Overview: Medieval medicine c.1250-1500

Medieval Medicine, c. 1250–1500

Why medicine changed little

Medieval medicine was characterized by continuity in ideas about disease, treatment, and prevention. The video identifies the Church as the main reason:

• It shaped attitudes: People were encouraged to respect tradition and ancient authorities, making new medical ideas harder to accept.
• It controlled written knowledge: Before the printing press, books were copied by hand. Ideas that conflicted with Church teaching were less likely to be reproduced.
• It endorsed ancient writers: The Church supported the teachings of Hippocrates and Galen because they fitted with its views.
• It controlled education: Universities were Church-funded, and doctors were trained mainly through books rather than experiments. Limited dissection and practical investigation made it difficult to test established ideas.
• Government had limited influence: Kings had no general duty to improve health, and local authorities had little power to improve public health.

Main ideas about disease and their effects

• God and sin: Disease could be understood as God’s punishment or a test of faith. This belief was reinforced by Church teaching and biblical stories.

  • Treatment: Prayer, attending Mass, pilgrimage to holy sites, touching relics, and seeking the king’s healing touch.
  • Prevention: Prayer, avoiding sin, and keeping clean, since hygiene was associated with godliness.

• Astrology: The position of the stars and planets—especially at a person’s birth—was believed to affect health. Though the Church initially resisted astrology, it later accepted it, and it was linked to ideas in Hippocrates’ writings.

  • Effect on care: Physicians consulted star charts when diagnosing patients and choosing treatments.

• The four humors: The body was believed to contain blood, phlegm, black bile, and yellow bile. Illness resulted when these became unbalanced. This was considered a rational idea because doctors thought they could observe signs of the humors.

  • Treatment: Doctors tried to restore balance by purging, using laxatives or inducing vomiting, and bloodletting. Bloodletting could involve opening a vein, using a bleeding cup, or applying leeches. Other methods included bathing and giving treatments with qualities opposite to the imbalanced humor—for example, a hot, dry remedy for excess cold, wet phlegm.
  • Prevention: People were advised to eat moderately and purge regularly. Wealthier patients might receive a personalized regimen sanitatis—instructions for maintaining health and balancing the humors.

• Miasma: Bad air or smells from rotting matter were believed to cause illness. The idea was associated with Hippocrates and Galen and also fitted the Church’s moral association between foul smells and sin.

  • Prevention: People tried to bathe, keep their homes clean and fresh-smelling, hang sweet herbs, or carry flowers and perfumes. Some efforts were made to remove filth from public places, though they were often disorganized and unsuccessful.

Healers and places of care

Care depended on a person’s wealth and illness:

• Physicians were the most expensive and were generally university educated. They diagnosed illnesses—often for wealthy patients—using texts, humoral ideas, urine charts, and astrology. They commonly treated patients from a distance, recommended remedies for symptoms, and did not usually perform surgery.
• Apothecaries prepared and sold herbal remedies. They were more affordable than physicians, so some people went directly to them. Their remedies drew on manuals.
• Surgeons and barber-surgeons ranged in skill and cost. Barber-surgeons were cheaper and performed basic procedures, such as pulling teeth. More skilled, expensive surgeons could undertake procedures such as setting limbs.
• Hospitals were generally Church-run and charity-funded. They offered hospitality, including rest, food, and prayer, and might provide herbal remedies, but were not primarily places for medical treatment. Most did not admit infectious patients or pregnant women.
• Care at home was common for ordinary people. Women in families often grew herbs and prepared remedies, sometimes using herbal manuals.

The Black Death case study

The video describes the 1348 outbreak and distinguishes two forms:

• Bubonic plague was associated with fleas on rats and caused buboes, or swellings. The video says it killed about 40% of those who contracted it.
• Pneumonic plague was spread through coughs and sneezes and was described as killing nearly everyone who caught it.

People blamed the plague on miasma, imbalanced humors, God’s punishment, or the position of the planets. Some also connected it with volcanic eruptions, and some recognized that contact with the sick could spread disease.

Treatments included prayer, bloodletting, purging, herbal remedies, and attempts to burst buboes. Prevention included prayer and pilgrimage, carrying sweet-smelling items, and quarantine—trying to prevent strangers from entering a city. The video notes that quarantine was difficult to enforce because local government was weak.

Some people avoided bathing, fearing that open pores would let disease in, and some stopped cleaning streets because they thought foul smells might drive away miasma. These measures were ineffective.

Exam technique

For a 12-mark question such as “Explain why there was hardly any change in ideas about disease during the medieval period, 1200 to 1500”:

• Focus on the topic specified—in this example, ideas about disease, not treatments or prevention.
• Give three distinct reasons, each in its own paragraph.
• Develop each reason into a sustained explanation by linking cause and consequence. The video uses Church control of education as a paragraph example.

Speakers and sources featured

• Speaker: The video’s presenter and narrator, from the CHSG History channel.
• Historical authorities and texts mentioned: Hippocrates, Galen, the Bible, Articella, and Materia Medica.
• Institution discussed as an influence: The medieval Church.