Medieval Medicine: Ideas and Treatments

Medieval Medicine: Ideas and Treatments

In the medieval period (c.1250-1500), medical understanding was limited, treatments were often ineffective, and life expectancy was short. Medicine was heavily influenced by the ancient world, the Christian Church, and superstition.

Key Ideas About Disease

The Theory of the Four Humours

The most important medical theory in the medieval period came from the ancient Greek physician Hippocrates (c.460-370 BC) and was developed by the Roman physician Galen (c.129-216 AD):

• The body contained four humours (liquids): blood, phlegm, yellow bile, and black bile.
• Health depended on keeping these humours in balance.
• Disease was caused by an imbalance of the humours (e.g. too much blood caused fever).

Humour	Element	Season	Quality
Blood	Air	Spring	Hot and wet
Phlegm	Water	Winter	Cold and wet
Yellow Bile	Fire	Summer	Hot and dry
Black Bile	Earth	Autumn	Cold and dry

Galen and the Church

Galen was the supreme medical authority throughout the medieval period:

• He built on Hippocrates' Theory of the Four Humours and developed the Theory of Opposites — treat an illness with the opposite quality (e.g. if the patient has too much phlegm (cold and wet), give them hot, dry food or medicine).
• Galen believed the body was designed by a creator — this fitted perfectly with Christian teaching, which is why the Church promoted his work.
• Galen's ideas went unchallenged for over 1,000 years because:
• The Church controlled education (universities, monasteries) and banned ideas that contradicted its teachings
• Galen's texts were the basis of medical training
• Dissection of human bodies was generally forbidden, so his errors (many based on animal dissections) could not be corrected
• There was a culture of reverence for ancient authority rather than independent investigation

Supernatural and Religious Beliefs

Most medieval people believed disease could be caused by:

• God — Illness was a punishment for sin or a test of faith. The appropriate response was prayer, fasting, and pilgrimage.
• The Devil and evil spirits — Possession or curses could cause disease.
• Astrology — The alignment of planets and stars was believed to influence health. Physicians used astrological charts to diagnose illness and choose treatments.
• Miasma — "Bad air" (foul-smelling air from rotting matter, swamps, or human waste) was thought to cause disease.

Treatments

Treatments in the medieval period included:

• Bloodletting — The most common treatment. Blood was removed by cutting a vein (phlebotomy) or using leeches. Based on the idea that illness was caused by excess blood.
• Purging — Using laxatives and emetics (to cause vomiting) to restore the balance of humours.
• Herbal remedies — Plants and herbs were widely used. Some had genuine medicinal properties (e.g. willow bark contains salicylic acid, similar to aspirin). Remedies were recorded in books called herbals.
• Prayer and pilgrimage — Visiting shrines of saints (e.g. the shrine of St Thomas Becket at Canterbury) was believed to cure illness.
• Cauterisation — Burning wounds with a hot iron to stop bleeding.
• Trepanning — Drilling a hole in the skull to release "evil spirits" — this practice dated back to prehistoric times.

Who Provided Medical Care?

Provider	Description
Physicians	University-trained (studied Galen and Hippocrates for 7+ years); few in number; expensive; available only to the wealthy
Apothecaries	Prepared and sold herbal medicines; acted as a kind of pharmacist
Barber-surgeons	Performed surgery (amputations, bloodletting, pulling teeth); had no formal training; surgery was crude and painful
Wise women/folk healers	Used herbal remedies and traditional knowledge; treated most ordinary people
The Church	Ran hospitals (more like hospices — care, not cure); monks and nuns nursed the sick
Hospitals	About 500 hospitals in England by 1500; provided food, rest, and prayer rather than medical treatment. The sick were separated from the healthy but rarely treated

Public Health

Medieval public health was poor, especially in growing towns:

• Streets were filthy — animal dung, human waste, and rubbish were common.
• Water supplies were often contaminated.
• Town authorities made some efforts: regulations on butchers' waste, attempts to clean streets, cesspits were emptied.
• Monasteries had the best sanitation — piped water, latrines, infirmaries.

Key Exam Points

• Medieval medicine was dominated by Galen, the Church, and supernatural beliefs — understand why these persisted.
• Be prepared to explain why there was little progress in medicine during this period.
• Know the link between the Church and medical conservatism — the Church preserved ancient knowledge but also prevented new ideas.