Medicine in the Renaissance city

Conrad and Lieber, and two on Western Europe by Nutton and Touati. It is introduced by Conrad and Wujastyk, organizers of a conference on contagion at the Wellcome Institute for the History of Medicine in 1993, on which the volume is based. The book is particularly useful in presenting a global picture of the notion of contagion in various pre-modern societies by first looking at the terms that implied transmission: epaphe, synanachronsis in Greek; upasarga in Sanskrit; contagio in Latin; adwa in Arabic; xiangran, chuanran in Chinese. All these ancient terms contained ambiguous and unclear notions on person-to-person contact and transmission. Many of them were related rather to ideas of pollution, or to supernatural causes. None of them was found to be of central importance in ancient medical theories. Even when the danger of being close to the sick was observed, there was generally no systematic understanding of the mechanism of transmission. No coherent contagion theory thus appeared in the West before the sixteenth century. This point is particularly well argued in Nutton's paper. A major reason for the marginal importance of contagion in pre-modern medicine is that, for most ancient medical systems, other factors such as seasonal or environmental influences, physical constitution of the person, and religious or supernatural elements were more important in the explanation of the spread of diseases. Kuriyama emphasized the issue of seasonal influences as part of the cosmic order in the Chinese case. This is again mentioned by Chang, for whom the notion of "fetal toxin", not contagious itself, could be brought out by unseasonal breath (qi), central in the spread of smallpox. Quite similar to the Chinese case, early European doctors preferred using the categories of bodily change and external alteration in the surrounding air to explain the occurrences of diseases. Religious, ethical or ritual factors are discussed at length by Cullen, Das and Zysk for the Chinese and Indian cases. In classical ayurveda, the main explanations for the spread of diseases remained divine, supernatural, or moral. In medieval Islamic medicine as described by Conrad, the omnipotence of God and the divine will prevented a full development ofany theory of contagion, even though adwa as applied to leprosy and plague did imply contagion and transmission. One particular disease is used more frequently than others to illustrate the secondary importance of contagion in this volume, and that is leprosy. Lieber emphasizes that the Biblical …