1. The Medieval Period / The Middle Ages - c1200-c1500

Name five believed causes of disease.

Causes:

• Theory of Four Humours (imbalance).

• Theory of Opposites.

• Miasma Theory.

• Religion - punishment for sin.

• Astrology.

What is miasma?

Bad air believed to cause illness if breathed in.

Where was miasma believed to be found?

Near swamps, corpses and rotting objects.

Which ancient philosopher made Theory of the Four Humours?

Hippocrates, Greek philosopher.

What was Hippocrates' main method of tending to patients?

Clinical observation (watching and recording symptoms.)

Which four humours made up the Theory of the Four Humours?

Blood, phlegm, black bile and yellow bile. (Believed blood most abundant, a lot of bloodletting performed as treatment.)

Influence of Hippocrates' Theory of Four Humours?

Many treatments like bloodletting, purging and changes in diet, Theory of Opposites based on his theory.

What was Galen's Theory of Opposites?

An excess humour was treated with its opposite.

(e.g cucumber for fever, cold and wet against hot and dry)

Why did Galen dissect animals?

To gather evidence for his theories.

What did Galen use animal dissections to study?

The functions of organs, nerves and the skeletal system.

Why did the Medieval Church support Galen's theories?

Theories matched Christian beliefs - single Creator designed body perfectly, did not dissect humans.

What did the support of Galen’s theories by the Church cause?

Stagnation, hindered medical advancements as Galen’s work was taught in universities (all run by Church at the time.)

Why did the Church oppose human dissection?

It believed the body had to remain intact for the soul to reach heaven.

Why did people in Medieval England accept Galen's theories?

All universities taught Galen’s theories, most educated ppl were taught that as truth, reading over experimenting, ppl trusted the Church.

Why were Galen's theories rarely questioned?

There was little scientific knowledge about disease.

Who did Medieval people believe could make them ill as punishment for sin?

God.

How did Medieval physicians use astrology?

They used star charts to diagnose illness, Church frowned upon this.

What did physicians check before diagnosing illness with astrology?

A patient's birth date.

Name six treatments for disease.

Treatments:

• King's touch.

• Bloodletting.

• Purging.

• Pilgrimage.

• Bathing - dissolve blockages of humours, public baths spread disease.

• Herbal remedies & Alchemy.

How could Medieval physicians perform bloodletting?

Three ways:

• Cutting a vein.

• Using leeches.

• Cupping.

What is an emetic?

A substance that makes a patient vomit. (e.g. bitter herbs)

Why were emetics used?

To purge the body.

How did Medieval physicians use horoscopes?

To decide when treatments should take place.

Why did people believe a King's touch could heal?

Divine Right of Kings, holy oil placed on King's hands at coronation, believed God gave the King supernatural powers.

What is a pilgrimage?

A journey to a religious place.

Why did sick people touch relics?

Chruch promoted, based on belief that saints performed miracles.

What was an apothecary?

A person who mixed herbal remedies to treat the sick.

What is alchemy?

Early form of chemistry to create cures, performed by some apothecaries. (developed into iatrochemistry in Renaissance.)

What was a barber surgeon?

A person who carried out operations such as amputations and tooth extractions.

What did barber surgeons do after amputations to stop bleeding?

Cauterisation (burning wounds with hot iron) or tying off blood vessels.

What was considered as a barber surgeon’s greatest skill?

Speed, before patient died from shock due to extreme pain.

Who was the main source of care in Medieval villages?

Wise women.

What did wise women mix and perform?

Herbal remedies, rituals and minor sugery.

What was the role of a Medieval hospital?

To care for patients, not cure them.

How many hospitals were there in Medieval England and Wales?

Nearly 1200.

How many of the hospitals were owned and run by the Church?

Around 30%, focused on spiritual healing, not physical or providing medical care. "Hospital" - hospitality.

How many beds did most hospitals have and why?

12 beds for each of Jesus' disciples, intention to save patient's soul.

Where were people with infectious or incurable diseases kept as they are not admitted into hospitals?

Lepers (ppl with leprosy, fingers and toes fall off) - Leper houses (although declining in 1350s.)

"Deserving" poor - Almshouses set up in 14th century. (alms - charity.) Not for cure, for care.

How many of the hospitals housed the poor and elderly?

47%.

How many of the hospitals were leper houses outside town walls?

31%.

How many of the hospitals provided shelter for traveling pilgrims and travellers?

12%.

How many of the hospitals cared for the sick?

10%, remember "care, not cure."

Name four preventions of disease.

Preventions:

• Religion - prayer, tithes, confessions, pilgrimage.

• Hygiene.

• Diet - no overeating or too rich diet.

• Purifying the air. - pomanders, burning herbs.

What was the Regimen Sanitatis?

A guide to maintaining a healthy lifestyle.

What did the Theory of the Four Humours link good health to?

Digestion, balance of humours.

What did physicians discourage to maintain good health?

Overeating.

What is purging?

Making a patient vomit or defecate to remove excess bile.

How could purging be carried out?

Using laxatives or emetics.

What was a pomander?

A locket containing sweet-smelling herbs.

Why were pomanders worn?

To protect against miasma.

What five things did the Medieval Church recommend to prevent illness?

Recommended:

• Tithes (10% of wealth donated to Church.)

• Regular prayer.

• Confession.

• Leading a morally good life.

• Pilgrimage.

When did the Black Death arrive in England?

1348.

How many of the population did the Black Death kill?

Over half the population of Europe, ~50 out of 80 million.

What was the role of the government?

Tried to clean streets, but did not have systems (e.g. sewers) or funds to carry out.

Church had most of the power and money.

What are buboes?

Pus-filled boils.

Where did buboes usually develop?

Armpits and groin.

What four other symptoms were caused by the Black Death?

Other symptoms:

• Coughing up blood.

• Chest pains.

• Breathing difficulties.

• Fever.

How many people were buried each day in London at the peak of the Black Death?

Roughly 200.

What unusual event in 1345 was linked to the Black Death?

The alignment of Jupiter, Mars and Saturn.

What did people think the planetary alignment of 1345 meant?

A sign of disaster.

How long did the Black Death usually take to kill its victims?

Three to five days.

What four ways did physicians treat the Black Death?

Ways:

• Bloodletting.

• Purging.

• Using strong-smelling herbs.

• Lancing (cutting open and draining) buboes.

What is self-flagellation?

Whipping yourself to show repentance to God. (Not supported by Church, walking from town to town only spread disease further with fleas.)

Why did people practise self-flagellation?

To prevent the Black Death. (But they attracted mass crowds of people who watched, fleas spread quickly.)

What is quarantine?

Isolating sick people from healthy people.

How long did newcomers have to quarantine during the Black Death?

40 days.

Why did the English government introduce 40-day quarantine?

To prevent the spread of the Black Death.