Medieval Medicine, c.1000-1500

Question 1

When was Gilbert Eagle’s Compendium Medicine and what was it?

Answer 1

C.1230, a comprehensive English medical textbook blending European and Arabic medical knowledge together

Question 2

When did the Black Death arrive in England?

Answer 2

1348

Question 3

Where did the Black Death arrive from? and How?

Answer 3

Asia through trade routes. Bubonic plague spread by infected fleas on rats. Pneumonic through coughing.

Question 4

What was the Four Humours Theory?

Answer 4

Set fourth by the Greeks (Hippocrates and Galen), the idea that the body was a balance of four humours (Blood, yellow bile, black bile and phlegm). If balanced you were healthy, if unbalanced you would get sick.

Question 5

What was a cure for unbalanced blood? (four humours)

Answer 5

Bloodletting or eating and drinking red wine or meat

Question 6

Who cured the sick in Medieval England?

Answer 6

Barber surgeons (bloodletting and minor surgery); Wise women or men (First aid, herbal remedies, supernatural cures i.e. charms); Travelling healers (extracted teeth, sold potions, mended fractures); Herbalists in monasteries (used herbal treatments, bloodletting and prayers); Trained doctors (expensive, few of the, studied for at least 7 years, used Galen and Hippocrates as well as Compendium Medicine and Avicenna’s canon of medicine)

Question 7

What Islamic medical text did Avicenna write and what was important about it?

Answer 7

The Canon of Medicine, it highlighted 760 drugs/medicines and was used until 1800.

Question 8

What did Doctors use to identify/treat disease? (Not supernatural)

Answer 8

Clinical observation (checking pulses and urine); four humours

Question 9

What did Doctors use to identify/treat disease? (Supernatural)

Answer 9

Position of the Stars and Planets; charms and prayers

Question 10

How did Christianity affect Medieval Medicine?

Answer 10

1) Christians believed it was good to look after the sick;
2) God sent illness as a punishment or a test of faith, so curing was against God’s will;
3) Monks preserved and copied by hand ancient medical texts;
4) Prayers the most important treatment rather than drunks;
5) Christians created over 700 hospitals between 1000-1500;
6) Church believed in miraculous healing and the sick were encouraged to visit shrines and pray to saints.
7) Hospitals were funded by teh Church or wealthy patrons
8) Hospitals did not cure the sick and so many had priests not doctors
9) Church approved the medical ideas of Galen and Hippocrates and encouraged their ideas in universities; they were not to be challenged
10) Roger Bacon arrested for suggesting doctors should do original research

Question 11

How did Islamic medical knowledge spread?

Answer 11

Arrived in Italy around 1065 through latin trnaslations from Constantine the African. The unviersities in padua and Bologna in Italy became the best places to study medicine in Europe.

Question 12

What were the key Islamic ideas about medicine?

Answer 12

1) Encouraged medical learning and discoveries as Muhammad (pbuh) said ‘For every disease, Allah has given a cure’. So doctors were inspired to find them
2) Muslim scientists were encouraged to find new cures and drugs such as senna and naphtha
3) Mental illness was treated with compassio
4) Valued Hippocratic and Galenic medicine, and preserved and learned from the books of the ancient world
5) Muslim hospitals were meant for treating patients not simply caring for them like in the Christian world.

Question 13

Who was Al-Razi/Rhazes?

Answer 13

C.865-925; Islamic doctor, distinguished measles from small pox for the first time, wrote over 150 books, followed Galen but was critical of him

Question 14

Who was Avicenna?

Answer 14

980-1037; Islamic doctor, wrote the Canon of Medicine which was an encyclopaedia of Ancient Greek and Islamic medicine which listed over 760 different drugs such as laudanum and discussed anorexia and obsesity. Used until the 17th century.

Question 15

Who was Ibn al-Nafis?

Answer 15

Islamic doctor; in the 13th century he concluded that Galen was wrong about how the heart worked, claiming that blood circulated via the lungs, but Islam did not allow human dissection and his books were nto read in the West. Europeans continued to accept Galen’s mistake until the 17th century.

Question 16

Medieval surgery was a risky business for the patient because surgeons…

Answer 16

1) Operated without effective painkillers
2) Had no idea that dirt carried disease
3) Could not help patients with deep wounds to the body
4) Sometimes thought pus in a wound was good (it was not and is not.)

Question 17

Medieval procedures for surgery were…

Answer 17

1) Blood letting to balance humours
2) Amputation to cut off a painful or damaged part of the body e.g. for breast cancer
3) Trepanning to drill a hole in the skill to ‘let the demon out’ e.g. for epilepsy
4) Cauterisation to burn a wound to stop the flow of blood using a heated iron

Question 18

What forms of anaesthetic were typically used in medieval surgery?

Answer 18

Mandrake root, opium and hemlock, but too much might kill the patient

Question 19

Who was Abulcasis?

Answer 19

A Muslim surgeon, wrote a 30 volume medical book in 1000; invented 26 new surgical instruments and many new procedures e.g. ligatures made cauterisation popular.

Question 20

Who was Hugh of Lucca and his son Theodoric?

Answer 20

In 1267 criticised the common view that pus was needed for a wound to heal; used wine on wounds to reduce invenction and had new methods of removing arrows; clashed with Hippocratic ideas and did not become popular

Question 21

Who was Mondino de Luzzi?

Answer 21

Led new 14th century interest into anatomy; in 1316 wrote Anathomia which became the standard dissection manual for over 200 years; in 1315 supervised a public dissection in Bologna, the body did not fit Galen’s description so people said the BODY was wrong rather than Galen

Question 22

Who was Guy De Chauliac?

Answer 22

French surgeon who wrote Great Surgery in 1363 which had references to Islamic and Greek writers like Avicenna and Galen (quoted 890 times); opposed Thedoric of Luccas idea about preventing infection

Question 23

John of Arderne

Answer 23

Most famous surgeon in Medieval England; set up the Guild of Surgeons in London in 1368. Wrote the surgical manual Practica based on Greek and Arab knowledge and used experience in the Hundred Years War between England and France.

He specialised in operations for anal abscess (swelling with pus), a condition common in knights

Created a painkiller ointment from Hemlock and Opium which removed the need for cauterisation

Question 24

What was unhygenic about Medieval Towns?

Answer 24

1) Water - as towns grew, increased demand led to rivers being used to remove sewage and other waste.
2) Sewage - towns were usually dirty with few paved streets; cesspits (holes where human waste was put) could overflow onto roads and into rivers
3) Rubbish - poorer areas had dirty streets littered with toilet waste and household rubbish
4) Tradesmen’s waste - leather tanning used dangerous smelly chemicals, while butchers dumped blood and guts into rivers

Question 25

What was hygenic about Medieval Towns?

Answer 25

1) Water - came from local springs, wells or rivers; some Roman systems survived and still worked well while towns like Exeter used new technology with pipes made of wood or lead (poisonous :O)
2) Sewage - most towns and some private houses had privies (outside toilets) with cesspits to collect waste; people left money for public privies to be built when they died
3) Rubbish - Medieval town councils passed laws encouraging people to keep the streets in front of their houses clean and tidy
4) Tradesmen’s waste - Town councils and local craft guilds encourage tradesmen to keep to certain areas and keep them clean

Question 26

Why was it hard to keep medieval towns clean?

Answer 26

Town populations grew and public health facilities couldn’t cope; rivers were used for drinking water, transport and to remove waste; people had no knowledge of germs they believed in miasma

Question 27

What was Miasma theory?

Answer 27

Bad smells/bad air spread disease, so nice smelling herbs would keep you healthy.

Question 28

Name the key features of a monastery/abbey that kept them clean

Answer 28

1) Lavatorium - pipes delivered local well water to wash absin; filters removed dirt
2) Dormitory - monks washed their clothes rregularly as well as their feet and faces
3) Privies - these toilets sometimes contained pottoes to collect urine to bleach wool. They were emptied into pits, from which the waste was taken to be used as manure/fertiliser.
4) Rivers - waste water from toilets was put into the river down stream removing waste and keeping upstream water clean for dirnking
5) Infirmary hall - they had a small hospital

Question 29

Why were conditions better in monasteries?

Answer 29

1) Wealth - they had money to keep facilities clean
2) Knowledge - monks could read and understand books so they learnt basic ideas about separating clean water from wastewater and they understood the Ancient Roman idea of a routine involving moderation in diet, sleep and exercise to balance humours.
3) Location - Isolation helped protect monks from epidemics as monasteries were usually away form towns and they were built near to rivers so had a good supply of water
4) Rules - monks obeyed the abbot strictly and so lived simple lives and kept clean for God e.g. baths once a month

Question 30

What were believed causes of the Black Death?

Answer 30

1) Position of the stars and planets
2) Bad air/miasma theory
3) Wells poisoned by the Jews
4) Punishment from God

Question 31

What were the real/actual causes of the Black Death?

Answer 31

1) Bacteria (Yersina Pestis) which grew in fleas’ stomachs
2) Fleads fed on the rats’ blood, disease killed rats, fleas moved on to humans
3) Fleas passed the disease on to humans
4) Food shortages meant the poor were more vulnerable to infection as they were malnourished

Question 32

What does S.Q.U.A.L.I.D stand for? (Reasons the Black Death spread so quickly)

Answer 32

S - Street cleaning was poor
Q - Quarantine was not effective on infected villages
U - Unhygenic habits
A - Animals dug up quickly-buried victims’ bodies
L - Laws about cleanliness were hard to enforce
I - Ignorance of germs and causes of disease
D - Dirty streets encouraged rats to breed

Question 33

What remedies were there for the Black Death?

Answer 33

P - Prayer
U - Unusual remedies ie.e drinking mercury or shaving a chicken and strapping it to buboes
M - Moving away before the Plague arrived
A - Avoiding contact with people and quarantining infected places

Question 34

How many people died in Europe and Britain from the Black Death?

Answer 34

In Europe nearly 50% of the population.
In Britain at least 1.5 million, potentially 1/3rd of the population. Approximately 30% in rural areas and 60% in towns

Question 35

Impacts of the Black Death? (REPS)

Answer 35

R - Religious impact - Damage to the Catholic Church as experienced priests died; others had run away
E - Economic impact - Plague created food shortages; prices went up (inflation), creating more harship; Landowners switched to sheep farming which required less workers; Farm workers demanded higher wages and were less willing to be tied to the land
P - Political impact - Demans for higher wages contributed to the Peasants Revolt (1381) and weakening of the feudal system
S - Social impact - whole villages were wiped out. Potentially 1/3rd of the entire population died.

Question 36

While the Black Death subsided by 1350…

Answer 36

it never really died out. Further plague outbreaks occurred at intervals from the later half of the 14th century until the 18th century. It came again in the Great Plague of 1665 for example.

Question 37

What did the Church do for medical progress?

Answer 37

Helped:
- provided hospitals and monasteries to look after the old, infirm and the sick
- established the first hospitals which saw people begin to be treated in a specific setting
- texts, many from the Islamic world, helped spread good practice among those willing to listen

Hindered:
- prayer and pilgrimage - disease was God’s punishment
- resisted some progress such as did not believe in dissection or autopsies
- would not have Galen questioned