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Key factors that influenced diseases
beliefs (religions and superstitions)
role of individuals
communication
chance
war
government
science and development
medieval period
1000 AD to 1500
Medieval ideas about diseases
very limited medical knowledge- no knowledge of germs
blood poisoning common
death by wars
no idea about sanitation and causes of illness
Hippocrates
father of modern medicine- was an ancient greek philosopher who thought he needed to know how the body works in order to treat diseases
Hippocrates’ theories on diseases
the ‘four humours’- 4 substances that make up the body
The four humours
black bile, yellow bile, blood and phlegm- 4 substances that made up the human body
hippocratic oath
pledge to not do harm to a patient
Hippocrates’ belief on healing patients
bleeding or purging
Claudius Galen
made major breakthroughs in anatomy, lived in Rome and found may useful information by dissections
Church’s belief on medicine in medieval period
sickness was the divine punishment of sin
Year of the black death
1348
percentage of British population killed from black death
40%
Medieval beliefs for the causes of diseases
Punishment from God, Miasma, Astrology, unbalanced humors
Methods of preventing disease by punishment of God
Praying regularly, attending church
Methods of treating diseases by punishment from God
Herbal remedies
Methods of preventing diseases by miasma
taking a bath, using rushes and herbs like lavender, carrying sweet smelling flowers
Method of treating diseases by miasma
Removing filth of the streets (ordered by King Edward III to Lord Mayor)
Methods of preventing diseases by astrology
no method of prevention
Method of treating diseases by astrology
movements of sun, moon, stars and planets affected people’s bodies, zodiac charts used to show when to treat each part of body
Method of preventing diseases by unbalanced humors
healthy diet: eating too much frowned upon, purging and laxatives
Regimen sanitatis- instructions provided by a physician to live a healthy life
Method of treating diseases by unbalanced humors
bleeding, blood letting through leeches
Middle ages
medieval times
phlegm
water in the body
Yellow bile
Puss (WBC), vomit
black bile
blood clots, excrement
Galen’s theory of opposites
Galen’s theory where each humor needed to be in complete balance to be healthy
Hippocrates’ ideas
the universe made of 4 basic elements which was also in the body
Reasons for popularity of theory of opposites and theory of four humors
supported by the church as it didn’t contradict ideas of God
Galen’s incorrect beliefs
heart controlling speech
Impact of Galen’s work
ideas lasted more than 1400 years, his books supported by the church, doctors used his theories for next 1000 years, dissections still used today
Women training (medieval)
knowledge passed down generations, ‘wise women’, midwives
Use of women treating diseases (medieval)
Most treated at home by female member of family
treatments women gave (medieval)
mainly herbal remedies (eg. honey to fight infections)
Physicians training (medieval)
trained at university, watching dissections while listening to lecturer reading from Galen’s books
Use of Physicians (medieval)
highest ranking doctors, afforded only by the wealthy, only diagnosed, did not treat
Amount of Physicians in 1300s England
less than 100 (<100)
Physicians treatments (medieval)
treatments based on four humors. eg. bleeding, purging, advising to life a ‘healthy life’
Surgeons training (medieval)
trained by watching others, apprenticeship (women), guilds of master surgeons
Use of surgeons (medieval)
people with a bit of money
Surgeon treatments (medieval)
most surgery performed by ‘barber surgeons’, simple operations, offered: blood letting, tooth extractions, amputations
John Bradmore (medieval)
developed forceps to remove arrowheads following the prince of Wales being wounded on a battlefield
Henri de Mondville (medieval)
a french army surgeon who taught his students to bathe and cleanse wounds then closing them up quickly- disagreeing with Galen’s theory of letting wounds form pus.
Problems with surgeries (medieval)
infections
only simple operations (lack of knowledge)
no anaesthesia (pain)
blood loss
Blood letting
patient bleeding on purpose to balance the four humors and cure them
problems with blood letting
often patients bled too long and died from blood loss
Examples of issues with blood letting
US President George Washington died of blood letting
Amount of children who died before age 7 (medieval)
30%- due to poor medical care and malnourishment
Amount of England’s population killed through dysentery, typhoid, smallpox and measles (medieval)
10% of English population killed
Towns in medieval times
more dangerous, due to higher density of people, causing more disease to spread
Barber Surgeons
unqualified surgeons who carried out minor operations for most people
Women’s role in medieval times
family members and midwives
Physician’s work (medieval)
looked at sample of urine, blood and faeces, consulted star charts
Use of Medieval hospitals
used as a place to rest and recover- mostly located in monasteries
cause of diseases at home (medieval)
homes heated using open fires, caused smoky air (miasma)
treatment of disease for illiterates
went to physicians and looked to God
Reason for black death because of astronomy
star charts in 13448 showed ‘bad alignment’ of stars, blamed for black death
fever reasons (medieval)
too much blood, cold, too much phlegm, depression, lack of black bile
Use of baths (medieval)
prevent blockages of humors
Boiling foxes in water and bathing with it (medieval)
foxes’ water making them more aware and back to healthy
Christianity helping medical knowledge
copies of ancient books made (incl. Galen) after collapse of Roman empire- used to teach barber surgeons
hospitals founded in middle ages as part of monasteries (similar to modern care homes)
Nuns cared for patients in hospitals- food and herbal remedies given
Saints linked to different illnesses, people prayed to particular saints for help
mass said 7 times a day
Hospitals in England by 1400
500 hospitals (most were very small with only space for 10 patients)
Lord Mayor Richard Wittington hospitals
paid for an 8 bed hospital in London for unmarried pregnant women
Leper houses
built outside towns to separate people with Leprosy from rest of society
Christianity hindering medical knowledge
church controlled universities were Physicians trained, teaching only Galen’s ideas
held back scientific knowledge
did not like physicians challenging traditional ideas
people told to pray as ‘most important treatment was prayer’
al-razi
A doctor who helped plan the building of the first documented general hospital in the world in Baghdad (modern day afghanistan) which opened in 805 AD, wrote over 200 books and were translated into Latin and used to teach in many universities, first to work out difference between smallpox and measles, believed in observation and seeking natural causes
Ibn Sina
astronomer and doctor who wrote many books including ‘canon of medicine’ in 1025 which was the most well known, first doctors to build on works of Galen
Islamic medicine compared to English medicine (medieval)
considered to be more advanced with new discoveries and developments in Islamic kingdoms
Communication in Islamic medicine
doctors travelled frequently to the Holy land with crusaders and learned new ideas from Islamic kingdoms (war helping progess)
Black death mortality rate
40% of english population died from disease
Black death year
1348
Black death international impact
spread across europe
First instance of black death
23rd June 1348
transmission of black death disease
carried by sailors with flea bites
Symptoms of black death
Swelling with pneumonic plague or bubonic plague and ended with death
pneumonic plague
caused respiration and breathing issues and fevers
Bubonic plague
buboes- caused tennis ball sized swellings, lung restrictions and swollen arms
effect of black death after 18 months
half of population infected and dead
Plague carts
carts used to carry dead bodies which were later piled up
Black death blame
miasma, astrology, God punishing humans, four humors out of balance, anti-semitism, earthquake in China
Most common victims of the black death
priests due to being on patients bedside- causing infections
Places with most severe impact due to black death
Norwich- second largest city at the time- overcrowding caused more infections
Effect of black death on Norwich
5000 of 7000 population died
Time taken for population recovery
400 years to return population to pre-black death population levels in England
Flagellants (medieval)
people who whipped themselves and each other while walking around to prove to God their confessions
Treatments of black death
praying to God and going to church
making human sized candles and burning it
avoid eating too much
avoid baths
avoid sex
avoid plague victims
clean filth from streets
bathe in urine
drink mixture of vinegar and mercury
year that black death completely goes away
1350- entirely goes away
buboles
red humps that was a symptom of the black death
problems with public health in medieval times
overcrowded streets
no sewers, dirty streets- some homes had toilets overhanging streams
miasma in the air
lack of medical knowledge- based on ancient ideas of Galen and Hippocrates and arab doctors (Al-Razi, Ibn Sina)
Roman public health facilities causing black death (medieval)
built in the 11th century, such as public baths, toilets, fountains and sewers were left in disrepair and destroyed by those who wanted to remove remains of romans
Toilets built on bridges causing black death (medieval)
built over thames river causing waste to be washed into the city
Gong farmers causing black death
emptied waste from a pit that wealthy individuals could afford to build, they would sometimes empty it into a river or another part of town
Butchers causing black death (medieval)
butchers allowed to slaughter animals in towns and cities, dumping waste into streets or rivers, if the waste on the street was not washed away, it would rot and attract rats, spreading diseases
solutions to waste on streets (medieval)
40p fine introduced in 1309- equivalent to £400 in 2021 for anyone who dumped rubbish in the street
Solutions to butcher’s waste
butchers banned from slaughtering animals in the street
muck rakers
employed to remove waste on the streets and latrines
gong farmers
emptied out cesspits and would dig sewage out and take it out of the city but most would dump the waste elsewhere in the city
surveyors of the pavement
employed to remove rubbish and waste from pavements
cesspits
individual toilets built for wealthier individuals
Bath houses (medieval)
improved public health by having 18 in London
understanding of personal hygiene (medieval)
some knowledge- King John travelled with a bath tub