AQA GCSE HISTORY - HATP - Middle Ages

Health and the People Module containing all facts, figures, names and dates for the middle ages

who was galen

a greek doctor who had a huge significance in the development of medicine in the middle ages

how many books did galen write and why was this important

350 books, covering every aspect of medicine in detail which combined old ideas and his work, it seemed as if Galen had covered everything so they used his books for the next 1500yrs and also people in the middle ages respected traditional ideas

how was galen’s ideas supported by the church

his ideas fitted in with that of the christian church which controlled education in the middle ages as he taught that the body had been created by one god, who made all the parts fit together perfectly despite not being a christian

what are the key features before galenic medicine

-hippocrates was the main influence on medical ideas

-hippocrates taught that people got ill because their humours were out of balance

-he taught doctors to examine patients carefully and to keep detailed notes of symptoms

what were galen’s old ideas building on hippocrates

-galen believed people got sick because of their humours being out of balance

-he recommended exercise and a good diet to stay healthy

-most common treatment was restoring the humours by purging or bleeding

what were galen’s new ideas

-the theory of opposites was used to treat sick people by giving treatment that was ‘opposite’ to which humour was causing the illness, e.g. too much phlegm indicated it was caused by cold and so hot spices were used

what were galen’s discoveries in anatomy

-the brain, not the heart, controlled speech

-the arteries and not just the veins carried blood around the body

what did galen encourage physicians to do and why did it have a limitation

-physicians should find out as much about the human body as possible and so encouraged dissecitons of humans when possible but also to dissect apes since they were most like humans but bodies of apes are not like humans so there were some inaccuracies

what was the long term significance of galen

-he had the support of the church and wrote such good books that doctors followed his ideas for the next 1500yrs

what was the theory of 4 humours

-body contains 4 humours of black/yellow bile, phlegm and blood and people got sick if these humours were out of balance

how did the theory of 4 humours affect treatment

doctors would restore the humours by bleeding, e.t.c. and gave advice on what to eat and exercise.

why did people follow the theory of 4 humours

-advice on diet and exercise did work

-the theory made sense as sick people would vomit, e.t.c. to try and get rid of excess humour

what were the main beliefs about the causes of illness and disease in the middle ages

punishment from god, miasma, astrology and unbalanced humours

why did people believe in ‘punishment from god’

this was the most common belief that god sent illness to punish people for their sins

why did people believe in ‘miasma’

a common explanation was that bad air caused illness as there was a link between the bad air and filth on the street but they couldn’t explain the link

why did people believe in astrology

illness was sometimes linked to the movement of the planets and astrology

why did people believe in unbalanced humours

hippocrates and galen taught people got ill when they’re humours were out of balance and islamic and european physicians had been trained on galen’s books so believed in this aswell

what were some common methods of preventing, diagnosing and treating illnesses in the middle ages

using a urince chart, bleeding, herbal remedies, cleaning the streets and the zodiac man

what was the urine chart

physicians ussed a chart to test a patient’s urine, showing colour, smell and thickness and it was one way to test if a patient’s humours were out of balance

what was bleeding

people were bled regurlarly to avoid illness and done by a doctor by letting blood flow from the arm or using leeches, monks in monasteries were bled 7-12 times a year and losing 3-4 pints of blood per bleed

how was ‘cleaning the streets’ a method of prevention

in 1349, plague had struck london and king edward III ordered the lord mayor to remove all the filth lying the street, claiming the filth was infecting the air

how was the zodiac man used

doctors believed the movement of the sun, moon and planets through constellations affect people’s bodies and the zodiac chart showed when and when not to treat each part of the body

how were herbal remedies used

most common remedies were made from herbs, minerals and animal parts and women knew how to make them off by heart, they would say a prayer while making the remedy to increase the effectiveness

who were physicians and how many were there

physicians were the highest-ranked doctors that were well-paid and treated kings, nobles, e.t.c. there were less than 100 physicians in england in 1300

what treatments did physicians offer

a wide range of treatments based on the theory of 4 humours, as well as bleeding and purging they would advise patients on how to stay healthy like washing, cleaning, e.t.c.

what training did physicians go through

physicians were trained at university where they would watch dissections that were designed to show the descriptions of the body were correct and no investigations led to new discoveries as they believed Galen’s books covered everything about the human body

what role did women play as doctors

-most people couldn’t afford a physician and so were treated at home by a member of family or their local wise women

-they learned a wide range of remedies from their mother/grandma and were not just superstition as some did work like honey

-women also acted as midwives and some even earnt apprenticeships

what role did surgeons play as doctors

-local surgeons were for people who were worried about their illness but had little money

-some surgeons were skilful because they had been trained as apprentices to experienced surgeons and there was a guild of master surgeons which required new members to gain licences by passing tests

how did religion affect preserving knowledge

-collapse the roman empire nearly destroyed all medical knowledge by the greeks and romans but christianity and islam saved them

-monks made copies of the books by hand, including the works of galen

how did religion affect education and training

-christian church controlled the universities where physicians were trained and made sure they read and trusted galen’s work

-physicians were not encouraged by the church to challenge traditional ideas since if they question galen they may also question the bible

how did religion affect the ideas about the causes and treatments of disease

-god had sent disease and so there was no need to look for other causes of disease and so ideas remained unchanged

-if disease was a punishment for sin then there was no need to look for other treatments, you just need to pray more

how did religion affect hospitals

-christian church taught that sick people should be looked after and so hospitals were founded that look after the poor and elderly but not those with contagious diseases

what treatments were given in medieval hospitals

-nuns provided food, rest and herbal remedies and the most important treatment was prayer

what are some stats for medieval hospitals

-By 1400, there were nearly 500 hospitals in england with an average of about 10 patients in each

-specialist hospitals were also setup like leper houses built out of town to help those with leprosy

-Richard Whittington, the lord mayor, built an 8-bed hospital for unmarried pregnant women

how did islamic medicine affect hospitals

-Islamic teachings encouraged people to take care of their diet, exercise and hygiene and to care for the sick

-they were funded by wealthy individuals and open to all, organised into wards and physicians were also trained here

what are some stats for hospitals in islam

-first islamic hospital was in Baghdad around 805AD and by the 1100s, every large town in Islamic world had a hospital

-hospital at Cairo, built in 1283, had specialist wards for mental and physical problems, a surgery, pharmacy, library and lecture rooms for teaching with a christian chapel and mosque

how did islamic medicine affect preserving knowledge

-Islamic physicians built on the ideas of Ancient Greeks and Romans and many Greek medical books were translated into Arabic by Islamic scholars with the city of Baghdad being the main centre for medical texts

-Galen’s books could’ve been lost without these

-Islamic doctors wrote multi-volume medical encyclopedias with organised medical knowledge in great depth that was translated into latin to be used by europeans to learn more about islamic medicine

what were the names of some famous islamic physicians

-Al-Razi(or Rhazes)

-Ibn-al-Nafis

-Al-Zahrawi(or Albucasis)

-Ibn Sina (or Avicenna)

what did Al-Razi(Rhazes) do

-wrote over 50 books based on the ideas of Galen, Hippocrates and Indian and Chinese sources

-his books were used for centuries after his death in 925AD

-his books emphasised the importance of the physician carefully diagnosing the illness and he also described smallpox and measles accurately

what did Ibn-al-Nafis do

-argued against Galen’s theory that blood was produced in the liver and burnt up as a nutrient and instead argued that blood circulated around the body

what did Al-Zahrawi(Albucasis) do?

-he was a well-known expert in surgery

-produced a book describing abdominal operations and showing illustrations of more than 200 surgical instruments

what did Ibn Sina(or Avicenna) do?

-encouraged observation and experimentation, as well as the importance of clean air and water

-wrote on a wide range of topics with his most famous books being: The Book of Healing and The Cannon of Medicine

-The Cannon of Medicine became the main medical textbook of physicians up until the 17th century and described over 700 drugs and medicines and their uses, and how to diagnose disease

what were treatments like in surgery

-most surgery was performed by ‘barber-surgeons’ that did amputations but they couldn’t do complex operations inside the body as they didn’t know enough anatomy and faced the 3 main problems

what are the 3 main problems facing surgeons in the middle ages

-Pain: surgeons had to amputate limbs or remove painful tumours with no pain relief and so had to resort to using herbal remedies

-Infection: wine,vinegar and honey were used to clean wounds, but they didn’t prevent infections spreading

-Bleeding: large cuts were sewn up and cauterised but surgeons couldn’t stop heavy bleeding

what training did surgeons undergo

-surgeons didn’t go to university but trained as apprentices through observing others and improved their skills on practice and reading books

what was the importance of john bradmore

-he developed a new forcep which could pass through the cheek wound to take hold of the arrowhead and remove it and then dressed the wound with barley and honey

-this is an example of how war developed medicine

-saved henry V in 1403

what were some problems with galen facing surgeons

-galen taught that wounds were more likely to heal if pus developed, believing pus carried away poisoned blood that caused infection so doctors covered wounds in ointments and bandages designed to make pus develop

-Henri de Mondeville disagreed with this idea and taught his students to bathe and cleanse wounds then close them up quickly, without forming pus

-Wrote his book 'La chirurgie’ in the 14th century which emphasies this and became a foundational text

what was the importance of guy de chauliac

-he was french physician that wrote a seven-volume book on surgery called ‘Chirurgia Magna’

who was John of Arderne

-he created a recipe for anaesthetic in 1376 which may have worked

-he created the guild of surgeons in 1368 and wrote practice, a surgical novel, in 1376

what were some public health problems

-water for dirnking/cooking was collected from a river/storage pit and cesspits were built near water supplies

-people threw rubbish into the streets/rivers

-cattle/sheep/geese roamed the streets and horses were used as transport, these animals leave dung

-diseases such as plague were common and spread very quickly

-open sewers and drains ran through the streets

what were some public health improvements

-night carts collected human waste from cesspits and rakers were sent to clean the streets

-cesspits were lined with brick/stone so they didn’t leak into water supplies

-laws were passed to punish people for throwing waste into the street

-in Exeter, aqueducts were built to bring fresh water into the town

-In Newcastle, streets were paved to make them drier and easier to clean

-in 1388, the government ordered town authorities to keep the streets free of waste and they introduced new public health measures

-in the 13th century, the great conduit was built to bring clean water into london as the thames was too toxic

why did monasteries have good health standards

-monasteries were wealthy which allowed them to install water supplies/sanitation

-monasteries were often close to rivers, built in isolated places where they drew freshwater

-monks were expected to keep clean, they washed their clothes and bathed

what was life like in a monastery

-monks were cared for in infirmaries which normally had their own kitchen, that served food to help patients recover

-some monasteries had hospitals that cared for poor people

-monasteries had 2 seperate water supplies, one for cooking and drinking and the other for drainage and washing

-latrines were put in separate buildings, which were built over streams of running water that carried waste away

why were monasteries better than towns

-monastery populations were small and had 1 leader (the Abbot) who controlled everything whereas towns didn’t have a single person in charge

-towns had to rely on wealthy individuals to fund projects to improve standard of living

what were the effects of the black death on britain

-it reached england in 1348 and killed 1/3 of the population within a year

-towns and ports were the hardest hit and only remote farms avoided it

-the plague affected both the rich and poor

what were the causes of the black death

-bubonic plague was carried by rats and spread by fleas which led to death in 3 days

-epidemic was made worse by pneumonic plague where the disease attacked the lungs which led to death in a day or 2

what were some common explanations behind the cause of the plague

-god’s punishment

-miasma

-astrology

-theory of 4 humours

what superstitious prevention methods were used

-bishops ordered daily services to pray for forgiveness

-people lit huge candles in church as offerings to god

-people fasted to show they were sorry for their sins

-people went on pilgrimages to pray for god’s forgiveness

-activities that may be insulting to god were stopped

-some people punished themselves in public and begged god for forgiveness

what were some prevention techniques linked to miasma

-king edward III wrote to the mayor of london to clean the streets since the ‘bad air’ was making people sick

-doors and windows were shut and sealed

-people carried sweet-smelling herbs or lit fires to overpower the bad air

-people kept the air moving by ringing bells or keeping birds to fly around the house

what were some other methods of prevention

-people stopped strangers entering their villages in case they carried the disease

-butchers were punished for leaving their remains on the streets

what treatments were used for the black death

-prayed for victims to recover

-they put holy charms around the necks of the sick

-they cut open buboes to let out the pus

-they used leeches to bleed the patients and used treatments based on galen’s theory of opposites

what was the short-term impact of the black death

-black death killed over 1/3 of medieval england in a year with whole villages wiped out

-loss of many workers led to food shortages and so food prices increased

what were the long-term impacts of the black death

-survivors became better-off, due to a shortage of workers they could demand to be paid more by their employers

-people had more money and spent this on education, more people learned to read and write which also helped to spread new ideas quickly