Summary
Summary GCSE History Medicine Through Time - all revision notes
Notes for all of this part of the course - including for specific people (e.g. Alexander Flemming)
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c1250-c1500: The Middle AgesIdeas: supernatural and religious
- The church taught that God made people ill because he was displeased with
them or was testing their faith → There was no need to search for other rational
explanations for disease which held back research ← few new medical ideas in
medieval times
- Most of what ordinary people learned was taught by the Church
- It was the centre of formal learning; it set up and ran universities where physicians
were trained
- It discouraged dissection and didn’t approve of challenging ideas and authority
- Unlike most people, monks and priests could read and write. Most large collections of
books were in monasteries → the Church controlled what was read
- It approved of traditional, rational explanations of disease → it promoted the idea of
Galen as his theories fitted Christian beliefs that the body had a soul and that all
parts had been created by God to work together
- It taught people to follow Jesus’ example and care for the sick ← many hospitals
were housed in monasteries and nunneries
Rational explanations for disease
The Four Humours (4H):
- The Ancient Greeks thought that everyone had a mix of four humours in their body
(blood, phlegm, yellow bile and black bile) and a person became ill when these were
unbalanced, so to get better you need to put the balance right.
Theory of Opposites (TOO):
- In 2c AD, Galen developed the idea of the Four Humours further. Besides bleeding
and purging to remove excess humours, treatment based on TOO aimed to balance
the humours by giving the patient the ‘opposite’ of their symptoms ← e.g. if you
had too much phlegm (linked to water and cold) you should eat hot peppers.
Miasma:
- Disease is transmitted by ‘bad air’ ← related to God as bad smells indicated sin
Hippocrates
- Ancient Greek physician whose ideas and books were very influential.
- He dismissed the idea of gods causing disease - he believed there was a physical
reason for illness which needed a physical cure.
- Most of his treatments were based on diet, exercise and rest but he also used
bleeding and purging to remove excess humours.
- He wrote the Hippocratic Oath ← where doctors swear to respect life and prevent
harm
- His method of clinical observation - studying symptoms, making notes, comparing
with similar cases, then diagnosing and treating - is the basis of today's approach
Galen
- Galen was a Greek physician who wrote many books and his ideas were the basis
for medical training in the Middle Ages
, - He developed Hippocrates’ idea and mainly used bloodletting, or purging to prevent
and treat illness, as well as his own treatments based on his TOO.
- He drew detailed diagrams of human anatomy using knowledge he gained from
operating and carrying out dissections on dead (mostly animals’) bodies
Prevention and treatment
Rational treatments in connection with 4H
1. Bloodletting was the most common treatment. Either done by cutting a vein, using
leeches or by cupping. Different points in the body were used for different illnesses.
Occasionally performed by physicians but, more usually, by barber-surgeons or non
medical people
2. Purging. Either making a patient vomit or go to the toilet to remove food from the
body. Emetics and laxatives were mixed by apothecaries, wise women or, at the
patient’s home, physicians prescribed treatments and sometimes gave enemas
themselves
Methods to prevent illness
Religious and supernatural
- Chanting incantations
- Self punishment e.g. flagellation ← punish self so God won’t
- Carrying lucky charms or amulets
- Living a Christian life - e.g. praying, going to church, obeying the Commandments
Rational methods
- Purifying the air
- Bleeding and purging
- Not overeating
- Exercising
- Bathing and washing
- Keeping the streets clean
Treatments
Traditional remedies
- Most common were traditional ones made with herbs, which were drunk, sniffed or
bathed in
- Different foods to rebalance the humours and ointments to apply to the skin
- Made at home or mixed and sold by an apothecary
Religious treatments
- Praying
- Fasting
- Going on pilgrimage
- Paying for a special mass to be said
Supernatural treatments
- Specific ideas for specific illnesses, e.g. hanging a magpie’s beak around your neck
to cure toothache
Caring for the sick
Barber-surgeons
➔ No training
➔ Carried out bloodletting, pulling teeth, lancing boils and also cut hair
, ➔ Did basic surgery e,g, amputating limbs (very low success rate)
➔ Cheaper than a physician
Care in the home
➔ Most ill people were treated at home by a female family member
➔ The village ‘wise woman’ would also tend to people in their homes for free
Apothecaries
➔ Received training but no medical qualifications
➔ Mixed medicines and ointments based on their own knowledge or directions of a
physician
➔ Cost money (but less than a physician
Physicians
➔ Medically trained at university and passed exams
➔ Diagnosed illnesses and gave treatments, or sent patients to the apothecary or
barber-surgeon
➔ Expensive, so only used by the wealthy
➔ Very few of them, with women physicians incredibly rare
What physicians did
1. Observed patient’s symptoms and checked their pulse, skin colour and urine for both
colour and taste
2. Consulted urine charts in their vademecum (handbook)
3. Consulted zodiac charts to help diagnose the illness and to work out the best time to
treat the patient
4. Then either treated the patient themselves (rare), or sent them to a barber-surgeon
or apothecary
Hospitals
- Places where travellers and pilgrims stayed on their journeys
- Number increased during the Middle Ages
- Many were run by the Church, so the emphasis was on God and healing souls
- Some were built for specific infectious diseases
- Patients were given fresh food and plenty of rest
- Places of recuperation rather than places where patients were treated for disease
- Patients and their surroundings were kept very clean
- Usually, people with infectious diseases or incurable conditions were not admitted
The Black Death, 1348-9
- Bubonic plague, carried by fleas living on black rats, brought to different countries on
trading ships. Passed to humans when an infected flea bites them.
Causes (what they thought) and avoidance
- Religion → God sent it as a punishment for people’s sins → praying and fasting →
show God how sorry they were by punishing themselves
- Astrology → the position of Mars, Jupiter and Saturn was unusual at this time
- Miasma → caused by decaying rubbish → cleaning up rubbish in the streets,
carrying herbs and spices to avoid breathing in ‘bad air’, lighting fires, ringing bells or
having birds flying around the room to keep air moving
- Four Humours imbalance
- Outsiders: strangers or witches had caused the disease → not letting unknown
people enter the town or village
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