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Changing Explanations in Mind-Body Medicine

Class 3: Mind and Body in Renaissance and Early Modern Medicine

Introduction: During the Renaissance and early modern periods (ca. 1350–1650), most practicing physicians and medical writers continued to understand health and illness within the framework handed down to them by their ancient and medieval predecessors. Medieval representations of the humoral perspective circulated widely in the Renaissance period, book publishers produced attractive editions of Hippocrates’ and Galen’s works, and Avicenna’s Canon continued to enjoy great success as a textbook well into the seventeenth century. Although anatomical teaching and investigation matured in the sixteenth century and was followed in the seventeenth by major physiological discoveries such as William Harvey’s (1578–1657) of the circulation of the blood, medical ideas and techniques remained solidly grounded in the past. To most students, who automatically identify science with medical progress, this will seem absurd and thus needs to be underscored and reinforced by a close study of the medical ideas and practices during and after Harvey’s time as presented by Porter.

A corroborating perspective on the continuing popularity and wide dissemination of classical and medieval ideas about the humors and the relationship between the biological and psychological dimensions of medical practice can be gained from contemporary court records. In the English legal system, mental incompetence was formally determined by court proceedings. Records from the thirteenth to the mid-seventeenth century as examined by Neugebauer show that magistrates and juries regularly appealed to familiar biological and psychological explanations to account for the onset of insanity. In many cases, insanity was thought to be the result of physical illness or injury, but in other cases emotional shocks, intense fear, prolonged grief, and stressful life events were said to be the causes.

Readings

  • Porter, Roy. The Greatest Benefit to Mankind: A Medical History of Humanity. New York: W.W. Norton & Company, 1997, 168–186, 195–197, 211–216, 232–235.
  • Neugebauer, Richard. “Medieval and Early Modern Theories of Mental Illness.” Archives of General Psychiatry 36 (1979): 477–483.

Discussion Questions

  1. As Porter makes clear, there was evidence for both dramatic change and persistent continuity in sixteenth and seventeenth century medicine. Which was more substantial, change or continuity? Back up your position with specific evidence from the reading.
  2. Why didn’t scientific advances like the new understanding of human anatomical structures and new insights into physiology like the discovery of the circulation of the blood lead to fundamentally new ideas about disease or therapy? Why did old practices like humoral adjustment by bloodletting carry over so strongly into this period or, at best, undergo only superficial change?
  3. Consider the cases of John Fitzwilliam, John Norwich, Bartholomew de Sakeville, Robert Barry, James Benok, Henry Williams, and Elizabeth Gate presented by Neugebauer on pp. 481–482. Which explanation of the onset of mental illness—biological or psychological causes—seems to dominate, or are both sets of ideas present in equal measure?
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