Medieval Britain 1066–1509, Year 11: medieval medicine, hospitals and surgery (Health and the people option)

yellow bile; black bile

HintTwo fluids of the same kind, told apart by colour.

The whyThe idea came from the ancient Greek doctor Hippocrates and was developed by Galen, a Greek doctor working in Rome. Each humour was linked to a season and to qualities of hot, cold, wet and dry.

The humours being out of balance

HintHealth meant having the right amount of each.

The whyTreatment therefore aimed to put things right, for example by bleeding a patient thought to have too much blood, or by purging with something to make them vomit.

Family members and local wise women or healers

HintClose to home.

The whyCare was mostly given in the household and the village, using herbal remedies handed down by word of mouth. Apothecaries sold medicines, and barber-surgeons did operations such as bloodletting. The university-trained physician treated the rich.

Miasma

HintFrom a Greek word for pollution.

The whyIt lasted from ancient times into the second half of the 19th century. It led people to clean up filth and carry sweet-smelling herbs, which sometimes helped for the wrong reason.

The Church supported them

HintThe same body controlled the universities where physicians were trained.

The whyTraining meant studying the ancient texts and accepting them, not testing them. With the Church behind his work, to challenge Galen could look like challenging the Church itself.

Urine

HintIt was held up to the light in a glass flask.

The whyPhysicians compared it against a chart. They also checked the position of the stars and planets, since astrology was thought to affect the body. Only the rich could afford a university-trained physician.

To care for the sick, not to cure them

HintThey were usually run by monks and nuns.

The whyThe Church ran hundreds of them. They offered rest, food and, above all, prayer: care of the soul came first. Trying to cure an illness could even seem to challenge God's will.

Monks copied out ancient medical texts by hand

HintBefore printing, a book survived only if someone wrote it out again.

The whyThis kept the ideas of Hippocrates and Galen alive. It also meant that the same ideas, right and wrong, were handed down unchanged for centuries.

Ibn Sina (Avicenna)

HintEuropeans knew him by a Latin form of his name beginning with A.

The whyCompleted around 1025, it gathered the medical knowledge of the Greek and Islamic worlds into one vast work. It was translated into Latin and remained a standard textbook in Europe's universities for centuries.

Al-Razi (Rhazes)

HintHe also wrote a book called 'Doubts about Galen'.

The whyHe stressed careful observation of patients and was willing to question the ancient authorities. He ran a large hospital in Baghdad where doctors were trained.

Scholars in the Islamic world translated them into Arabic and preserved them

HintThink of Baghdad's House of Wisdom.

The whyLater the texts were translated from Arabic into Latin, in places such as Toledo in Spain, and so came back into western Europe along with the discoveries of Islamic doctors.

Barber-surgeons

HintThey also cut hair.

The whyThey learned by apprenticeship, not at university, and were looked down on by physicians. Much of their experience came from treating wounds in war.

Cauterisation

HintIn the 16th century Paré replaced it with tied threads.

The whyIt sealed the blood vessels but was agonising and damaged the flesh around the wound. Bleeding was one of the three great problems of surgery, along with pain and infection.

Wine

HintAn everyday drink that happens to kill some germs.

The whyThey also argued that pus was not a healthy sign, against the accepted teaching of Galen. Their ideas were not widely taken up.

Natural drugs from plants, such as opium and hemlock

HintHerbal potions; too strong a dose could kill.

The whyBecause the dose was so hard to judge, operations had to be fast and simple. Surgeons could set bones, remove arrowheads and cut off limbs, but they could not safely operate deep inside the body.

Albucasis (Al-Zahrawi)

HintSometimes called the father of surgery.

The whyHis book, 'Al-Tasrif', was translated into Latin and used by European surgeons for about five hundred years. He described ligatures for tying blood vessels long before Paré.