The medieval period was a time of continuity for medicine, meaning there was no or not much change in ideas and treatments for diseases.

The Church - most powerful institution in society

Attitudes:

Controlled peoples attitudes

Encouraged a conservative attitude to respect tradition and ancient ideas, which made people resistant to new ideas about medicine.

Education:

The church funded Universities and therefore controlled the training of doctors

Doctors were encouraged to learn through books and not practical dissections

Experiments were discouraged and doctors in training did not have the facilities or equipment to carry them out

Lack of dissections and experiments meant that no new ideas could be discovered and the current ideas couldn’t be tested

Communication:

No printing press until 1440

Produced and monks hand-copied books, meaning any books that dd not coincide with the church’s teaching were not produced.

Most people were illiterate

Individuals:

Encouraged people to follow the work of two ancient individuals

Hippocrates and Galen

The church agreed as it fit with their teachings

Government:

Kings had no duty to improve health

Local governments had very little power to take action to improve public health in towns

Ideas, Treatments and Preventions:

God and sin:

The idea that disease was a punishment form God or a test of faith

This was taught by the church and reinforced by bible verses e.g. leprosy was God’s punishments, there was a also a lack of scientific knowledge meaning there was no evidence to challenge this idea.

To treat disease, people prayed, attended Catholic mass, went on pilgrimages to visit relics and people believed that the King’s touch could cure Scrofula as it was believed that the King was chosen by God and was seen as God’s representative.

To prevent disease, people would pray regularly, have good hygene by bathing regularly, avoiding sin, repenting

Four humours

The idea that disease an illness was caused by an imbalance of your hours: blood, phlegm, black bile and yellow bile. This was a rational idea that was based on evidence observed by doctors and scientists.

This was based on the writings f the hippocarets and galen which was supported by the church. The work was so detailed that it was hard to challenge it. The training of doctors was based on these ancient books and no experiments and so doctors didn’t have the opportunities to challenge this theory

The treatments were designed to bring the patient humour back into balanced, purging, laxatives, bloodletting, bathing, giving a treatment which had oppposited characteristic to the humour that is unbalanced, herbal remedies

To prevent an unbalance of humours people were encouraged to keep a balanced diets, to bathe and hygiene, vomiting to clear system

Astrology

The idea that heath was affected by the position of planets and stars, especially their positioning when you were born

This was resisted at first by the church as it seemed a lot like fortune telling, however after the black death the church came to accept it and after encouraged this idea, it also fit with Hippocrates writing as they also thought that the plant and stars affected the balance of your humours.

When treating disease, physicians checked star charts before diagnosing patients, they checked the positions when the patient was born to use the correct treatments.

there was no way of preventing the position of stars

Miasma

The idea that bad air and smells created by rottin mater could make you sick, this was a rational idea that wasn’t based on God or superstition

This was based on the work of Hippocarates and Galen, Galen had qarned the dangers of living next to a bad-smelling swamp. It also fitted with religious teaching, bad smells were associated with sins

To prevent disease, it was believed that it was important to stay smelling fresh, therefore regularly bathing in public baths or rivers, cleaning homes and decorating them with sweet herbs, and carrying posies and nice smelling flowers, there were also attempts to include public health by cleaning streets to get rid of the smell of faeces and animals.

Medical Care:

Physicians:

were very expensive, university educated, trained by church, tried by books (artecella), diagnosed the rich using star charts, testing urine and humours, they matched remedies to individual symptoms rather than disease as a whole, they didn’t treat disease directly or perform sugery.

Hospitals:

They were run by the church and funded by charity, they offered hospitality, they treated disease with herbal remedies, prayer, food, hygiene and rest, however they did not admit infected patients or pregnant patients, instead, they usually cared for the elderly.

Homes:

Women would be in charge of caring for ill patients, they would mix up herbal remedies using herbal manuals

Surgeons:

Barber surgeons were cheap but untrained and performed simple surgery like teeth-pulling. Skilled surgeons were expensive but highly skilled surgeons, they performed complex surgery like setting limbs

Apothecaries:

Once a physician had prescribed a treatment a patient would go to an apothecary for treatment, they were cheap and affordable, they mixed herbal remedies using herbal manuals.

The Black Death of 1348-49

This outbreak led to SOME new ideas and preventions.

Bubonic Plague - spread by fleas on rats - caused buboes - 40% death rate

Pneumonic Plague - spread by coughs and sneezes - fever and vomiting - 100% death rate

Origins:

Miasma (most popular), Unbaanced humours, punishment of God, position of planets, volcanic eruptions, contact with sick

Treatments:

prayer, bleeding and purging, herbal remedies, bursting buboes

Preventions:

prayer, pilgrimages, flagellation, carrying posies, avoiding bathing as it opens pores and lets disease in, quarantining was encouraged but local government lacked power so they weren’t enforces, they stop cleaning streets as they thought the smell of dead bodies would drive away the miasma