Middle Ages

• Medieval doctors studied for 7 years at a University, such as the University of Padua in Italy
• They didn't have to meet any patients while studying, but they studied Galen and Hippocrates as well as textbooks like 'Compendium Medicine' by Gilbert Eagle
• Medieval doctors used a medieval urine chart for diagnosis, which included color, smell, and thickness of urine. They may have even tasted the urine to judge if the patient's humours were in balance
• They also used a Zodiac chart to determine when and where not to treat each part of the body based on the patient's astrological sign
• Medieval treatments included various methods, some of which can be seen in clips about the Barber Surgeon in the Middle Ages
• Ordinary people turned to barber surgeons for treatment in the Middle Ages
• The most influential belief in the medieval period was the balance of humours in the body
• Medieval period: 850 - 1450, also known as the Middle Ages
• Medieval theories of disease came from a dual approach: natural and supernatural
• Ancient ideas influenced Medieval medicine by providing a natural approach to medicine
• Hippocrates:

  • Greek physician
  • Theory of the Four Humours: Illness is caused when liquids (black bile, yellow bile, blood, phlegm) are out of balance
  • First-ever totally natural theory
  • Hippocratic Oath
  • Emphasized clinical observation
• Galen:

  • Roman physician
  • Adapted Theory of Four Humours and developed the Theory of Opposites
  • Believed in balancing humours with opposite reactions
  • Conducted famous dissections
  • Believed the brain controls the body
  • Made correct observations about the brain but incorrect ones about the left kidney, blood production, jaw bones, blood movement in the heart, and liver parts
• Hippocrates and Galen were important for Medieval medicine because they provided natural approaches to medicine, emphasizing the balance of bodily fluids and clinical observation
• Historians think that the plague arrived in England during the summer of 1348
• During the following autumn, the plague spread quickly through the south-west, with few villages escaping
• Churchyards were full with bodies as the plague spread quickly during the winter of 1348-1349 to the north of England
• By 1350, nearly the whole of Britain was infected with the plague
• At the end of 1350, nearly two and a half million people were dead due to the Black Death
• Food shortages occurred as peasants who worked the land died, food was not harvested, and farm animals escaped
• 1/3 population of Europe died due to the Black Death
• Peasant wages increased as there was a shortage of workers, and landowners needed them, paying them more to work for them
• The Catholic Church was weakened as churchmen were criticized for deserting their villages
• Medieval people believed that the Black Death was caused by miasma or bad air
• The actual cause of the Black Death was the bacterium Yersinia pestis, but they did not know this at the time
• Symptoms of the Black Death included buboes, fever, chills, vomiting, diarrhea, and ultimately death
• Treatments for the Black Death included bloodletting, herbal remedies, and prayers
• The impact of the Black Death included a significant reduction in the population, economic changes due to labor shortages, and weakening of the Catholic Church
• Surgery involves performing medical procedures on the body, while anatomy focuses on the study of the body's structure and organs
• Knowledge of anatomy was limited because human dissection was banned by the Pope in 1306
• Some universities allowed dissection of one body per year after 1400, but unauthorized dissection was punishable by death
• Factors hindering progress in Medieval surgery and anatomy:

  • Communication: Books of Galen were still used
  • Religion: The Church was extremely powerful, and most people were afraid to challenge their beliefs
• Significance of Galen's work in terms of anatomy:

  • Galen was right about the brain controlling the body
  • Galen was wrong about the left kidney being higher than the right, blood being made in the stomach and burned as fuel, the human jaw having 2 bones, blood moving through invisible pores in the heart, and the liver having 5 parts
• Problems faced by medieval patients in surgery:

  • Problem 1: Pain
  • Problem 2: Infection
  • Problem 3: Blood loss
• Hugh of Lucca and his son Theodoric:

  • Some surgeons believed pus was good, but Hugh and Theodoric disagreed
  • They advocated for getting rid of pus using wine and honey in wounds
  • Their ideas went against Hippocratic advice and were not popular
• John of Arderne:

  • Most famous surgeon in medieval England
  • Wrote a surgical manual 'Practica' with illustrations of his operations and instruments
  • Used opium for pain relief
  • Developed an operation to treat anal abscess
  • Created a Guild of Surgeons in 1368, separating surgeons from barber surgeons
• Challenges in overcoming pain, infection, and blood loss during the Medieval period:

  • Limited knowledge and understanding of anatomy and physiology
  • Lack of effective anesthesia and antiseptic techniques
  • Limited surgical instruments and techniques available at the time
• Christianity influenced medieval medicine by:
• Illness was seen as sent from God, so curing it would be a challenge to God
• Christians believed in 'Care for the patient, but don’t necessarily cure them'
• Illness was viewed as a punishment for sins