Download 6. Medicine in the Middle Ages

Medicine in the
Middle Ages
AD 500 to 1400
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What happened when the Roman Empire collapsed?
The Roman Empire grew too large to control its borders
successfully. During the 5th century, neighbouring
barbarian tribes swarmed in and overran and colonized
the western part of the empire. By AD 500 Europe
consisted of many small, feuding tribal kingdoms.
There were frequent wars between these tribes, and in the
process the benefits brought by the Romans were lost.
Their buildings, public health systems, libraries and
medical books were destroyed. It was now dangerous to
travel, so communications were limited, and there were no
longer opportunities for doctors to learn or train.
Explain how war affected the progress of medicine at
this time, in your Factors page.
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Britain in the Dark Ages
After the Romans left Britain in AD 410, society went back
to its pre-Roman, uncultured ways. Villas were left to rot,
and local people took bricks and stones to build their own
homes. The bathhouses, toilets and sewage systems in
towns fell into disrepair, and cleanliness became a thing
of the past.
Over the next 500 years, the time known as the Dark
Ages, there were waves of invasions by barbarians such
as the Saxons and Vikings. They took what they wanted
and often destroyed what they did not. Many settled in
Britain, bringing their own beliefs and cultures.
Little is known of the state of medicine at this time,
but what progress or regress would you expect to
have seen?
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Norman Britain
Archaeological evidence has shown that the Normans built
sewers and cesspits in towns like York and that there was
some attempt at cleanliness again.
For those at the top of the feudal system (lords,
barons, knights) living standards improved with
stone-built castles and manor houses.
For the majority of the population (the peasants),
however, home was a small timber house
consisting of one room for the whole family, with
a stall at one end for the owner’s cow or pig.
Inside it was dark, smoke-filled (there was no
chimney) and damp. Peasants worked from
dawn till dusk for themselves and their lord,
usually in the fields, in all weathers.
What effects would the living conditions of a) the
rich and b) the poor have on their health?
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Britain in the later Middle Ages
Life in Britain improved from about the time of the Norman
conquest (from 1066). Travel and communications
became safer and trade increased. Harvests improved
and there was more money about. The church also
became wealthier and stronger all over Europe.
What benefits to medicine and health
might these improvements have brought?
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How the church helped
medicine
How the church
hindered medicine
Copy this chart into your books and use the
information on the next five slides to complete it.
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The medieval church
The medieval church was a very strong force throughout
Europe. Christianity had been brought by the Romans
and remained after their decline. Religion played a
greater part in medicine in the Middle Ages than at any
other time:
the church was at the centre of everybody’s lives
the village priest controlled what people did and what they
should believe. He preached that God punished people
for their sins with diseases and death
the pope in Rome refused to allow new ideas that might
contradict the Bible
the church controlled education. Only priests and monks
could read or write and the monasteries banned books of
which they disapproved.
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Re-enter Galen!
Most copies of Galen’s books were
lost in the Dark Ages but some were
discovered in the later Middle Ages.
The church liked Galen’s writings – his idea of human
anatomy being part of a great design matched the story of
God’s creation. His works did not conflict with the Bible,
instead they supported Christian teachings.
Throughout the later Middle Ages, therefore, the church
promoted Galen, and monasteries used his theories as
the basis for training doctors.
Anyone found questioning or criticizing Galen’s ideas
was harshly treated. One 13th century priest, Roger
Bacon, was imprisoned for encouraging doctors to carry
out their own research instead of just believing Galen.
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Hildegard of Bingen (1098–1179),
Abbess of Rupertsberg. Became
an expert on cures using herbs,
animals and stones following
visions of God.
“…the care of the sick is
to be placed above and
before every other duty, as
if indeed Christ were being
directly served by waiting
on them…” rule from a
Benedictine monastery.
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Dissection was
banned by the
church until the 14th
century
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“Write these words on the jaw
of the patient: ‘In the name of
the Father, Son and Holy
Ghost, Amen + Res + Pax +
Nax + In Christo Filio’. The
pain will cease at once, as I
have often seen.” English
doctor, 1300s.
“Healing shrines developed a great range of relics, pious
images and souvenirs. The blood of St Thomas à Becket
cured blindness, insanity, leprosy and deafness – and
ensured Canterbury’s popularity.” Roy Porter, medical
historian, 1997.
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Hospitals
The only hospitals in the Middle Ages were those run by
monasteries. St Bartholomew’s and St Thomas’ in London
date from 1123 and 1215.
Medieval hospitals generally housed the poor, the elderly or
pilgrims rather than offering medical care. About ten percent
of hospitals actually looked after the sick. Inside, they were
much like a church, with side chapels and altars at which
monks would pray for the souls of the patients.
Many people were excluded from hospitals: “We strictly
ordain that sick and weak people should be admitted
kindly and mercifully, except for pregnant women,
lepers, the wounded, cripples and the insane.” From the
rules of the Hospital of St John, Cambridge.
Treatments consisted of herbal remedies, warmth,
food, and a lot of prayers.
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“There is no doubt that religion obstructed the progress
of medicine in the Middle Ages.”
Using the information in your chart discuss this
statement. Make sure that you include as many
different aspects as you can and try to compose a
balanced argument. You should make it clear in your
conclusion whether you think the church caused
medicine to progress or regress.
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The medical role of women in the Middle Ages
Women could not train as doctors because only men
could go to university.
Most people were treated at home by their wife or
mother. Few could afford doctors, and herbal
remedies handed down from mother to daughter were
probably as effective as any treatment.
There were also ‘wise women’ in most villages who
offered treatment, although the church disapproved
and sometimes accused them of witchcraft.
Women acted as midwives.
Women could become surgeons as surgeons did not
have to train at university.
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How effective was herbal medicine?
Herbal cures were
often the only
remedies available to
sick people and were
handed down by word
of mouth from one
generation to the next.
We have seen that herbs have
been used in healthcare
throughout the history of
medicine. As communications
improved in the ancient
civilizations, so new plants were
discovered, and the range of
herbal remedies expanded.
Effective medicine or old wives’ tales? For herbs to
have been used for so long, it is likely that they must have
had some good effects. Modern scientific knowledge has
proved that about fifty percent of old herbal cures were
effective, although those using them would not have
understood why.
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True or false?
Chew willow bark to cure a headache.
True – willow trees contain a form of aspirin.
Carrots help you see in the dark.
True – Carrots contain high levels of vitamin A,
which helps prevent deterioration of the eye.
An infusion of hairy roots will prevent baldness.
False.
Use crushed garlic and onions to treat a boil.
True – These ingredients can kill bacteria.
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The Black Death
In 1348–49 Britain faced the worst crisis in its history. A
deadly disease arrived from Europe which appeared to
kill people at random, and no one knew why.
This disease was the bubonic plague. The symptoms
were a fever, headache, tiredness and painful swellings
(buboes) the size of an apple in the groin and armpits.
Small, oozing red and black spots appeared all over the
body, giving the disease the name the Black Death.
Patients lasted just a few days before a painful death.
The plague killed the rich and poor, priests and criminals.
What really frightened people, however, was the speed
with which the disease swept across Europe and the
number it killed. Nearly forty percent of the English died.
Never before or since has there been any disaster so
horrific.
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Areas affected by the Black Death
The Black Death came from China.
The increase in trade meant many boats were travelling from port to port.
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What was believed to cause the Black Death?
It was not until 1894 that it was discovered that the
bubonic plague was caused by germs, carried by the fleas
which live on black rats.
Back in 1349 people had very different ideas about the
cause of the disease.
Look at the list of the causes people believed in and the
evidence on the next two slides.
Which beliefs have we seen already in prehistoric
medicine?
Which beliefs are new?
Why do you think no one suspected the fleas?
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Breathing bad air (miasma) –
medieval towns were very
smelly and the smell was
supposed to contain diseases
Touching a
victim
The position of the
planets – the
relationship of the
planets and the
movement of the
Sun affected health
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Annoying God –
the plague was
his punishment
What did
people
believe
caused the
Black Death?
An imbalance of
the body’s four
humours –
Galen can’t be
wrong!
Looking at a
victim – the
disease was
spread by eye
contact
Drinking from
poisoned wells –
Germans believed
the Jews were
poisoning drinking
water to kill off nonJews
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Were any of these ideas correct?
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Sources about the Black Death
The sources on this slide and the next were written in
the 14th century.
“The cause was the close position of Saturn, Jupiter and
Mars on 24th March 1345. Such coming together of
planets is always a sign of wonderful, terrible or violent
things to come.” Guy de Chauliac, a French doctor.
“It was thought that the whole area was infected through
the foul blast of wind that came from the south.” de Smet.
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“[A person] rose and read a letter out loud. In it, the angel
said that Christ was displeased by the wickedness of the
world and named many sins: not observing Sunday, not
fasting on Friday, blasphemy, money-lending and adultery.”
Matthew of Neuenberg.
“The plague spread because of contagion; if a healthy man
visited a plague victim, he usually died himself. It spread
invisibly from house to house and finally from person to
person.” Jean de Venette.
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How did people try to prevent or cure the Plague?
People in the Middle Ages had little idea of how to cure
illnesses. When it came to the Plague they didn’t stand a
chance. Terrified and desperate, they went to extreme
lengths to escape its horrors.
Look at the treatments they tried on the next slide.
Which of these might have helped prevent the Plague?
What do their ideas on causes and treatments tell us
about their knowledge about medicine?
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Strap a live
chicken
(shaved) to the
Plague sore
Sit in a sewer –
the bad air of the
Plague will be
driven away by
the worse air of
the drains
Let the blood out
of the patient
Eat crushed emeralds
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Eat arsenic
powder
Run for
the hills
How to
prevent the
Black Death
Put herbs on
the fire to
make the air
smell sweet
Kill all the
dogs and
cats in town
Drink 10-yearold treacle
Go from
town to town
flogging
yourself with
a whip
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The effect of Arab medicine on the West
The Dark Ages might have been a time of chaos for Europe,
but further east a new, Islamic civilization was developing the
ancient Greek ideas.
The Arabs admired the writings of Hippocrates and Galen.
Medical students studied them carefully. New discoveries
were made, some of which challenged Galen’s ideas.
The Muslims believed, however, that the Koran, their holy
book, held all the knowledge needed and did not encourage
the search for new discoveries. The Koran also taught them
to look after the sick, and many large hospitals were built.
When Europeans went on crusades to the Holy Land in
the 12th and 13th centuries, their doctors gained firsthand knowledge of Arab medicine, which was advanced
by Western standards.
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The Middle Ages – progress or regress?
Ordinary people
Wealthy people
There was little change. They
had not had access to Roman
doctors or public health
systems.
Their medical care declined
and they lost access to baths
and toilets.
Some benefited from the
hospitals of the later Middle
Ages, but there were not many
of them.
By the later Middle Ages the
rich could visit doctors who
followed the ideas of Galen.
Most treatments were herbal
remedies.
Most treatments were based on
the Four Humours.
Life expectancy remained much Life expectancy fell during the
the same as in the Roman
Dark Ages, but was about the
period.
same as in the Roman period
by the end of the Middle Ages.
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