Medicine stands still: 1000-1500
Causes of diseases
● Many believed disease was punishment from god for sins - believed cure was prayer and
repentance
● Also from supernatural beings so people were trialled as witch and then executed
● Could be caused by evil spirits inside someone - church performed exorcisms
● Miasma theory - bad smells cause disease
● Everyday life:
○ Warfare and famine were frequent
○ Childbirth was extremely dangerous
○ Many believed illness and early death were common
Influences in medicine
● The Church:
○ Very powerful in medieval Europe
○ Encouraged people to believe disease was punishment from God
○ Made scholars of medicine learn works of Galen - agreed with Church’s belief that
God created human bodies
○ Outlawed dissection - limited discovery of inside human body (Galen’s ideas based
on animal dissection)
○ Christian duty to look after poor and sick so Church set up many hospitals
● War:
○ Led to advancements in surgery and treatment of wounds
○ Cauterisation of wounds (applying heat to edges of wound) was common and fatal
○ Caused surgeons to develop their own antiseptics and painkillers
○ Army surgeons were good at carrying out amputations with a saw and knife
○ New tools such as arrow cups were developed
○ Manuals helped spread knowledge
● Science:
○ Scientists began to question Galena and HIppocrates’ methods but were silenced by
Church
Diagnosing disease
● Astrology was main method of diagnosing
● Astrology: idea of movements of planets and stars have effect on Earth and people
● New method - developed in arabic medicine and brought to Europe
● Doctors used almanack to see alignment of stars and planets
● Could then use this info to predict how patient’s health could be affected
● Zodiac chart: different star signs thought to affect different parts of body
● Would base off treatment on complications in chart
● Urine used as diagnostic tool
● Doctor would look at colour, smell and may taste it then compare to urine chart to determine
issue
Hippocrates (460-377BC) and Galen (129AD)
● Extremely influential in diagnosis and treatment
● Both wrote down beliefs about medicine (translated into Latin for Church’s use)
● Their ideas considered “absolute truth”
● Arrived in Europe via Islamic texts and beliefs
● Taught many centuries after their deaths
, ● Some still continue to be used today eg. Hippocratic Oath
Four humours
● Created by Hippocrates
● Believed body was made up of four humours (blood, phlegm, yellow
bile, black bile)
● Needed to be in balance for good health
● Developed further by Galen who believed disease could be treated
by opposites
● Different foods, spices, drinks etc had different humour and could
balance excessive humour causing disease
Miasma Theory
● Idea that bad air (miasma) causes disease when someone breathes it in
● Very influential - lasted until 1860’s (replaced by Germ Theory)
● Promoted people to be hygienic but then strengthened theory
● Four humours and miasma (while wrong) assumed disease had natural cause, suggesting
people could take action against it
Islamic/Arabic Medicine
● While large amount of medical knowledge in west was lost after fall of roman empire, medical
ideas eg. four humours were preserved by Islamic scholars
● Hunain ibn Ishaq (9th cent.) translated Greek medical texts into Arabic
● Avicenna (980-1037AD) translated works of ancient Greece and Rome into Arabic and
brought to Europe:
○ 40 of his medical texts survived
○ Wrote Canon of Medicine - brought together ideas of Galen and Hippocrates
■ Used widely in Europe and Islamic world until 1700’s
● Rhazes (860-932AD): wrote first authentic description of symptoms of smallpox
● Albucasis (936AD) wrote book for amputations, removal of bladder stones, etc
● Avenzoar (12th cent.) described parasite causing scabies and began doubting Galen
● Ibn-al-Nafis (13th cent.) also doubted Galen - suggested blood flows from one side of heart to
other via lungs - not recognised by West until 20th cent.
● Other islamic texts as well were translated into Latin
● Hospitals were for medical education as well as healing since establishment in 900’s
○ Students received practical training
○ Cleanliness encouraged
○ Often centred around fountain and had cooling breeze circulating
● Islamic medicine generally more rational and evidence-based than European (partly from
knowledge of classical medical texts)
● Such as Western Europe, religion strongly affected development of medicine eg. Islam also
prohibited dissection
● Alchemy helped develop new drugs:
○ Attempt to turn base metals into gold and discover elixir of eternal life
○ Traces origins to Egyptians and preserved in Islamic world
○ Superstition played large part - unsuccessful experiment could be by stars
○ Invented useful techniques eg. distillation and prepared drugs eg. laudanum
Treating disease
Treating disease - superstitions
● Sick people encouraged to pray (disease was “punishment from God”)
● Could do pilgrimage to a holy shrine (such as St John of Bridlington)
, ● Flagellants: people who whipped themself in public to be forgiven by God (especially common
in epidemics)
● Many doctors had superstitious beliefs eg. used astrology
Treating disease - humours
● Bloodletting and purging popular because fitted with humours theory
● If someone had too much blood, doctor would make small cut or use leeches - some patients
would die from too much blood loss
● Purging: act of getting rid of other fluids from body by excreting
● Bloodletting caused more deaths than prevented, but remained popular - proves strength of
medieval people’s beliefs in face of observational evidence
Treating disease - miasma theory
● Purifying and cleaning air could prevent sickness and improve health
● Physicians carried posies or oranges when visiting patients to avoid catching disease
● Juniper, myrrh and incense were burnt during black death so smoke and scent could fill room
and stop bad air bringing disease
Treating disease - remedies
● Remedies from apothecary, local wise woman or made at home were popular
● Contained herbs, spices, animal parts and minerals
● Passed down or written in books - some called Herbals - explaining how to mix them
● Some based on superstition eg. powdered unicorn’s horn
Treating disease - healers
● Physicians: male doctors trained at university for at least 7 years
○ Training lacked physical experience but had large amounts of texts read
○ Used handbooks and clinical observations to check patients’ conditions
○ <100 physicians in England so very expensive
● Apothecary: prepared and sold remedies while giving advice on how to use them
○ Most common form of treatment since most accessible for those who could not afford
physician
● Wise women: also sold herbal remedies
Treating disease - hospitals
● Set up university schools of medicine throughout Europe - trained on texts of Hippocrates and
Galen
● Main purpose to care for sick and elderly
● Provided patients with food, water, and warm place to stay
● Most also had developed water and sewage systems so fairly hygienic
● Some monasteries also cared for sick, elderly and poor
● Most sick people were treated at home by members of family
Treating disease - barber surgeons
● Surgery very dangerous - no way to prevent blood loss, infection or pain
● Attempted rarely and for minor procedures
● Very few university-trained, highly paid surgeons, but surgery not respected profession
● Most operations carried out by barber surgeons - lack of hygiene
Progress in surgery
● Hugh of Lucca and his son Theodric worked as surgeons in Italy in early 13th cent.
○ Recognised importance of practical experience and doubted Galen’s ideas
○ Dressed wounds with bandages soaked in wine - wine helped keep wounds clean
and prevent infection
○ Pus not healthy sign (unlike other doctors who might release pus because they
believed it helped release toxins from body)
● Some surgeons tried to find pain-relievers
Causes of diseases
● Many believed disease was punishment from god for sins - believed cure was prayer and
repentance
● Also from supernatural beings so people were trialled as witch and then executed
● Could be caused by evil spirits inside someone - church performed exorcisms
● Miasma theory - bad smells cause disease
● Everyday life:
○ Warfare and famine were frequent
○ Childbirth was extremely dangerous
○ Many believed illness and early death were common
Influences in medicine
● The Church:
○ Very powerful in medieval Europe
○ Encouraged people to believe disease was punishment from God
○ Made scholars of medicine learn works of Galen - agreed with Church’s belief that
God created human bodies
○ Outlawed dissection - limited discovery of inside human body (Galen’s ideas based
on animal dissection)
○ Christian duty to look after poor and sick so Church set up many hospitals
● War:
○ Led to advancements in surgery and treatment of wounds
○ Cauterisation of wounds (applying heat to edges of wound) was common and fatal
○ Caused surgeons to develop their own antiseptics and painkillers
○ Army surgeons were good at carrying out amputations with a saw and knife
○ New tools such as arrow cups were developed
○ Manuals helped spread knowledge
● Science:
○ Scientists began to question Galena and HIppocrates’ methods but were silenced by
Church
Diagnosing disease
● Astrology was main method of diagnosing
● Astrology: idea of movements of planets and stars have effect on Earth and people
● New method - developed in arabic medicine and brought to Europe
● Doctors used almanack to see alignment of stars and planets
● Could then use this info to predict how patient’s health could be affected
● Zodiac chart: different star signs thought to affect different parts of body
● Would base off treatment on complications in chart
● Urine used as diagnostic tool
● Doctor would look at colour, smell and may taste it then compare to urine chart to determine
issue
Hippocrates (460-377BC) and Galen (129AD)
● Extremely influential in diagnosis and treatment
● Both wrote down beliefs about medicine (translated into Latin for Church’s use)
● Their ideas considered “absolute truth”
● Arrived in Europe via Islamic texts and beliefs
● Taught many centuries after their deaths
, ● Some still continue to be used today eg. Hippocratic Oath
Four humours
● Created by Hippocrates
● Believed body was made up of four humours (blood, phlegm, yellow
bile, black bile)
● Needed to be in balance for good health
● Developed further by Galen who believed disease could be treated
by opposites
● Different foods, spices, drinks etc had different humour and could
balance excessive humour causing disease
Miasma Theory
● Idea that bad air (miasma) causes disease when someone breathes it in
● Very influential - lasted until 1860’s (replaced by Germ Theory)
● Promoted people to be hygienic but then strengthened theory
● Four humours and miasma (while wrong) assumed disease had natural cause, suggesting
people could take action against it
Islamic/Arabic Medicine
● While large amount of medical knowledge in west was lost after fall of roman empire, medical
ideas eg. four humours were preserved by Islamic scholars
● Hunain ibn Ishaq (9th cent.) translated Greek medical texts into Arabic
● Avicenna (980-1037AD) translated works of ancient Greece and Rome into Arabic and
brought to Europe:
○ 40 of his medical texts survived
○ Wrote Canon of Medicine - brought together ideas of Galen and Hippocrates
■ Used widely in Europe and Islamic world until 1700’s
● Rhazes (860-932AD): wrote first authentic description of symptoms of smallpox
● Albucasis (936AD) wrote book for amputations, removal of bladder stones, etc
● Avenzoar (12th cent.) described parasite causing scabies and began doubting Galen
● Ibn-al-Nafis (13th cent.) also doubted Galen - suggested blood flows from one side of heart to
other via lungs - not recognised by West until 20th cent.
● Other islamic texts as well were translated into Latin
● Hospitals were for medical education as well as healing since establishment in 900’s
○ Students received practical training
○ Cleanliness encouraged
○ Often centred around fountain and had cooling breeze circulating
● Islamic medicine generally more rational and evidence-based than European (partly from
knowledge of classical medical texts)
● Such as Western Europe, religion strongly affected development of medicine eg. Islam also
prohibited dissection
● Alchemy helped develop new drugs:
○ Attempt to turn base metals into gold and discover elixir of eternal life
○ Traces origins to Egyptians and preserved in Islamic world
○ Superstition played large part - unsuccessful experiment could be by stars
○ Invented useful techniques eg. distillation and prepared drugs eg. laudanum
Treating disease
Treating disease - superstitions
● Sick people encouraged to pray (disease was “punishment from God”)
● Could do pilgrimage to a holy shrine (such as St John of Bridlington)
, ● Flagellants: people who whipped themself in public to be forgiven by God (especially common
in epidemics)
● Many doctors had superstitious beliefs eg. used astrology
Treating disease - humours
● Bloodletting and purging popular because fitted with humours theory
● If someone had too much blood, doctor would make small cut or use leeches - some patients
would die from too much blood loss
● Purging: act of getting rid of other fluids from body by excreting
● Bloodletting caused more deaths than prevented, but remained popular - proves strength of
medieval people’s beliefs in face of observational evidence
Treating disease - miasma theory
● Purifying and cleaning air could prevent sickness and improve health
● Physicians carried posies or oranges when visiting patients to avoid catching disease
● Juniper, myrrh and incense were burnt during black death so smoke and scent could fill room
and stop bad air bringing disease
Treating disease - remedies
● Remedies from apothecary, local wise woman or made at home were popular
● Contained herbs, spices, animal parts and minerals
● Passed down or written in books - some called Herbals - explaining how to mix them
● Some based on superstition eg. powdered unicorn’s horn
Treating disease - healers
● Physicians: male doctors trained at university for at least 7 years
○ Training lacked physical experience but had large amounts of texts read
○ Used handbooks and clinical observations to check patients’ conditions
○ <100 physicians in England so very expensive
● Apothecary: prepared and sold remedies while giving advice on how to use them
○ Most common form of treatment since most accessible for those who could not afford
physician
● Wise women: also sold herbal remedies
Treating disease - hospitals
● Set up university schools of medicine throughout Europe - trained on texts of Hippocrates and
Galen
● Main purpose to care for sick and elderly
● Provided patients with food, water, and warm place to stay
● Most also had developed water and sewage systems so fairly hygienic
● Some monasteries also cared for sick, elderly and poor
● Most sick people were treated at home by members of family
Treating disease - barber surgeons
● Surgery very dangerous - no way to prevent blood loss, infection or pain
● Attempted rarely and for minor procedures
● Very few university-trained, highly paid surgeons, but surgery not respected profession
● Most operations carried out by barber surgeons - lack of hygiene
Progress in surgery
● Hugh of Lucca and his son Theodric worked as surgeons in Italy in early 13th cent.
○ Recognised importance of practical experience and doubted Galen’s ideas
○ Dressed wounds with bandages soaked in wine - wine helped keep wounds clean
and prevent infection
○ Pus not healthy sign (unlike other doctors who might release pus because they
believed it helped release toxins from body)
● Some surgeons tried to find pain-relievers
