Medicine and Public Health from Roman Britain - 1350 (Medieval Era)

Question 1

How long did the Roman’s rule Britain?

Answer 1

4 centuries

(49-449AD)

Question 2

What did the Romans believe caused disease?

Answer 2

• The four humours (imbalance)
• Punishment from the Gods
• Miasma

Question 3

Describe the theory of the four humours

Answer 3

• Developed by Hippocrates in Ancient Greece
• Body made up of 4 substances - blood, phlegm, black bile, and yellow bile
• Imbalance of these causes illness
• Hippocrates reccomended bleeding or purging to get rid of excess humours
• Also reccomended healthy diet, exercise, and regimen to prevent illness in the first place

Question 4

Describe the theory that punishment from the gods caused disease

Answer 4

• Viewed diseases as punishment from gods or the result of curses
• Built temples to gods and worshipped + prayed for cure
• Worshipped Asclepius, the god of healing + medicine

Question 5

Describe the theory that bad air (miasma) caused disease

Answer 5

• The Romans never built settlements near to swaps
• Believed bad air + smalles caused sickness
• Believed until mid-19th century (germ theory)

Question 6

Describe Galen’s career/life

Answer 6

• Born in second century AD in Greece
• Moved to Rome and became doctor/surgeon to gladiators. Operated on wounds recieved in fights
• Became famous for his public dissections which took place in the Forum. Also known for medical lectures.
• Became Emperor’s personal physician - ideas became most important at the time.
• Developed anatomical knowledge through dissection of animals. Recorded findings in books.

Question 7

Describe Galen’s theory of opposites

Answer 7

• Built upon Hippocrates’ theory of the 4 humours
• Another way of balancing the humours
• Either hot or cold and either wet or dry. Each humour different

Question 8

Describe Galen’s dissections

Answer 8

• Perfomed them to learn about inner workings of body
• Could only dissect animals as Romans believed dissecting humans would damage them in the afterlife.
• Mostly dissected pigs (for show) and monkeys (for accuracy)
• Some conclusions about humans correct, others not! (2 jawbones, 7 breast bones, blood seeps through walls in heart)
• Wrote books about dissections. Formed basis for medical knowledge until Renaissance

Question 9

What was one of the major factors influencing medicine at this time?

Answer 9

The Role of Individuals:

Galen’s theories provided the basis of medical training for thousands of years

Question 10

Describe the influence of the Roman Empire on medicine in this era.

Answer 10

• Roman army well organised and offered medical training for surgeons + doctors to treat soldiers. Even though only directly benefitted army, citizens learnt by example how to pick good settlement site and provide clean water.
• Violent entertainment such as gladiatorial combat meant doctors became skilled at treating wounds and administering herbal remedies. Didn’t treat ordinary citizens but knowledge exchanged + spread.
• Responsible for spread of Christianity.

Question 11

Describe what happened to medicine in Britain once the Romans left.

Answer 11

• Medical knowledge was lost. Libraries dismantled or destroyed and army doctors returned to Rome. What remained was kept alive by Church + monasteries. Christianity arguably biggest legacy of Roman Empire.
• Church liked the work of Galen because it fitted in with what the Bible taught - one God created all humans + soul existed. Galen continued to influence medicine in Britain until Middle Ages/Renaissance.

Question 12

Were the Romans more concerned with the causes of disease or the prevention of it?

Answer 12

Prevention

Question 13

What did the Romans recognise there was a link between?

Answer 13

Dirt and the spread of disease

Question 14

Why did the authorities ensure that Rome was kept clean and healthy?

Answer 14

Because it was hugely overcrowded so they had to ensure it was clean and healthy otherwise they risked epidemics

Question 15

What was the Romans main motivation for improving/maitaining public healthy?

Answer 15

They wanted to keep the army healthy so that they would have healthy soliders to protect the Empire and help it expand.

They also wanted healthy workers and merchants too to keep the Empire fed and prosperous.

They saw the benefits to wider society.

Question 16

What technology did the Romans use to improve public health (or in their public health system)?

Answer 16

• Aqueducts
• Water pipes
• Reservoirs
• Public fountains
• Forts
• Public baths
• Private houses
• Public toilets
• Sewers

Question 17

What role did aqueducts play in the Roman public health system?

Answer 17

• Ran for miles through countryside.
• Transported water from rivers and lakes to towns and cities

Question 18

What role did reservoirs play in the Roman public health system?

Answer 18

Held the water supply + distributed it to the piping system

Question 19

What role did public fountains play in the Roman public health system?

Answer 19

Provided water for drinking + washing.

Most people got their water from fountains, street pumps, and rain buckets as only the rich had piped water,

Question 20

What role did forts play in the Roman public health system?

Answer 20

Had their own bath house, water supply, and latrines.

Many also had hospitals for the soldiers

Question 21

What role did public baths play in the Roman public health system?

Answer 21

Places for exercise, washing, talk, and business.

Even small towns had one. Charged lowest unit of Roman currency.

5000 people used per week but the water was only changed once!

Question 22

What role did private houses play in the Roman public health system?

Answer 22

Rich were supplied with water but public needs were prioritised (fountains + baths)

This meant that in a drought the rich would have to fetch water from the fountains whilst the poorest could still access what water there was

Question 23

What role did public toilets play in the Roman public health system?

Answer 23

Often flushed by water from baths then drained into sewers.

Seated around 20 people in one room and were a place to chat and shit.

Sponges on sticks (placed in vinegar when not in use) were provided (instead of loo roll)

Question 24

What role sewers play in the Roman public health system?

Answer 24

Carried waste away from houses, latrines, and baths in the cities to nearby rivers/the coast.

Built from stone and depended on there being enough water in the system to flush the waste out. If there wasn’t (summer/drought) then waste would build up and disease would spread.

Question 25

What were the positives of public health in Britain in the early Middle Ages?

Answer 25

• Rich still had high standards of cleanliness. Many had a privy which was seperate from their living quarters
• Lead pipes still supplied water to the houses of merchants + the rich
• Hygene in monasteries and convents was good. Fresh water piped in and waste disposed of in running water
• Town councils provided fresh water and public baths known, as stewes, to keep population clean + healthy.

Question 26

What were thenegatives of public health in Britain in the early Middle Ages?

Answer 26

• Lead pipes for water were only built if they could be privately funded. Leaky and gave water a bad taste (because they were poisonous).
• Water was contaminated by other sources (sewage + butcher’s blood) and not healthy to drink
• Streets strewn with rubbish and human + animal waste. This attracted lots of rats
• Government laws to keep the streets clean were difficult to enforce
• In most places there was no public provision of clean water

Question 27

What was a key factor that influenced public health in the early Middle Ages?

Answer 27

Government:

Didn’t think it was their job to improve public health + not priorty.

Led to regression

Question 28

What was a key factor that influenced ideas about the causes of disease in the Middle Ages?

Answer 28

Attitudes + Beliefs:

The Church banned all dissection and controlled what was taught,

but, also set up medical schools

Question 29

What was the impact of religion on the development of medical knowledge?

Answer 29

• Only constant authority after collapse of Roman Empire.
• Had libraries preserving medical knowledge + books. Meant Church had monopoly on treatment + training (apart from village healers) so could choose which books to copy + distribute. Therefore, works of Galen appeared everywhere.
• Sick were encouraged to pray - each ailment had a different Saint!
• Shared some power with King, and it was believed this gave him healing powers. Believed the King could heal tuberculosis through touch.

Question 30

What was the role of the Church in training doctors?

Answer 30

• Majority of doctors trained by reading books. Best libraries were in monasteries or convents, so doctors spent a lot of time there.
• Some of these religious insitiutions developed into universities which were controlled by the Church.
• By the 12th century, it was difficult to become a doctor without a few years study. This meant the Church controlled medical profession until the Refomation.
• The Church did not let anyone criticise or try to prove Galen wrong as it liked his ideas so much. Therefore doctors were wrongly training in theory of 4 humours etc.

Question 31

What types of causes did the Church teach caused disease?

Answer 31

Natural and supernatural

Question 32

What natural explinations did the Church give for disease?

Answer 32

• Galen said illness was caused by imbalance in humours, so the Church also taught this.
• Popular remedies for disease were bleeding, purging, or treating with opposites.
• Pus was thought to be a sign of healing.

Question 33

What supernatural explinations did the Church give for disease?

Answer 33

• Illness and disease were caused by sin. Prayer was the easiest cure, or you could pay Church to pray for you. Also pilgramages to saints’ shrines.
• This also encouraged people to follow the rules of the Church in their day-to-day lives and attend church to prevent illness.
• Astrology was also used to treat the sick. The position of the moon was though to be important when bleeding a patient.

Question 34

What was the role of the Church in caring for the sick?

Answer 34

• During Middle Ages, over 1000 hopsitals set up. These were run by monks or nuns who prayed for the soul of the sick.
• Very few hospitals employed a doctor as they thought it was God’s job to decide what to do with them - monks + nuns just cared in the meantime.
• Many refused to admit infectious or incurable patients because there were no doctors to look after them. This was a direct result of the Church’s teachings on the cause of disease and is very different to today.
• However, being able to rest in a warm, clean, comfortable environment and eat good food for a couple of days would probably have cured many.

Question 35

What impact did the factor of war have on medicine and treatment?

Answer 35

Led to new ideas + innovations + technology, but also loss and destruction of others.

Question 36

What impact did the factor of government have on medicine and treatment?

Answer 36

Populations didb’t value public health if their rulers didn’t

Question 37

What impact did the government of Ancient Rome have on medicine?

Answer 37

• Funded public works to promote good health.
• Thought healthy citizens less likely to rebel
• Healthy workers + merchants important for strong + prosperous empire
• Galen was the Emperor’s doctor and was encouraged to publish his texts and teach others.

Question 38

What impact did the government of the Middle Ages have on medicine?

Answer 38

• Kings + governments not interested in medicine.
• More intertested in defending kingdoms and did not recognise that healthy subjects would help with this.
• Church controlled many aspects of medicine anyway
• Lack of interest probably had a negative effect on public health in itself - if the King didn’t care, why should anyone else?

Question 39

What impact did war during the Roman period have on medicine?

Answer 39

• Brought the Romans to Britain. They also brought their medical knowledge, standards of cleanliness, and emphasis on hygene.
• War also led to Romans leaving.
• Libraries and public works destroyed + fell into decay and medical knowledge was lost.

Question 40

What impact did war during the Middle Ages have on medicine?

Answer 40

• Soldiers who traveled to the Middle East to fight in the Crusades brought back medical knowledge.
• However, meant gov. prioritised war over public health + medicine.