Medicine

• The Christian Church was dominant in medieval society. Belief in religious and supernatural causes of illness were common.
• God and the cause of disease


  The Church taught, and people believed, that God made them ill because He was either displeased with them or was testing their faith. This belief, and trust in ancient medical practices, held back medical research and meant that few new ideas about the causes of disease appeared in medieval times.
• Astrology

  The alignment of planets and stars was thought to cause some diseases. Astrology was used to help diagnose what was wrong with a patient. Use of astrology wasn't new in 1250 but it increased through this period, especially after the Black Death.
• The Church's control of ideas


  Most of what ordinary people learned was taught by the Church. The Church was also the centre of formal learning; it set up and ran universities where physicians were trained. Unlike most people, monks and priests could read and write. Most large collections of books were in monasteries. This meant the monasteries had a lot of influence over what books were written and read. The Church approved of traditional, rational explanations for disease. Dissections were usually performed at universities, but they were not common in this period. The Church also taught that people should follow Jesus' example and care for the sick. Many hospitals were housed in monasteries and nunneries.
• In what ways did the Christian Church (a) help and (b) hinder medicine in the Middle Ages?
• The Four Humours


  The Ancient Greeks thought everyone had a mix of four humours in their body. They believed people became ill when this mix was unbalanced, so to make people better they tried to put this balance right. These ideas continued well into the Middle Ages.
• Theory of Opposites


  In the 2nd century AD, a doctor called Galen developed the idea of the Four Humours further. Besides bleeding and purging to get rid of excess humours, treatment based on his Theory of Opposites aimed to balance the humours by giving the patient the 'opposite' of their symptoms.
• Hippocrates


  Hippocrates was an Ancient Greek doctor. His ideas and books were very influential well into medieval times and beyond. He dismissed the idea that gods caused disease – he believed there was a physical reason for illness, which needed a physical cure. Most of his treatments were based on diet, exercise and rest but he also used bleeding and purging to get rid of excess humours. He wrote the Hippocratic Oath, where doctors swore to respect life and prevent harm. His method of clinical observation – studying symptoms, making notes, comparing with similar cases, then diagnosing and treating – is the basis of the approach used today.
• Galen


  Claudius Galen was a Greek doctor who worked in Ancient Rome. He wrote many books and his ideas were the basis of medical training in the Middle Ages. He developed Hippocrates' ideas and mainly used bloodletting, or purging, to prevent and treat illness, as well as his own treatments based on his Theory of Opposites. He also drew detailed diagrams of human anatomy using knowledge he gained from operating on wounded gladiators and carrying out dissections on dead (mostly animals') bodies.
• Miasma


  Another theory about the cause of disease was that it was transmitted by 'bad air'. This was related to God because bad smells indicated sin. The theory originated in the Ancient world but continued into the Middle Ages and well into the 19th century.
• Give four reasons why Ancient explanations and ideas for disease dominated medicine in the Middle Ages.
• Rational treatments in connection with the Four Humours

  • Bloodletting
  • Purging
• Traditional remedies


  • Herbs
  • Foods
  • Ointments
• Religious treatments


  • Praying
  • Fasting
  • Going on pilgrimage
  • Paying for a special Mass to be said
• Supernatural treatments

  • Hanging a magpie's beak around your neck to cure toothache
• For each of the six rational prevention methods above, explain why people believed each method would help them stay healthy.
• Methods to prevent illness

  • Living a Christian life
  • Self-punishment
  • Carrying lucky charms or amulets
  • Chanting incantations
  • Bathing and washing
  • Exercising
  • Not overeating
  • Bleeding and purging
  • Purifying the air
  • Trying to keep streets clean
• Who treated the sick?

  • Barber-surgeons
  • Apothecaries
  • Physicians
  • Care in the home
  • Hospitals
• What physicians did


  • Observed a patient's symptoms and checked their pulse, skin colour and urine
  • Consulted urine charts in their vademecum (handbook)
  • Consulted zodiac charts to help diagnose the illness and to work out the best time to treat the patient
  • Either treated patients themselves (though this was rare), or sent them to a barber-surgeon or apothecary
• List examples of people and conditions that would have been treated by each of the following: physicians, barber-surgeons, apothecaries, hospitals and the home.
• Hospitals


  Some hospitals were built for specific infectious diseases. Many hospitals were places where travellers and pilgrims stayed on their journeys. The number increased during the Middle Ages. Many were run by the Church, so the emphasis was on God and healing souls. Usually, people with infectious diseases or incurable conditions were not admitted. Patients and their surroundings were kept very clean. Hospitals were places of recuperation rather than places where patients were treated for disease. Patients were given fresh food and plenty of rest.
• What does this tell us about what they thought caused disease?
• The Black Death, 1348–9


  Symptoms included swelling of the lymph glands into large lumps filled with pus (known as buboes), fever and chills, headache, vomiting, diarrhoea and abdominal pain. Treatments included praying and holding lucky charms, cutting open buboes to drain the pus, holding bread against the buboes then burying it in the ground, and eating cool things and taking cold baths.
• Most historians today think this disease was bubonic plague, carried by fleas living on black rats, which brought the disease to different countries on trading ships.
• where patients were treated for disease
• Patients were given fresh food and plenty of rest
• The Middle Ages


  c1250–c1500
• The Black Death, 1348–9
• Symptoms of the Black Death

  • Swelling of the lymph glands into large lumps filled with pus (known as buboes)
  • Fever and chills
  • Headache
  • Vomiting, diarrhoea and abdominal pain
• Treatments for the Black Death

  • Praying and holding lucky charms
  • Cutting open buboes to drain the pus
  • Holding bread against the buboes, then burying it in the ground
  • Eating cool things and taking cold baths
• Medieval people tried to prevent and cure the Black Death in many different ways. What does this tell us about what they thought caused disease?
• Bubonic plague


  Carried by fleas living on black rats, which brought the disease to different countries on trading ships. Bubonic plague is passed to humans when an infected flea bites them and the disease enters their blood.
• How people thought the Black Death was caused

  • Religion: God sent the plague as a punishment for people's sins
  • Astrology: the position of Mars, Jupiter and Saturn was unusual at this time
  • Miasma: bad air or smells caused by decaying rubbish
  • Volcanoes: poisonous gases from European volcanoes and earthquakes carried in the air
  • Four Humours: most physicians believed that disease was caused by an imbalance in the Four Humours
  • Outsiders: strangers or witches had caused the disease
• How people tried to avoid catching the Black Death

  • Praying and fasting
  • Clearing up rubbish in the streets
  • Smelling their toilets or other bad smells, in the belief this would overcome the plague
  • Lighting a fire in the room, ringing bells or having birds flying around the room to keep air moving
  • Carrying herbs and spices to avoid breathing in 'bad air'
  • Not letting unknown people enter the town or village
• The Black Death reached Britain in 1348, killing about one-third of the population.
• Ideas about what caused the Black Death and how it could be treated tell us a lot about how people in Late Medieval England thought about illness and disease.
• In the Renaissance period there was further investigation into Ancient Greek and Roman theories on disease and anatomy. More and more, the old ways were challenged and existing assumptions were tested. However, some things stayed the same.
• Change in ideas on causes of disease

  • Fewer people believed in supernatural or religious causes of disease
  • Various new rational explanations for disease were suggested, such as seeds in the air spreading disease
  • Decline in the influence of the Church, and with it the focus on God as a cause of illness
  • Shift to a more scientific approach to diagnosing illness
• The changing influence of the Church

  • New religious ideas challenged the authority of the Catholic Church, weakening its influence
  • People were still very religious but they began to look for new explanations for the cause of disease, rather than believing that disease was caused by God
  • The ideas of Galen, which were supported by the Church, were relied upon less
• Continuity in ideas on causes of disease

  • The theory of miasma continued to be believed by many to be the cause of disease
  • The Theory of the Four Humours continued to be an accepted explanation for disease, although by 1700 very few physicians still believed in it