Medieval Medicine

Hippocrates

• An Ancient Greek physician

• Known as the ‘Father of Modern Medicine’

  • One of the first people to state the importance of observing a patient’s symptoms before diagnosis

  • Doctors today still take the Hippocratic Oath which promises that they will not harm patients in their care

  Hippocrates theorised that four humours made up the human body:

  • Blood

  • Phlegm: A water-like substance coughed out or contained in a sneeze

  • Black Bile: Blood that had clotted, seen in vomit or poo

  • Yellow Bile (Choler): A substance contained in vomit or pus

• People believed that for a person to be healthy, the four humours should be in balance

• Hippocrates’ theory stated that if someone had more or less of one of these humours, the body would become unbalanced. The person would then become ill

• The humours also linked to seasons, elements and star signs

Galen

• An Ancient Roman physician 

• He expanded on the Theory of the Four Humours

• He had a keen interest in anatomy

  • He publicly dissected animals, particularly pigs

    • This provided Galen with evidence for his theories on the functions of organs, nerves and the skeletal structure of the human body

• The use of pigs meant that his ideas were mostly incorrect when applied to human anatomy

  • Despite this, Galen's ideas dominated medical thinking for 1,400 years until Vesalius' discoveries

• Galen's Theory of Opposites argued that the cure for an excess of one humour is treatment with the opposite humour

  • For example, people believed that the cure for too much phlegm (cold) was eating a hot pepper (hot)

Why was Hippocrates & Galen still important in Medieval England?

Restrictions from the Church -

• The theories of Hippocrates and Galen did not require human dissection which allowed the Church to support them

  • The Church did not believe in cutting the body as, for a person's soul to go to heaven, the body needed to be intact

A lack of medical knowledge -

• Many people in Medieval England could not read

• Physicians who had read Hippocrates and Galen were regarded as better-educated

  • This meant that Medieval people did not question the physicians

• Due to a lack of scientific discoveries, there were no better explanations for illness than those suggested by Hippocrates and Galen 

• Hippocrates encouraged physicians to observe a patient’s symptoms

  • The Four Humours theory matched with what Ancient and Medieval physicians saw in their patients

Medieval Doctors

• Followed the ancient Greek method of ‘clinical observation’

• Concentrated on two observations - the pulse and smell, taste and look urine

• Common treatment was bloodletting, using leeches, praying or astrology

• Based treatments on the Four Humours

• To qualify as a doctor in the Middle Ages you had to go to university for 7 years, you would read, listen to lectures and not actually see a patient!
  Ordinary people turned to barber surgeons, wise women or monks

Christianity

• Christianity was the main religion of Western Europe and influential in people’s lives

• Believed in ‘care not cure’ as illnesses was a punishment from God

• Believed in miraculous healing, praying and pilgrimage

• Set up hospitals which were centres of rest, normally small (12 patients like Jesus’ disciples)

• Christian church controlled the universities, approved of Galen’s books because he believed in God

• Role of doctor was to diagnose and comfort

Islam Medicine

• Islamic empire ruled by Caliphs who were interest in Science

• They had libraries that preserved medical books

• The Qur’an says ‘for every disease, Allah has given a cure’

• Al- Razi (Rhazes) distinguished measles from smallpox

• Ibn Sina (Avicenna) wrote the cannon of medicine which was used as a standard in European medicine textbooks until the 17^th Century

Medieval Surgery

• Most surgery took place on the battlefield

• In everyday life surgery was performed as a last resort

• Patients faced problems with pain and shock in operations

• Some attempts at pain relief were opium, mandrake and alcohol (which often didn’t work)

• Cauterisation was common - burning the wound to stop the flow of blood

John of Arderne - Famous surgeon in Medieval England, they had a manual with operations and instruments, based on Greek knowledge and his experience in the 100yrs war

Public Health

Medieval towns built near rivers

Rivers were used to dispose of sewage and other waste, and other waste

Cesspits where sewage was collected annually by gong farmers

Towns generally dirty places

Towns grew in population which put pressure on public health facilities

People had no knowledge of germs - they thought disease was spread by ‘bad air’ (miasma)

Some local councils tried to keep towns clean but it was not easy to maintain

Public Health in Monasteries

Christian monasteries were isolated but still near rivers

They had elaborate systems of pipes to deliver water with filtering systems which removed impurities

Monasteries had excellent facilities for washing (cleanliness close to Godliness)

Monasteries wealthy which meant they could build good facilities

Monks educated and disciplined - had access to medical books

Black Death, 1348

Causes - people believed it was caused by bad air, punishment from God, position of stars/planets and Jews. Rats actually caused the black death and probably thrived because of the dirty conditions

Treatment - people used to drink mercury, shave a chicken bottom and put it on their buboes, run away, quarantine

Consequences - death (1.5 million in Britain), food rotted because it was unharvested, peasants could demand more pay and better conditions (because the disease killed a large part of the population, including workers, so they were fewer left to work, creating a labour shortage)