Medieval things Flashcards
list the 4 humours
- yellow bile
- blood
- black bile
- phlegm
what were thought to be the features of yellow bile? [4 humours]
- hot and dry
- choleric, bad-tempered, ambitious
- to rectify - induced vomiting and dieting
what were thought to be the features of blood? [4 humours]
- hot and wet
- sanguine, optimistic, impulsive
- to rectify; bloodletting, red wine, red meat
what were thought to be the features of black bile? [4 humours]
- cold and dry
- melancholic, creative, depressed
- to rectify; laxatives, vegetables
what were thought to be the features of phlegm? [4 humours]
- cold and wet
- phlegmatic, unemotional, lazy
- to rectify; steam
describe the state of the medical profession in the medieval era
- solitary expensive unregulated doctors
- apothecaries and physicians
what did medieval doctors do?
used some clinical observation but only looked at 2 indicators (pulse and urine)
what did apothecaries do?
prescribed natural medicines such as herbs, oils, and animals
how were physicians trained in the medieval era?
- spent 7 yrs at university where they listened to debates, lectures and readings
- had muslin, Indian, Chinese and ancient Greek (medical textbooks were based in Greek knowledge) teachings
- could leave without ever seeing a patient (‘good’ physicians read books, not necessarily treated patients)
in 1300, how many physicians were there in England?
fewer than 100
why was there limited medical progress in the medieval era?
- church suffocated new ideas as supernatural beliefs helped the church by turning people to them
- war and conflict destroyed much of roman progress
- no government encouragement
- hard to travel and communicate
what are some examples of a lack of rationality in medicine in the medieval period?
- witchcraft and charms
- zodiac charts
- astrology
- superstitious beliefs were accessible and widely held
summarise the history of astrology
developed in Islamic medicine and brought to England between 1100-1300
what were some ‘supernatural’ causes of disease that were believed in the medieval period?
- doctrine of signatures
- punishment from god for leading a sinful life or society’s sins - meant people didnt search for cures or causes
- demons
what were some ‘natural’ causes of disease that were believed in the medieval period?
- miasma theory was based in observation - poisonous particles suspended in air
- 4 humours
what did the belief that disease was a punishment from god for leading a sinful life or society’s sins mean for medicine?
people didnt search for cures or causes
what did Hippocrates do?
- hippocratic oath
- wrote the hippocratic corpus (60+ books)
- promoted rest & exercise & a healthy lifestyle
- created theory of the 4 humours
- 5th-4th cent BCE wrote ‘on airs, waters and places’
- promoted clinical observation
what was the Hippocratic Oath?
an oath taken by physicians to swear to practice medicine ethically and honestly
how many medical books did Hippocrates write?
over 60
What did Hippocrates’ ‘On Airs, Waters and Places’ argue?
that the environment (natural) was the cause of disease, therefore disease had a natural cure
what is clinical observation?
observing and recording symptoms and treatment of disease
what was the influence of the Hippocratic Oath?
- good but did mean people didn’t take risks
- still used today
what did Galen do?
- wrote 100s of treatises
- compiled all Greek and Roman knowledge to date
- promoted 4 humours theory and created the theory of opposites
- pig experiment - encouraged dissection where possible - proved brain not the heart controlled speech
- referred to ‘the creator’ which fit with Christianity
- made anatomical and physiological observations
- his ideas were translated into Latin which made him seem more trustworthy
what was the theory of opposites?
- created by Galen
- suggested different foods, drinks, herbs and spices had a humour which could balance the excessive humour causing the disease
what was the significance of Paracelsus?
- bridged gap into renaissance
- declared ‘galen is a liar and a fake’ but still believed in 4 humours
- argued the body was a chemical system that had to be in balance internally and in harmony with the environment - introduced new chemical substances into medicine eg mercury
- questioned some old ideas
what was the significance/impact of hippocrates?
- encouraged observation
- professionalism in doctors still evident today
- greek doctors developed the first rational system (based on logic and common sense)
what was the significance/impact of galen?
- his prominence due to approval by the Christian church meant there was a lack of new ideas as it became heresy to disagree despite his ideas often being wrong (jawbone, kidneys)
- ideas lasted over 1000 years and taught in medical schools
what did Paracelsus do?
- father of toxicology - worked on the effect of poisons on the human body
- disagreed with the 4 humours - added the idea of the holy trinity (salt, sulphur and mercury)
- thought disease attacked the body from the outside
- developed doctrine of signatures
describe Christian medical beliefs
- follow jesus’ example - belief in miraculous healing
- care not cure - illness is god’s punishment
- some are destined to die - Faritius (Italian Benedictine Abbot/physician)11th cent said ‘there is no medicine for death’
- pilgrimage, relics, prayer, and shrines all important
- Pliny’s Natural History provided everyday remedies
what did roger bacon do?
- encouraged doctors to learn from their own experiments
- in 1278 the christian church imprisoned him for questioning galen
what was the significance/impact of roger bacon?
highlighted church control - doctors not allowed to explore for themselves which meant medical progress did not happen
describe Islamic medical beliefs
- encouraged learning
- thought peace and order was necessary for progress
- illness not seen as divine punishment
- medical schools
- bimaristans provided treatment for all and had permanent doctors
- prohibited dissection
what did avicenna do?
- wrote ‘the canon of medicine’ - brought together ideas of Galen and Hippocrates and kept their ideas alive after the collapse of the roman empire
- described how contagious diseases spread and necessary methods of quarantine
- listed the medical properties of over 760 different drugs
- discussed anorexia and obesity
where was Avicenna from?
Persia
what was the significance/impact of avicenna?
- ‘canon of medicine’ became standard European medical textbook and used to teach doctors in the west until the 17th century
- Islamic doctors developed new techniques in medicine, surgery, pharmacology and dissection
- he founded hospitals and introduced physician training
what was the ‘Canon of Medicine’?
- written by Avicenna
- million-word textbook covering all aspects of medicine and bringing together the ideas of Galen and Hippocrates
- described sedative inhalation for surgery (a ‘soporific sponge’, soaked in an herbal potion that is placed under the patient’s nose during an operation to keep them sedated)
what did Hunain ibn Ishaq (Johannitius) do?
travelled from Baghdad to Byzantium to collect Greek medical texts and translated them into Arabic
what did Ibn Al-Nafis do?
- disproved galen’s heart theory - suggested that blood flows from one side of heart to other via lungs and doesnt cross the septum
- work wasn’t recognised in the west until 20th cent
- discovered new drugs
what did Al Razi do?
promoted careful observation and discovered the difference between smallpox and measles
what did Caliph Al-Rashid do?
- built a new Baghdad hospital/library
- linked physical and mental health
what did Abu al-Qasim (Abulcasis) do?
- wrote Al Tasrif
- invented 20 new surgical instruments
- popularised cauterisation
what was Al Tasrif?
- written by Abu al-Qasim (Abulcasis)
- 30 volume medical book which described amputations, removal of bladder stones, dental surgery, methods for handling fractures, dislocations, stitching wounds
what did Ibn Zuhr (Avenzoar) do?
- performed the first experimental tracheotomy on a goat
- described the parasite which causes scabies
- began to question reliability of galen
- Kitab al-Iqtisad
- kitab al-aghdhiya
- Kitab al-Taysir
what was the significance of Ibn Zuhr (Avenzoar)?
- applicated the experimental method
- contributed to the scientific advancement of microbiology
- began to question reliability of galen
- wrote a lot of book
What was the Kitab al-Iqtisad?
- “The book of moderation”
- a treatise on general therapy
- summary of various different diseases, therapeutics and general hygiene.
what was the kitab al-aghdhiya?
- manual on foods and regimen which contains guidelines for a healthy life
- contains classification of different kinds of dishes and foods like bread, meat, beverages, fruits and sweets.
- recommends specific foods for each season of the year. For example, during winter, digestion is accelerated, so the amount of food consumed should also be increased. Moreover, the food should also be warmer and drier, as temperatures are lower and humidity is higher.
What was the Kitab al-Taysir?
- 30 chapters
- provided clinical descriptions & diagnosis of diseases starting from the head
- accurate descriptions of the oesophageal, stomach and mediastinal cancers and other lesions
what were the origins of alchemy?
- origins in ancient egypt
- preserved in islamic world
what was the impact of alchemy?
- involved much superstition
- invented useful techniques eg distillation and sublimation
- prepared drugs ie laudanum, benzoin and camphor
how did barber surgeons learn?
on the battlefield, and some were apprenticed to other surgeons (though this was unreliable)
when was surgery used in the medieval period?
only as a last resort, though was sometimes successful (ie breast cancer, bladder stones, haemorrhoids) - and there was usually some rationale behind procedures
did medieval surgery have anaesthetics?
- some unreliable ones
- sedative potions standardised around a particular group of plants, usually mixed with opium and alcohol.
- English sedative dwale was an alcohol-based mixture containing bile, opium, henbane, hemlock, lettuce and vinegar.
- By the 15th century, a mixture of opium, mandragora and henbane was the sedative of choice for procedures like amputation.
what are some examples of procedures in medieval surgery?
- tooth extraction
- cupping
- bloodletting
- leeching
- draining or lancing of boils and cysts
- enemas
- might tackle amputations & operations when there was no other option.
who performed surgery in the medieval period?
- Religious laws forbade physicians, who trained in religious universities, from shedding blood, so surgeons often worked outside the medical establishment.
- local barbers offered small surgical procedures
- surgeons sometimes travelled around the country, extracting teeth and lancing boils in each town or village.
- Wealthier patients saw master surgeons whose status would be closer to that of the physician. And the surgeon would perform the surgery in the patient’s home.
when was the fellowship of surgeons est.?
1368
what did Frugardi do?
- 1180 wrote Practice of Surgery - textbook
- warned against trepanning
- performed ambitious operations
- emphasised importance of training - by 13th cent most towns demanded and required their doctors to have training
what did hugh and theodoric of lucca do?
- 1267 wrote a book which criticised the idea that pus was necessary for a wound to heal
- used wine as an antiseptic
- invented new ways to remove arrows
- went against hippocrates’ ideas of infection which made them unpopular
what did Mondino do?
- 1315 was allowed to conduct a rare public dissection
- 1316 wrote Anathomia - became the standard dissection book for over 200 yrs
- dissections were introduced at most unis
- but did not doubt galen
what did John of Arderne do?
- 1367 wrote Practica - surgical manual on Greek and Arab knowledge and 100 yrs war
- 1376 - created a recipe for an anaesthetic including hemlock, opium and henbane; in controlled doses, may have worked, but very likely to kill
- 1368 set up guild of surgeons to help separate them from barber surgeons
what was the ‘Practice of Surgery’?
a textbook written by Frugardi in 1180
what was ‘Anathomia’?
a dissection book written by Mondino in 1316 which became the standard dissection book for over 200 years
what was ‘Practica’?
a surgical manual on Greek and Arab knowledge and the 100 yrs war written by John of Arderne in 1367
what did de Chauliac do?
- 1367 wrote his textbook - Great Surgery which referenced Greek and Islamic writers
- used anatomical study
- disagreed with Theodoric which halted the progress of his ideas surrounding infection
- found treatments not cause of illness - not religious
- quoted galen ~890 times
how many times did de Chauliac quote Galen in ‘Great Surgery’?
~890
what was ‘Great Surgery’?
a textbook written by de Chauliac in 1367 which referenced Greek and Islamic writers
what was included in the 1245 public health law?
- Great Conduit begins construction
- built to bring clean water to London, as the Thames was getting too toxic
- 2.7 miles long, and comprised of hollowed-out tree trunks and lead pipes.
how long was the Great Conduit?
2.7 miles
what was the Great Conduit made of?
hollowed out tree trunks and lead pipes
why was the Great Conduit built?
to bring clean water to London, as the Thames was getting too toxic
what was included in the 1298 public health law?
- Ed I complained about unhygienic conditions in York (danger for soldiers preparing for invasion)
- council ordered building of public latrines
what was included in the 1330 public health law?
glamorgan council passed a law to stop people throwing waste onto streets and close to town gates
what was included in the 1371 public health law?
london prohibited killing large animals inside city
what was included in the 1373 public health law?
- london gave up controlling building and sewage disposal over walbrook stream
- make householders who use it pay a yearly fee to have it cleaned
what was included in the 1388 public health law?
parliament passed a law for a £20 fine for throwing rubbish into ditches, ponds and rivers
why was government action limited towards public health in the medieval period?
- it was hard to make people obey
- reactionary measures dealt with the symptom not the cause
- laissez-faire - didn’t invest in medicine
- disorganised government - hard to implement laws
describe the general living conditions in medieval england
- traditional gender roles
- roman catholic church incredibly important
- rural, agricultural living
- peasant life
- death common
what made the roman catholic church so important in the medieval period?
- people had to pay a 10% tithe to them
- they controlled community facilities and learning centres
- monks were relied upon for literacy
- they controlled thinking, as life was overseen by local bishops
how did rural, agricultural living impact people’s lives in the medieval period?
- no sewers
- relied on crops for food which led to many famiens
what was peasant life like in the medieval period?
- spun wool to make clothes
- children helped parents - no school
- small homes made of twigs, clay, thatched roof, limited furniture, and animals
why was death so common in the medieval period?
- infant mortality
- ever-present conflict (fall of roman empire, crusades)
- epidemics
- childbirth
from 1000-1500, how many hospitals were built?
over 7000
what kind of care was received in medieval hospitals?
- few physicians - mostly elderly nuns
- main treatment was prayer and some herbal remedies
- many were small almhouses to provide for elderly and unable to work
how were medieval hospitals funded?
by the church or endowments from rich people to pay for beds
why was health generally better in monasteries and abbeys?
- had 1 leader (abbot) and were small, so there was the power to enforce rules about cleanliness and waste disposal
- had more money from charity etc so infrastructure was improved and had cleaner facilities
- routine of cleanliness as part of religion
- isolated as they thought lay people were sinful - this protected them from epidemics
- augustine monks may have known how to amputate limbs, fashion surgical instruments, induce birth and cure scurvy and hangovers
what were lavatoriums?
in medieval monasteries/abbeys, they were pipes with filters to remove dirt from local well, go to wash basins
what kind of infrastructure did monasteries and abbeys have to improve cleanliness?
- lavatoriums
- privies
- dormitories
- libraries
what were privies?
in medieval monasteries/abbeys, toilets emptied into pits and used to make manure
how did dormitories in monasteries and abbeys improve cleanliness?
meant nuns and monks washed clothes, faces and feet regularly
how did libraries in monasteries and abbeys improve cleanliness?
monks read books which gave them the basic idea of clean vs dirty water, and roman idea of diet, moderate exercise to balance humours
what were the two different types of plague?
bubonic and pneumonic
what was the pneumonic plague?
- killed faster than bubonic (~48hrs)
- shortness of breath, vomiting, flu-like symptoms
what was the bubonic plague?
- caused by blood infection
- created haemorrhaging, flooding of lungs, buboes
- killed slower; died in ~1 week,
how many people died due to the black death?
~20 million
what was the death rate due to the black death?
- 40-50% some places 80%
- florence’s population halved
- 90,000 in venice killed
what did people believe caused the black death?
- people were aware of contagion but not transmission
- thought it was the last judgement
- thought it was transmitted by sight
- ethnic hatred
- infected air and miasma
how was ethnic hatred fuelled by the black death?
- pogroms in 1348, but some occurred before the plague even arrived
- suggests it was a planned process led by elites to liquidate debts
- forced confessions
what were the actual causes of the black death?
- fleas carrying disease on rats on boats
- vast trade routes - sailors from black sea, went to northern italy which was the hub of europe
what sort of treatments did people use for the black death?
- suggested alternate sleeping patterns to keep heat away from liver
- pastes
- flagellants
- Guy De Chauliac (papal doctor) discovered difference between bubonic and pneumonic plague - did some bloodletting and lancing
- shaving a chicken and putting it on buboes
- drinking mercury
- eat less lettuce
- fled towns
- quarantines imposed by local councils
what were flaggellants?
- marching mobs which emulated jesus’ suffering to prevent the black death
- challenged the church’s authority
why were quarantines enforced by local councils against the black death not very effective?
hard to enforce
what were the short-term impacts of the black death?
- morality collapsed - theft, pillage, murder, anarchy
- violent religious cults
- graveyards full - plague pits
- famine
- civil court cases left
- houses abandoned
what were the long-term effects of the black death?
- damaged faith so the church lost some power as people felt god had abandoned man
- reduced amount of owned land which helped dismantle feudal system - more land = better wages; however Ed III passed law so people must accept 1347 level wages
- new appreciation of life leading to the renaissance - acceptance of death decay and disease
- establishment was shaken as institutions failed - gvt, medicine, church
what % of Avignon’s Cardinals died of the Black Death?
50%
