This is a time of continuity in medicine, not a lot of change in terms of ideas about disease, treatments or Preventions
Reason for lack of change
The church was so powerful, it controlled almost every aspect of life
How the church controlled ideas about medicine
1. Encouraged people to respect tradition and ancient ideas
2. Controlled communication, no printing press until 1440 AD so only church-approved ideas were reproduced
3. Encouraged people to follow the work of Hippocrates and Galen, whose work was a thousand years old
4. Controlled education, funded universities and trained doctors to learn through books not practical experiments
The government at the time did not have a great deal of power over ordinary people's lives, kings had no duty to improve health and local government had little power to improve public health
Idea: God and sin
Disease was a punishment from God or a test of faith
This idea was taught by the church and reinforced by Bible stories
Lack of scientific knowledge made it difficult to challenge the church's teachings on disease
Religious approach to treatment
Prayers, going to Mass, pilgrimages to holy sites, belief in the king's healing touch
Religious approach to prevention
Prayers, avoiding sin, maintaining hygiene as it was linked to godliness
Idea: Astrology
Health affected by position of planets and stars, especially at birth
The church initially resisted astrology but later accepted and encouraged it, especially after the Black Death
Astrology's impact on treatment
Physicians checked star charts to diagnose and choose treatments
Four humors theory
Body contained four liquids (blood, phlegm, black bile, yellow bile), imbalance caused sickness
This theory was based on evidence, not God or superstition, but was supported by the church as it was from the writings of Hippocrates and Galen
Treatments based on four humors theory
1. Purging, bloodletting, using opposites, herbal remedies
2. Patients encouraged to keep humors balanced through diet and regular purging
Idea: Miasma
Bad air and smells from rotting matter could make you sick
This idea was also based on the work of Hippocrates and Galen, and was encouraged by the church as it linked bad smells to sin
Preventions based on miasma
Bathing, keeping homes clean and fresh-smelling, carrying posies, attempts to improve public health by cleaning filth
Types of healers
Physicians
Apothecaries
Surgeons/barber-surgeons
Home remedies by women
Physicians
University-educated, trained by the church, diagnosed disease from a distance using star charts and humors, did not actually treat patients or perform surgery
Apothecaries
Mixed herbal remedies, more affordable than physicians
Surgeons/barber-surgeons
Lacked training, only did basic surgery like tooth pulling, more skilled surgeons were very expensive
Home remedies
Women grew herbs and mixed herbal remedies, some had extensive knowledge
The Black Death led to some new ideas about the cause of disease, such as linking it to volcanic eruptions or realizing it was spread by contact with the sick
Treatments for the Black Death
1. Continued religious treatments like prayer
2. Tried to rebalance humors through bleeding and purging
3. Some patients tried bursting buboes
Preventions for the Black Death
1. Religious preventions like prayer and pilgrimage
2. New preventions like flagellation, avoiding bathing, quarantine, and stopping street cleaning
Quarantine was not very effective as local government lacked the power to enforce it
Reasons for lack of change in medieval medicine
The church's control over education, communication, and attitudes
Lack of government power to drive change
Reliance on ancient authorities like Hippocrates and Galen