Great Discoveries in Medicine
Great Discoveries in Medicine
by William Bynum, Helen Bynum, Editors
Thames & Hudson, London, 2011
304 pp., illus. 382 col. 342, 40 b/w. Trade, £24.95
Reviewed by Enzo Ferrara
Istituto Nazionale di Ricerca Metrologica (INRIM) and Istituto di Ricerca Interdisciplinare sulla Sostenibilità (IRIS)
The Dutch historian Iohan Huizinga wrote in The Waning of the Middle Ages (1919) that one of the most significant cultural transitions of Western civilization took place in the late medieval Europe (XIV-XV century), when sight definitively prevailed at a brainy level above other senses, until thinking itself was conceived as a sequence of visual images. This passage coincided with a breakthrough in the theoretical and practical means – clocks, maps, weights, and pilot books developed to quantify the observable physical reality. Even music started to be ‘read’ on pentagrams by chanters and musicians, to delight ears.
In the Middle Ages sight and quantifications became the basic instruments of artists as well as of artisans, scholars, and merchants. It was the integration of their separately refined skills that gave birth eventually to the first scientific developments: perspective and optics attracted painters; anatomy was interesting for sculptors, statics for architects. Quantification was the springtime of Renaissance and, later on, of modern sciences, which with the key contribute of mathematics were to blow up in the following centuries.
Evidence of surgery is reported in Egyptian papyri; the first European school of medical philosophy was funded in the X century AD at Salerno (Southern Italy), a crossroad of Arab, Greek, Latin, and Hebraic civilizations. But the apprenticeship of medicine as a mature discipline took millennia. Differently from other sciences, even after the Middle Ages, it remained more like sorcery barely anchored to an uncertain empiricism than an ordered subject of study.
The evolution of medicine as art and science can gladly be appreciated through the pages of Great Discoveries in Medicine. This is a collection of 382 sketches, stamps, photos, digital representations, and microscopy images depicting from the earliest descriptions of disease and healing in ancient Near Eastern cultures (Assyrian, Babylonian, and Egyptian) until the momentous hyper-technological approach of the late XX century, including assisted reproduction, cardiac surgery, key-hole treatments, and organ transplants.
William Bynum – professor emeritus at University College (London), author and editor of numerous books on the history of medicine – and Helen Bynum – who lectured in medical history at the University of Liverpool, now a freelance writer – already co-edited in 2007 the five award-winning volumes of the illustrated Dictionary of Medical Biography. In this new superb visual account of historical theories and practices of healthcare, they have been able to alternate technical and scientific discourses with representations intimately linked with religious and supernatural interpretations of medicine.
Seventy contributions of distinguished experts from around the world forms the book that is composed of seven parts dealing with such themes as the discover of body functions, from ancient times (Egypt, India, China, Greece, Islam) to modern pathological anatomy; the progressive understanding of health and disease, from the make out of blood circulation to psychoanalysis; the succession of medical triumphs, from anesthesia to neurosurgery. Concise descriptions of the analyzed issues complete the presentations that repeatedly combine technical illustrations with allegoric, informative or even advertising images.
Other topics include the long revered concepts of humors and pneumas – i.e. the ensemble of body fluids and air required by various organs to function, according to ancient Greeks, related with cosmic energies, the discovery of the pathogenic role of parasites and vectors, the consequences of the genetic revolution, the introduction of machines as defibrillators and endoscopes, and the pharmacological cure of pandemic illnesses as tuberculosis, smallpox, typhus and HIV. The Bedlam institute of London, the most famous mental hospital in the English-speaking world, is also briefly depicted.
One point emerges in particular as a landmark of medical developments: the inner features of medicine are as hardly adaptable to mathematics as their evidences are suitable to be appreciated by direct sight. Although scientific quantification took at last advantage on the uncertain pragmatism of medical art; nevertheless, our understanding of the workings of our bodies and minds remains inextricably related to how we perceive ourselves and the world we live in. It was only combining the invention of microscopy on one side, with statistics and epidemiology on the other, that the two emblematic levels of medicine – microscopic and macroscopic – were reconciled.
The editors explain that actually people “live longer, suffer less pain, and are healthier than even their grandparents were two generations ago” (p. 259). Yet, a major endangerment of public health is the dehumanization of medicine, due to the ubiquitous use of pills, exam techniques, and instrumental therapies treating our bodies as machines, with structural (muscles, bones, and skin), mechanical (the heart, veins, and lungs imagined as pumps and tubes), and electrical (brain, nerves, neurons) components, all of them changeable or reparable, of course, like technical devices to be refurbished. This is not the case of this collection, whose convincing result is a restoration of both the components of rational medicine it deals with: art and science. Through its pages, soul alternates feeling of pain and hope. It is an exaltation of the human element too, reminding us that “the reasons for a healthier longevity are complex and the real medical improvements that have been made during the past century are only a part of the story” (p. 259).