One aspect of the renaissance had a monumental effect on medicine as much or more as that of the printing press. This was the discovery of optics, which led to the first telescope in the 1500s and the microscope in the 1600s. Both astronomy and medicine had been literally in the dark before this time trying to deal with the two greatest mysteries of mankind, disease and the cosmos. With only normal vision, it was quite natural for early explanations to fly off into the realm of the metaphysical. The first cell was seen by Robert Hooke in 1665 and then drawn in his famous publication Micrographia. Ten years later, Antonie Leeuwenhoek of Holland described red blood cell and then bacteria seen wiggling around. At this time, England was lucky to have a king, Charles II, who could see the future potential for science and founded the Royal Society in 1660. This was a fraternity for scientists with regular meetings and many famous names in the original group included Robert Boyle, Robert Hooke, and Isaac Newton. The motto of the Society was, "Take nobody's word for it." Because he was not English and a janitor by trade, it would take some politicking to get Leeuwenhoek into the Society as a member in 1675. He would need to come to London with his microscope and some slides. But his discoveries were quite visible to all the other members. Seeing bacteria created much enthusiasm in the Society and they were originally called animaleules, the irony is that it would take nearly 200 years to finally connect bacteria to disease. England had been getting organized in relation to early science and medicine and by 1540 had created the Royal College of Physicians, both at Oxford and Cambridge, along with the Barber Surgeons Company, which govern many practices including bloodletting, tooth extractions, and amputations. France was a little tardy, but by 1730 had created their own Barber Surgeon Company, courtesy of Louis XIV. For much of his 70-year reign, Louis suffered from a chronic infected rectal fistula. All of the best salves from the exalted court physicians were to no avail and in desperation, he called upon a lowly barber surgeon. Members of the court whispered derisively in private, but the fistula healed. Louis was impressed enough to found the French Royal Academy of Surgery. He also favored the graduate doctor over the standard midwife, and the field of obstetrics made great strides with tested and rational approaches. Having multiple illnesses, Louis also took the controversial drug antimony, which had been banned in France due to toxic side effects. Antimony was a heavy metals like arsenic and was used as a substitute for bloodletting because it caused purging in the form of vomiting or diarrhea. But by chance, this element was also effective for a particular parasite found mainly in India. Details of Louis diseases are lacking, but he must have had some improvement which greatly advanced the chemical approaches to disease. Antimony eventually became a staple for parasitic diseases. Back in 1670 the famous English physician Thomas Sydenham or the English Hippocrates, who had received his education in Padua began documenting the relationships between symptoms and disease. These descriptions were actually patterns which were often variable. The term pattern language accurately describes medicine in general. This term was originally the title of a book, which came out of the architectural school at UC Berkeley. The idea is that an architecture, medicine, or other art forms like music, the possibilities are infinite. But the realities tend to occur in certain patterns which represent the common or the more functional. Doctors are forced to think in patterns and have to sift through many separate bits of information, trying to piece together a particular pattern, leading to a particular diagnosis or possibilities for diagnosis. For medicine, probabilities also play a large role in the final determination. Doctors are always thinking within spectrums and where within a given spectrum they might be residing in their own thinking. Fever had always been an empirical part of many diseases. The clinical thermometer was finally invented in 1860, and by 1868, Carl Wunderlich of Germany had written a text categorizing all the various fever types of many diseases. Intuition could naturally think of fever as a voracious force that needed to be starved. An Irishman named Graves contemplated this and tried his own experiment. Shock nurses heard him direct, give them eggs, beef broth and chicken soup, but saw the patients grow stronger each day. Graves had one wish for the epitaph on his tombstone, he fed fevers. The terrible racking fever peroxisomes of malaria were finally tamed herbally in Peru with the bark of the quinoa tree. Europeans named at chin Conan, after the Spanish counts of Chin Kong, who came to Peru with her husband, the Viceroy, and dutifully acquired malaria. After being cured by the local Indians she surprisingly had the back powdered and bestowed on a grateful Spain in 1682. The Jesuit's back was snapped up by the rest of malarial Europe, except in England, where Oliver Cromwell denounced it as sacrilegious. Despite quinine from malaria or spruce SAP for scurvy, the new found knowledge of physiology, anatomy, and embryology still had little impact on therapy. Infant mortality before the age of five in 1700 was three out of four, mainly from ramping infections diseases like diphtheria, smallpox, typhoid, and various forms of streptococcus. Psychiatric disease was handled mainly by lockup. The English facility in London known as Bedlam was charging the public to view the lunatics, much like a zoo, lacking anything better therapy hearken back to the humoral theories with disease seen as some rank fluid needing to be eliminated. Bleeding, purging, puking and perspiring were the standards at the time. Intuitively, the colon was seen as a poisonous reservoir for the causes of cancer, tuberculosis, rheumatism, and most everything else causing sluggishness. Colonic therapy became geared for the rich with elegance salons for multiple patrons with exotic fruit sprays rafting in the air. For reasons that can be speculated upon endlessly the patients seem to swear by these treatments and it was comforting to imagine a focus of all that made one hill conveniently flushed aside. Bleeding also made sense somehow, and for women and children, a painless alternative to the scalpel was first discovered around 900 AD and became increasingly popular. Taken from water an hour before use to induce an appetite, leeches were placed in a wine goblet, which was then quickly upturned onto a promising piece of flesh. After 15 minutes the typical leech grew from 2-6 inches and then fell off bloated with blood. When short of supplies, the leech could also snip the tails off the feeding leeches, and blood would flow freely at the end for as long as desired. Economic but messy. By the 1600s, more vigorous bleeding became the vow. Solemn rituals with scalpel weeding surgeons and Peter bowls flattened on one side to fit snugly against the body were used along with fine venetian bleeding glasses, kept his heirloom. Bleeding became so fashionable in France that by 1833, 41 million leeches were important to keep up with the demand. Back in the laboratory, scientists were increasingly examining the chemistry of disease, as well as the chemistry of normal physiology. In 1848, a new medicine called laboratory medicine was introduced in Paris by Louis Pasteur, a chemist, not a doctor. Soon after Claude Bernard in France described the new you interiority, the balanced inner chemistry of the body and initiate a new field, endocrinology. Bernard was a teacher and told his students to wear their imagination like an overcoat and when they entered the laboratory to put that coat aside so they could do their experience with complete objectivity. Put it back on when you leave the laboratory so that you can try to foresee some of the unknowns you are seeking. This interior world also began the concept of homeostasis. Any organism exists in a constant state of exchange with its interior and exterior environment. The processes that govern this flux have internal controls with detectors, thermostats, and feedback systems. These controls attempt to maintain a steady internal environment, the extracellular fluid of the organism. This environment is kept within healthy bounds. For chemical concentrations, various pressures, growth rates or electrical charges. The thermostats typically send out signals, more gas, more breaks, which act upon some peripheral organ, which in turn creates the desired effect. The hypothalamus in the center of the brain is the control center, which influences the thyroid, the adrenals, ovaries, breasts or testes, by measuring the actual chemical output of these glands, and then sending out specific stimulating factors for final regulation. Within certain degrees, an organism can also adapt to external changes by recalibrating this internal environment. An example is the increased production and concentration of red blood cells, beginning within hours. When a human relocates to a higher altitude. The end result of this regulation or adaptation is called homeostasis, and any disease state can also be considered an imbalance within this mill you. In medical schools, the time worn adage, what's common is common, is typically taught early on with the corollary, when you hear hoof beats, don't think of zebras. Adages can often sound stupid, but tend to be totally accurate. Like all bleeding eventually stops, or, you'll never make a diagnosis until you think of it first. But this is all part of the education in medicine that doctors eventually grasp on their own. For baseball fans, this is reminiscent of the famous Yankee catcher, Yogi Berra, a baseball guru who would say, it ain't over until it's over, or when you come to a fork in the road, take it, or it's deja vu all over again. We have seen how Padua, in Northern Italy, near Venice, became a major medical mecca for learning, especially in the realm of anatomy. From out of the center in 1760 came the Italian Dr. Giovanni Morgagni. By this time, human dissection was completely accepted and autopsies had even become fashionable. Morgagni became quite famous for this, and was even scandalized once when he started an autopsy on a patient who has not yet died. But his greatest contribution in medicine came with his correlation of symptoms and disease to actual organ damage. This was just another brick in the wall for the pattern language of medicine added onto Sydenham's early contribution. The Spanish-American War of 1898 also led to an important medical discovery by the army surgeon Walter Reed in Cuba. Yellow fever was an ever-present danger for the American soldiers, and its cause or transmission was unknown at that time. A local Cuban physician felt that mosquitoes were responsible, but he was not believed. Other ideas held that the disease was transmitted by the vomit or diarrhea from dying patients. The heroic story of Walter Reed's team is told beautifully in the book, The Microbe Hunters, which is highly recommended for many of its chapters. In order to prove that mosquitoes were responsible for transmission, the experimenters would have to let a mosquito bite a dying patient and then get that same mosquito to bite one of the experimenters. This was extremely risky because 20-30 percent of those afflicted with yellow fever would die, and Walter Reed might've been one of these if his colleagues hadn't held him back from being a test subject himself. Other tests subjects were subjected to close contact with the vomit or diarrhea from the sick in a separate contained environment for days. A handful of people actually died in these experiments. But only luck kept the number from being even higher.
