Medicine through time - Section 1

Medieval ideas about cause of disease

Cause	Summary	Pros	Limitations
God or the devil	God sent illnesses to punish people for their sins	Gave people hope that they could be cured miraculously	No new ideas or medicines were being made
The four humours (Blood, yellow bile, black bile, and phlegm)	Illness was caused when the humours were out of balance	Doctors had a basic understanding of what went on inside the body	Only provided four solutions, medications wouldn’t work
Bad air (Miasma)	Bad air and dirt in the street caused illness	Encouraged good hygiene - bad conditions caused illness	There was a lack of evidence
Other	Outrageous fashions, punishment for being disrespectful, minority groups were blamed	Gave people hope - they had someone/ something to blame so believed they could be healed	There wouldn’t be an effective treatment and could single out a group of people

Hippocrates and Galen

Key ideas of Hippocrates

Development	Summary	Why is it important?
Hippocratic oath	An oath doctors take - doctors aren’t magicians, work for patients, standards of treatments	Gave people faith in doctors and meant they didn’t blame them for mistakes
Hippocratic collection of books	Books written by doctors that contained symptoms and treatments of diseases	Doctors used them to treat patients and were used for theories
Observing and recording	Doctors should carefully record symptoms and development of disease	Use the right cure if the cause was found , helped to treat future patients
Natural treatments	Look for natural treatment instead of praying to the gods for help	Illness are more likely to be treated, proves that praying isn’t the best solution
Four humours	The body contained four humours and we are sick when they are unbalanced	Doctors had ideas about how blood worked and affected the body

Galen :

Revived methods preferred by Hippocrates: Observation and the four humours

Believed in the healing power of nature, use of opposites (a fever would be treated with something cold)

People who were weak were given hard physical exercises

He extended knowledge of anatomy by dissecting pigs and apes and studying their bone structure and muscles

Concentrated studies on movement of blood and the nervous system by experimenting with the spinal cords of pigs

Galen had great influence - he wrote many books because he wanted knowledge to be shared, these books were still being used in the middle ages and for many were the primary source of medical information

How did Christianity affect Medieval medicine?

Role the church	How did Christians cure the sick
Follow the teachings of Jesus Illness came from GodPrayers to God were deemed the most important treatment Shrines dedicated to saintsRespected Hippocrates and Galen Monks wrote texts by hand Focus on care not cure	700 hospitals were started in England They centred around providing calm and clean places for recoveryRun by monks and nuns - diet + prayer Depended on charity Money came from Churches or patrons Hospitals for the mentally ill Monasteries infirmary’s - free for poor and sick

Helped and Hindered

Hindered -

Still strongly believed that God made people ill. Intervention would be challenging God’s plan

Main treatment was prayer to ask God to forgive and stop punishment

Hospitals but not for infectious diseases or incurable illnesses

Did not approve of challenges to ideas of the Church

Discouraged human dissection

Helped-

Books supplied in monasteries

Sometimes helped with hands on medical training, however it was very expensive

Followed Jesus and believed that it was crucial to care for the sick

Ran hospitals

What were hospitals like:

Many early hospitals were set up for sufferers of leprosy (lepers)

Only the rich has access to most hospitals (patients had to give 100 shillings to the funds of the hospital) and no leper could be admitted unless other patients gave their consent

Effects of Islam on Medieval medicine

Caliphs were interested in science, supported medicine, developed libraries, provided peace needed for medical progress

They believed that Allah had given a cure for every disease and they just had to find it, Prophet Muhammed inspired people to seek learning

Both Islamic and European medicine followed ideas of Hippocrates and Galen however Islamic medicine wasn’t restricted by them

In the Islamic Empire the first hospitals were set up for people with mental illnesses. These people were treated with compassion as victims of an unfortunate illness. Hospitals called bimaristans were built in many Islamic cities to provide medical care for everyone, doctors were permanently present and medical students trained alongside them. Their medical ideas reached England through trade as merchants brought new equipment, drugs and books

How did they treat illness in the Middle Ages

Treatment	Summary	What can we learn
Astrology	Heavenly bodies influenced human fortunes, planet positions affected body	Very spiritual - focused on treatments on the supernatural
Wise Women	Create remedies from the local landscape	Doctors were only men. Medicine was expensive so natural medicines were used
Barber surgeons	Untrained and dealt with minor surgeries, became competition for surgeons	Medicine was expensive. It was difficult to see a proper doctor
The Church	Taught that Christians should care for the sick. Funded university’s	No medical advancements could be made. Cared about care not cure
Natural remedies	Medicinal plants, Monasteries had herbs or local apothecary	Accessible for most.

Trepanation - Drilling a hole in the skull

Flagellation - Whipping yourself as punishment

Burns - Applying ointment of vinegar, opium and rose oil to stop drying out or blistering

Epilepsy - A potion of liquorice, sage, willow, roses, fennel, cinnamon, ginger, cloves, mandrake, dragons blood, and three types of pepper

Headache - Trepanation to let out evil spirits

Fever - Drain blood

Stomach ache - Rub a live snail on aching area

What was public health like in the Middle Ages

Public health is the health of the public, the responsibility of the government

Good	Bad
Many towns had bath houses Monks were skilled medical personnel available to most people Cities like Coventry had waste collectionIn 1421, in Coventry every man had to clean the street in front of their house People used toothpicks, tweezers and mouthwashes In 1388 parliament issued a £20 fine for littering in rivers and ponds In 1329 in Winchester people had to check the quality of meat before it was sold Waste disposal was banned into the river Sherbourne nine times 1421-1475	Few regulations about building or water disposal in towns Butchers often brought live animals into the town to slaughter themDisease spread much quicker in towns than the countrysideCesspits were often built next to town wells, cesspits were emptied infrequentlyClean water was often drawn from rivers or streams that were contaminated No dustbins Household waste was thrown onto the streets

Good

Bad

Many towns had bath houses Monks were skilled medical personnel available to most people Cities like Coventry had waste collectionIn 1421, in Coventry every man had to clean the street in front of their house People used toothpicks, tweezers and mouthwashes In 1388 parliament issued a £20 fine for littering in rivers and ponds In 1329 in Winchester people had to check the quality of meat before it was sold Waste disposal was banned into the river Sherbourne nine times 1421-1475

Few regulations about building or water disposal in towns Butchers often brought live animals into the town to slaughter themDisease spread much quicker in towns than the countrysideCesspits were often built next to town wells, cesspits were emptied infrequentlyClean water was often drawn from rivers or streams that were contaminated No dustbins Household waste was thrown onto the streets

What can we learn from the Black Death

Cause	Treatment
Miasma - Bad air could cause and spread disease	People would carry round herbs and flower petals to avoid smelling the streets
An imbalance of the four humours	Doctors often tried bloodletting to balance the humours
Punishment for sins such as greed and blasphemy	Prayed for forgiveness and in extreme cases Flagellants whipped themselves to punish and protect
Blames Jews and accused them of poisoning wells	Attacks on Jewish communities spread. Edward 1 expelled all Jews in 1290
Belief in witchcraft and spells causing the disease	Women who were accused of being witches were put on trial

Positive	Negative
New religious groups were set up who criticised the Catholic Church The feudal system collapsed Women had new job opportunities Peasants attitude change and they believed they challenge authority Lords lost a lot of moneyNew medical discoveries and artistic ideas would bring a re-birth of culture Wages increases 400% because workers could demand more Poor peoples clothing and diet improvedOfficials realised towns and cities had to be cleaner Medical knowledge improved as doctors were allowed to study dead bodies	About 33% of the population died it took 250 years for it to recover Paintings, plays, and books became grisley, images of death were everywhere Harsh laws tried to stop the freedom and improvements to peasant’s lives Tax increased a lot Many Churches closed down it was hard to find enough people to become priestsSome villages never recovered and were left abandoned

Positive

Negative

New religious groups were set up who criticised the Catholic Church The feudal system collapsed Women had new job opportunities Peasants attitude change and they believed they challenge authority Lords lost a lot of moneyNew medical discoveries and artistic ideas would bring a re-birth of culture Wages increases 400% because workers could demand more Poor peoples clothing and diet improvedOfficials realised towns and cities had to be cleaner Medical knowledge improved as doctors were allowed to study dead bodies

About 33% of the population died it took 250 years for it to recover Paintings, plays, and books became grisley, images of death were everywhere Harsh laws tried to stop the freedom and improvements to peasant’s lives Tax increased a lot Many Churches closed down it was hard to find enough people to become priestsSome villages never recovered and were left abandoned

Many public health measures emerged during the Black Death these included

Medical inspections- A plague doctor would come to inspect suspected cases of plague and isolate the infected and their families in their homes

Isolation of people who were sick in plague hospitals. Hospitals were built throughout Europe and remained as fever hospitals for infectious patients until the 1900’s

Restricting ships to port - In 1347 the Venetian authorities isolated ships in port for 30 days to ensure they were not infected. The period was extended to 40 days, and the word quarantine come from the Italian word for 40

Control of the movement of people and goods