could meet this unexpected test.
And it was because of such high qualifications, devotion, and practical success, that the better class of physicians was now recognized as belonging to the untitled aristocracy of Italy. Having completely secularized their profession, they made it more respected than the clergy. Several of them were not only medical but as well the political advisers, and the frequent and favored companions, of princes, prelates, and kings. Many of them were humanists, familiar with classical literature, collecting manuscripts and works of art; often they were the close friends of great artists. Finally, many of them realized the Hippocratic ideal of adding philosophy to medicine; they passed with ease from one subject to another in their studies and their teaching; and they gave the professional philosophical fraternity a stimulus to subject Plato, Aristotle, and Aquinas -- as they subjected Hippocrates, Galen, and Avicenna -- to a fresh and fearless examination of reality.
