Medicine

From Medieval Wiki

By Kaelen Alexander

“Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing” -Voltaire

Contents 1 Background of Medieval Medical Care 2 The Black Death 3 Medical Treatments During the Medieval Period 4 Health Providers During the Medieval Period 5 Advancements In Medical Care 6 Men's vs. Women's Roles in the Practice of Medicine 7 Vocabulary and Terms 8 Bibliography

Background of Medieval Medical Care

The Greek[1] and Roman[2] theories and beliefs on the distinction between the soul and the body greatly influenced the study of medicine during the Medieval Period. Arabian[3] methods of healing also affected these people. Medieval medicine was advanced by the political and economic changes of the time as well as a significant increase in the population, which led to urbanization and developments in education. Education expanded in the form of universities, which then led to more professionalism in medicine. The medical treatment one received depended upon their social status in society and their age. Typically, it was just the wealthy that could afford to receive medical treatment from trained physicians, while the less fortunate obtained medical care from folk healers and monks. Initially, because of a lack of medical knowledge, the perspective on medicine by health providers took a less scientific point of view, and more of a religious outlook. Forces beyond nature were believed to cause disease and injury. Therefore, treatments consisted of prayer, meditation, herbal remedies, and spells. Medical work focused more on curing the soul than curing the body. For good health, doctors stressed having a healthy diet, being in a good atmosphere, engaging in physical activity, and prevention of disease. Natural functions were believed to be the best way to sustain one’s health.

The Black Death

The Black Death or Plague as it was known during the Middle Ages, was a devastating illness, which killed 25%-50% of the European population. This event resulted in significant changes in the cultural, economic, and political climate for a long period of time. "Father abandoned child, wife husband, one brother another, for the plague seemed to strike through breath and sight. And so they died. And no one could be found to bury the dead, for money or friendship."-Agnolo di Tura del Grasso. The Black Death is a disease caused by a bacterium that is transmitted to humans by fleas; the flea's original host was a rat. This disease causes three types of illness, of which the Bubonic plague is the most common. The Bubonic plague results in the creation of "buboes," or painful lymph nodes. Invasion of the lungs results in the Pneumonic plague, a rapidly fatal illness that is highly contagious. In the Black form of the plague, hemorrhages (internal bleeding) turn black giving the name "Black Death" to this illness.

Medical Treatments During the Medieval Period

Beyond a religious approach to treating illness, the other main types of medical treatments during the Medieval Period were herbal and folk remedies, and surgery, which were based on the four humors. There were many different herbal remedies involving various ingredients, though all originated from nature and animals. For instance, they sometimes included urine, animal excrement, and ground earthworms. Folk remedies usually consisted of various types of trees, flowers, herbs, and other plants, however it was not only the substances that made these remedies beneficial. It was also the mixture of the plants and their powers, the spoken incantations, and the knowing when and where to get their resources. For example, St. John’s Wort, if found by accident on Midsummer’s Eve, was thought to be best for curing fever. (Today, St John’s Wort is still used, but for treating depression.) Another example is that of garlic and mustard, thought to prevent one from getting the plague. (Today, garlic is thought to help the immune system and aid in the prevention of heart disease.) They believed that every substance form nature contained some type of power. With respect to surgery, doctors performed complicated procedures, though it was used as a last resort, and there were no anesthetics. In spite of this, surgery was identified as a successful way to treat breast cancer, gangrene, cataracts, hemorrhoids, fistulas, and tuberculosis of the lymph glands. Although there were no anesthetics, they did create remedies to ease the pain and promote sleep during the surgical procedure. Unfortunately, some of the ingredients contained in the potions were in fact, life threatening. For example, hemlock juice and opium were commonly used. The most common surgical method was that of bloodletting. This treatment method was related to the four humors, as this process was meant to reinstate the stability of these forces.

Medical practitioners viewed disease as an incident caused by bad odors and an imbalance in the four humors: phlegm, black bile, yellow bile, and blood. This concept was at the foundation of the religious beliefs of Greek and Roman medicine. The four humors related to the four elements: water, earth, fire, and air. It was believed that disequilibrium between these forces could also cause a change in one’s personality. When there was an excess amount of any of the humors, a person could get rid of them through urinating, defecating, crying, or sweating. Furthermore, to determine the diagnosis of an illness, doctors sometimes used the color of the excess humor to decide what type of plant should be used, by choosing a plant of the same color. For example, a plant such as dandelion were thought to be connected to the liver’s yellow bile and were used to treat a condition known as jaundice. (Today’s natural medicine practices still use this plant in their remedies).

Doctors also utilized the color of a patient’s urine to decide what kind of treatment should take place, as well as taking blood samples and the patients pulse. Some treatments consisted of the use of cauterization, diuretics, laxatives, fumigation, or simply taking a hot bath. Antibiotics were not created until the 1800s, and without them that left most diseases incurable. In addition, people of this time cared little about good hygiene, and as the populations of cities and towns grew, sanitation deteriorated. Therefore, infections became an even greater problem.

Health Providers During the Medieval Period

Other kinds of medical providers included monks, midwives, nurses, dentatores and leeches. Monks copied manuscripts from Latin or Greek medical writers. There is verification that monks practiced what they attained from the medical Writing. They cared for the ill and aged members of their monasteries, each of which had an infirmary. The skills of midwifery were passed down from other midwives, or learned from their husbands or fathers who took part in the medical profession. Medieval nurses were those women who worked in hospitals and were responsible for the basic needs of patients. Nurses came from all socio-economic groups. Dentatores were the dentists of the medieval period. There services were very expensive so only a limited number of people could receive care from them. Dentatores used bones to make dentures, mended loose teeth with metal bindings and filled cavities with gold. Leeches were uneducated practitioners who relied primarily on folk medicine. They often assisted surgeons as well.

Advancements In Medical Care

The Islamic World aided in the building of hospitals for the people of Europe, for the Christians had cared greatly for the sick and wounded. Hospitals were run under monastic rule. Medieval practitioners viewed medicine and surgery as two different concepts. They interpreted medicine, a focus of physicians, to be problems inside the body or soul, while surgeons on the other hand, managed dislocations, wounds, fractures, syphilis, urinary complications, amputations, and skin diseases. Over time, people started to take into account who was performing the surgeries and medical care, and soon the medical profession was based upon legal requirements and a curriculum with formal education. In some places, doctors were required to pass an exam before being allowed to start their practice. They were also given state licenses. Untrained physicians underwent prosecution and were subjected to fines. Despite these threats and restrictions, some healers were scholars or priests.

Men's vs. Women's Roles in the Practice of Medicine

Men and women's roles in the medical community were very different. All university trained physicians were of the male gender and practiced in cities in towns, while the majority of women practitioners were folk healers and generally cared for female patients in the more rural areas. Unfortunately, educated physicians shunned women practitioners, which led to witch hunting and religious persecution. Over the years, this resulted in fewer folk healers. In fact, it was believed that folk healers were allies to the devil because they were so adept in their occupation. Despite the different ways in which male and female caretakers were viewed, one of the most famous and respected medical practitioners was a woman known as Trotula of Salerno[4]. Trotula di Ruggiero was considered to be the world's very first gynecologist. Her focus was women's health and skin diseases. She also wrote several medical texts to help teach male doctors about the female body, for men were not well informed on the subject and advised women on the issues of menstruation, pregnancy, and childbirth. She was ahead of her time, in that she recognized that men, and not only women, could have problems that contributed to infertility. Lastly, Trotula advocated for pain relief during childbirth, which at the time, was against Christian beliefs.

Vocabulary and Terms

1. Physician—doctor.

2. Monk—religious figure; holy person.

3. Yellow Bile—choler; digestive fluids causing bad temper.

4. Black Bile—melancholy; digestive fluids causing sadness.

5. Phlegm—mucus, specifically from your lungs.

6. Cure vs. Treat—eliminate whole disease vs. eliminate symptoms of disease.

7. Anesthesia—pain relief/prevention.

8. Excrement—waste products.

9. Diagnose—to identify a problem/illness.

10. Therapeutic—for treatment.

11. Cauterization—a method by which one stops bleeding with heat.

12. Diuretics—medication to remove excess fluid, and/or lower blood pressure.

13. Laxatives—a medication that stimulates bowel functions.

14. Fumigation—to rid of foul odors.

15. Breast Cancer—cancer of the breast tissue.

16. Gangrene—dead body tissue.

17. Cataracts—condition causing blurred vision; lens becomes opaque.

18. Hemorrhoids—swollen veins of the anus.

19. Fistula—an abnormal connection between two organs.

20. Tuberculosis—a bacterial infection, primarily of the lungs.

21. Syphilis—a sexually transmitted disease.

22. Amputations—to surgically remove a limb.

23. Incantation—spell; charm.

Bibliography

Websites:

http://www.skell.org/explore/med.htm#intro

http://library.thinkquest.org/15569/hist-6.html

http://www.learner.org/interactives/middleages/health.html

Books:

Gottfried, Robert S., The Black Death. New York: The Free Press: 1983

Bishop, Morris, The Middle Ages. New York: American Heritage Inc.: 1996

Articles:

"medicine, history of." Encyclopædia Britannica. 2008. Encyclopædia Britannica Online. 9 Dec. 2008 [5].