The Medical Book: From Witch Doctors to Robot Surgeons

Book Preface

The Medical Book, a vast journey into the history of medicine that includes eminently practical topics along with the odd and perplexing. We’ll encounter subjects that range from circumcision to near-death experiences and from witch doctors to robot surgeons. Educational content from The Great Courses provides a wonderful glimpse of the richness of medical history and the amazing progress humankind has made from the Stone Age until today:

In today’s era of modern Western medicine, organ transplants are routine, and daily headlines about the mysteries of DNA and the human genome promise that the secrets of life itself are tantalizingly within our reach.… Yet to reach this point took thousands of years. One step at a time … humanity’s medical knowledge has moved forward from a time when even the slightest cut held the threat of infection and death, when the flow of blood within the body was a mystery, and “cells” were not even a concept, and when the appearance of a simple instrument allowing a physician to listen to the beat of a diseased heart was a profound advance.

Each entry in The Medical Book is short—at most only a few paragraphs. This format allows readers to jump in and ponder a subject without having to sort through a lot of verbiage. When was the first time physicians studied maggot therapy to clean wounds and save lives? Turn to the entry “Maggot Therapy” for a brief introduction. Do acupuncture and truth serum really work? When was the first eye surgery performed? Will humans ever be able to be frozen and resurrected a century later? What’s the difference between yellow fever and sleeping sickness? We’ll tackle these and other thought-provoking topics in the pages that follow. Health care is among the most significant issues of our time, and it will be more so in the future. This book should appeal to students and their parents, health-care practitioners, and even many of the exuberant fans of Grey’s Anatomy, House M.D., and the countless medical shows—past, present, and future—that capture our hearts and minds.

When colleagues ask me what I feel are the greatest milestones in medicine, I usually offer three events. The first involves the use of ligatures to stem the flow of blood during surgeries, for example, as performed by the French surgeon Ambroise Paré (1510–1590). He promoted the ligature (e.g., tying off with twine) of blood vessels to prevent hemorrhage during amputations, instead of the traditional method of burning the stump with a hot iron to stop bleeding. The second key milestone includes methods for decreasing pain through general anesthetics such as ether, attributed to several American physicians. The third breakthrough concerns antiseptic surgery, which was promoted by British surgeon Joseph Lister (1827–1912), whose use of carbolic acid (now called phenol) as a means of sterilizing wounds and surgical instruments dramatically reduced postoperative infections.

If pressed, I would add two additional key developments in the history of medicine. The use of X-rays was the first of several groundbreaking modern approaches for visualizing the interior of living humans. Also very important was the gradually increasing openness of physicians and authorities to the dissection of bodies in order to learn about human anatomy. In fact, several milestones in this book offer portrayals of the human body by such greats as Leonardo da Vinci (1452–1519), Bartolomeo Eustachi (1500–1574), Andreas Vesalius (1514–1564), Pietro da Cortona (1596–1669), William Cheselden (1688–1752), Bernhard Siegfried Albinus (1697–1770), William Hunter (1718–1783), and Henry Gray (1827–1861). In order to become seasoned dissectors and anatomists, surgeons of the past often were able to suppress normal emotional responses for their human brethren. For example, English physician William Harvey (1578–1657), famous for his elucidation of blood circulation, participated in dissections of both his sister and his father. In the early 1800s, the appetite for corpses was so great in England that anatomists frequently collaborated with grave robbers to secure needed specimens. As I mention later in this book, art historians Martin Kemp and Marina Wallace write, “The portrayal of the human body, however ostensibly neutral or technical the illustration, always involves a series of choices, and invariably brings into play strong sensations. Historical images of the dissected body range from the most flamboyant of the multicolored waxes, in which dissected figures assume the roles of expressive actors and actresses in their own timeless drama, to the remorselessly sober woodcuts in Henry Gray’s famous Anatomy. All the images exhibit what an art historian would call ‘style.’”

Historian Andrew Cunningham writes, “The problem underlying all illustrations of anatomical dissection is that they are all … idealizations. Indeed this is why engravings [and photographs] are attempts at solving the same problem: that of bringing into view … the things that the anatomist wishes to make visible. For anatomizing is not only a very messy business … but distinguishing all the structures that are visible to the eye of the trained anatomist is very difficult for those who are not yet anatomists.”

On a personal note, I should mention that I’ve suffered from a strange case of anatophilia—that is, an extreme love of anatomy—since childhood. While I was growing up in New Jersey, my bedroom featured plastic anatomical models of the heart, brain, head, eye, and ear. My walls were covered with posters of organ systems rendered in exquisite precision. In college, I wore only anatomy T-shirts featuring circulatory systems, dissected frogs, and the like. It is this passion for understanding biology and the human body that led me to write this book.

Finally, we should note that before germ theory and the rise of modern science, a significant portion of medicine was based on superstition and the placebo effect. On this topic, medical experts Arthur and Elaine Shapiro write, “For example, the first three editions of the London Pharmacopoeia published in the seventeenth century included such useless drugs as usnea (moss from the skull of victims of violent death) and Vigo’s plaster ([including] viper’s flesh, live frogs, and worms).” Even the beloved doctor Ira Johnson in Robert Heinlein’s novel To Sail Beyond the Sunset admits the limitations of medicine and the ubiquity of the placebo effect in rural America around 1900: “I don’t do them much good. Iodine, calomel, and Aspirin—that’s about all we have today that isn’t a sugar pill. The only times I’m certain of results are when I deliver a baby or set a bone or cut off a leg.” Even today, according to the Institute of Medicine, less than half the surgeries, drugs, and tests that doctors recommend have been proved effective.