The Middle Ages - grade 9 knowledge

Summarise Hippocrates

• Greek doctor & teacher, created theory of 4 humours

• Believed body contained 4 humours: black bile, yellow bile, blood, phlegm

• If I’ll, humours are imbalanced, vise versa

• Believed you saw evidence when sick, e.g nosebleed = too much blood

• To cure, get rid of humour that is imbalanced, e.g use leeches to remove excess blood

Summarise Galen

• Roman doctor, developed 4 humours by creating theory of opposites

• If you had too much of a humour, you cure it with opposite

• E.g. too much phlegm which is cold and wet → have something spicy which is hot and dry

How was the theory of 4 humours put into practice?

• Church supported the idea

• Physicians taught about it when educated by church

• Physicians used urine charts linked to 4 humours to check colour, smell, taste to check for illness

• E.g. white = too much phlegm

Summarise how miasma was an idea on cause of disease

• People blamed bad stinking air, miasma, for causing disease

• Believed dirt/waste from streets poisoned air, causing illness, seemed logical as dirty places smelt bad

• King Edward III said “the filth from the houses is infecting the air with contagious sickness” during Black Death

• Idea of miasma supported by Hippocrates and Galen, making it more supported

• Also thought air was sent from god, or caused by planets

Summarise how god was an idea on cause of disease

• Bible taught purple that disease was a punishment from god for sins, or god testing your faith

• Common disease linked to sin was leprosy

• 1348-49 Black Death was thought to be punishment for peoples’ sins

• Prior of Christchurch Abbey wrote that 1348 Black Death was caused by god who used “suffering to drive out the numberless sins of people”

Summarise how the supernatural was an idea on cause of disease

• Many people in Middle Ages were superstitious

• In 14th century, astrology was key part of medical training, physicians used planetary movements & zodiac signs in treatment

• Physicians believed stars and planets affected health and caused disease, e.g. movement of Saturn and Jupiter was to blame for Black Death

• Other causes were witchcraft, bad luck, blaming minority groups such as Jews, who were blamed for poisoning wells

Why was there a lack of progress in the Middle Ages

Respect for tradition, lack of education and scientific knowledge, power church

Methods of preventing disease in Middle Ages (religious)

• Flagellants whipped themselves→beg god for forgiveness during Black Death

• Fasting, offerings to god, lit candles→show sorry for sins

• Continued Christian lifestyle, pray, church, commandments

• King ordered religious services during Black Death

Prevention of disease in Middle Ages (supernatural)

• Based treatments on zodiac charts

• Wore amulets, bought incantations to provide protection from spirits

Prevention of disease in Middle Ages (rational)

• Attempted to solve miasma→removing dirty that poisoned air

• Carried sweet smelling herbs, lit fires to overpower bad air

• Rang bells to keep air moving away from them

• Rich visit bath houses, hing sweet herbs in houses

Prevention of disease (hygiene)

• Regimen Sanitatis promoted by physicians

• Included avoiding stress, exercising, eating healthy diet, bath regularly

• Only used by rich as was expensive to have lists created for you

Which city was the first to have piped water

London

How was waste and litter a problem for public health + solution

• streets filled with litter, threw blood, human waste onto it

• Solution: laws banned littering, public latrines(toilet) built in London, butchers throw away waste out of towns

How was dirty water a problem for public health + solution

• water supplies polluted by human and industrial waste

• Solution: in Gloucester, used lead pipes and aqueduct to bring in fresh water, only for rich

How was too many animals a problem for public health + solution

• animals butchered in streets, horses left dung in streets

• Solution: 12 rakers employed to clean London streets by 1370, cities like Newcastle paved streets→easier clean

Why were leaking latrines a problem for public health + solution

• latrines and cesspits contaminated water supplies

• Solution: laws on locations for private latrines, cesspits build w stone→stop leaks, night carts for emptying cesspits in towns like hull

Religious treatment Middle Ages

• Healing prayers, incantations

• Paying for mass

• Fasting

• Pilgrimages to tombs→sick touch holy relics, pray at shrine to cure

Herbal remedies as treatments Middle Ages

• drink/sniff/bathe, given by wise women or apothecary

• Honey put on wounds→fight infection, aloe Vera→digestion

• Most remedies: herbs, minerals, animal parts

• Stye in eye: onions garlic, bulls bladder, wine

Four humours treatment Middle Ages

• blood letting: most common way

• Cupping: warmed cups onto open cuts→draw blood into cup

• Leeching: leeches suck out blood

• Purging: swallowing mixture herbs+animal fat→make sick, laxatives empty bowels + cleanse

• Bathing: warm baths with herbs draw out humours

Supernatural treatment Middle Ages

• Toothache: magpies beak around your neck

• Barber surgeons ‘trepanned’ skulls→release demons making them ill (DANGEROUS)

Surgery Middle Ages (surgeons)

• remove eye cataracts, trepanning

• Wine as antiseptic, natural substances(opium, hemlock) anaesthetics, honey clean wounds

• Not trained, knew little about anatomy

• Use ‘Wound Man’ illustrations→advice how to deal w different wounds

• Frequent war: surgeons in demand, skills increased, Prince Henry V saved by surgeon John Bradmore

• No idea dirty carried disease, equipment filthy→infection

• Couldn’t prevent infection or stop heavy bleeding→most deaths came from this

Wise women care Middle Ages

• local woman w medical experience, ‘Lady of the Manor’

• Use herbal remedies, charms/spells: cheap

• Helped w childbirth, could train to be midwife with a bishops permission

• Not allowed be physicians

Apothecaries care Middle Ages

• trained + experienced, but no medical qualifications

• Mixed ingredients, produce medicine for physicians

• Understood remedies, healing power of plants/herbs

• Cheaper than physician

Physicians care Middle Ages

• medically trained university, 7 years, using Hippocrates+Galen, no dissection→little anatomical knowledge

• 100 male physicians in England

• Diagnose illness, suggest treatment by surgeons/apothecary

• Clinical observation: took pulse, examined whole body

• Four humours, urine charts, astrology for diagnosis, carried Vademecum (book of diagnoses)

• Very expensive, only rich afford

Barber surgeon care Middle Ages

• untrained, experienced

• Used wound man diagram for advice

• Pull out teeth, let blood, lance boils, remove tumours

• Basic surgery: amputate limb, remove arrowheads

• No anaesthetic or antiseptic→low success rate

• Cheapest

When was first hospital created in England + name, location

1123, St. Bartholomew’s, London

By 1400, how many hospitals in England

Over 500

Management in medieval hospitals

• Majority run by church

• Emphasis on gods healing power

Patients in medieval hospitals

• Not allow those w infectious disease

• Mostly for old/poor/travellers

Doctors, nurses, carers in medieval hospitals

• most didn’t have doctors

• Had priests, monks and nuns ran hospital

Treatment in medieval hospitals

• care not cure

• Patients given good, warmth for comfort

• Monks believed god cured you, offered prayer, go mass 7 times a day

Conditions of medieval hospitals

• kept very clean by monks

Had gardens, herb + vegetable patches

Describe the spread of the Black Death (countries)

First broke out in china, then spread to India, across Europe, until reached Dorset in England

When did the Black Death reach Dorset, England

1348

How had the Black Death spread by 1349

Spread around rest of Britain, killing 40% population, higher number in towns and ports

During the Black Death, how many people were buried a day in London at one point

200

What was the Black Death called at the time

The pestilence

What did Irish monk Brother John Clynn say about the Black Death

“I waited amongst the dead for death to come”

Symptoms of the bubonic plague

• painful swellings under armpits/groin; buboes

• Blisters all over, followed by:

• High fever, severe headaches, vomiting fits, unconsciousness, then death

Ideas on cause of Black Death

• caused by god as punishment for sins

• Movements of planets (mars, Saturn, Jupiter)

• Miasma→caused by poisonous fumes released by a volcano

• Jews:religious scapegoat, blamed for spreading by poisoning wells

What was the actual cause of the Black Death

• Spread when fleas bit infected rats, then passed disease onto other rats and humans

• Trade amongst ships brought rats + fleas to England

Treatments of Black Death (herbs, eating)

• rubbing onion, herbs, chopped up snake on boils, rubbing chickens bottom on buboes

• Drinking vinegar, eating crushed minerals, arsenic, mercury, 10yr old treacle

Treatments of Black Death (physicians,miasma)

• Physicians: pop buboes to release pressure, bleeding, leeching

• Sitting close to fire/in sewer→drive out fever, fumigating house w herbs to get out bad air

Treatment of Black Death (religious)

Praying to god in hope he would cure illness

Preventions of Black Death (government)

• introduced quarantine to stop ppl moving around so much

• Victims stopped from leaving homes

• Hospitals wouldn’t accept sufferers

• King Edward ordered cleaning streets to stop; bellied odour would drive away miasma

Preventions Black Death (religious)

• seeking gods forgiveness (VERY common)

• Flagellants whipped themselves for forgiveness

• Daily church services, prayers, pilgrimages common

General preventions of Black Death

• carry posy of flowers/herbs around neck or bathe to avoid corrupted air

• Escaping plague, avoid people

Living conditions in 1340s

• large cities: hotspot for spread of Black Death, ppl lived close to each other, 60% Londoners died

• Animals: horse manure everywhere, butchering meat→waste and blood on streets

• Medieval towns: no drainage, sewers, rubbish collections, so rats lived there + germs grew

• Disposed bodies in very basic way, helped spread disease further

How did church limit medical progress in medieval Britain

• Extremely rich + powerful, dominated lived of all ppl who feared god

• Bible said god sent disease as punishment for sins, only he cured

• So no need to look for other cause/ treatment

• Said anyone who dared challenge church would go hell

• English scientist Roger Bacon jailed; challenged churches views on medicine

• Controlled all education + libraries

• Trained all physicians: taught Galen + Hippocrates, challenge them = challenge god

• Dissection banned

How did Hippocrates and Galen limit medical progress in medieval Britain

• well respected ideas; over 1000 yrs old + logical

• Galen wrote over 300 medical books, detailed + illustrated, doctors believed was correct

• To doctors, could see evidence that theory worked:

• When sneezing, had too much phlegm, sneezing was body rebalancing humours, made sense

• All medical training focused on work of Hippocrates and Galen

• Taught it was correct, not challenge it, instead prove Galen right

How did a respect for tradition limit medical progress in medieval Britain

• majority respected the past, wanted keep everything as was

• No access to new books/ideas = little opportunities for new ideas

• Physicians not challenge past, support old theories

• Medicine always done this way, why change?

How did the king and government limit medical progress in medieval Britain

• king not interested in public health, his tasks were to defend country

• Government not take taxes to improve ppls health/medicine, so no money spent to improve

• Government only aimed to tackle PH during Black Death