Medieval Medicine: Religious Explanations of Disease

Explaining Disease with Religion

• Disease was attributed to a lack of scientific understanding.
• The Church's teachings were strictly followed due to the deep religious faith of the time.
• Disease was seen as divine punishment for sins, a test of faith, or a means to cleanse the soul.
• Religious treatments included prayer, self-flagellation, lighting candles, using holy relics, fasting, and pilgrimage.

Religion's Impact on Medieval Medicine

• Religion hindered medical development.
• The Church controlled medical training at universities.
• Dissections, essential for understanding anatomy, were banned by the Church.
• Dissections often reinforced Galen's ideas, attributing discrepancies to the dissected criminal.
• Roger Bacon was imprisoned for advocating independent research.
• Religious treatments were ineffective, such as writing religious words to cure a toothache.
• Only 10% of hospitals in England cared for the sick, the others mainly offered hospitality.

Significance of the Four Humors

• The theory was developed by Hippocrates.
• Disease was believed to be caused by an imbalance of bodily fluids, or humors.
• Galen's Theory of Opposites suggested treating imbalances with opposing elements.
• Each humor (blood, phlegm, black bile, choler/yellow bile) was linked to specific characteristics for diagnosis.
• Treatments included herbs, purging, bathing, and specific diets.

Medieval Treatments

• Blood-letting was used to remove excess humors through cutting veins, leeches, or cupping.
• Purging involved emetics, laxatives, or enemas to cleanse the body.
• Remedies used herbs like aloe vera, mint and chamomile.
• Theriaca, a common remedy, was a spice-based mixture with up to 70 ingredients.
• Warm baths with herbs were prescribed to dissolve blockages or ease aching joints.

Medieval Preventives

• Church attendance and a sin-free life were believed to prevent disease.
• Hygiene practices included frequent bathing and hand washing to avoid miasma.
• Diet was crucial, as digestion was thought to produce humors; moderation was advised.
• Air purification involved spreading sweet herbs, carrying flowers, and using pomanders.

Influence of Ancient Ideas

• Book learning was highly valued due to widespread illiteracy.
• Physicians were judged by their knowledge of books, not patient treatment experience.
• Classical texts were favored over physical evidence.
• The Church supported Galen and Hippocrates' ideas, as they aligned with religious beliefs about the body's design and soul.
• Dissections were illegal, reinforcing reliance on established theories.
• Discrepancies found during dissections were blamed on the dissected individual.

Other Medieval Ideas

• Miasma, or bad air from decaying matter, was thought to cause disease.
• Astrology, or the alignment of planets and stars, was used to explain illness.
• These ideas were rationalized within a religious framework as God's will.

Influences on Disease Causation Ideas

• The Church maintained the status quo and controlled medical training.
• The four humors theory was promoted by the Church due to its alignment with religious teachings.
• Criticism of established theories was discouraged.
• Limited scientific understanding constrained new knowledge, with experimentation discouraged.
• Fear of hell reinforced belief in God and traditional ideas, limiting innovation.

Medieval Medical Providers: Part 1

• Trained physicians had 7-10 years of university education.
• Diagnosis involved assessing urine, feces, blood, astrological charts, and humoral tendencies.
• Treatments, based on Galen, included blood-letting, purging, and herbal medicine.
• Physicians were expensive, catering mainly to the wealthy, and were few in number (less than 100).
• Apothecaries, trained through experience, mixed herbal remedies.
• Apothecaries were cheaper and more accessible than physicians.
• Unlike physicians, they didn't swear an oath and could prescribe poison, causing tension with physicians.

Medieval Medical Providers: Part 2

• Housewife-physicians used traditional herbal remedies passed down through families.
• They managed childbirth and bone-setting without formal training.
• Barber surgeons, with no formal training but good dexterity, performed surgeries based on experience.
• Barber surgeon treatments included bloodletting, basic surgery (e.g., amputations), and haircuts.
• Priests, often also physicians, recommended spiritual and humoral remedies, including prayer and offerings.

Effectiveness of Medieval Hospitals

• Hospitals provided rest, good food, and a hygienic environment.
• Hospitals focused on care rather than cure, with spiritual treatments emphasized due to the belief that God sent disease as punishment.
• People with infectious ("incurable") diseases were not admitted to avoid doubt in God and the Church.
• Limited treatments were available due to a lack of doctors and surgeries.

Medieval Beliefs About the Black Death (1348)

• The Black Death was viewed as an incurable, apocalyptic punishment from God.
• The disease was highly contagious.
• Mass deaths led to improper burials.
• Catching the plague was considered a death sentence.
• Symptoms of bubonic plague included buboes, boils, fevers, chest pains, and coughing up blood.

Methods of Coping with the Black Death (1348)

• Religious treatments involved confessing sins, praying, fasting, pilgrimages, offerings, and self-flagellation.
• Astrological treatments included praying, using holy relics, purging, bleeding, and taking herbs.
• Miasma treatments focused on strong-smelling herbs, theriaca, fires, and boiling vinegar.
• Humoral treatments involved bleeding, purging, special diets, and balancing humors.
• Isolation of the infected through quarantine laws and pesthouses.

Limited Change in Medieval Medicine: Part 1

• The Church was influential, attributing disease to God's will and supporting Galen's ideas.
• Education was controlled by the Church, reinforcing Hippocrates and Galen's theories.
• Doctors were discouraged from experimenting or challenging established knowledge.
• Dissections were not used for discovery but to confirm Galen's anatomical ideas.

Limited Change in Medieval Medicine: Part 2

• Society respected tradition due to the Church's influence.
• The Church hand-wrote books, inhibiting the spread of new ideas.
• Doctors lacked training to challenge existing theories, and innovation was discouraged.
• No major breakthroughs occurred due to limited education and Church control.
• Theories by Hippocrates and Galen were believable, and symptoms seemed to validate the four humors.
• Governments did not fund medical research, prioritizing defense over healthcare.

Renaissance Medicine

• The Renaissance marked a "rebirth" with new ideas.
• Protestantism challenged Catholic teachings, reducing the Church's influence on science.
• Art, especially through perspective, aided accurate anatomical depictions.
• Humanism emphasized learning and independent thought.
• Dissections became more common as the Church's power declined.
• Vesalius and Harvey disproved Galen's theories, leading to discoveries about blood circulation and anatomy.

Renaissance Key Discoveries: Sydenham

• Sydenham rejected reliance on medical books.
• He treated diseases based on observed symptoms, categorizing them.
• He posited that symptoms were side effects of one cause: the disease.
• His work laid the foundation for a more scientific approach in the 18th century.
• Sydenham could distinguish measles from scarlet fever.
• He could not isolate microorganisms causing diseases.

Renaissance Key Discoveries: Printing Press

• The printing press was developed around 1440, leading to hundreds by 1500.
• Information spread accurately and quickly due to reduced inconsistencies.
• Scientists shared their work across Europe.
• The Church lost control over the spread of information.
• Old ideas also spread faster.
• The printing press did not improve understanding of disease causes.
• Printing remained expensive and inaccessible to ordinary people.

Renaissance Key Discoveries: Royal Society

• The Royal Society allowed scientists to perform and promote scientific experimentation.
• The society encouraged the sharing of scientific knowledge and debate of new theories.
• King Charles II's support lent credibility to the Royal Society.
• The society published journals, such as Philosophical Transactions.
• Focus was primarily on science, which did not directly advance medicine.
• The Royal Society remained largely among top scientists instead of being accessible to ordinary people, and most doctors still used old ideas.

Renaissance Key Discoveries: Microscope

• Antonie van Leeuwenhoek created the first microscope.
• He observed "animalcules."
• It was published in Philosophical Transactions and rapidly spread.
• Hooke confirmed his findings with his own microscope.
• Van Leeuwenhoek could not link "animalcules" to bacteria or disease causes.

Vesalius' Discoveries

• Vesalius dissected stolen corpses of criminals.
• He disproved Galen's anatomical depictions, finding 300 mistakes, publishing his work in "On the Fabric of the Human Body" (1543).
• His book became the new standard, used to train doctors, including in Cambridge by 1560.
• Veaslius encouraged other doctors to perform dissections to experiment.
• Vesalius found that the lower jaw was one part, not two.
• Veaslius found that Vena cava did not lead to the liver
• Veaslius found that men did not have one fewer pair of ribs than woman
• Vesalius found that human liver did not have five separate lobes
• Veaslius found that the human breastbone was in 3 parts, not 7

Significance of Vesalius' Discoveries

• Vesalius' work increased interest in anatomy and dissections.
• It made anatomy study fashionable and important in medical education.
• Doctors and professors began conducting dissections themselves, enabling practical training.
• Galen was disproved, but some physicians argued the human body had changed since Galen's time.
• Vesalius inspired others to correct his mistakes and discover veins, leading to Harvey's discovery of blood circulation.

Harvey's Discoveries

• Harvey proved blood flows only toward the heart, disproving Galen's claim that the liver produces blood.
• Harvey discovered that arteries and veins are linked in one system by tying a cord around someone's arm and cutting off blood flow.

Impact of Harvey's Discoveries

• Harvey's arguments relied on careful observation of human and animal anatomy.
• His book, "Anatomical Account of the Motion of the Heart and Blood," marked the beginning of modern physiology.
• He encouraged further experimentation by disproving Galen's theories on liver function.
• Harvey proved blood circulated instead of being absorbed, advancing scientific thinking and experimentation.
• Understanding blood circulation had limited practical impact on 17th-century medical treatments.
• Many doctors criticized and ignored his discoveries, continuing usual treatments and thinking.

Factors Enabling Vesalius and Harvey

• The mechanical water pump helped in making connections with the pumping of the heart.
• The printing press allowed them to spread their ideas faster, allowing them to learn from each other.
• Society’s attitude now focused more on scientific thinking and challenging Galen.
• Dissections became more acceptable.
• Instead of confirming old ideas they were more focused on finding out new things.
• Humanism was a love for learning and finding things out for themselves, which disproved older practices due to people experimenting and believing not everything is from God
• Key institutions allowed harvey to thrive through Charles I by trusting him more and listening to his ideas.
• Harvey was inspired by Vesalius, who was the first to popularize dissections, and that inspired him and others to experiment therefore disagreeing with Galen.

Changes in Treatment and Prevention During the Renaissance.

• Medieval ideas about the causes of illness persisted, despite changes in understanding of anatomy and advancements.
• Widespread belief in the theory of miasma which become more popular during epidemics such as the Great Plague.
• Although the Church lost influence, many people still believed God sent disease and relied on religious cures.
• Treatment advancements didn’t help increase the understanding of disease, therefore it didn’t help medicine practically.

Treatments and Preventions During the Renaissance Part 1

• Transference treatment, a disease can be transferred to something to cure a patient.
• Miasma prevention/treatment, people got rid of trash on the streets and fined those who did not clean outside their homes, additionally the drainage of swamps and bogs.
• Practicing moderation prevention, people avoided drafts, exhaustion, rich and fatty foods, too much alcohol and being lazy.

Treatments and Preventions During the Renaissance Part 2

• Home and body kept clean and free from bad smells.
• Regimen Sanitatis, practiced to avoid diseases and started to believe in other factors.
• Herbal remedies, the use changed slightly, and new remedies were chosen for their color or shape instead of humors.
• Chemical cures iatrochemistry, is using some chemicals.

Similarities Between Medical Care in Medieval and Renaissance Periods

• Physicians still learned from books.
• Physicians lacked practical training, with students not doing dissections.
• Medical care remained costly, with few physicians available.
• Physicians still used humoral treatments like bleeding and purging.
• Apothecaries still mixed remedies.
• Apothecaries were more popular than physicians for first calls.
• Apothecaries trained by "masters."
• Physicians still diagnosed and sent patients to apothecaries or surgeons for treatment.
• Surgeons still did removals of teeth and amputations.

Changes in Medical Care During the Renaissance

• Physicians learned from new books by Vesalius.
• Physicians developed an understanding of anatomy.
• Dissections were no longer illegal, but there were not enough corpses.
• There was a push for a scientific approach to medicine with independent investigation..
• People used new treatments like iatrochemistry.
• Apothecaries now need several years of training, alongside new apprenticeship and licenses were necessary.
• Surgeons now need a license to practice too.
• Surgeons also had advancements in understanding.

Hospital Changes from Medieval to Renaissance

• Treatments remained the same - patients in hospitals could expect food, prayers, and warmth.
• Hospitals were run by the Church until 1536.
• Traditional hospitals did not admit patients who were contagious.
• Some specialist hospitals existed, like leper houses.
• Specialized hospitals for plague or pox, known as pest houses, appeared.
• Patient records suggest hospitals treated wounds and curable diseases.

Shift in Hospital Care After 1536

• The English Church split from the Catholic Church due to Henry VIII's divorce.
• People began to believe there was no longer a barrier between themselves and God.
• Most hospitals closed due to their connection to the Church.
• Small charitable hospitals opened to counter this lack of availability and reopened eventually without religious sponsors.

Ideas About the Causes of the Plague (1665)

• The weird planetary alignment between Jupiter and Saturn, and the spreading of comets motion was similar to the spread of the plague
• God sent the plague to remove human wickedness.
• Spread from person to person contact, so they would quarantine infected people.
• Miasma, created by stinking rubbish, dung hills, and vapor absorbed into soil, caused the spread in warm weather..

Treatments for the Plague (1665)

• A transference of the disease: involved strapping a live chicken to buboes.
• Patients were wrapped in thick woolen clothes and placed by a fire to sweat out the diseases.
• People would lance the Bubos to let the pass out. Quacks made herbal rememdies for treatments but were seen as doctors with no training,
• They had plasters to ease the plain along with plague water, which was an herbal remedy using both native herbs and new ingredients for apothecaries.

Preventative Measured Used in the Plague (1665)

• Wear charms and crossings, and write certain words to fortify your bodies against the plague
• Prayer and repentance.
• Carry a pomander, which is a ball containing perfume substances.
• Special diets were set to avoid catching the disease along side fasting. .
• Infection quarantine will take place over 40 days.
• Public meetings, street entertainment and large funerals were banned in this time.
• Streets were cleaned and fires were set to try and drive away miasma.
• Quick removal of dead bodies.
• Doctors wore special costumes with beaks that contained sweet herbs in side to avoid miasma.

Similarities and Differences Between the Black Death (1348) and the Great Plague (1665)

• Punishment in the spread with signs of prayers and charms with both planets having weird alignment for each.
• 1348 had punishments mainly set for sinning, along side the concept of self flagellation.
• Living the life of Healthy and balancing each humans. 1665 had bird like doctor costumes with deaths mainly focus on miasma.

Great Plague Developments in Medicine (Renaissance).

• Limited progress, largely due to changes in the idea about disease which makes treatments mostly the same because discoveries from that period did not reach everybody.

Renaissance Period progress in medicine.

• The new ideas encourages science and people to challenge the new ideas.
• Printing press has allowed new technology and ideas to spread fast.
• Vesalius and Harvey were the lead to encourage understanding with detail of the anatomy which has allowed to slowly encourage Galen to step a side.
• However the new ideas never had changed because other discoveries by Harvey and Vesalius has not helped with medicine practice, along side the church still holding power.