Pre-medieval Medicine

Medical practices in medieval times were strongly influenced by ancient ideas, especially those of Hippocrates and Galen. Their theories, though flawed by modern standards, helped shape the development of medicine for centuries. The combination of natural and supernatural treatments, alongside the knowledge passed down through the ages, played a crucial role in the evolution of medical practice until the advent of modern scientific understanding in the 19th century.

Ancient Ideas - The Work of Hippocrates

Hippocrates

Hippocrates was a Greek doctor born around 460 BCE on the island of Kos. He is often referred to as the ‘Father of Modern Medicine’ due to his significant contributions to the field. One of his major achievements was the development of the Hippocratic Oath, a pledge that doctors still take today (in a modified form). In this oath, medical professionals vow to do their best to treat patients with care and respect, as well as maintain patient confidentiality.

Hippocrates is also known for formulating the theory of the Four Humours, which became a cornerstone of medical thinking for centuries. According to this theory, the human body was believed to be composed of four key substances or "humours": blood, phlegm, black bile, and yellow bile. It was thought that an imbalance of these humours caused illness. The humours were also thought to be linked to the seasons, with each humour being associated with a particular time of year.

Hippocrates promoted the idea that illnesses had natural causes rather than supernatural ones, challenging the prevailing belief that diseases were caused by the gods or evil spirits. He encouraged doctors to look for natural causes and remedies for diseases, rather than relying on superstition. Additionally, he introduced clinical observation, where doctors would study the symptoms of a patient over time, rather than just focusing on the disease itself. This approach laid the foundation for modern medical practices.

The Hippocratic Corpus is a collection of writings attributed to Hippocrates and his followers. These texts spread his ideas across ancient Greece and beyond, influencing medical practices in other parts of the world.

Ancient Ideas - The Work of Galen

Galen

Galen was a prominent Roman doctor born in AD 129, who further developed and expanded on the medical theories of Hippocrates. He is best known for his Theory of Opposites, which was based on the idea of balancing the Four Humours. According to Galen, if a person’s humours were out of balance, they could be treated using opposing substances. For example, if someone had too much phlegm, they could be treated with something hot or spicy, which would balance the coolness of phlegm.

Galen’s work on anatomy was based on dissections of animals, particularly pigs and monkeys. Although this allowed him to make valuable discoveries, such as the fact that the brain controls speech, it also led to mistakes. For instance, Galen mistakenly believed that blood passed from one side of the heart to the other through tiny holes in the septum, the wall dividing the left and right sides of the heart. In fact, blood flows through veins and arteries, not through these holes. Additionally, Galen incorrectly stated that the human jawbone was made of two bones, when in fact it is a single bone.

Natural and Supernatural Treatments

In medieval times, treatments for illnesses often combined both natural and supernatural methods. Supernatural treatments included:

• Prayer, seeking divine intervention for healing.
• Astrology, using the positions of the stars and planets to influence health.
• Trepanning, a procedure in which a hole was drilled into the skull, believed to release evil spirits causing illness.

Despite these beliefs, Hippocrates and Galen promoted the idea of using natural treatments for medical care. Some common natural remedies included:

• Bloodletting, where blood was removed from the body to restore balance among the humours.
• Purging, which involved inducing vomiting or diarrhoea to rid the body of excess substances.
• Herbal remedies, using plants and natural substances to treat ailments.

Treatments Based on the Four Humours

Many medical treatments in medieval times were based on the Four Humours and the Theory of Opposites. According to Galen, if an individual had an imbalance in their humours, medical practitioners would attempt to correct the imbalance by applying the opposite effect. For instance:

• If a person was believed to have an excess of phlegm, leading to cold-like symptoms, they might be treated with warm or hot remedies.
• If someone suffered from a fever (seen as an excess of yellow bile), they might be given cooling treatments.

Doctors also used bloodletting to reduce the amount of blood in the body if they believed someone had too much. Similarly, nosebleeds were thought to be the body’s natural way of releasing excess blood, and in some cases, doctors encouraged this process to maintain balance.

Although these treatments were based on ancient ideas, they laid the groundwork for later medical practices. Medical practitioners of the time were encouraged to closely observe their patients and their symptoms, attempting to select the most appropriate treatment based on the humours and symptoms.

The influence of Hippocrates and Galen persisted for over 1,500 years, until the Germ Theory of disease, developed by Louis Pasteur in 1861 and later expanded by Robert Koch, revolutionised medical understanding in the 19th century.

Providers of Treatment in Medieval Times

Monasteries

During medieval times, monasteries played an important role in providing medical care to people in their local communities. Treatments provided in monasteries often included herbal remedies, which were based on local plants and plants known for their healing properties. Additionally, prayer was used as a form of spiritual treatment, in line with the religious beliefs of the time.

Wise Women

In villages, wise women were often the local providers of medical care. These women relied heavily on knowledge passed down through generations, using herbal remedies and practical experience to treat ailments. Their knowledge of plants and natural medicine was highly valued in rural areas.

Physicians

For wealthier individuals, a physician was often employed to provide medical care. Physicians were highly trained and had often studied at university, where they would learn ancient medical texts, particularly the works of Hippocrates and Galen. These doctors were typically well-versed in the theory of humours and other classical medical concepts. They were especially relied upon by the aristocracy and upper classes, who could afford their services.