by Jacob Fine, York University undergraduate student
During the pandemic we currently face, it’s easy to take 21st century medicine for granted. Too often we hear complaints about modern medicine but, while far from perfect, it certainly surpasses that of any historical period. In exploring how our ancestors coped with sickness, it becomes clear just how much we owe to science. It is science that has made medical progress possible, and given us reason to be optimistic. Along with that optimism, we should recognize the need for raising consciousness about and appreciation for science and how it proceeds.
Much has changed in the field of medicine since the Neolithic period of about 12,000 years ago. In this time, ‘proto-surgeons’ drilled holes in people’s skulls (commonly referred to as ‘trepanning’ or ‘trephination’) to bring them back to life or resuscitate those believed to be dead - an action we now consider both horrifying and ludicrous, particularly when compared to the precision of today’s neurosurgery.
Fast forward to 4th Century BCE Greece when Hippocrates proposed that diseases were the result of natural events. This was revolutionary compared to the superstitious explanations that existed before. Despite this advance, Hippocrates also believed many things that we would consider strange, such as his four-humour theory of disease. This theory stated that all disease was the result of an imbalance of four bodily fluids: blood, phlegm, black bile and yellow bile. Ironically, the father of medicine is unlikely to pass a modern medical school entrance exam!
The Dance of Death (1493) by Michael Wolgemut, depicting the Black Death. Image from Wikipedia.
Travelling forward to the Middle Ages, some experts estimate that about one-third of all European infants died before the age of five. In the 14th century, the devastating Black Death killed 25-30 million people. Some estimate the death toll to be 30-50% of all people in infected areas. While Hippocrates’ theories persisted, medieval medical practitioners also included astrologers, monks, herbalists, and other professions we would not consider scientific by today’s standards. During this time, explanations for disease included demonic possession, sin transgression and witchcraft. Consider how the general public might have dealt with the Black Death in light of such beliefs. Thanks to science and our modern understanding of virology and epidemiology, we have a lot less reason to fear disease than our ancestors.
I write this article while many are in quarantine. The word quarantine comes from the Italian word quarantino, which refers to a “40-day period.” During the Black Death, this was the period of time prescribed by health officials for isolation. Renaissance Italian historian, Jane Stevens Crawshaw, explains that medieval physicians adopted the number forty for symbolic and religious reasons, and not because of any actual empirical evidence. The Noachian deluge tale (the biblical flood) that was said to have lasted for forty days and forty nights, along with other “quadragintian” stories, did influence this practice. By comparison, modern health officials make decisions about isolation periods based on evidence about incubation periods and methods of disease spread. So, while today’s practices are based on evidence, many scientific words have non-scientific etymologies. We can only imagine how 31st and 41st Century scientists will view these practices!
Great historical physicians Galen, Avicenna, and Hippocrates (left to right). Image from Research Gate.
The infamous Black Death (14th century, bubonic plague), along with the Plague of Galen (2nd century, probably smallpox or measles), the Plague of Justinian (6th to 8th century, probably bubonic plague), and the more recent Spanish Flu (20th century, influenza) have posed some of history’s greatest threats. Unlike Greco-Roman medicine, we do not treat disease as an imbalance of blood, phlegm, black bile and yellow bile. Nor do modern doctors base their treatment plans on astrological charts. If these semi-medically literate civilizations survived, then so can we. Experts now have much better tools to learn from past pandemics, particularly the Spanish Flu, which occurred during the emergence of modern medicine.
One can only imagine what Hippocrates would have thought of modern molecular genetic tests, from RT-PCR to IgM/IgG. Thanks to science, we know diseases can be caused by microbes and not some semi magical miasma. Even most six year olds know a thing or two about germs and genetics, but this knowledge would have utterly bewildered the greatest physicians of the past.
Our ability to develop increasingly accurate models of the world around us is what science is about. Insofar as disease is part of the world around us, science by definition develops better models of disease. Therefore, if you are concerned about your own health and the health of the community, then becoming familiar with the scientific method is necessary. It follows that if governments are concerned for the health of their citizens, then they too must become scientifically aware.
Last month, a poll from York University confirmed that, “a vast majority of Canadians (82% and 78%, respectively) thought that scientific evidence and advice from medical doctors” should be the primary influences on government-decision making.” Though this is optimistic news, there is no good reason for why this number should not be higher. And as the coronavirus SARS-CoV-2 continues to spread, the need for science-based decisions is ever-increasing. Science may hold the global spotlight now, but only we humans can determine its future.
This change must include better conversations between scientists and the general public. Since politicians are elected, a more scientifically aware electorate will vote for politicians who value science and evidence-based decisions. The responsibility rests on the shoulders of scientists to publicize the knowledge of their fields to non-scientists. After all, not everyone can use a pipette, telescope, or scalpel.
After exploring our species’ medical history, the sheer amount of knowledge we take for granted is apparent. If it weren’t for science, who knows if physicians would still enchant or trepan the sick. So take a step back and think of all the other historical periods. With this pan-historical mindset, a feeling of gratitude coupled by rational optimism should emerge, even during these difficult times. The urge for scientific progress should be widespread, an urge that, if shared by everyone, would be a significant improvement and advance.
About the Author
Jacob Fine is a second-year Biology student at York University. He is currently an editor for the STEM Fellowship Journal, a member of the Baycrest Hospital Youth Council, and runs a small private tutoring service. He is also the founder of the Asadi-Lari Interdisciplinary Contest at STEM Fellowship and the Universe Discovery Project at York University. He enjoys reading, playing piano and drums, and loves philosophical discussions.