Scientific Medicine 1500 To Present

The remainder of this chapter will focus on science and medicine since 1500. Medieval science (1150-1450) was constrained by the earlier Greek paradigm of Aristotelian science and the Arabic renderings of these teachings by Avicenna. With the introduction of instruments such as the mechanical watch, the magnetic compass, and the magnifying glass, it became possible to quantify and critically examine some features of human experience and the underlying philosophical tradition. Out of this interaction grew the experimental method of verification and falsification which provides the basis of the Scientific Era (62).

In the following sections, I will review each of the major areas that affect the development of the ''science of obesity.'' To put this in the broader context, the reader is referred to the timeline in Figures 3-7.

dissections. Andreas Vesalius was only 28 years old when he published his masterpiece. In 1543, Copernicus (64) also published his book on the solar system, arguing that planets revolved around the sun. In his accurate and careful dissections, Vesalius showed that the human body could be directly explored by appropriate experimental methods. In so doing, he applied the concept of direct verification and experimental manipulation and identified a number of inaccuracies in the anatomy of Galen, which appears to have been based on animal dissections and treatment of wounded gladiators.

A key element in communicating these discoveries, including those of Vesalius and Copernicus, was the process of movable type and printing invented by Gutenberg. This technical development was followed by the steady distribution of printing presses throughout Europe over the next 50 years. The printing press made classical literature widely available and made it possible to communicate original observations to an ever-growing audience in a relatively short time, as contrasted to handwritten books. The revolution in communication had begun, and the age of anatomy, ushered in at the beginning of the 16th century, expanded rapidly. This was also the peak of the Renaissance. Up to the 16th century, Galen and his writings from Roman times and the Canons of Avicenna from Arabic medicine had been the main source of information about anatomy, physiology, and clinical medicine. Although there is no clear evidence that either Galen or Avicenna ever dissected a human cadaver, their influence was only broken by the application of direct observation and verification after hundreds of years.

The first anatomical dissections of obese individuals are attributed to Bonetus (65). Other descriptions appear in the publications by Morgagni (66), by Haller (67,68), and most particularly by Wadd (69). Of the 12 cases presented in Wadd's book, Comments on Corpulency, Lineaments of Leanness, two had been examined at postmortem and had been found to have enormous accumulations of fat. This was the first instance of a monograph devoted to obesity that contained anatomical dissections.

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