文艺复兴时期医学史

文艺复兴时期的医学The Renaissance Time Medicine145316世纪,一、社会和文化背景二、人体解剖学的兴起三、医学观念的变革四、外科学的进展五、内科学和传染病,一、社会和文化背景,地理知识的扩大；资本主义手工工场的出现；中国四大发明的传播(火药、指南针、造纸和印刷术)；东罗马帝国灭亡后文化西迁；,人文主义和自然科学的兴起以恢复古代希腊和罗马文化纲领的思想文化运动天文学的进步哥白尼天体运行论(1543年),文艺复兴的特征是欧洲封建制度开始崩溃，新兴的资产阶级崛起了，他们对封建制度及其意识形态展开了全面的进攻。,文艺复兴时期的社会情况,自然科学的进步,文艺复兴 The Renaissance ：一场伟大的文化运动 cultural movement ；发祥于意大利佛诺伦萨Florence,Statue of David,Mona Lisa,Florence,雅典学院 The School of Athens,拉斐尔Raphael,Michelango,Leonardo da Vinci,Galileo Galilei,Nicolaus Copernicus,Dante-alighieri,文艺复兴时期的伟大人物：但丁 达芬奇 米开朗基罗 伽利略 哥白尼,二、人体解剖学研究的兴起,欧洲的中世纪，教会反对进行人体解剖1316世纪，以解剖的例证来说明盖仑、阿森维纳的教材。,早期的人体解剖活动,古希腊思想的复兴：只有对人体本身进行解剖研究，才能认识到人体的美，只有直接研究人体，才能成为真正的艺术家。,The Vitruvian Man,达芬奇的人体比例研究,The Vitruvin Man,达芬奇(Leonardo da Vinci 145215l9),达芬奇绘制的解剖图谱,最后审判The last jugement,米开朗基罗画作的人体结构细节非常清楚,米开朗基罗(Michelangelo 1475-1564),巴黎审判,拉斐尔的画作充分体现了对人体结构的细致把握,拉斐尔(Rophael 1483-1521),二、人体解剖学研究的兴起,维萨里(Vesalius，A. 15141564)1543年出版人体的构造维萨里第一次与盖仑相反地描述了静脉和人类心脏的解剖驳正盖仑的错误约200余处,他尖锐地批评了盲目崇拜古人的风气。他说：“我要以人体本身的解剖来阐明人体之构造为己任。盖仑过去进行尸体解剖，不是人的，是动物的，多半都是猴子的。这不是他的过失，因为他没有机会解剖人体。但是现在有了人体可供观察，却仍坚持错误的人们才是有罪的。难道为了纪念一位伟大的活动家必须表现为重复他的错误!”,现代人体解剖学的奠基,维萨里毕业后马上在帕多瓦大学的外科学和解剖学教研室活动了教职，并且在波伦亚大学和披萨大学担任客座讲师 Obtain a chair of Surgery and Anatomy at Padua and guest lectured at Bologna and Pisa 维萨里把实地解剖作为自己教学的基本工具，自己处理解剖过程中的具体环节，鼓励学生们一定要自己动手解剖。实际操作中的观察被认为是最可靠的知识来源。这与中世纪的经院教学有着天壤之别。Carried out dissection as the primary teaching tool, handling the actual work himself and urging students to perform dissection themselves. Hands-on direct observation was considered the only reliable resource, a huge break with medieval practice 1543年他到巴塞尔协助出版七卷本的（人体构造）一书，这本书是现代人体解剖学的奠基石。他将这本书献给了神圣罗马帝国的查理五世皇帝。很多人认为当时的大画家提香的学生梵凯尔卡为该书画了插图，但是缺乏证据。无论如何一位艺术家在相当短的时间里要画出273幅插图是不可能的。In 1543 took residence in Basel to help publish the seven-volume De humani corporis fabrica (On the fabric of the human body), a groundbreaking work of human anatomy which he dedicated to Charles V. Many believe it was illustrated by Titians pupil Jan Stephen van Calcar, but evidence is lacking, and it is unlikely a single artist created all 273 illustrations in so short a time. 维萨里出版（人体构造）第一版是才28岁。Vesalius was 28 years old when the first edition of Fabrica was published,De humani corporis fabricaOn structure of the human body人体的构造,1543年维萨里出版了人体构造，从此人们对实地解剖、实验观察和人体机制的探讨变得更加自信。in 1543, were first printed the books De humani corporis fabrica by Andreas Vesalius, which gave a new confidence to the role of dissection, observation, and mechanistic view of anatomy,The contributions to anatomy 1脉管系统或循环系统的研究工作是维萨里对现代医学发展的最重要的贡献，其中有很多发现是对盖伦理论的否定。Work on the vascular and circulatory systems was his greatest contribution to the complex and modern medicine. Against Galens theory .心脏的节律与脉动的频率是一致的The cardiac systole is synchronous with the arterial pulse . 心脏有两个室腔和两个房腔，右心房是上、下腔静脉的延续；左心房是肺静脉的延续。 Identified two chambers and two atria. The right atrium was considered a continuation of the inferior and superior venae cavae and the left atrium was considered a continuation of the pulmonary vein. 心肌不是真正的肌肉，因为它不具有随意支配的特点The heart was not a true muscle due to its obvious involuntary nature of its motion.,The contributions to anatomy 2维萨里认为脑和神经系统是意识和情绪的中心，这与亚里士多德的心脏-意识中心理论是相反的。Vesalius believed that the brain and the nervous system are center of the mind and emotion in contrast to the common Aristotelian belief that the heart was the center of the body 神经系统是传递感觉和运动信息的结构，神经不是象亚里士多德认为的那样起源于心脏，而是起源于大脑。Defined a nerve as the mode of transmitting sensation and motion,and believed that nerves do not originate from the heart, as was the Aristotelian belief, but that nerves stemmed from the brain.,骨骼系统构成人体的支架结构；精确描述了颞骨岩部中的骨迷路的前庭结构。Believed the skeletal system to be the framework of the human body. accurately described the vestibule in the interior of the temporal bone of the skull . 肾不是滤过尿液的结构，而是滤过血液并且生成作为排泄物的尿液，后者经输尿管进入膀胱。The kidneys were not a filter device for the urine to pass through but rather that the kidneys serve to filter blood as well and that the excrement then traveled through the ureters to the bladder,文艺复兴时期的解剖教学活动,解剖条件和解剖方法的发展,三、医学教育观念的变革,重视临床观察的医学家“没有科学和经验，谁也不能作医生”“我的著作不象别的医生那样，抄袭希波克拉底和盖仑，我是以经验为基础，用劳动写成的。”对癫痫作了重要的观察，认为麻痹和语言障碍与头部的伤害有关。他提倡应用许多化学品，主张简化处方。,巴拉塞尔萨斯(Paracelsus）1493-1541,巴拉塞尔萨斯 是一个瑞士籍的德国人文艺复兴时期的内科医生、植物学家、炼金术师和星相学家。他创立了毒理学的基本原则，发现了一些疾病的心理学因素。Paracelsus born Philippus Aureolus Theophrastus Bombastus von Hohenheim, 11 November 1493 24 September 1541) was a Swiss German Renaissance physician, botanist, alchemist, astrologer, and general occultist. He founded the discipline of Toxicology. Modern psychology often also credits him for being the first to note that some diseases are rooted in psychological illness.,他是一个非常激进的医学实践活动的支持者，坚持对自然现象的直接观察，反对事事从古典教科书里寻求答案的做法。他最有影响的活动是对医学、科学和神学教育中经院派教学法的抨击。他对一些古典医学家如阿维森纳等既肯定优点又指出不足的作法为独立地依凭实践经验进行科学研究和医学教育开辟了正确方向，这应该是他最大的思想方法的成就。He is also known as a revolutionary for insisting upon using observations of nature, rather than looking to ancient texts, in open and radical defiance of medical practice of his day. Paracelsus most important legacy is likely his critique of the scholastic methods in medicine, science and theology . His attitudes towards the uncritical copy of the teachings of the old Fathers of Medicine, such as Avicenna and Averroes, without categorically denying their obvious merits, was his first and foremost achievement for independent and empirical approaches to research and teaching.,四、外科的改革,巴累改革了传统外伤治疗，主张创伤后的出血也不必用饶灼法，只要用结扎法即可。他将人体解剖学知识应用到外科上，使传统的外科有了重大的改变，并使外科医生的地位提高。创伤治疗等书都是用他本国的文字法文写的，这在文艺复兴时期也是一个大的改革。新的外科器械、新的手术方法连同中