medieval medicine, English

In the Middle Ages (11th–16th centuries), medicine was notoriously unsuccessful and the practice of public health and hygiene was virtually non-existent. Little was known about the anatomy of the body as human dissection was forbidden by the church, except on executed criminals where it was seen as part of the punishment; physicians followed ancient medical texts written by classical thinkers, such as Galen, whose theories were based on dissections of animals and usually incorrect. Diagnosis was based upon observation of physical symptoms, especially the patient's urine, and treatment followed the theory of the humours (four body fluids: blood, phlegm, yellow bile, and black bile). Medieval monasteries had infirmaries for the sick, but there were few hospitals in England; the earliest hospitals, St Bartholomew's (1123) and St Thomas's (around 1215), were in London.

Doctors One of the pilgrims in Chaucer's The Canterbury Tales (c. 1387) was a doctor, criticized by Chaucer for his fine clothes and his love of gold. However, he is typical of many doctors of the time, whose university training involved learning the medical and philosophical ideas of Asclepius, Hippocrates, Avicenna, and Galen. Notable medieval English doctors include John of Gaddesden (1280–1361), John of Arderne (1307–80) and John of Mirfield (died 1407). Many medieval doctors were monks. Women were not allowed to practise medicine, and in 1322 the doctors of Paris had Jacoba Felice, a successful French women doctor, excommunicated and forbade her to practise medicine.

Treatments Doctors believed that an imbalance of the four humours caused illness, and used treatments believed to be the opposite of the disease to counteract and restore the balance; for example, water cooled with snow would be prescribed to counteract a smallpox fever. Doctors would combat the ‘humours overflowing’ by bleeding, purging (giving laxatives), or giving emetics to cause vomiting. No doctor was complete without the ‘bottles, medicaments, and cordial tots’ carried by Chaucer's physician, but in addition to a range of herbal remedies, medieval medicine also involved astronomy, prayer, charms, and magic. The touch of a king was said to cure scrofula, or ‘the king's evil’, a tuberculosis of the lymph glands that caused swellings, particularly in the neck. Prayer and the sign of the cross were thought to stop toothache. Some cures – such as that which involved bathing in water in which blind puppies had been boiled to death – defy modern explanation.

Medieval medicine had a low success rate; when Pope Clement VI was ill in the 14th century, the Italian poet Petrarch wrote to remind him of the saying, ‘I died of too many physicians’. Medieval people had little idea of hygiene and no knowledge of its relation to disease. Although in 1349 King Edward III tried to have ‘the human faeces and filth that lay in the streets and lanes’ of London removed, following the outbreak of the Black Death in England the previous year (an epidemic of plague that swept through Europe in the mid-14th century), this was mainly because people believed that diseases were carried by bad smells. However, the development of lazar houses to isolate lepers helped to reduce the incidence of leprosy, even if the cause of the disease was unknown. Doctors were helpless against diseases such as the Black Death, and medieval society developed a morbid fascination with the dance of death, a common theme in late medieval art.

Surgery Medieval surgeons, known as barber-surgeons, were somewhat more successful. They had mastered practical first aid, and advertised pictures of ‘Wound Men’ showing wounds they could heal. However, their only way to prevent blood-poisoning was cauterization (sealing with a hot iron or boiling oil) and, without effective anaesthetics, medieval surgery remained very painful and usually fatal.

Further detail of background and medical developments in the Middle Ages is given in medieval medicine.