History of Printing Medical Texts

Medical texts throughout history have shown us how societies have changed their approach to treating illness and disease over time, and how drastically these approaches may differ from society to society. This page specifically focuses on the printing of medical texts across different cultures and societies throughout history.

Early Civilizations

A medical recipe concerning poisoning written in Cuneiform from Nippur, Iraq, 18th century BCE

Cuneiform in Mesopotamia

The oldest Babylonian medical texts date back to around 2000 BCE, and were written in Sumerian through cuneiform, which involved making wedged indentations on clay. The most well-known and extensive medical text was the Sakikkū or Diagnostic Handbook, written in Akkadian by Esagil-kin-apli during the reign of Adad-apla-iddina (1069–1046 BCE).. The Diagnostic Handbook was comprised of a total of 40 tablets separated into 6 chapters, and contained information about symptoms, empirical observations, and logical rules regarding prognosis and diagnosis. These logcal rules somewhat resemble modern approaches to medicine and diagnoses, in which disease, treatment, and chance of recovery are determined through inspecting and observing the patient's symptoms.

===Papyrus in Egypt===

A page from the Edwin Smith Papyrus with Hieroglyphic transliterations on the right

One of the earliest forms of a paper-like writing surface was papyrus in ancient Egypt. The ancient Egyptians used the stem of the papyrus plant as a material to make many goods, including paper. The Edwin Smith Papyrus, written around 1700 BCE, is believed to be the oldest medical text that references the practice of surgery. The medical information could be dated even further back, since the author was actually attempting to copy a manuscript dating back to around 3000-2500 BCE. The text, written on a 15 foot long papyrus scroll, described various diseases, cures, and anatomical observations. Because the surviving text solely deals with surgical cases, it is believed that the Edwin Smith Papyrus was originally intended to be a surgical textbook. It detailed a total of 48 cases, each divided into 4 or 5 sections.

Parchment, Paper, and Transcription

While many other early civilizations like India and China also had significant medical texts, Prior to the invention of the printing press, the vast majority of medical texts were written and copied by hand. There are some exceptions like woodblock printing in China, which could be traced back to as early as 220 AD.

The Renaissance and Mechanical Printing

The invention of mechanical printing had a huge impact on books, including medical texts. It immediately improved anatomical illustrations and moedels, as well as clearer diagrams of procedures. Because orignals can now be used to reproduce identical copies, illustrations became more elaborate, and artists ptrated paying greater attention to their details and accuracy. One of the most important medical texts arose during this era of book printing: De humani corporis fabrica libri septem by Andreas Vesalius

De humani corporis fabrica libri septem

Andreas Vesalius (31 December 1514 – 15 October 1564) was a Renaissance physician in the 16th century who played a major role in advancing the study of anatomy through his most famous work, [De humani corporis fabrica libri septem ("On the fabric of the human body in seven books"). Vesalius believed that anatomy could only be taught and learned through dissection and observation, which was reflected in his detailed anatomical models and descriptions. His conception of the human body as a system of interconnected parts pioneered a new method of studying and teaching anatomy that closely resembles modern practices. Vesalius' magnum opus, De humani corporis fabrica libri septem, was a collection of seven different books that each focused on a different component of the human body:

1. The Bones and Cartilages
2. The Ligaments and Muscles
3. The Veins and Arteries
4. The Nerves
5. The Organs of Nutrition and Generation
6. The Heart and Associated Organs
7. The Brain

Vesalius' work was not particularly renowned its content, but rather for the 250+ illustrations of the human body. The books were printed using woodblock engravings, which allowed for incredible precision and detail. While the specific artists and woodcutters that Vesalius employed are unknown, it is generally agreed upon that the illustrations came from the "circle of Titian," and Titian himself chose the woodcut that would be used to reproduce the drawings. Vasalius would would ultimately use 254 woodblocks for the anatomical illustrations, and 22 more would be used in another version of his work called De humani corporis fabrica librorum epitome, commonly referred to as Epitome.

Although the artistic sources remain unknown, the illustrations and figures in Vesalius' works masterfully combined elegance and anatomical accuracy, and greatly surpassed those in any other medical texts at the time. A very well-preserved copy of the De humani corporis fabrica libri septem can be found in the World Digital Library.

Modern Medical Texts and the Digital Era

With the improvements in book manufacturing as well as our knowledge of human anatomy and physiology that we've made in the past century, medical texts are now much more detailed and accurate in terms of content and any illustrations or diagrams. With the transition into the digital era, the majority of medical journals and texts today can be found online through databases that are available to the general public, like [PubMed]. It would be fair to say that the improvement of modern medical texts is much more hindered by our lack of knowledge rather than printing. While it seems like we've already reached the limit in terms of book printing, we are constantly expanding our understanding of human physiology through research as well as creating new and innovative technologies.