c.1250-c.1500 - Medicine in Medieval England

• •  ME: CAUSE OF DISEASE - Lack of knowledge and understanding made disease unexplainable
• • ME: CAUSE OF DISEASE - People believed sickness was a punishment from god for people's sins or testing them, sickness showed them the error of their ways to make them become better people
• •  ME: CAUSE OF DISEASE - People believed evil supernatural beings (like demons and spirits) sent illness
• •  ME: CAUSE OF DISEASE - people believed in the idea that astrology  (movement of planets and stars) affected people’s health, physicians used an almanack (special calendar which told them where different stars and planets were at a given time) to diagnose patients, physicians used when the patient were born and when they started to feel ill to diagnose them
• • ME: CHURCH’S INFLUENCE - the church gave people guidance (moral and spiritual), education, rites of passage and charity
• • ME: CHURCH’S INFLUENCE - illness was believed to have sometimes been sent by evil spirits so when patients recovered the church said it was a miracle from God as the patients prayers had been answer
• ME: CHURCH’S INFLUENCE - the only people who could write were majority monks so books and learning had to be filtered and controlled by the church to fit christian ideas
• • ME: CHURCH’S INFLUENCE - the church outlawed dissection meaning doctors could discover anatomy for themselves
• • ME: CHURCH’S INFLUENCE - the church followed theories by Hippocrates and Galen which was so central to medical learning it was difficult to disagree
• • ME: HIPPOCRATES + GALEN - their ideas were considered to be absolute truth by the catholic church
• • ME: HIPPOCRATES + GALEN - galen only dissected animals so some of hi ideas of anatomy were wrong
• • ME: HIPPOCRATES + GALEN - hippocrates ‘hippocratic oath’ is still used today (a promise made by doctors to obey rules of behaviour in their professional lives)
• • ME: HIPPOCRATES + GALEN - believed you should observe your patients to treat them
• • ME: FOUR HUMOURS - created first by hippocrates then developed by galen
• • ME: FOUR HUMOURS - body was made of four humours - blood, phlegm, yellow bile and black bile
• • ME: FOUR HUMOURS - for a patient to be healthy the 4 humours needed to be balances, if one was in too little or excess supply they become sick, proven when patients threw up yellow or black liquid, had a bloody cough or sneezing and coughing phlegm
• • ME: FOUR HUMOURS - galen said the body could be balanced by the theory of opposites, : if you had too much of a humour, you needed to cure it with the opposite. For example: if you had too much phlegm, which is cold and wet, you were given something spicy which is hot and dry to cure the sickness
• • ME: MIASMA - the idea bad air (smells) cause disease when someone breathed it in, originated in ancient greece
• • ME: MIASMA - promoted people to be more hygienic, like cleaning streets, which did help stop the spread of disease
• • ME: MIASMA - 4 humours and miasma were wrong but encouraged people to think of natural causes of disease instead of supernatural, implied people weren't powerless against disease and that they could investigate and take action against it
• • ME: TREATMENT - prayer and repentance - sickness was believed to be punishment from god so patients were encouraged to pray (often to saints), go on pilgrimages and holy shrines, and in Europe some people (flagellants) whipped themselves in public to show god they apologies for their past actions (common in epidemics e.g. the black death
• • ME: TREATMENT - bloodletting - if someone had too much blood in them barber surgeons (majority) would make a small cut in an open vein and drains the blood, keep leeches hungry for one day then attach them to the patient, or cupping which involved cutting the skin then creating a vacuum around the cut to draw out the blood
• • ME: TREATMENT - purging - making people vomit or take laxatives to remove excess humours acquired from food
• • ME: TREATMENT - air purification - physicians carried poesies and oranges to protect themselves when seeing patients, incense was burned to ward off bad air during the Black Death
• • ME: TREATMENT - herbal remedies - herbal infused drinks, sniff or bathe in herbs, created by wise women or apothecary
• • ME: MEDICAL HEALERS - physicians - trained at universities for 7-10 years (e.g. cambridge, paris, bologna, montpellier and padua), read ancient texts and writings from the Islamic world, little practical work during school, diagnosed illness and recommended treatment using clinical observation, consulted astrological charts and humoural tendencies, would observe the patient's blood, urine and faeces samples, not allowed to to carry out clergy procedures, did not carry out procedures (left to lower paid+less trained)
• • ME: TREATMENT - apothecaries - prepared and sold remedies and gave advice on how to use them, studied herbal manuals which had been passed down by family members, trained though apprenticeships, not bound by ‘hippocratic oath’ making them untrustworthy, created amulets and charms for patients which was frowned upon by physicians, cheaper alternatives to physicians
• • ME: TREATMENT -  barber surgeons - carried out minor  procedure (teeth pulling, hernias, cataracts) only as there was no pain relief and a high chance of death in surgeries, least qualified, little medical training so no real desire to experiment with new treatments
• • ME: TREATMENT - wise women - created herbal remedies, skills were devalued, not well record, carried out everyday medical car, could not go to university, people were suspicious
• • ME: PLACES OF CARE - hospitals - run and set up by monasteries, people were cared for by nuns and monks, funded by wealthy endowment, main purpose was to care for the sick and elderly (palliative care), some herbal remedies, denied access for infectious, pregnant women and insane people
• • ME: BLACK DEATH - series of plagues which swept through England during the 14th century, 2 illnesses (bubonic plague - spread by flea bites carried by rats on ships, severe headaches, high fevers, pus-filled swellings in the armpits and groin + pneumonic plague - spread by coughing and sneezing, attacked the lungs,painful breathing, coughing blood), estimated to have killed ⅓ of the british population
• • ME: BLACK DEATH - caused by religious and supernatural - punishment for sin, unusual aligning of the planets in 1345
• • ME: BLACK DEATH - caused by miasma - released by poisonous fumes from earthquakes or a volcano
• • ME: BLACK DEATH - caused by jewish population/ outsiders coming to England
• • ME: BLACK DEATH - caused by imbalance of the humours
• • ME: BLACK DEATH - prevention religious + supernatural - pray, pilgrimages, offerings to god, self-flagellation
• ME: BLACK DEATH - prevention natural - escape the country, carry strong smelling flowers/ herbs under your nose, avoid bathing (opens up pores to bad air), lance buboes
• • ME: BLACK DEATH - prevention - doing joyful things, avoiding sadness, avoid people with the disease, bleeding + purging
• • ME: BLACK DEATH - prevention government action - quarantine laws stopped people moving around, people in a new area had to quarantine for 40 days, cleaning streets to avoid bad air, parliament closed, banned large gatherings to avoid crowds
• • ME: BLACK DEATH - prevention - used existing ideas to cure it but a lack of medical knowledge made these ideas false and no way of knowing what caused it