AQA GCSE History Health and the People- Medieval Medicine

Introduction/basic info

Europe was divided into fiefdoms- 5th century AD. Few could read or write, no one could question authority (Church), lots of medical knowledge was lost at the collapse of the Roman Empire

The Four Humours

Yellow bile- fire
Black bile- earth
Blue phlegm- water
Red blood- fire
They all make up our constitution and if out of balance, cause illness

Christian medical ideas

-Believed they should help the sick like Jesus did
-But believed God caused illness for a reason, so they shouldn't cure people
- The most care given was prayer, miraculous healing at shrines, pilgrimages
-In 1000-1500 more than 700 hospitals were built in England, as rest centres
-Also had asylums
-Monasteries had infirmaries to provide treatment

How doctors were taught

-Church thought Hippocrates and Galen were right
-Doctor training began after 1200, when Europe was peaceful and prosperous
-Church controlled universities
-Medicine was taught after religion
-Only Greek and Roman knowledge was taught
-Approved of Galen as he believed in one God
-A monk, Roger Bacon, was arrested for suggesting doctors do their own research

Islamic medicine

-First hospitals were for mental illness
-Treated compassionately
-In 805, Caliph-al-Rashid set up a major hospital in Baghdad with a medical school and library
-Treated patients and built more so everyone could access it
-Doctors always available and trained students
-The Caliph supported science and medicine
-Translated Greek manuscripts and preserved hundreds of books

Did Christianity help or hinder medicine? -Helped

-Added to Public Health by purifying water
-Opening medical universities
-Caring for sick

Did Christianity help or hinder medicine? -Hindered

-Didn't treat patients
- Didn't search for knowledge
-Women couldn't be doctors
-Believed in the four humours, God causing illness, planets affecting disease, etc.
-Banned dissection (said you would go to hell)
-Didn't spread knowledge

Did Islam help or hinder medicine? -Helped

-Caring and treating sick
-Baghdad alone had 60 hospitals in 1100
-Trained doctors at hospitals
-Spread knowledge with good libraries
-Learnt from Hippocrates, Galen, Indian and Peruvian doctors
-Men and women could be doctors

Did Islam help or hinder medicine?-Hindered

-Didn't spread knowledge of anatomy
-Didn't think new discoveries were important as Qur'an had everything

What did Christians believe caused illness?

-God
-Bad smells
-The supernatural
-Four Humours
-Planets positions

God causing illness

Punished people for their sins e.g. if people strayed from 'faith's direction', He sent a plague. The Doctrine of Signatures- God created illness but also herbs and plants to create treatment, people have to do the work

Bad smells causing illness

Some noticed the link between disease and bad smells. Less in the country and more in towns/cities where people lived closer together with animals and filth. Travellers often said you could smell a town before you saw it. So people thought disease spread to neighbours and friends through bad smells

Every day life and illness

Most thought illness and early death was inevitable, that it was natural so many died before the age of 7. Many women died during childbirth and men would remarry. War and famine were frequent.

The supernatural causing illness

Mystery and magic used as explanations. Witchcraft was feared and many believed the world was full of demons causing trouble and death. Sudden disease and misfortunes could be easily blamed on the supernatural, especially with the Church preaching good vs evil

The Four Humours causing illness

Every doctor agreed with Hippocrates and Galen about them, even had a chart for what illness was caused by which humour, with Zodiac charts showing best times to treat them

Other lack of knowledge

Many Greek and Roman books were lost and replaced with superstition. Universities had basic anatomy lectures, just reading Galen's text whilst a butcher pointed at body parts. Ideas were judged on debating skills, not science.

Average life expectancy in the 1400s?

35

Medieval diagnosis

Many doctors followed Greek clinical observation to diagnose, but soon just took the pulse and tested the colour, taste and smell or urine.

Medieval Treatments

From diagnosis, medicines from plants, animals, spices, oils, wines and rocks were prescribed. Bloodletting was common as they thought it would restore the balance of the four humours. It didn't work. Others treatments included forcing a patient to vomit or excrete. Often combined these with prayers and charms.

Medieval Medicine in towns

Many could not afford to see doctors, so towns were a medical marketplace.
-Wise women/men offered remedies, first-aid or supernatural cures.
-Barber-surgeons weren't very respected but very common.
-Monasteries and parish priests used prayers and charms. There were specific saints for illnesses.
-Potions were offered in markets along with teeth pulling, setting dislocated limbs and splints.

How doctors learned

Doctors were qualified after seven years of study at universities like Oxford or Cambridge without seeing a single patient. Learned Hippocrates and Galen's ideas, some Muslim, Indian, Chinese works and British textbooks. Only some information was ever written down.

Islamic doctors: Al Razi / Rhazes

Stressed careful observation, could distinguish between measles and smallpox, directed a hospital, criticised Galen.

Islamic doctors: Ibn Sina / Avicenna

Wrote a huge medical encyclopaedia called 'al-Quran' summarising Hippocrates and Galen, developed new drugs still used today

Islamic doctors: Abucalsis

Invented 26 surgical tools still used today e.g. the scalpel, catgut

Islamic medicine problems

-Prohibited dissection
-Most wouldn't criticise Galen
-Couldn't stop plagues

Surgeons and procedures

-Most surgeons were also barbers, trained by sight or on the battlefield.
-Most common procedures were bloodletting, amputation, drilling a hole in the skull to get rid of demons

Cauterisation

Burning a wound to stop blood flow, without pain relief. Too much killed a patient.

Public health- the bad

-Dirty rivers
-Lived with animals
-Busy streets
-Population had gone up 500% in last two centuries
-Trade flowed in and out
-Few solid roads
-Streets made up of earth, dung, alcohol, rotting food, urine, entrails
-Privys were a luxury
-Deadly pathogens e.g. salmonella and e. coli were everywhere
-Government more concerned with law and trade
-No sewer systems
-Rats, fleas flourished

Public health- the good

-Washed faces
-Exercised
-Good diets
-Bath houses
-Quarantined houses for disease
-Kings ordered street cleaning

Monasteries

-Were isolated with clean water supply
-Had wash basins, filtering systems, toilets emptied into a pit, baths
-Benedictine monks washed clothes regularly, bathed twice a year, hands and feet cleaned in ceremonies
-Got many donations so were rich and had land

The Black Death/Bubonic Plague- when?

1348-1350

The Black Death/Bubonic Plague- symptoms

-Buboes
-Fever
-Bed-ridden
-Sweating

The Black Death/Bubonic Plague- treatment

Doctors thought good smells would work, prayer

The Black Death/Bubonic Plague- initial impacts

Asking God why, mass graves, people died quickly

The Black Death/Bubonic Plague- how it spread

Spread from rats in Asia that traveled with trade along the Silk Road, rats were infected and carried infected fleas which bit people, drank too much blood and were sick into their bloodstream

The Black Death/Bubonic Plague- believed causes

Plants, bad smells, enemies poisoning wells, God

The Black Death/Bubonic Plague- how many died

-The population decreased by 1 million
-Hundereds of deserted villages
-High land was found to be safer so less died there
-25,000 in London died
-25% to 50% of Europe died
-Total 75-100 million people died

The Black Death/Bubonic Plague- social impact

-33% of Wales and England died
-Took 250 years to recover
-Feudal system collapsed so peasants were free
-Villages deserted
-Poor people's clothing and diet improved
-Officials cleaned towns
-Harsh laws tried to stop the peasants acting so freely

The Black Death/Bubonic Plague- cultural impact

-New medical discoveries
-Artistic ideas led to cultural rebirth
-Creative work was more morbid for a time

The Black Death/Bubonic Plague- economic impact

-Tax increased as war got too expensive
-Wages went up by 400%
-Values of Lord's land decreased

The Black Death/Bubonic Plague- religious impact

-Peasants stood up to authority believing God had spared them

The Great/Pneumonic Plague- when was the biggest epidemic?

1664-1665

The Great/Pneumonic Plague- symptoms

-Weakness
-Sneezing
-Red rings on the skin

The Great/Pneumonic Plague- how it spread

-spread amongst people by sneezing
-some believed it to have originated in Holland through wool trade as there was an epidemic there in 1633-34 though King Charles II had banned Dutch trade as they were at war in 1665
-The plague was common in London in the 17th century and 3 years before 1665 no one died of it, but it was thought the hot summer of 1665 caused the rats and fleas to multiply more and spread it again

The Great/Pneumonic Plague- how many died

over 100,000 Londoners

The Great/Pneumonic Plague- treatment

Good smells, but doctors covered up with suits and masks with herbs inside

The Great/Pneumonic Plague- reaction

-People quarantined in houses with a cross on the door
-weekly lists of death
-bedsheets of dead hung over smoke from fires
-houses cleaned
-some linked it to dirt as more of the poor died
-cloth traders and people fleeing from it spread it further

The Great/Pneumonic Plague- cause

same as Black Death/Bubonic Plague