Christianity and The Medical Sciences

• It must be remembered that before Christianity came to power, Greek rationalism was beginning to make inroads into a rational and scientific approach to understanding illnesses, their causes and cures.

• Contrary to the enlightened, rational approach of the Greeks, the understanding of the Bible on diseases, their causes and cures can only be described as pre-scientific.

• When Christianity gained control of the Roman empire, this pre-scientific attitude coupled with a reliance on miraculous cures meant that Greek medical knowledge was successfully suppressed for almost a millennium.

• Having successfully suppressed Greek medicine, the Christian churches did their best to prevent development of the medical sciences. Some examples
  • Anatomy and Physiology
  • Inoculation and Vaccination
  • Use of Anesthetics during Childbirth

• Conclusions

Hippocrates' innovative ideas were passed on to the School of Alexandria [which was set up by the Hellenistic ruler, Ptolemy I (c. 367-283 BC) around the last quarter of the fourth century BCE.] There the scientific tradition was carried further by doctors such as Herophilus (fl. c 280 BCE) and Erasistratus (c304-c250 BCE) . They made fundamental discoveries in anatomy and physiology. Their discoveries include the functions of the human nervous, reproductive and digestive systems. A large part of their success was due to they being able to secure the dissection of human cadavers (provided by the government!) [2]

Another great figure in Greek medical science was Galen (129-c200 CE). Galen continued the scientific philosophy of medicine by using observations to test assumptions and hypothesis. He carried out hundreds of dissections - enabling him to expand further medical knowledge. Galen made major discoveries including the function of the arteries and the workings of the bladder. He was also known to show the workings of the nervous system by taking a live pig and then removing its function one by one. Galen was later appointed the doctor for the emperor Marcus Aurelius in Rome. Galen's work were to dominate the field (for better and for worse - as we shall see) for the next millennium. Up until the early nineteenth century medical students still consulted his works. Some 20,000 pages of his works still survive to this day. [As an aside, it is interesting that Galen's main criticism of the Christians of his time was that they were relying on undemonstrated laws.] [3]

All these advances were to be quickly overturned once Christianity gained ascendancy in the fourth century CE.

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The Biblical Pre-Scientific Theology of Diseases

According to such a view, God sent diseases to human beings to show his displeasure. According to the Old Testament, it was God who afflicted King Uzziah (II Chronicles 26:19-21) and Miriam [Moses' sister] (Numbers 12:9-12) with leprosy:

II Chronicles 26:19-21 Then Uzziah was angry. Now he had a censer in his hand to burn incense, and when he became angry with the priests leprosy broke out on his forehead, in the presence of the priests in the house of the Lord, by the altar of incense. And Azariah the chief priest, and all the priests, looked at him, and behold, he was leprous in his forehead! And they thrust him out quickly, and he himself hastened to go out, because the Lord had smitten him. And King Uzziah was a leper to the day of his death, and being a leper dwelt in a separate house, for he was excluded from the house of the Lord.

Sometimes God simply allows Satan to inflict illness on people; the case in point is where he allowed Satan to afflict boils on Job just to test the latter's resolve. (Job 2:7)

Job 2:3-7 And the Lord said to Satan, "Have you considered my servant Job, that there is none like him on the earth, a blameless and upright man, who fears God and turns away from evil? He still holds fast his integrity, although you moved me against him, to destroy him without cause." Then Satan answered the Lord, "Skin for skin! All that a man has he will give for his life. But put forth thy hand now, and touch his bone and his flesh, and he will curse thee to thy face." And the Lord said to Satan, "Behold, he is in your power; only spare his life." So Satan went forth from the presence of the Lord, and afflicted Job with loathsome sores from the sole of his foot to the crown of his head.

Mark 9:17-27 And one of the crowd answered him, "Teacher, I brought my son to you, for he has a dumb spirit; and wherever it seizes him, it dashes him down; and he foams and grinds his teeth and becomes rigid; and I asked your disciples to cast it out, and they were not able." And he answered them, "O faithless generation, how long am I to be with you? How long am I to bear with you? Bring him to me." And they brought the boy to him; and when the spirit saw him, immediately it convulsed the boy, and he fell on the ground and rolled about, foaming at the mouth. ...And when Jesus saw that a crowd came running together, he rebuked the unclean spirit, saying to it, "You dumb and deaf spirit, I command you, come out of him, and never enter him again." And after crying out and convulsing him terribly, it came out, and the boy was like a corpse; so that most of them said, "He is dead." But Jesus took him by the hand and lifted him up, and he arose.

These pre-scientific conception of diseases and their cures have two important corollaries:

• Firstly, diseases were caused either by God, Satan or evil spirits. Theologically there were specific reasons for the infliction of these diseases. Given this premise, seeking out these reasons - is it a form of punishment by God? a test? is it due to evil spirits which took advantage of the "unholy" state of the person? - seems as important as, if not more than, seeking a cure.

• Secondly, since the cause is theological, the cure has to be theological as well. This means that it led believers away from finding rational, natural explanations and methods for cures and towards supernaturalistic approach based on appeasement of God's anger or the thwarting of the intentions of Satan. [4]

The Suppression of Greek Rationalism in Medicine

Contra Celsum 8:31 It is demons which produce famine, unfruitfulness, corruptions of the air, pestilences; they hover concealed in the clouds in the lower atmosphere, and are attracted by the blood and incense which the heathen offer to them as gods. [5]

All diseases of Christians are to be ascribed to these demons; chiefly do they torment fresh-baptized Christians, yea, even the guiltless newborn infants. [6]

Of course this aversion to taking medicines and consulting doctors has a scriptural base. The death of King Asa was attributed to him seeking doctors instead of God to cure him:

II Chronicles 16:12 In the thirty-ninth year of his reign Asa was diseased in his feet, and his disease became severe; yet even in his disease he did not seek the Lord, but sought help from physicians.

Contraria sunt divinae cognitioni praecepta medicinae [The precepts of medicine is contrary to divine knowledge] [8]

Of course the practice of dissecting cadavers to learn about human anatomy and physiology was extremely repulsive to the early Christians. Again the theological basis of this abhorrence is easy to understand: the doctrine of the bodily resurrection made them worried that these mutilated bodies would have some problems with being reanimated during the final general resurrection. Thus the Church Father Tertullian (c160-c225) labeled Herophilus, the great doctor of the School of Alexandria, a "butcher". St. Augustine used similar phrases to describe all doctors who performed dissection on the human body.

The science of medicine, then, became so strongly associated with ungodliness that there arose the Latin proverb, Ubi sunt tres medici ibi sunt duo athei [Where there are three doctors there are two atheists.].[9]

As Charles Freeman noted in his book The Closing of the Western Mind, this condemnation of rational medicine was theologically grounded:

The rejection of a scientific approach to medicine is underlined by the belief ... that the soul is of greater value than the body and that suffering is a part of the Christian tradition, even to be welcomed as a test of faith. A sick man in danger of death urgently needed, it was said, a priest for his soul rather than a doctor for his body. [10]

The second front in the attack on medical sciences was provided by the Church's belief in miraculous cures. These miracles include miraculous streams or pools of water, the power of the holy word and relics. Here too there are firm scriptural bases. We have seen how the Syrian Naaman was cured of leprosy by dipping himself in the river Jordan (II Kings 5:1-27). Jesus cured a blind man by having the latter clean himself in the pool of Siloam (John 9:7-11). As for the efficacy of relics we are told that the bones of the prophet Elisha (II Kings 13:20-21), the shadow of Peter (Acts 5:15-16) and the handkerchief of Paul (Acts 19:11-12) were sufficient to effect miraculous cures. [12]

Thus we find that the belief in miraculous cures flourished during the dark ages. The cathedral of Cologne was supposed to house the miracle-cure inducing skulls of the three wise men who visited the baby Jesus. John Chrysostom (c347-407) wrote of children who would hang small copies of the gospels around their necks as protection against harm. Relics from various saints were attributed with powers to cure anything from fevers (St. Remy) to toothaches (St. Apollonia)! Epilepsy, exorcised by Hippocrates 500 years before the Christian era, was now placed under the auspices of St. Christopher. [13]

This belief in the efficacy of miraculous cures contributed much to the demise of scientific medicine. The reasons why this became so are simple. If miracles are sufficient in the provision of cures (at least in popular belief), there is then no need for the alternative: scientific medicine. Furthermore, the minds that fed on the belief of miracles are minds that were not prepared to ask rational questions regarding the true nature of diseases. Thus the waning of the rational approach to medicine was inevitable once Christianity gained ascendancy in Europe. [14]

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Opposition to the Sciences of Anatomy and Physiology

Men of science also rose, in the stricter sense of the word, even in the centuries under the most complete sway of theological thought and ecclesiastical power; a science, indeed alloyed with theology, but still infolding precious germs. Of these were men like Arnold of Villanova, Bertrand de Gordon, Albert of Bollstadt, Basil Valentine, Raymond Lully, and, above all, Roger Bacon; all of whom cultivated sciences subsidiary to medicine, and in spite of charges of sorcery, with possibilities of imprisonment and death, kept the torch of knowledge burning, and passed it on to future generations. [16]

As we have seen above, the earliest fathers of the church condemned the dissection of cadavers on theological grounds. It is to be expected that the medieval church would not take this resurgence of a practice so antithetical to their theology easily. In the thirteenth century, Pope Boniface VIII (c1234-1303) issued a papal bull that decreed excommunication for anyone who dared to dissect a cadaver. This was to cripple the development of the science of anatomy and physiology for the next two to three centuries. [19] The papal bull was far reaching in its effects. Thus we find, a couple of centuries later, Leonardo da Vinci (1452-1519) being forbidden to enter a hospital because he had once dissected a human corpse. [20]

In the field of anatomy and physiology, the major turning point in the battle between the church and science came in the figure of one man: Andreas Vesalius(1514-1564). Despite the condemnation of the ecclesiastical authority, the real possibility of excommunication, imprisonment and even death, Vesalius went ahead and dissected human cadavers. His work, published as the seven-volumed De Humani Corporis Fabrica (1543) was the epitome of methodological examination and observation of the human body. His empirical work showed that Galen made some serious mistakes more than a thousand years ago. He showed that there was only one jawbone and not two as Galen had asserted. He understood the function of the vena cava as being one of the two great veins which circulated blood back to the heart. Galen had thought that the vena cava originated in the liver. There were two additional things which Vesalius' anatomical work did not find that were to land him in trouble later. Firstly, he showed that men had no missing rib - contrary to what many had thought, based on the story of the creation of Eve in Genesis 2. Secondly, he could find no "incorruptible bone" in the human body, a vital part of the anatomy believed by most in the middle ages to form the nucleus of the resurrected body. Without this "incorruptible bone" it seems that the whole doctrine of bodily resurrection was thrown in doubt. [21]

Vesalius' work drew the ire of everyone who wanted to keep the status quo. Galen's work was safe and sanctioned - some of his medical colleagues did not take to his discoveries kindly. A former professor of Vesalius, Sylvius, denounced his ex-pupil as a "madman". Yet another colleague, a former assistant named Colombo, tried to discredit his work. However his most vociferous opponents were to be from the church. Initially Vesalius was protected somewhat from the ecclesiastical authorities as he was the physician to Emperor Charles V. However after the abdication of Charles V in 1555 Vesalius became a sitting duck. He was denied any permission to dissect any cadavers. Finally a trumped-up charge of dissecting a living man was used to get rid of him. The Inquisition forced him to make a pilgrimage to the holy land - on the way back from there, he was shipwrecked and probably died of hunger on the Greek island of Zante. [22]

Another important case that should be mentioned is that of the Spanish Unitarian, Michael Servetus (1509-1553). During his lifetime, he gained prominence in medical circles as a skilled dissector. It was probably during these dissections that Servetus came up with the discovery of the lesser circulation of the blood. He came close to discovering the major circulation [a] of the blood as well. Servetus presented his discovery in his book Restitution of Christianity (1553). However, all his opponent could see in the book was his heretical Unitarian views. His books were burned, and he was tried and imprisoned by the Catholic Church. He managed to escape and went to Calvinist Geneva. His treatment was worse there. He was arrested and burned at the stake, together with his books, in 1553 by the Calvinists as a heretic. [23]

However the discoveries of these great men could not longer be clamped down on. Soon after the death of Vesalius, the papal authorities began to grudgingly give out licenses to dissect to various universities. [24]

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The Holy War Against Inoculation and Vaccination

In 1717 Lady Mary Montagu, wife of the English ambassador to Turkey, herself a survivor of smallpox, witnessed how the Turks inoculated themselves against the disease. Small parties of old women would go around from house to house carrying nutshells filled with pus from a mild smallpox case. The pus was then smeared on a purposely opened wound of the patient (or customer). Lady Mary noted that most of the patients would fall sick for a few days but most were back to normal within eight days. Those inoculated became immune to the full blown disease. So impressed was she with the method that she had her own son, Edward, inoculated. Upon returning to England in 1721 tried to get inoculation introduced in London. Initial tests on six prisoners (who volunteered after being promise a reprieve) were successful. The technique quickly spread throughout Europe. [26]

Since live smallpox virus were being introduced into the bloodstream by inoculation, there is always a possibility that the full blown disease could develop. Indeed there was a death rate of 2-3% due to inoculation. The death rate from someone naturally infected with the diseases was much higher, of course, normally around 20-40%. Thus while inoculation was by no means completely safe, it could reduce the death rate by as much as 95%. [27]

The reaction of the ecclesiastical authorities was predictable. Theologians from all over Europe and America were condemning the life saving procedure. In 1772 Rev. Edward Massey of England published a sermon entitled The Dangerous and Sinful Practice of Inoculation. He argued that Job's anger was due to his brain being affected by inoculation from smallpox. Who inoculated him? Well Satan, of course! The Right Reverend went on to argue, consistent with Biblical teachings, that diseases are sent by God as a form of punishment for sin. Any attempt to prevent diseases is a "diabolical" attempt to thwart the will of God! Another English ecclesiastic, Rev. Delafaye wrote a sermon entitled Inoculation an Indefensible Practice. In France, in rare solidarity with their English counterparts, the theologians at the Sorbonne roundly condemned inoculation. Things were the same in Scotland. The Calvinist church there denouncing the practice as "flying in the face of Providence" and "endeavoring to baffle a divine judgment." [28]

Of course there were some in the clergy that supported inoculation. One example was that of Cotton Mather (1663-1728), the puritan minister infamous for his role in the Salem witch trials. It was he who convinced Dr. Zabdiel Boylston to try out the new technique during a smallpox epidemic in Boston in 1721. In the two years following he performed almost 300 inoculations, out of which only six died. By comparison, from the almost 6000 that caught smallpox naturally, nearly 1000 died. By any measure Dr. Boylston's inoculation was a success. In 1738 the procedure was successfully employed, by another doctor, after a severe epidemic in Charleston, South Carolina .

However ecclesiastics like Cotton were in the minority. The majority , supported by conservative doctors and newspapers, were clearly against the procedure. Once again the objection was theological. His opponents asserted that smallpox is "a judgment on the sins of the people" and warned that "to avert it is but to provoke him more". Other added that inoculation is "an encroachment on the prerogatives of Jehovah", who has the right "to wound and smite". [29] A pastor, William Cooper, vituperated:

The small pox is a judgment of God, sent to punish and humble our sins; and what shall we so evade it, and think to turn it away from us?...God has predetermin'd and fixed the Period of every ones life...so that if this time be come Inoculation will not save the Person's Life. [30]

It was good that Satan should be dispossessed of his habitation which he had taken up in men in our Lord's day, but it was not lawful that children of the Pharisees should cast out by the help of Beelzebub. We must always have an eye to the matter of what we do as well as the result, if we intend to keep a good conscious toward God. [31]

The scientific progress in the war against smallpox was to take an even larger leap forward with the discovery of vaccination by Dr. Edward Jenner (1749-1823). [b] As a doctor in Gloucestershire, England, Jenner noted that individuals previously infected with cowpox (a milder version of smallpox normally contracted from cows by milkmaids) were never infected with smallpox later. In 1795, Jenner tried smallpox inoculation on a man previously infected with cowpox and found that he did not develop any symptoms or fall ill, save a small swelling on the arm where the inoculation was done. Furthermore when a small pox epidemic broke, the man took care of his infected family but never fell ill himself. After several such cases, on the 14th of May 1796, Jenner decided to experiment with vaccinating a young healthy eight year old boy with cowpox. The boy fell slightly ill a week later but was well again within a couple of days. He then tried inoculating the boy with smallpox on the 1st of July. The boy did not fall ill then and did not do so even when Jenner tried again a few months later. [33]

Unlike smallpox inoculation, where there is a small probability that those who were administered it could die from the full blown disease, cowpox vaccination does not have this potentially lethal side-effect but provide the same kind of immunity against small pox. The result was tremendous. In Berlin, Germany the number of deaths dropped from more than 4,000 (in the period 1783 to 1792) to 535 (from 1814-1822). In Copenhagen, Denmark the number of deaths dropped from 5,500 in the twelve years before the introduction of vaccination to 158 in the sixteen year span after its introduction. In Vienna, the annual death rate from smallpox dropped from 800 to less than thirty in 1803. In London, whose horrible death tolls we have seen above, vaccination is so successful that by 1890 there was only one death from smallpox that whole year. [34] The vaccination program was so successful that by 1978, smallpox had been effectively eradicated from the face of the earth (with the exception of some stored in biological warfare plants and, perhaps, in some religious terrorist hide-out).

Vaccination, thus eliminated the last moral reason anyone could have against inoculation, the (small) probability of deaths from patients developing the full blown smallpox. Yet the reaction of church authorities and theologians was again negative. In 1798 conservative doctors and clergymen of Boston founded the "Anti-Vaccination Society." They called on the people of Boston to stop vaccination as the life saving procedure was "bidding defiance to Heaven itself, even to the will of God". [An old version of the "playing God" argument used by modern religious opponents against research in genetics, cloning and stem cells.] They informed their fellow Bostonians that "the law of God prohibits the practice." In his sermon at the University of Cambridge in 1803, Reverend Ramsden criticized Jenner with verses from the scriptures.

This opposition to vaccination did not just stop at setting up societies or making sermons from pulpits. There were much more serious practical consequences. In 1885 a smallpox epidemic broke out in Montreal, Canada. Almost everyone was vaccinated except the Catholic population there. When the authorities tried to force vaccination on their Catholic citizens, they were met with opposition that threatened to become violent. Rather than explaining to their parishioners the benefits of vaccination, the catholic clergy tolerated and in some cases even encouraged the behavior of the laity. A priest of St. James Church said in a sermon that, "if we are afflicted with smallpox, it is because we had a carnival last year, feasting with the flesh, which has offended the Lord;...it is to punish our pride that God has sent us smallpox." One religious newspaper even went further, telling the Montreal Catholics to take up arms rather than submit themselves to vaccination. Instead the catholic ecclesiastical authorities in the city called on their people to make certain devotional exercises, to hold a procession with an appeal to the Blessed Virgin and to use the rosary as specified. Needless to say the Catholic population in Montreal suffered many needless deaths from smallpox until the proper measure was finally enforced. [35]

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Outlawing of Anaesthetics During Childbirth

Christian theologians had always looked at the pain of childbirth as the result of the curse of God on Eve and all her descendents; for disobeying his command. This curse is very clearly spelled out in the Bible:

Genesis 3:16 To the woman, God said, "I will greatly multiply your pain in childbearing, in pain shall you bring forth children."

This "heritage of pain" is described many times in the Old Testament:

Isaiah 26:17 Like a woman with child, who writhes and cries out in her pangs, when she is near her time ...

Thus, as Eve cried out in pain to bring for her children, so shall all women throughout history do so. The pain was a reminder of the Fall. So taught the theologians.

Our story begins in 1591 with an Edinburgh woman named Euphanie Macalyane. Unable to bear the pain of childbirth she asked the midwife, Agnes Sampson, to give her a remedy to relieve her suffering. At that time James VI (1566-1625) was the king of Scotland. [It was this same James who upon becoming king of England in 1603 authorized the English translation of the Bible which is known today as the King James Version, or simply, the Authorized Version.] And James, upon hearing of this abomination was furious and ordered Euphanie to be burned alive. It was the pious king's warning to any woman who dare to evade the curse of Eve. [36]

The discoverer of anesthesia for women in labor was the Scottish doctor, James Baker Simpson (1811-1870). As a child he was told of the near fatal pain his mother went through in giving birth to him. It was a scene that was described to him in vivid details. The boy grew up to become a doctor. He was speedily promoted to the post of chief obstetric assistant.

It was in his duty as an obstetrician that he witnessed with his own eyes the suffering that had previously been described to him. As a humanitarian, Simpson was convinced that no woman ought to suffer such an agony. He began working for an analgesic that would help to alleviate this suffering. After many trials and errors he finally discovered that the pain could be reduced with the use of chloroform. He tested his discovery on women in labor with astounding success. On November 10th 1847, in an address to the Edinburgh Medico-Chirurgical Society, Simpson reported that he had tested the analgesic thirty times and met with success every time. Not wanting to keep the discovery to himself, he revealed his methods in the hope that no woman henceforth need to suffer the pangs of labor.

The reaction of the Scottish Calvinist Church was swift and furious. "What a Satanic invention!" they cried, "What a shame upon Edinburgh!" The ecclesiastics objected to this rebellion against God, "Did not the Almighty pronounce this primal curse? Pain of childbirth was God's will. Now one of God's creatures, impiously rebelling against the divine command, had dared to frustrate God's will." Death by fire for heresy had already been abolished by then, no doubt that would have been Simpson's fate had it been allowed. Nevertheless the ecclesiastical authorities still had ways and means of persecuting the doctor. In churches the preachers warned pregnant women that should they allow this devilish treatment to be administered on them, the children will be denied the sacrament of baptism. This warning must have worked for we have record of Simpson complaining to a friend that "Many of my lady patients had strong religious scruples against anesthesia. Most of them consult their ministers." The pulpit was not the only place from which the clergy attacked Simpson. They sent circulars to all doctors in Edinburgh which contain the following words:

To all seeming, Satan wishes to help suffering women but the upshot will be the collapse of society, for the fear of the Lord which depends upon the petitions of the afflicted will be destroyed.

In other words the preachers feared that once pain has been taken away, people will no longer be religious! The doctors, in general, being good Christians sided with the clergy. Most of the Christian laity as well, being a faithful flock of the church, joined in the condemnation of Simpson, and his discovery. In his defense Simpson cited Genesis 2:21 where God put Adam to sleep before taking out one of his ribs to make Eve. But he was no match for the theological sophistry of the Scottish Calvinists. They replied that Adam's "operation" was done before the Fall but that the curse on Eve was pronounced after it. So the curse stays!

For six years the conflict raged. The scale was finally tipped in Simpson's favor when Queen Victoria (1819-1901) accepted the use of anesthetic when she was giving birth to prince Leopold. [37]

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Conclusions

• The suppression of Greek rationalistic principles in medicine was an expected consequence of the beliefs that it was God who was the cause of diseases and that miracles and relics were the way to ask God to heal them. Within this context we could understand why Tertullian labeled one of the greatest Greek doctors in antiquity a "butcher".

• We see the same consistent application of theology in the opposition of the early and medieval Christians to the practice of dissecting cadavers. It put the whole idea of bodily resurrection and the veracity of some Biblical stories (e.g. the creation of Eve from Adam's rib) into doubt. Given that principle, it is obvious that the religious leaders would choose to suppress the practice.

• The men who opposed inoculation and vaccination had nothing to gain personally from preventing these medical techniques from reaching the public. As human beings, they would have surely felt the pain of seeing so many people die. Their arguments were entirely theological and, I might add, based on a consistent reading and understanding of the Bible. If the prerogative for inflicting diseases and for curing them is with God (which clearly is the case as we have seen above) then trying to prevent diseases would be like trying to thwart the will of God.

• Finally in the case of the provision of anesthetics to women in labor, the argument was again theological. If God has placed the pain upon Eve as a punishment, men should not be "playing God" to remove that curse. The pain of childbirth, according to this theologically informed view, was not an "evil" that should be alleviated, but a from of suffering to be humbly accepted by women as a reminder of the original sin against God. Again absent this theological view, everyone involved would have had no reason to denounce this advance.

Thanks to the relentless fight by scientists and enlightened people in the past we find such theological defenses quaint. For we see clearly the benefits these advances in medicine have brought to all. However it must be remembered that there is a new front of theological attack on medicine and the life sciences. The current theologically based opposition to embryonic stem cell research, cloning, in-vitro fertilization and genetic engineering are based on the same logic that had been the cause of misery in the past.

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Notes

References

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