The Doctor’s Decalogue
For in ten words the whole Art is comprised —
For some of the ten are always advised:
Piss, Spew and Spit,
Perspiration and Sweat;
Purge, Bleed, and Blister,
Issues and Clyster.
– Edward Baynard, M.D. 1719
The body of medical knowledge has existed in three distinct phases. The first phase would stretch from the beginnings of history to about 450 BCE, the time of Phythagorus and Hippocrates. What we now consider Hippocratic Medicine took for granted that disease is caused by natural subjects and natural law (that the world is ordered and governed in a certain way). No one really knows why the Greeks suddenly shifted to this natural law, but it’s been the basis of our medical thinking ever since.
Pre-Hippocratic medical knowledge was interpretted in strictly supernatural terms, while Hippocratic medicine saw illness as a practical matter. The big differentiation here is what caused disease; Asclepian medicine assumed that all disease was a spiritual matter; you had made Asclepus unhappy, pray to him to heal, et cetera. Hippocratic medicine, on the other hand, took the effort to make medicine scientific; it assumed that you could understand and explain disease by natural law. The Hippocratic medical literature also developed procedures of examination that would not be significantly expanded on until the early 1800s.
In fact, the next major era of medical knowledge came about only a few hundred years after the advent of Hippocratic medicine, with the proliferic Galen. Until the mid-1500s, all knowledge of how the body worked came from Galen’s discections of pigs, Barbary apes, and cows. Looking at his anatomical drawings, it very clear that the only time he saw the inside of a human body was in the aftermath of battles. Regardless, his proliferic publication of material and his sheer intelligence made him the authority in medicine for the next 1000+ years.
Towards the middle of the 16th century, this steadfast belief in Galenism began to change, largely with the advent of the scientific revolution. People began to see that an understanding of nature is obtained not from authoritative texts but by observation, experimentation and quantitative reasoning. Medicine slowly became a scientific activity, one where you do and experiment and learn for yourself, as opposed to book-learning. (As an aside, there is a fabulous painting called Habit de Medecin that, for the life of me, I couldn’t find an image of – this is a pity, as it represented the mid-1500 view of what a physician was comprised of: primarily books.) But even with this shift in thinking and move towards experimentation and direct experience, medicine was still virtually the same in 1700 CE as it was in 200 BCE. The major advancements, and the third period of medical knowledge, didn’t begin until the mid to late 19th century.