Health + People

• Medieval medicine approaches


  • Natural
  • Supernatural
  • Ideas of Hippocratic and Galenic methods and treatments
• Medieval doctor


  • Followed ancient Greek method of clinical observation to produce diagnosis
  • Tended to concentrate on two indicators - pulse and colour/taste/smell of urine
• Medieval doctor treatments


  • Bloodletting
  • Giving patient something to make them vomit/go to toilet
  • Remedies combined natural + supernatural approaches - prayers, charms (KINGS TOUCH), astrology
• Four humours


  • Body contains 4 important liquids: blood, phlegm, yellow + black bile
  • Believed person became ill when humours imbalanced
  • Doctors job to restore balance
  • 4 humours linked in to other things - nature, seasons, elements etc
  • Developed by Hippocrates
• Medieval doctors training


  • To qualify would take at least 7 years at university such as Oxford
  • Qualified doctors often left uni before seeing patient
  • Learned treatments of Galen and Hippocrates
• Who treated ordinary people

  • Trained doctors (very expensive = limited to the rich)
  • Wisewomen (herbal + natural remedies - knowledge passed down by word of mouth)
  • Christian churches (set up hospitals to care for poor + sick - only 10% cared for sick - 47% house the poor and elderly and provided no medical care)
  • Apothecaries (sold drugs + medicine+ advised on their use)
  • Barber surgeon (provided minor treatment - low status - v common)
• Hippocrates


  • 4 humours, Hippocratic oath, clinical observation
  • Encouraged observation, professionalism, developed first rational system of medicine
• Galen


  • Belief of 4 humours, use of opposites, books used, studied heart
  • Ideas approved by Christian Church, lasted for over 1000 years
• Christianity believed in following the example of Jesus - caring for sick (NOT curing)
• Christianity believed illness came from God as punishment or test of faith
• Christianity encouraged belief in miraculous healing - many shrines which people would pilgrimage to - e.g shrine of St Thomas Beckett at Canterbury
• Christianity promoted Hippocratic + Galenic ideas - supported 'design theory'
• How Christians treated the sick

  • Between 1000 and 1500 more than 700 hospitals started in England
  • Many hospitals centres of rest
  • Some small with space for only 12 patients (same number as Jesus disciples)
  • Many run by monks or nuns to strict pattern of diet and prayer
  • Depended on charity for money - usually financed by Christian Church or wealthy patrons
  • St Leonards York = example of large hospital
  • Lazar houses dealt with those who had leprosy - often started by crusading orders
• In Europe, training of doctors began after 1200 = more peaceful and prosperous
• Christian church controlled universities = aim to understand old knowledge NOT discover new ideas
• Church saw doctor as someone who could predict symptoms and reasons for why God might inflict illness on patient - NOT healer
• Islamic Empire


  • Ruled by Caliph - provided peace + order needed for medical progress
  • Caliph's library preserved hundreds of ancient Greek medical books which were lost to Western Europe during Dark Ages
  • Islamic religion encouraged medical learning
  • First set up hospitals for people with mental illnesses - people treated with compassion - v different to Christian doctors who saw illness as punishment from God
  • Hospitals tended to cure for patients, not just care
  • Bimaristans set up to provide for everyone - doctors always present and students trained alongside them
  • Baghdad capital of medicine
• "For every disease, Allah has given a cure"
• Al-Razi


  • Stressed need for careful observation, distinguished measles from smallpox, wrote over 150 books
• Ibn Sina


  • Wrote encyclopaedia of medicine which covered all knowledge at time, listed medical properties of 760 different drugs, became standard European medical textbook
• Who practised surgery


  • Barbers who combined haircutting with small surgical operations
  • Surgeons learned by being apprenticed to another surgeon
• What surgeons could do

  • Bloodletting
  • Amputation
  • Drilled into skull to treat epilepsy (thought to be caused by demons inside brain)
  • Most surgery occurred on battlefields - patients faced pain + shock
  • Used natural substances such as mandrake root, opium + hemlock as anaesthetics
  • Cauterisation = burning wound to stop flow of blood
• Abulcasis


  • Muslim considered 'father of modern surgery', invented 26 new surgical instruments and described new procedures
• Frugardi


  • Wrote a textbook on surgery in 1180, warned against trepanning, tried ambitious surgeries on chest + attempted to remove bladder stones
• Hugh of Lucca and son Theodoric


  • Worked in Italy, wrote book in 1267 criticising view pus needed for wound to heal, used wine on wounds to reduce infections, went against Hippocratic advice = unpopular
• Mondino


  • Wrote book in 1316 which became standard dissection manual
• De Chauliac


  • Famous French surgeon, his textbook dominated English/French surgical knowledge, quoted Galen 890 times, disagreed with Lucca's ideas
• John of Ardene


  • Used opium + henbane to dull pain, developed operation to treat anal abscesses, formed Guild of Surgeons
• Towns built near bodies of water as needed access = various systems of water supply
• As towns grew existing systems couldn't cope with demand so used tech with pipes made from wood or led
• Sewage removed in rivers and thrown onto streets
• Most towns had privies
• Cesspits collected sewage - dug out annually by gong farmers = valuable source of manure - if not collected sewage seeped into rivers + wells
• Towns were very dirty
• Open drains ran down streets to carry away water/waste often overflowed
• Between 1250 and 1530 number of towns grew as population increase
• Lack of knowledge of germs = lack of sanitation
• Belief in miasma
• Businesses threw waste in rivers - councils tried to stop this - restricted workers activities to certain areas = Worcester 1466 law said entrails and blood of butchered animals had to be carried away same night
• Timeline of public health laws

  • 1298 - King Edward I complains unhygienic conditions in York = danger to his soldiers prepping for war - build latrines in the city
  • 1330 - Glamorgan council passes law to stop butchers throwing remains into High Street
  • 1371 - London mayors + councillor prohibit killing of large animals within city walls
  • 1374 - London Council gives up trying to control sewage disposal over Walbrook stream - instead make householders pay fee to have it cleaned annually
  • 1388 - Parliament passes law fining people £20 for throwing waste into ditches, ponds and rivers - however difficult to enforce