Medicine in britain, c1250 - present

• Religious ideas on the cause of disease

  • God made them ill because he was displeased with them (testing their faith)
• Church's control of ideas

  • Church was the centre of formal learning as most people are taught by the church
  • Monks and priests could read and write (monasteries had lots of influence over what books were written and read)
  • Church approved traditional and rational explanation for disease (promoted ideas of Galen as his theories fitted christian beliefs - body had a soul and all parts had been created by god to work together)
  • Anything found that contradicted Galen might be ignored -> knowledge of anatomy did not advance greatly)
  • Taught people to follow Jesus' example and care for the sick (many hospitals were housed in monasteries and nunneries)
• Rational explanations for disease at that time

  • The four humours
  • Theory of opposites
  • Miasma
• The four humours

  • Ancient Greeks thought everyone had a mix of four humours in their body
  • Believe that people become ill when the mix is unbalanced
  • Make them better: balance the mixes (bleeding, purging)
• Theory of opposites


  • Galen
  • Balance humours by giving the patient the opposite of their symbols
  • E.g have too much phlegm -> eat hot pepper
• Miasma


  • Disease was transmitted by bad air
  • Related to god because bad smells indicate sin
• Claudius Galen

  • Wrote many books
  • His ideas were the basis of medical training in the middle ages
  • Developed Hippocrates' idea
  • Mainly use bloodletting, purging, his own theory to prevent and treat diseases
  • Drew detailed diagram of human anatomy (from knowledge he gained from operating on wounded gladiators + carry out dissections on dead bodies)
• Hippocrates


  • Dismissed the idea that god caused disease
  • Believe that there was a physical reason for illness which needed a physical cure
  • Treatments based on diet, exercise and rest
  • Also used bleeding, purging to get rid of excess humours
  • Wrote the Hippocratic oath (doctors swore to respect life and prevent harm)
  • Carry out clinical observations (study symptoms, making notes, compare with similar case, diagnose and treat)
• Rational treatments (four humours)

  • Bloodletting
  • Purging
• Bloodletting


  • Most common
  • Cutting a vein with leeches / cupping
  • Different points in body were used for different illnesses
  • Occasionally done by physicians but usually by barber surgeons / non medical person
• Purging


  Make patient vomit by emetics and laxatives / go to toilet to remove food from body
• Religious and supernatural methods to prevent illness

  • Living a Christian life (praying, go to church, obey commandments)
  • Carry lucky charms or amulets
  • Chanting incantations
  • Self punishment (e.g flagellation - punish yourself so god wouldn't)
• Rational methods to prevent illness

  • Keep streets clean
  • Bathing and washing
  • Exercising
  • Not overeat
  • Bleeding + purging
  • Purifying air
• Traditional remedies

  • With herbs (Drunk, sniffed or bathed in)
  • Different food to rebalance humours
  • Ointments to apply to skin
  • Made at home / mixed and sold by an apothecary
• Religious treatments

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

  • Specific ideas for certain illnesses (e.g hanging magpie's beak around neck to cure toothache)
• People who treated the sick

  • Barber surgeons
  • Apothecaries
  • Physicians
  • Care in the home
• Barber-surgeons

  • No training
  • Carry out bloodletting, pulling teeth, lancing boils, cut hair, basic surgery (e.g amputating limbs at low success rate)
  • Cost less than physician
• Apothecaries


  • Received training but no medical qualifications
  • Mix medicines and ointments based on their own knowledge or directions of physician
• Physicians


  • Medically trained at universities and passed exams
  • Diagnosed illness, give treatments, send patients to apothecary / barber surgeon
  • Expensive
• Process of physicians treating patients

  1. Observe patient's symptoms

  2. Check pulse, skin colour, urine (colour and taste)

  3. Consult urine charts in their vademecum (handbook)

  4. Consult zodiac charts (help diagnose illness, work out best way to treat patient)

  5. Treat patients themselves / send to barber surgeon or apothecary
• Hospitals at that time

  • People with infectious / incurable diseases not admitted
  • Clean
  • Places of recuperation rather than places where they are treated
  • Some built for specific infectious diseases
  • Many run by church (emphasise on god and healing souls)
  • Increased during middle ages
• The black death: killed about ⅓ of the population in England
• Thoughts on causes of the black death at that time

  • Religion: god set the plague as punishment for people's sins
  • Astrology: position of mars, jupiter and saturn was unusual at that time
  • Miasma: bad air / smell caused by decaying rubbish
  • Volcanoes: poisonous gas from European volcanoes and earthquakes carried in air
  • Four humours: imbalance in the four humours
  • Outsiders: strangers / witches caused the disease
• Trying to prevent catching the black death


  • Praying and fasting (show god they were sorry by punishing themselves)
  • Clearing up rubbish in the streets
  • Light fire in room, ring bells, have birds flying around in room (keep air moving)
  • Carry herbs and spices (avoid breathing in bad air)
  • Not letting unknown people enter town or village
• Symptoms of black death

  • Swelling of lymph glands
  • Fever
  • Headache
  • Vomiting, diarrhoea and abdominal pain
• Treatments for black death at that time

  • Praying and holding lucky charms
  • Cutting open lumps to drain pus
  • Holding bread against the lump then bury it in the ground
  • Eating cool things and taking cold bath
• Fewer people believed in supernatural or religious causes of disease (more scientific) during the Renaissance period
• Theory of miasma continued to be believed as a cause during the Renaissance period
• Theory of four humours continued during the Renaissance period
• Thomas Sydenham


  • Have a book 'Observationes Medicae'
  • Didn't rely on medical books when making diagnosis
  • Based treatment on the disease
• Change in work of physicians and scientists

  • Physicians stopped using astrology charts for diagnosis and treatments
  • Realised that urine was not a good indicator of disease and stopped using urine charts for diagnosis
  • Carry out more direct observations and examinations of their patients instead of relying on the patient explaining their symptoms
• Development of printing press

  • Many exact copies of texts could be produced in a short amount of time
  • Help reduce the church's control of ideas (it could no longer prevent the publication of ideas it didn't approve)
  • Ideas and discoveries of scientists and doctors could be shared more effectively and faster across a wider area
• Royal Society


  • Aimed to further scientific understanding by carrying out and recording results of experiments
  • Share scientific knowledge and encourage new theories and ideas
  • Sponsor scientist to enable them to carry out research
  • Published a journal 'philosophical transactions'
  • Allow scientists to study, challenge and build on each other's research
  • Theories could be confirmed or dismissed quicker
• Hospitals (1500)

  • Used less by travellers
  • Free, charity funded hospitals were set up
  • More pest house appear (people with a particular contagious disease go)
  • Run by physicians (focus on treating the sick rather than by religion)
• Changes in prevention and treatment

  • More emphasis on removing miasma through draining swamps, removing sewage and rubbish
  • People regularly changed their clothes to keep clean rather than just bathing
  • Some effective herbal remedies got discovered
• Training for apothecaries and surgeons

  • Continuity: Still not given university training, Still considered inferior to physicians and cheaper
  • Changes: Both were better trained through guild systems, Licence needed to work as apothecary or surgeon (only issued after training)
• Training for physicians

  • Continuity: Trained at universities, Training based on learning from textbooks rather than practical experience
  • Changes: Better access to wider variety of medical books and detailed drawings due to printing press, New ideas about anatomy inspire them to become more practical and experimental, Dissection became legalised
• Vesalius


  • Studied medicine in Paris
  • Became professor of surgery in Italy
  • Carried out large number of dissections on human bodies
  • Made many discoveries about how the body worked
• Importance of Vesalius

  • Improved understanding of the human body
  • Proved that some of Galen's work was incorrect (encouraged others to question Galen's theories)
  • Encouraged and inspired other medical professionals to carry out dissections and make further discoveries
  • His work widely published in England and Europe (medical textbook)