From the Four Humors to the Two Femurs: How the Medical Renaissance Shaped Modern Medicine

From Greek physician Hippocrates’s initial theory of the four humors regulating the immune system and emotions in the human mind to physician-anatomist Vesalius’s early illustration of the human body, society has revolutionized the field of medicine to a great extent since the earliest forms of medicine recorded in history. The Medical Renaissance represents a time period of innovation and sparked a growing interest once again in the progression of European medicine and treatment from the early fifteenth century to the late seventeenth century. The unique approaches to healing oneself and treating others in society, both physically and emotionally, were critical to how individuals studied medicine in the following years of the Renaissance as well as into the modern twenty-first century. As European medical knowledge expanded due to revived interest in ancient medical techniques from the ancient Greeks, Romans, and Persians, there was also a high demand of knowledge necessary in order to battle the evolving diseases and health issues that lethally advanced since the bubonic plague of the 1400’s. Renaissance medicine greatly influenced the progression of medicine beyond its primitive form as observed through the revolutionary works of physicians such as Andreas Vesalius, Leonarda Da Vinci, Ambroise Paré, Hieronymus Fabricius and many more individuals that celebrated humanist values of medicine. Simultaneously, reflecting on renewed perspectives from antiquity, such as Hippocrates’s humoral theory, was a crucial factor and pattern seen in the innovations and theories discovered during the Renaissance. Despite the accuracy of these discoveries in the following centuries and the sociocultural standards of the time that limited accessibility to medical supplies, the anatomical, physiological, and psychological approaches in studying Renaissance medicine fostered a pathway for humanist values and techniques that are existentially present in medicine today.

The era of rekindled interest in medical healing and treatment techniques and approaches during the Renaissance led many new thinkers to reflect on the past and uncover the revolutionary works of ancient Greek and Roman philosophers and physicians while creating their own definition of what “Renaissance medicine” included. In uncovering the works of Hippocrates of Kos, who was a Greek physician during the classical era of antiquity around 460 BC, individuals of the Renaissance found diverse approaches to clinical procedures, pushing the age of medicine into a more practical realm. Above any other ancient philosopher or physician, Hippocrates was given his title as the “father of modern medicine” due to his primitive contributions to the diagnosis of patients and belief that health issues seen during the age of antiquity occurred from natural effects and bodily responses to external factors that were rational in theory, rather than illogical spiritual assumptions or claims of religious omens (Chrysopoulos). As he moved away from the traditional perspective that diseases were a result of bad omens or religious morality, Hippocrates paved the way for future healers through naming new diseases, such as cancer, claiming an “Oath of Conduct” among physicians, and fostering the epitome of patient-physician relationships (Chrysopoulos). Thus, Hippocrates was especially referenced and observed by the new thinkers of the Renaissance age.

By advocating for the Hippocratic philosophy that there must be a “healthy mind in a healthy body,” he used the aspect of natural sciences to diagnose and heal patients through his famous theory of the four humors (Hartnell). In Hippocrates’s treatise, On the Nature of Man, he essentially argues that “the nature of man consists of four humors and the properties of each of these correspond to each of the four seasons, predominating in the season in which it shares the same nature: blood, hot and wet in spring; yellow bile, hot and dry, in summer; black bile, cold and dry, in autumn; and phlegm, cold and wet in winter” and that “good health is defined as the balance and mixture of the humors” (Jouanna). Due to the lack of medical knowledge and resources to perform advanced clinical procedures, Hippocrates and other early thinkers invested their philosophical ideas prior to any practical ideas in medicine. Thus, consistent with his theory of the four humors, Hippocrates built on the idea that every healthy individual must balance their four emotional and physiological humors, while those who are sick or have a deadly disease most likely have an imbalance of one or more of the humors. The concept of interconnecting emotions with physical effects of health problems was revolutionary for the time because, as a parallel to modern medicine, Paul Ekman, known as the psychologist and researcher most credited with his theory of the universal facial expressions, portrayed “seminal research on the biological effects of diverse emotions through an evolutionary Darwinism approach” in his extensive research (Stewart). In addition, Galen of Pergamon, an ancient Greek philosopher who studied the footsteps of Hippocrates in the Roman Empire, commented on Humorism and On the Nature of Man in his own personal research essays, asserting that substances in the bodies that can be deemed as “perishable” are too insignificant to affect our overall health and morality (Galen). With the four humors, the challenged perspectives did not invalidate the aspect of Humorism, but rather encouraged the thinkers and physicians during the Renaissance age to push beyond the boundaries of natural sciences in theory. As a result, Renaissance physicians took note of previous innovations and ideas, and there was a new collective approach to studying medicine that relied on facts and experiments rather than pure theory or rationalism. Through the creation of and access to more resources and the rise of evolving diseases, the Medical Renaissance stimulated advanced methods of physical observation for sources of diagnosis and operations of the body.

Given the invention of many surgical and clinical instruments, such as a sharp-end tool known as a fleam for bloodletting and tools made for sterilizing body knives, medicine was progressing with the demand of new plagues and diseases in the early 1500’s (Murrell). Leonardo da Vinci, an Italian artist, philosopher, engineer, and revolutionary anatomist known for embracing the characteristics of the hypothetical “Renaissance Man,” invested his time in observing human bodies and understanding how the biological and physiological systems work on the external surface. Following the ways of previous anatomists that pioneered in paving the way for dissections around the early ages of the Medical Renaissance, da Vinci initially observed corpses in secret before he successfully contributed to the European medical communities around him and was given access to resources from sponsoring hospitals. According to historians of the age, it was commonly believed that da Vinci paid grave robbers to dig out and uncover cadavers for his earliest studies, portraying the reality and struggle of early physicians in the Renaissance (Murrell). After taking the risk of observing the musculoskeletal interiors and exteriors of over a dozen bodies, da Vinci curated all of his findings and illustrations in his notebooks and essays, including the iconic “Viturian Man” illustrations that were based off of the architect and writer Marcus Vitruvius Pollio from antiquity (Artem). Due to the remarkable contributions found in his anatomical sketches and the “Viturian Man” following the theme of the Renaissance, da Vinci was the ultimate epitome of the “Renaissance Man”, with not only his excellence in a variety of worldly subjects, but also through his sense of individuality and celebration of self-indulgence. Although his artwork and ideas were symbolic of his individuality, da Vinci’s contributions were also essential for other anatomists and physicians—and even aspiring ones—to study the internal body despite their lack of access to cadavers. Medical information and research were made possible through Johannes Gutenberg’s innovation of the printing press, as it allowed for theories to be shared quickly and more efficiently than ever before. Consequently, Gutenberg’s printing press allowed other physicians to spot inaccuracies in da Vinci’s shared research proposals due to his lack of medical education and accessibility, regardless of his socio-economic background. Instead, the empty spaces and numerous questions that arose from his illustrations and conclusions were finished by another substantial thinker—a Dutch anatomist named Andreas Vesalius.

Above all the Renaissance physicians during the Medical Renaissance age, Vesalius was one of utmost importance for his title as the founder of modern human anatomy. In his studies at the University of Padua, Vesalius recorded revolutionary discoveries in his book, De Humani Corporis Fabrica Libri Septem. While accurately recording the fine details and functions of the human body that he doubted from Galen’s original theories, Vesalius served a bridge between philosophers from antiquity - early Renaissance anatomists - and his own group of thinkers during the gilded age of the Medical Renaissance. Vesalius’s contributions have been proven today with advanced technology, such as MRI scans and x-rays (Hartnell). For instance, Vesalius mentioned the three parts of the sternum and pointed out the physical location of illustrations of the human body, describing in intricate detail the functions and existential purposes of the bone in his essays and illustrations (Vesalius). Standing out against other anatomists during the concurrent Medical Renaissance, Vesalius argued, “By not first explaining the bones, anatomists delay the inexperienced student and, because of the difficulty of the subject, deter him from a very worthy examination of the works of God” (Vesalius). Through his passionate words and thorough research in his studies that encourage curiosity within his own methods of evaluation, Vesalius inspired rising physicians and future anatomists during and after the Medical Renaissance age. Fabricius, another physician who made a groundbreaking discovery in medicine on the concept of the fetus, was inspired by Vesalius and made accurate innovations to medicine (Murrell). Moreover, the expansion of medicine and exchange of theories and opinions would not have been possible without Gutenberg’s development of the printing press. Through the mass media of medical information spreading among the European countries in the late Middle Ages, medical knowledge spread throughout the communities and accounted for many catalyzed discoveries among new thinkers. With different approaches to medicine, healthcare and medicine were taken into account within hierarchical society, and improvements evidently led to improved lifespans and morality.

There were both cultural and religious proscriptions on healing individuals and how the study of the human body would proceed in the realm of medicine. With the power of the Church as a growing institution and force in the late Middle Ages, those who mixed herbs and created “potions” to heal themselves were looked down upon in thinking that the Church was ultimately the only place close to the definition of a hospital (Murrell). More specifically, the higher classes and nobles with financial support were able to receive such treatments from the Church, while not many peasants had the privilege of obtaining such medicines or considering proper ways of treatment, as these were beyond their budget. Selling indulgences and seeking forgiveness for their personal sins were ways that the Church encouraged spiritual healing rather than physical healing. Self-flagellation and punishment for naturally having a disease disproved the validity of the Church’s responsibility for healing patients and many individuals felt self-aware when they discovered that religion did not immediately heal their bodies like a cure. No one challenged the Church’s ideals of medicine publicly, however, as blasphemy and heresy only lead to further punishment. Nevertheless, despite these religious concerns, anatomists continued to uncover more questions behind the human body system and functions. Moreover, anatomists of the late Middle Ages acquired bodies through different methods, many of them being physically and culturally risky. As mentioned, while some anatomists were granted the privilege of receiving cadavers from hospital sponsors, others had no choice but to steal corpses from public locations, such as graves. The first college of physicians did not open in London until the 1500’s, but even then, not as many bodies were easily donated to the colleges as they are today, and no one knew which bodies would have been optimal to study due to different causes of deaths (Stewart). On the other hand, not every physician, or general member of society, was wealthy enough to attend school, let alone one specializing in medical education. The question of ethics was brought up in understanding that many physicians had no choice but to access their anatomical discoveries through stealing bodies (Artem). Although it was illegal and some medicinal practitioners were arrested and punished for their actions, the acts were necessary in the name of medicine.

Connecting the parallels from ancient Greek and Roman medical techniques to evolving Renaissance approaches, the knowledge of medical treatment through the realms of anatomy, psychology, and physiology has expanded beyond its initial form. Ultimately, though many procedures and approaches were not the most effective or efficient in theory compared to modern techniques, each separate idea from the Medical Renaissance gave birth to medicine as we know it today. Without understanding how philosophers viewed medicine during the Renaissance age and the extent of their accessibility to medical exploration compared to the twenty-first century in terms of resources as well as sociocultural norms, physicians would never have understood the pure sensation of treatment and healthcare through its origin and evolution from hundreds of years ago. Moreover, acknowledging the phenomenon of modernization and globalization of medical knowledge helps establish a motivational drive for healers today to recall and empathize with the original goals and purpose of medieval medicine that were just as ideal as they are today. Thus, modern healers and physicians must credit the methods and techniques birthed from the Medical Renaissance, as the time period paved the road for the current understanding of the workings of the human body and mind. The value of humanism must be upheld in celebrating the individual contributions to medical knowledge, which have built the foundation of the field of medicine and health today. Regardless of the age, the theme of humanism is consistently notable through the rising years of the 1400’s into the sixteenth and seventeenth centuries, as philosophers from any period optimized the resources available to them and took advantage of previous knowledge despite the lack of medical education in society. The aspect of individual contributions and genuine curiosity in how the human body and mind function portrays the ultimate value of Renaissance humanism, which physicians and medical students studying anatomy, physiology, or psychology still value today in modern medicine.