Clarification and medical history of apparent death
The medical theories of antiquity are largely forgotten with the fall of the Roman Empire. Thus, medicine in the Middle Ages initially consisted of improvisation and superstition, [1] if treatment was given at all – because illnesses were God’s work and only he could decide whether recovery would occur or not – then usually with very surprising therapeutic approaches. With the Crusades, Islamic medicine finds its way into the West. It is mainly based on the ancient theories of Hippocrates (ca. 460 – 370 v. Chr.) and von Galen (ca. 130 – 200 n. Chr.), co-founder of the four-fluid theory, according to which a person is only healthy if the four bodily fluids blood, phlegm, yellow bile and black bile are in balance. [2] Due to the dogma of leaving the body intact under all circumstances, two strands develop in the treatment of patients: doctors deal exclusively with internal medicine, surgical treatments fall into the hands of so-called hand surgeons who, without academic training, pull teeth, amputate and drill into skullcaps, all without serious anesthesia, not to mention observing hygiene. Even if there are already some experts who really know how to preserve life, the obscure methods of treatment not infrequently lead to the death of the patient sooner or later. This is how the health care of the Middle Ages and the Renaissance is similar to the doctors of the 17th century. The medicine of the twentieth century has become suspect, and the practical remedies of the time – emetics, pulverized genitals, feces and urine, and other now questionable things – have long since ceased to convince even those who prescribe them. [3] The epidemics of that time always cause chaotic conditions, they bring an almost unbelievable amount of dead, depopulate whole regions and the corpses are hastily buried in mass graves without careful examinations. This is where Bondeson sees a possible beginning of the apparent death discussion, as many doctors in the 17. It seems that the scientists of the nineteenth century had already been aware of the danger that in this chaos fatal errors of judgment could occur. [4] He sees the proof among other things in the discovery of bones during an excavation of a plague mass grave of 1722 in Marseille, to which a good two and a half centimeters long bronze needle stuck in the big toe, presumably intentionally driven under the toenail, in order to examine the entrance of the death. [5] Such methods will be considered in more detail in the next chapter.
While physicians prefer to leave the question of the meaning and nature of death to philosophers and theologians, questions of prediction and exact fixation of the time of death appear to be important for medicine. [6] Since individual cases of apparent death have been known since antiquity, other physical changes are used in addition to the negative breath sample to determine actual death. [7] Traditionally, this is generally pulselessness, pale and cold skin, eye changes and finally death spots and rigor mortis. [8] As a rule, the judgment of relatives is sufficient to convince the doctor that death has occurred. [9] Even if recently there are individual voices of reflection, the general state of research is that until the middle of the 18th century, the blood-letting was not a problem. Twentieth-century apparent death is not a serious problem, either for physicians or for the public consciousness. [10]
The physicians of 17. and 18. The medical science of the twentieth century has to deal with ever new findings and to give up traditional ideas. The emerging questions of medicine concern the whole person, because how can one really heal, if one does not even know what "life" is? is what it means to be "sick" to be and where a disease originates in the first place? [11] A lively discussion developed, with the teachings of the mathematician, physicist and philosopher Rene Descartes (1596 – 1650) in the mid-17th century causing a furor in Germany. The first thing to be mentioned is the nineteenth-century physiology of the body, which describes the still largely incomprehensible physiological processes of the body as quite simple physical ones – namely heat, pressure, expansion, movement – and thus reveals the organism. [12] At first, dissections remained forbidden, but with the ravages of the plague and the fervent desire for a cure, they met with increasing acceptance. [13] With the advent of the natural sciences, the dead body is soon reified, [14] the sanctity of the body finally dissolved. The new interest of medicine does not shy away from anatomical experiments, also resorts to vivisection of animals, and thereby discovers more and more the innermost part of the human being. Thus, in 1628, one of the most groundbreaking discoveries in the history of medicine occurs: William Harvey (1578 – 1657) discovers the circulation of the blood, thus refuting Galen’s theory, which had been valid for centuries. [15] With his intention to support Galen’s theories, which he considered to be "minus firma" ("not quite sure"), it completely overturns the traditional view of the heart and its function and thus calls into question one of the most common methods of treatment: bloodletting. [16] The physician Tankred Koch considers bloodletting, which is automatically prescribed for almost all diseases and which Hippocrates had already ordered in his time, to be one of the most terrible means and the cause of many cases of apparent death. [17] Koch reported cases in which up to two and a half liters of blood were taken, and since plague germs multiplied faster than red blood cells, or blood overloaded with typhoid or cholera germs became thicker and thicker and less and less capable of transporting oxygen, one could quickly imagine that the poor people would soon show the signs of a "vita minima" (literally, "reduced life.", medical term for apparent death) show. [18] If, however, there is a last revolt of the supposed dead, the first remedy is to bring him back to life: Bloodletting. [19] It was not until the time of Christoph Wilhelm Hufeland, when the four-juice theory was replaced by the theory of vitalism – the view of a supernatural, immaterial life force in organisms – that the frequency of bloodletting decreased. [20] Already 100 years earlier, Harvey argues that nature shows the divine order of things, that the blood, for example, has an inherent power of self-motion that drives it through the veins to the center of the body. [21] This view will be dealt with in more detail in the following chapter. First of all, however, the attitude of the Enlightenment thinkers shall be summarized roughly and thus finally the way to the debate on apparent death shall be found.
