Medieval medicine

• Hippocrates - He is known as the ‘father of modern medicine’. He developed the Hippocratic oath, a version of which is still used today. In this oath, doctors promise that they will do their best to treat their patients and keep information confidential.
• Hippocrates - Also developed the idea of the four humours. This was the idea that the human body was made up of four substances: blood, phlegm, black bile and yellow bile. If the humours were out of balance, this was believed to cause illness. The humours were also thought to be linked to the seasons.
• Hippocrates - Encouraged doctors to seek natural causes and cures of illness. He also developed the idea of clinical observation of the patient, rather than just of the illness.
• Galen - Roman doctor who was born in AD129. He developed the theory of opposites, which concerned how people could be treated using the four humours.
• Galen - His work on anatomy was based on information gained by dissecting animals such as pigs and monkeys. Through this work, he discovered that the brain controls speech.
• Galen - He also made mistakes. He believed blood was produced by the liver which was then distributed to the rest of the body. work on anatomy was based on information gained by dissecting animals such as pigs and monkeys. Through this work, he discovered that the brain controls speech.
• Supernatural treatments: Prayer, astrology and trepanning
• Natural treatments: Bloodletting, purging and herbal remedies.
• Treatments based on the four humours: Galen believed that if the humours were out of balance, doctors should intervene. For example, if someone has a cold, they have a runny nose, and Galen believed that this was the body’s way of getting rid of excess phlegm.
• Treatments based on the four humours: When doctors gave treatments, they were attempting to support what the body tried to do itself. For example, nosebleeds were seen as the body’s natural way of getting rid of excess blood. If it was thought that someone had too much blood, Galen believed in using a natural treatment such as bloodletting.
• Treatments based on the four humours: Medieval medicine, based on the four humours, encouraged doctors to observe symptoms closely; so they could apply what they thought was the most appropriate treatment. These ideas and treatments were used until the 19th century, when germ theory was developed in 1861 by Louis Pasteur and later expanded by Robert Koch.
• Providers of treatment: Monasteries provided care for people in their local area. Treatments were based on prayer and herbal remedies.
• Providers of treatment: Local wise women also provided herbal remedies. They often used ideas that had been passed down through generations.
• Providers of treatment: Wealthy people could afford a private physician who had been trained at university. They usually practised the ideas of ancient doctors like Hippocrates and Galen.
• Christianity and medicine: The catholic church - It had a large role in training doctors and providing health care in infirmaries within monasteries. This meant that the Church heavily influenced ideas about the causes of disease and treatments throughout the medieval period.
• Christianity and medicine: The catholic church - The Church supported the use of the teachings of the Roman doctor Galen. He believed that a greater being had created human life, so his ideas were compatible with Christian beliefs. The Church controlled the teaching in universities. This meant Galen’s ideas continued to be followed and believed. This helped to encourage doctors to pursue natural causes and treatments of disease. Questioning the ideas of Galen was not encouraged.
• Christianity and medicine: The catholic church - People within the Church believed that it was their duty to help people who needed it. This included health care provided at monasteries, often by monks. Priests would pray for people who were ill.
• Christianity and medicine: The catholic church - It helped the progression of medicine as the Church was the only source of help for many people who were sick. The care provided by monasteries was free and monks copied out the works of Galen and Hippocrates. This was important in preserving the work of ancient doctors and allowing those ideas to later be developed and challenged.
• Christianity and medicine: The catholic church - It limited the progression of medicine as the Church limited the ability of doctors to challenge or question the ideas of ancient doctors and many treatments were based on the belief that God caused disease and that prayer could provide a cure for any illness.
• Islam and medicine: The Qur’an tells Muslims they have a duty to care for people who are sick. As part of pracising their faith, Muslims also have a duty to give money to charity. In medieval times, some of this money was used to pay for hospitals to be built.
• Islam and medicine: Their faith also encouraged Muslim doctors to develop new ideas and treatments. This means that Islamic medicine at this time is seen as having been more advanced than medicine in England. This was partly because in England, the Catholic Church limited how much doctors could challenge the work of Galen.
• Islam and medicine: Al-Razi -

  • Al-Razi was a doctor who helped to plan the building of a hospital in Baghdad, in modern-day Iraq. This was the first documented general hospital in the world and it opened in AD805.
  • He hung meat in different parts of the city and the hospital was built in the area where the meat took the longest amount of time to rot.
• Islam and medicine: Al-Razi -

  • Like Galen, he believed in the importance of observation and seeking of natural causes of illnesses.
  • Al-Razi was the first person to work out the difference between smallpox and measles.
  • He wrote over 200 books, which were translated into Latin and used to teach in many universities across Europe.
• Islam and medicine: Ibn Sina -

  • Ibn Sina was a doctor and astronomer.
  • He wrote many books, the most well-known of which was The Canon of Medicine, completed in 1025.
  • The Canon of Medicine explored ideas about anatomy and human development, and it encouraged natural treatments.
  • He is known for being one of the first doctors to build on the works of Galen and not just copy them.
• Islam and medicine: During the medieval period, there were wars over control of the Holy Land. These were called the Crusades. As a result of the Crusades, doctors frequently travelled to the Holy Land with the Crusaders and learned new ideas from Islamic kingdoms. This is an example of war helping medical ideas to progress.
• Surgery: Trepanning - A procedure where a hole was cut in the top of someone’s skull. This was thought to allow ‘bad spirits’ to escape the body. Most people died. However, archaeological evidence shows regrowth on some skulls, meaning people sometimes survived this surgery.
• Surgery: Cauterisation -  A process used to stop bleeding. It involved heating a piece of iron in a fire and pressing it onto a wound. This would seal the blood vessels, but it also risked a severe burn and caused pain for the patient. Additionally, there was a high chance of it causing infection and death.
• Surgery: Anaesthetics - In medieval times, surgeons experimented with anaesthetics to try to help patients experience less pain during operations. These were often herbal mixtures, made using ingredients such as opium or hemlock. However, most surgery took place without the use of anaesthetics. Patients were held down while a surgeon carried out the operation.
• Surgery: John Bradmore - A surgeon when Henry IV was king. Henry’s son was shot in the cheek by an arrow. Bradmore used honey and wine as an antiseptic. He also invented a medical instrument to safely remove the arrowhead. The young prince made a full recovery and later became Henry V.
• Surgery: John Bradmore - Later wrote about the methods he had used to treat Henry. This was important in communicating his new techniques, so other surgeons could learn from him.
• Surgery: Hugh and Theodoric of Lucca - Hugh of Lucca and his son, Theodoric, were Italian surgeons. They questioned the idea of Galen that pus in a wound was a sign that it was healing. To clean wounds, they used wine, which has antiseptic properties. Theodoric also experimented with herbal remedies as anaesthetics.
• Surgery: Barber surgeons - As well as cutting hair, barbers in Britain carried out basic surgery. They would carry out procedures such as removing teeth, amputations and bloodletting. They would also work with the army and help to treat injured soldiers at times of war.
• Town conditions: When the Romans conquered Britain in the 1st century, they built extensive public health facilities, such as public baths, toilets, fountains and sewers. After they left, these facilities where deliberately destroyed by people who wanted to remove the remains of the Roman Empire. 
• Town conditions: Toilets - In medieval times in London, public toilets were built on a bridge over the River Thames, so the waste would be washed away from the city. However, some homes had toilets that emptied directly onto the street below.
• Town conditions: Toilets - Wealthier individuals sometimes paid for their own toilets to be built. These led to a pit that would be emptied by a gongfermer. The waste was supposed to be taken outside the town or city walls. However, gongfermers would sometimes empty the waste into the river or dispose of it in another part of the town.
• Town conditions: Toilets - The consequence of these toilets was that a lot of human waste ended up being dumped on the streets of towns and cities, contributing to the spread of disease.
• Town conditions: Butchers - Butchers were allowed to slaughter animals in towns and cities. They would dump waste they could not sell in the streets or the river. Open drains ran down the middle of streets. This washed waste down into rivers. However, if there was a dry summer, this waste would be left in the streets.
• Town conditions: Butchers - The poor conditions attracted rats. This eventually contributed to the spread of the Black Death in the 14th century.
• Town conditions (Solutions): Punishments -

  • In 1309, a 40p fine - the equivalent of approximately £400 in 2021 - was introduced for anyone dumping rubbish in the street.
  • Butchers were banned from slaughtering animals in the street.
• Town conditions (Solutions): New jobs -

  • Gongfermers had the job of emptying out cesspits. They would dig the sewage out and were supposed to take it out of the city on a horse and cart. Sometimes they would just dump the waste somewhere else.
  • Muck rakers were a bit like street cleaners. They were paid to remove waste from streets.
  • Surveyors of the pavement were employed to remove rubbish and waste from pavements.