medieval medecine

• Hippocrates


  Greek doctor & teacher who created the theory of the Four Humours. He believed the body contained four humours (black bile, yellow bile, blood and phlegm). If you are healthy the humours are balanced. If you are ill, you have imbalanced humours (too much of one).
• Hippocrates' cure for imbalanced humours


  Get rid of the humour that was unbalanced, e.g. you would need to use leeches or cups to remove the excess blood, or purging (forcing to throw up) if you had too much black bile
• Hippocrates' theory was rational (it made sense) as you could see the excess humour come out. Hippocrates recommended the observation of symptoms as well as diet, rest and exercise.
• Galen


  Roman doctor who developed the Four Humours by creating the 'Theory of Opposites'. His theory was very simple: If you had too much of a humour, you needed to cure it with the opposite.
• Galen wrote over 300 books on medicine, meaning his ideas were respected (even if they weren't correct!). His knowledge of anatomy was limited as he used animal such as pigs/monkeys to study anatomy as human dissection was banned. However he made some discoveries, for example that arteries, not just veins, carried blood around the body.
• Hippocrates and Galen's ideas remained the basis of medieval ideas on the causes of disease, 1000 years later! Why? Because 1) The church supported their ideas and 2) Their ideas were rational.
• Medical practitioners in the Middle Ages

  • Physicians
  • Barber Surgeons
  • Wise Women
  • Apothecaries
• Physicians


  Medically trained at Oxford or Cambridge for 7 years using Hippocrates and Galen + Muslim and Chinese texts, but without dissection so little anatomical knowledge. Only 100 male physicians in England. Used Four Humours (bloodletting, purging), urine charts & zodiac charts to diagnose. Very expensive.
• Barber Surgeons


  Untrained but experienced surgeon (quality of surgery better than knowledge). Combined hair cutting + surgery. Bloodletting, tooth extraction and trepanning. Cheapest surgery available. Apprenticed for seven years.
• Wise Women


  They would use herbal remedies and some chants and charms to help cure local villagers. They were cheap. Often helped with childbirth and they could train to be a midwife with a bishops permission
• Apothecaries


  Like a pharmacist or chemist. Could buy simples and compounds. Trained but had no medical qualifications, highly experienced. Understood herbal remedies and healing power of plants/herbs, e.g. honey used as an antiseptic, red rose and bamboo juice compound for smallpox.
• Hospitals: monks and priests

  Ran by the church, provided warmth, care and prayers. Emphasis on God's healing power, focus on 'care not cure', patients given food and warmth to make them comfortable, monks would pray and go to mass several times a day.
• Christian beliefs about sickness


  Sickness was sent by God to punish people for their sins. Therefore the sick could be healed if they prayed for forgiveness. People also went on pilgrimage to shrines to win God's forgiveness.
• Christians built over 700 hospitals in England between 1000 and 1500, e.g. St Leonard's in York. Nuns fed the sick and gave them herbal remedies but prayer was the most important treatment. There were special hospitals for contagious diseases such as leprosy called 'Lazar houses'.
• Monks preserved and studied the ideas of Hippocrates and Galen because they backed up the idea of a single God. Monks in monasteries copied out the Bible, histories and other Ancient books, including books by Galen and other medical writers from Greece and Rome. The Church discouraged the dissection of human bodies because it was seen as an unchristian burial practice. Roger Bacon, a thirteenth century monk, was arrested for suggesting doctors should do original research.
• After the fall of the Roman Empire, the majority of Greek and Roman writings were lost in Europe. They were only preserved because of the Islamic Empires to the east. In time they then made their way back to Europe.
• In the 700s many Greek medical books were translated into Arabic by Islamic scholars. The city of Baghdad was the main centre for collecting and translating medical texts. Without these translations the books by Galen and other could have been lost.
• Islamic beliefs about medicine


  The Prophet Muhammad said 'For every disease, Allah has given a cure'. This encouraged scientific discovery.
• Islamic doctors discovered new drugs such as camphor (a mild anaesthetic used to treat swellings) and laudanum (a painkiller derived from opium). Gradually, some universities accepted Islamic ideas. Gerard of Cremona translated Avicenna. Universities in Padua and Bologna became the best places to study medicine, and the ideas reached England through trade. John of Arderne included Islamic ideas in his famous textbook 'Practica' in 1376.
• Problems with medieval surgery

  • Surgeons didn't know that dirt carried disease
  • Operations were done without effective painkillers
  • Blood loss could kill
• Barber-surgeons


  Could do different procedures: bloodletting (by a small cut in arm) to restore the Four Humours, tooth extraction, amputation for tumours, bladder stones, breast cancer, trepanning for epilepsy – drilling a hole in the skull to let the demon out. They learnt by being apprenticed for up to seven years, and by learning on the battlefield.
• Pain relief in medieval surgery


  Surgeons used natural substances such as mandrake root, opium and hemlock to dull the pain. Too strong a dose might kill the patient.
• Cauterisation


  Burning the wound to stop the flow of blood. It was extremely painful.
• Surgery improved in the medieval period, mostly through experimentation during war: 1180: Frugardi wrote a textbook called The Practice of Surgery, warning against trepanning. 1267: Hugh of Lucca criticised the view that pus was needed for a wound to heal. They used wine on wounds to prevent infection but because their ideas went against Hippocrates they did not become popular. 1376: John of Arderne wrote Practica, based on Greek and Arab knowledge. He used opium to dull pain, and tried to separate surgeons from lower-class barbers by forming The Guild of Surgeons within the City of London. 1403: John Bradmore used forceps to save Prince Henry V by removing an arrowhead.
• Medieval prevention and public health


  • Following a Christian lifestyle, praying, going to church and following the commandments
  • Wearing amulets, charms and basing treatments on zodiac charts
  • Carrying sweet smelling herbs and lighting fires to overpower bad air
• The English population doubled between 1000 and 1300. Towns were quickly built and badly planned. Streets were filled with litter and people threw blood and human waste onto it, water supplies were polluted by human and industrial waste. Animals were butchered in streets and horses left dung in streets. Latrines and cesspits contaminated water supplies. Privies were emptied once a year by gong farmers.
• Attempts at improving public health were limited – in 1371 London mayors prohibit the killing of large animals to make the city healthier, and in 1388 Parliament passed a law fining people £20 for throwing dung garbage into rivers. Why? Increasing taxes to fund improvements would be unpopular, laws were hard to enforce and monarchs didn't see public health as their responsibility.
• Monasteries


  They were in the uncrowded, isolated countryside. The church was rich enough afford stone pipes and filtering systems removed impurities. The monks could read ancient ideas about cleanliness. Monks were ordered to wash regularly. They had excellent facilities such as the lavatorium, toilets emptied into a pit.
• The Plague first broke out in China then spread across Europe until it reached England in 1348. It killed around 40% of the , 1.5 million people. For those unfortunate to catch the disease developed painful swellings under their armpits/groin called buboes. Blisters appeared all over, followed by a high fever, severe headaches, vomiting, fits, unconsciousness and then death.
• Ideas on the cause of the Black Death

  • Caused by God as punishment for their sins
  • Blamed on the movements of the planets (Mars, Saturn and Jupiter)
  • Blamed on bad air (Miasma)
  • Jews, a religious scapegoat, were blamed for spreading the disease by poisoning the wells
• Treatments for the Black Death

  • Rubbing onions, herbs or a chopped up snake on the buboes or rubbing a chicken's bottom on the buboes
  • Drinking vinegar, eating crushed minerals, arsenic, mercury or even ten-year-old treacle
  • Physicians would pop the buboes to release the pressure or try bleeding or leeching
  • Praying to God
• Prevention and public health measures for the Black Death

  • Local councils tried to quarantine infected places to stop people moving around so much
  • Flagellants whipped themselves for forgiveness. Daily church services, prayers and pilgrimages were common to ask God to stop
• Consequences of the Black Death: Food went unharvested and rotted, price of food therefore went up (inflation), Peasants were now in demand – so they were offered higher wages. This upset the idea of the feudal system, and eventually led to the Peasants' Revolt in 1381 when wages weren't increased. The reputation of the Church was damaged and it lost a great number of experienced clergy.