Mediaeval period:

850 - 1450

Middle ages

Same Time period as Islamic World, but different part of the world

Middle ages where in the Western Europe including Britain

Main religion - Catholicism

Islamic world was in Arabic countries

In the Islamic world they teach that illness comes from Allah, But he also put the cures on earth as well as the sickness.

The Four Humours

- * Flegmat - phlegm, Sangvin - Blood, Choleric - Yellow bile, Zaelic - Black Bile

If any of the humours were out of balance, you would be ill.

Based on careful observation

Doctors still have to swear under the Hippocratic oath, Not to wilfully harm their patients.
Galen: Had the theory of opposites, Had the first theory of arteries (by dissection) *1

Galen’s Bodily Beliefs:

• Thought the left kidney was higher than the right

• Believed blood was made in the stomach and burned as fuel in 12 hours

• Thought the jaw had 2 bones

• Developed surgery and anatomical knowledge by dissecting pigs and apes.

• There were some errors in his work, as apes and pigs are not entirely anatomically correct. Eg. Apes have 3 pieces of jaw and humans have 1.

Mediaeval Doctor Training:

Study for 7 years.

Didn’t have to meet any patients whilst studying.

Studied Galen and Hippocrates (mediaeval europe) and textbooks ‘Compendium Medicine’ by Gilbert eagle.

Used Mediaeval Urine chart (Natural);

Urine chart showed the colour, smell and thickness of the urine - the doctor may also taste this. Vital in diagnosis and a way to judge if the patients' humours were out of balance

Used Zodiac Chart (Supernatural);

The Zodiac chart told a doctor when and when not to treat each part of the body for the patient - for example when the moon was passing through Pisces, he should not treat the patient's feet.

Barber/Surgeons:

• Used ‘Leems’ to make small holes to allow free bleeding and hold open the wound

• Could potentially used a large funnel like pole to insert medicine in the rectum

• Barbers were licenced to perform amputations

• No medical training

• Surgery is more of a side ‘gig’ so you have to use ‘barbery’ as a main source of income

• Trepanning (small sharp tool hammered into the skull) was used to release ‘evil spirits’

Other Options:

• Wise people →Developed herbal remedies, basic first aid, supernatural treatments

• Praying

Mediaeval Hospitals:

• ‘Centres of rest’

• ‘Care but not Cure’

• Church taught that it was a duty to care for the sick

• Run by nuns and monks

• Shelter, housing, ect

• Not everyone could be admitted, eg no ‘lunatics’, ‘lepers’ pregnant women, babies or people who were contagious

• Many did not have doctors

• Usually small staff, sometimes just 12 for the twelve disciples

• Different types eg; Asylums such as Bedlam in London

Middle Ages Surgery:

Caesarean (c-section)

Purging (balance the four humours)

Barber surgeons amputations

Dental surgery

Trepanning

Anal absesses - treat swelling

Bloodletting

Cataracts

Three Problems In Surgery: 1: Pain - Anaesthetic 2: Infection - Antiseptic/bacterial 3: Blood Loss - Blood transfusion

Hugh of Lucca and (his son) Theodric of Lucca:

• Some surgeons believed that pus was good and encouraged it

• Hugh and Theodric of Lucca said ‘It is not necessary for pus to form in wounds, There can be no greater mistake’

• They wrote textbooks to explain the benefits of getting rid of pus using wine and honey in wounds

• Very basic antiseptic

• Unfortunately their ideas went against hippocratic advice and they were not popular

Guy De Chauliac:

• Wrote a textbook ‘Great Surgery’

• Dominated English and French surgical knowledge for 200 years

• Contained references to Greek and Islamic writers

• He quoted Galen 890 times

• Didn’t agree with Theodoric of Lucca’s ideas

• Wrote in detail about his opinion in the book, a main reason Lucca’s ideas did not catch on

John of Arderne:

• Most famous surgeon in mediaeval England

• Wrote a surgical manual ‘Practica’ which contained illustrations of his operations and the instruments he used

• Based on Greek and Arab knowledge and his experience with war

• Used Opium to help with pain

• Charged a large fee for operations he developed to treat abscess

• Created Guild of Surgeons in 1368 - Separated from barber surgeons

Frugardi:

• Wrote the book ‘The practice of Surgery’ (1180)

• Widely used in Europe

• Warned against trappaning

• Tried ambitious operations on the chest

• Attempted to remove bladder stones

Mondino:

• In 1315, a public dissection was allowed in Bologna, supervised by Modino de Luzzi

• Wrote a book called ‘Anathomia’ which became the standard dissection manual for over 200 years

• Dissections were introduced in most European universities to train doctors and show that Galen was correct

Christianity Influence:

Doom paintings - remind people what would happen to them if they sinned during their life

Pilgrimage - A long journey to repent for sinning, to a holy place

Flagellating - Whipping (yourself) for sins

Pope - Head of the Catholic church, ‘god's representative on earth’

Knowledge of anatomy in the mediaeval times were so restricted because in 1306, the pope banned human dissection. Nonpermissible dissection was punishable by death, halting most scientific interest in the human body.