THE WHOLE THING

• Hippocrates


  Greek doctor & teacher who created the theory of the Four Humours
• Hippocrates' theory of the Four Humours


  • 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)
• Curing illness according to Hippocrates


  Get rid of the humour that was unbalanced, e.g. use leeches or cups to remove the excess blood, or purging (forcing to throw up) if you had too much black bile
• Galen


  Roman doctor who developed the Four Humours by creating the 'Theory of Opposites'
• Galen's 'Theory of Opposites'


  • If you had too much of a humour, you needed to cure it with the opposite
  • If you had too much phlegm (cold and wet), you were given something spicy which is hot and dry to cure the sickness
  • If you had too much yellow bile (shown by having a fever), you were given lots of cool liquids and foods to cure it
• Galen wrote over 300 books on medicine, meaning his ideas were respected (even if they weren't correct!)
• Galen's knowledge of anatomy was limited as he used animals such as pigs/monkeys to study anatomy as human dissection was banned
• Hippocrates and Galen's ideas remained the basis of medieval ideas on the causes of disease, 1000 years later
• The church supported Hippocrates and Galen's ideas and their ideas were rational
• 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
• Physicians


  • Only 100 male physicians in England
  • Used Four Humours (bloodletting, purging), urine charts & zodiac charts to diagnose
  • Very expensive
• Barber Surgeon


  Untrained but experienced surgeon (quality of surgery better than knowledge)
• Barber Surgeons


  • Combined hair cutting + surgery
  • Bloodletting, tooth extraction and trepanning
  • Apprenticed for seven years
  • Cheapest surgery available
• Wise Women


  They would use herbal remedies and some chants and charms to help cure local villagers
• Wise Women


  • 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
• Apothecaries


  • 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 in the Middle Ages

  Ran by the church, provided warmth, care and prayers
• Hospitals in the Middle Ages

  • 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
• Christians built over 700 hospitals in England between 1000 and 1500, e.g. St Leonard's in York
• Christian hospitals


  • 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 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
• Islamic beliefs about medicine

  The Prophet Muhammad said 'For every disease, Allah has given a cure'. This encouraged scientific discovery
• Islamic medicine


  • Training hospitals provided care for all, and there were hospitals for mental illness
  • The Muslim doctor Al-Rhazi (Rhazes) wrote over 200 books, encouraged careful observation, distinguished measles from smallpox and wrote a book called 'Doubts about Galen'
  • The Muslim doctor Ibn Sina (Avicenna) wrote a 'Canon of Medicine', which was used to teach European physicians until the 1600s! It listed the medical properties of 760 different drugs, and contained chapters on anorexia and obesity
  • 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
• Barber-surgeons


  • Learnt by being apprenticed for up to seven years, and by learning on the battlefield
  • Patients faced pain and shock
• Substances used to dull pain

  Natural substances such as mandrake root, opium and hemlock
• Cauterisation – burning the wound – was used to stop the flow of blood. It was extremely painful
• Improvements in medieval surgery

  • 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
• Christian prevention of disease

  Many people thought that only God could cure diseases. They followed a Christian lifestyle, praying, going to church and following the commandments. Some (flagellants) whipped themselves to beg God for forgiveness during the Black Death
• Other medieval prevention methods

  • Some wore amulets, charms and based their treatments on zodiac charts
  • People carried sweet smelling herbs and lit fires to overpower bad air