of new and safer practices by islamicate scholars and physicians in arabian hospitals, ideas vital for the effective care of patients were developed, learned, and transmitted widely. hospitals developed novel "concepts and structures" which are still in use today: separate wards for male and female patients, pharmacies, medical record-keeping, and personal and institutional sanitation and hygiene. much of this knowledge was recorded and passed on through islamicate medical texts, many of which were carried to europe and translated for the use of european medical workers. the tasrif, written by surgeon abu al-qasim al-zahrawi, was translated into latin; it became one of the most important medical texts in european universities during the middle ages and contained useful information on surgical techniques and spread of bacterial infection. the hospital was a typical institution included in the majority of muslim cities, and although they were often physically attached to religious institutions, they were not themselves places of religious practice. rather, they served as facilities in which education and scientific innovation could flourish. if they had places of worship, they were secondary to the medical side of the hospital. islamicate hospitals, along with observatories used for astronomical science, were some of the most important points of exchange for the spread of scientific knowledge. undoubtedly, the hospital system developed in the islamicate world played an invaluable role in the creation and evolution of the hospitals we as a society know and depend on today. europe after 400 ce, the study and practice of medicine in the western roman empire went into deep decline. medical services were provided, especially for the poor, in the thousands of monastic hospitals that sprang up across europe, but the care was rudimentary and mainly palliative. most of the writings of galen and hippocrates were lost to the west, with the summaries and compendia of st. isidore of seville being the primary channel for transmitting greek medical ideas. the carolingian renaissance brought increased contact with byzantium and a greater awareness of ancient medicine, but only with the twelfth-century renaissance and the new translations coming from muslim and jewish sources in spain, and the fifteenth-century flood of resources after the fall of constantinople did the west fully recover its acquaintance with classical antiquity. greek and roman taboos had meant that dissection was usually banned in ancient times, but in the middle ages it changed: medical teachers and students at bologna began to open human bodies, and mondino de luzzi (c. 1275–1326) produced the first known anatomy textbook based on human dissection. wallis identifies a prestige hierarchy with university educated physicians on top, followed by learned surgeons; craft-trained surgeons; barber surgeons; itinerant specialists such as dentist and oculists; empirics; and midwives. institutions a miniature depicting the schola medica salernitana in salerno in italy the first medical schools were opened in the 9th century, most notably the schola medica salernitana at salerno in southern italy. the cosmopolitan influences from greek, latin, arabic, and hebrew sources gave it an international reputation as the hippocratic city. students from wealthy families came for three years of preliminary studies and five of medical studies. the medicine, following the laws of federico ii, that he founded in 1224 the university and improved the schola salernitana, in the period between 1200 and 1400, it had in sicily (so-called sicilian middle ages) a particular development so much to create a true school of jewish medicine. as a result of which, after a legal examination, was conferred to a jewish sicilian woman, virdimura, wife of another physician pasquale of catania, the historical record of before woman officially trained to exercise of the medical profession. at the university of bologna the training of physicians began in 1219. the italian city attracted students from across europe. taddeo alderotti built a tradition of medical education that established the characteristic features of italian learned medicine and was copied by medical schools elsewhere.turisanus (d. 1320) was his student.13th-century illustration showing the veins. bodleian library, oxford. the university of padua was founded about 1220 by walkouts from the university of bologna, and began teaching medicine in 1222. it played a leading role in the identification and treatment of diseases and ailments, specializing in autopsies and the inner workings of the body. starting in 1595, padua's famous anatomical theatre drew artists and scientists studying the human body during public dissections. the intensive study of galen led to critiques of galen modeled on his own writing, as in the first book of vesalius's de humani corporis fabrica. andreas vesalius held the chair of surgery and anatomy (explicator chirurgiae) and in 1543 published his anatomical discoveries in de humani corporis fabrica. he portrayed the human body as an interdependent system of organ groupings. the book triggered great public interest in dissections and caused many other european cities to establish anatomical theatres.the oldest polish collegium medicum at jagiellonian university founded in 1364 by the thirteenth century, the medical school at montpellier began to eclipse the salernitan school. in the 12th century, universities were founded in italy, france, and england, which soon developed schools of medicine. the university of montpellier in france and italy's university of padua and university of bologna were leading schools. nearly all the learning was from lectures and readings in hippocrates, galen, avicenna, and aristotle. in later centuries, the importance of universities founded in the late middle ages gradually increased, e.g. charles university in prague (established in 1348), jagiellonian university in cracow (1364), university of vienna (1365), heidelberg university (1386) and university of greifswald (1456). women in 1376, in sicily, it was historically given, in relationship to the laws of federico ii that they foresaw an examination with a regal errand of physicists, the first qualification to the exercise of the medicine to a woman, virdimura a jewish woman of catania, whose document is preserved in palermo to the italian national archives. early modern medicine places england in england, there were but three small hospitals after 1550. pelling and webster estimate that in london in the 1580 to 1600 period, out of a population of nearly 200,000 people, there were about 500 medical practitioners. nurses and midwives are not included. there were about 50 physicians, 100 licensed surgeons, 100 apothecaries, and 250 additional unlicensed practitioners. in the last category about 25% were women. all across england—and indeed all of the world—the vast majority of the people in city, town or countryside depended for medical care on local amateurs with no professional training but with a reputation as wise healers who could diagnose problems and advise sick people what to do—and perhaps set broken bones, pull a tooth, give some traditional herbs or brews or perform a little magic to cure what ailed them. people paracelsus (1493-1541). known as the "father" of toxicology. michael servetus (1511-1553). known as the first european to correctly describe pulmonary circulation. andreas vesalius (1514-1564). known as the modern founder of human anatomy. europe the renaissance brought an intense focus on scholarship to christian europe. a major effort to translate the arabic and greek scientific works into latin emerged. europeans gradually became experts not only in the ancient writings of the romans and greeks, but in the contemporary writings of islamic scientists. during the later centuries of the renaissance came an increase in experimental investigation, particularly in the field of dissection and body examination, thus advancing our knowledge of human anatomy.an experiment from william harvey's de motu cordis, 1628 replica of antonie van leeuwenhoek's microscope of the 1670s ideas animalcules: in 1677 antonie van leeuwenhoek identified "animalcules", which we now know as microorganisms, within their paper "letter on the protozoa". blood circulation: in 1628 the english physician william harvey made a ground-breaking discovery when he correctly described the circulation of the blood in his exercitatio anatomica de motu cordis et sanguinis in animalibus. before this time the most useful manual in medicine used both by students and expert physicians was dioscorides' de materia medica, a pharmacopoeia. inventions microscopes: bacteria and protists were first observed with a microscope by antonie van leeuwenhoek in 1676, initiating the scientific field of microbiology. institutions at the university of bologna the curriculum was revised and strengthened in 1560–1590. a representative professor was julius caesar aranzi (arantius) (1530–1589). he became professor of anatomy and surgery at the university of bologna in 1556, where he established anatomy as a major branch of medicine for the first time. aranzi combined anatomy with a description of pathological processes, based largely on his own research, galen, and the work of his contemporary italians. aranzi discovered the 'nodules of aranzio' in the semilunar valves of the heart and wrote the first description of the superior levator palpebral and the coracobrachialis muscles. his books (in latin) covered surgical techniques for many conditions, including hydrocephalus, nasal polyp, goitre and tumours to phimosis, ascites, haemorrhoids, anal abscess and fistulae. people women catholic women played large roles in health and healing in medieval and early modern europe. a life as a nun was a prestigious role; wealthy families provided dowries for their daughters, and these funded the convents, while the nuns provided free nursing care for the poor. the catholic elites provided hospital services because of their theology of salvation that good works were the route to heaven. the protestant reformers rejected the notion that rich men could gain god's grace through good works—and thereby escape purgatory—by providing cash endowments to charitable institutions. they also rejected the catholic idea that the poor patients earned grace and salvation through their suffering. protestants generally closed all the convents and most of the hospitals, sending women home to become housewives, often against their will. on the other hand, local officials recognized the public value of hospitals, and some were continued in protestant lands, but without monks or nuns and in the control of local governments. in london, the crown allowed two hospitals to continue their charitable work, under nonreligious control of city officials. the convents were all shut down but harkness finds that women—some of them former nuns—were part of a new system that delivered essential medical services to people outside their family. they were employed by parishes and hospitals, as well as by private families, and provided nursing care as well as some medical, pharmaceutical, and surgical services. meanwhile, in catholic lands such as france, rich families continued to fund convents and monasteries, and enrolled their daughters as nuns who provided free health services to the poor. nursing was a religious role for the nurse, and there was little call for science. asia in the 18th century, during the qing dynasty, there was a proliferation of popular books as well as more advanced encyclopedias on traditional medicine. jesuit missionaries introduced western science and medicine to the royal court, although the chinese physicians ignored them. events european age of enlightenment during the age of enlightenment, the 18th century, science was held in high esteem and physicians upgraded their social status by becoming more scientific. the health field was crowded with self-trained barber-surgeons, apothecaries, midwives, drug peddlers, and charlatans. across europe medical schools relied primarily on lectures and readings. the final year student would have limited clinical experience by trailing the professor through the wards. laboratory work was uncommon, and dissections were rarely done because of legal restrictions on cadavers. most schools were small, and only edinburgh, scotland, with 11,000 alumni, produced large numbers of graduates. places spain and the spanish empiredepiction of smallpox in franciscan bernardino de sahagún's history of the conquest of mexico, book xii of the florentine codex, from the defeated aztecs' point of view in the spanish empire, the viceregal capital of mexico city was a site of medical training for physicians and the creation of hospitals. epidemic disease had decimated indigenous populations starting with the early sixteenth-century spanish conquest of the aztec empire, when a black auxiliary in the armed forces of conqueror hernán cortés, with an active case of smallpox, set off a virgin land epidemic among indigenous peoples, spanish allies and enemies alike. aztec emperor cuitlahuac died of smallpox. disease was a significant factor in the spanish conquest elsewhere as well. mexico city epidemic of 1737, with elites calling on the virgin of guadalupe medical education instituted at the royal and pontifical university of mexico chiefly served the needs of urban elites. male and female curanderos