The Life of a Medieval Doctor

The Life of a Medieval Doctor

Larry Holzwarth - September 16, 2019

A physician in medieval times lived a stressful existence, contending with the diseases and illnesses of mankind. They were not solely based on physical and mental disorders. Illnesses of the day were as likely to have been caused by spiritual entities as by physical complaints. The doctor of the day had to battle with demons, witchcraft, the signs of the zodiac, other astronomical events, a vengeful God, and earthly enemies. Germs and bacteria were unknown. Viruses were beyond the knowledge and imagination of the man of medicine. Sin presented as great a cause of human illness as any other, according to the learned of the day.

The Life of a Medieval Doctor
Galen, one of the physicians of the ancient world, sits among six others. Wikimedia

Many years later, the French wit Voltaire would comment that “the art of medicine consists in amusing the patient while nature cures the disease”. The remark describes medieval medicine except that many of the medical practices were far from amusing. Torturing a patient to death was a common, though presumably unintended, practice of doctors. It was inevitable in a world in which exorcism was an accepted means of medical treatment. Here are some examples of the world of medieval medicine and the healing arts.

The Life of a Medieval Doctor
An ancient Roman fresco depicts Hippocrates, widely regarded as the founder of modern medicine. Wikimedia

1. The Hippocratic Corpus created the basis of all medicine

Hippocrates, the famed Greek physician from whom the science of medicine stemmed, was in actuality likely more than one person who assembled what is known as the Hippocratic Corpus. This includes the admonition to “Do No Harm”. Under the Hippocratic Corpus, the human body contained four “humors”. These properties reflect those of nature; fire, water, earth, and air. In the body, they are hot, cold, dry, and moist. Maintaining a natural balance of the four humors became the key to good health. Unfortunately for mere mortals, the humors were subject to influences from a wide variety of external factors, some of which a person had little control over.

The stars and planets exerted their influence over the humors of persons, thus an astrological evaluation was an important part of a physician’s evaluation of a patient. Practitioners of the Hippocratic Corpus evaluated diet as critical to the maintenance of balance among the humors, with diet inclusive of physical exercise. Hippocratic doctors were fairly advanced in the knowledge of anatomy and surgery, though not as advanced as the ancient Egyptians, as well as the preparation of certain nostrums proven effective against disorders, though in their view the medicines merely restored the proper balance of humors in the body.

The Life of a Medieval Doctor
Pagan beliefs were challenged by the Christian Church, through pagan practices yielded much more slowly. Wikimedia

2. Pagan medical practices dominated much of Europe at the beginning of the medieval period

Though the Greeks, Romans, and Egyptians all included religious practices as a part of the healing arts – the Greek god Asclepius was a physician, meditation in temples in his name would result in healing dreams – throughout Western Europe pagan practices dominated. It was from pagan beliefs that the healing properties of various roots, berries, and plants emerged, and with them the belief in the mystical powers of some vegetation. Medicine, such as it was, focused on curing illness and physical disorders, there was little interest in prevention. The onset of Christianity absorbed many of the pagan and folk traditions in Europe.

Many of the books of the Apocrypha included references to pagan and folk remedies and in particular the use of medicinal plants, as well as the nostrums which could be derived from them. Monasteries across Europe became the citadels of medical learning. Many became centers for the growing of gardens dedicated to medicinal plants, as well as distilleries for manufacturing liquors and brewing beer, both recognized for their healthful properties. The monks, being literate, were able to combine the medical knowledge of the ancient Greeks and Egyptians with the folk and pagan practices from their regions, and medicines which were dedicated to restoration of the Hippocratic humors gradually emerged across Europe.

The Life of a Medieval Doctor
Medieval monks and nuns preserved the ancient medical texts of the pagan Greeks, and translated them into Latin. Wikimedia

3. The emergence of the Christian Monks as healers and medical specialists

As Christianity took hold across formerly pagan Europe, monasteries established by the various Christian sects became the centers of scholarly study and medicine. The monks, who grew the plants, distilled the liquors, and copied and translated the ancient texts, became the leaders in medicine and the maintenance of health. Often isolated monasteries became the refuge of the residents of nearby farms and villages when illness struck, which was often. The combination of Christian belief and the emergence of philosophy led to the treatment of disease being a combination of secular and spiritual activities. Illnesses were treated with both medicinal nostrums derived from plants, and Christian prayer.

By the middle of the sixth century, ancient Greek texts which referenced the advances of the Hippocratic Corpus were translated into Latin – then the so-called universal language – and the monks also recorded advances in herbal medicines made on their own. As texts were exchanged between monasteries and abbeys herbal medicines available in isolated areas of Europe became known in others, where the necessary plants had been up to then unknown. In the European monasteries, the science of botany was born of the efforts of the monks and nuns. In the texts prepared, accurate drawings of many plants were included, as plants similar in appearance with less valued curative properties were identified and warned against.

The Life of a Medieval Doctor
Ancient Romans and Greeks like Hippocrates believed that the dispensing of medical care was a charitable duty. Wikimedia

4. Universal health care was prevalent throughout the medieval world

In the monasteries and abbeys, as well as the earliest hospitals dedicated to caring for the sick, the driving force behind the delivery of what is today called heath care was charity. In the days of the ancient Greeks and Romans clinics offering care for the sick and injured were established by local authorities, and care was offered regardless of the patient’s ability to pay. The health of the overall community was considered as paramount. The same philosophy was exhibited, though in a less charitable manner, by the removal of the highly contagious – such as lepers – into separate communities away from the general public.

The European monasteries continued the practice of offering medical care as a form of charity, in accordance with their perceived Christian duty. Two schools of thought emerged. In one, illness was a reflection of the judgment of God, and the use of medicines formed by pagan religions was heresy. In the other, which became supported by the Church by the fifth century, medicinal herbs and plants were gifts of the Creator, to be available to all and shared by all. This included those of the Islamic world, which began to be exposed to Europeans as a result of the Crusades. Medicine began to influence the evolution of the Christian church, especially in its position as to what constituted Christian charity.

The Life of a Medieval Doctor
Galen’s beliefs dominated medical thought in the early medieval period, though many were later proven wrong. Wikimedia

5. The influence of Galen both advanced and restrained the practice of medicine

Galen was a Greek surgeon and philosopher of the second century, widely considered the most advanced practitioner of the art of medicine of his day. Born into wealth, Galen was trained in anatomy and in the study of humors, and researched what became the fields of physiology, neurology, pharmacology, and many others while serving as the personal physician to several of the Emperors of Rome. During the Medieval period, Galen’s collected works were the definitive texts on human anatomy, though many of his postulations were wrong. Galen lived in a period when the dissection of a human body was forbidden, and he derived his theories on human anatomy from the dissection of animals, including pigs and monkeys.

It was Galen who connected the human soul and the human heart. He believed that the soul, the source of emotion, resided in the heart, which was red as a result. He also believed that blood transported in the veins was sourced in the liver rather than the heart. Eventually, Galen grew to believe that the soul was divided into three parts; the rational soul resided in the brain; the spiritual soul in the heart; the soul responsible for the functions of the body was to be found in the liver. Galen was also a pioneer in the practice of psychotherapy, describing the means by which a counselor could free a patient of uncontrolled passions through discussion. In Galen’s view, a successful counselor had to be a male of advanced age, free from any such passions himself. Women were too ruled by emotion to qualify in his estimation.

The Life of a Medieval Doctor
Surgical instruments of the medieval period, used by men with a limited understanding of human anatomy. Wikimedia

6. The rise of surgery during the medieval period

Galen had been a surgeon of considerable skill, and his records describing his surgical techniques were a major influence during the medieval period. His skills had been honed in caring for the emperors, as well as gladiators who had been injured in the arena. Galen developed a surgical procedure for the removal of cataracts remarkably similar to the procedure used today. He also developed and practiced brain surgery, including the removal of tumors. By the medieval period, surgeons used the surviving texts written by Galen and other practitioners from the ancient world as their guides. Surgery was thus developed based on the practices of individuals among the ancients, rather than standardized by any degree.

By the twelfth century, medical schools at universities (themselves evolved from the monasteries) began to create a more uniform study of surgery. Surgery began to be taught formally, particularly in Italy, but among medical practitioners, the surgeon was on the bottom rung of the professional ladder. The Crusades contributed to the low regard of surgeons. Surgeons traveling with the armies were tasked with declaring whether a casualty was dead, and if not, with treating their wounds. They were distinct from the barber surgeons, who performed tasks considered too mundane for the surgeon, such as bloodletting and stitching up wounds, as well as the trimming of beards and hair.

The Life of a Medieval Doctor
Galileo Galilei instructs a priest in astronomy at the University of Padua. Wikimedia

7. Surgeons grew in respect in Italy and France

Italy’s University of Padua gradually expanded its training of surgeons, including the performance of autopsies and dissections of cadavers in the twelfth and thirteenth century. It required its students to study not only anatomy, but diseases and general health. The language of medicine was Latin, meaning students needed to be well-versed in that language, and many of them also resorted to texts in the original Greek. Thus surgeons were among the most well-educated of the time. One such surgeon, who studied in both France and Italy (at Bologna) was Guy de Chauliac. The Frenchman wrote one of the most respected and widely-read texts on the practice of surgery during the thirteenth century, though there is no evidence that he ever performed surgery himself. Written in Latin it was eventually translated into other languages.

In his text, de Chauliac lamented that surgery had been transferred into the hands of “mechanics”. He insisted that those who practiced surgery must first be trained in all forms of medicine, including, “air and food and drink and the like since these are the causes of all health and illness”. De Chauliac referred to surgery as a practice of last resort when treating illness, claiming that a surgeon, “must know how to regulate diet and drugs, because without them surgery, medicine’s third tool, cannot be brought to perfection”. Guy de Chauliac was a leader in the conversion of the practice of surgery, and all medicine, from a craft to a science based on texts and training created by its practitioners.

The Life of a Medieval Doctor
Chaucer’s England restricted surgeons in the procedures they were allowed to perform, due to the danger involved. Wikimedia

8. Surgeons were limited in their practice in England by law

Despite the advances in surgical and medical training on the continent of Europe during the medieval period, surgeons were still often separate from doctors, and held in lower regard, particularly in England and the Germanic lands. Barber surgeons were far more common than trained surgeons, and they were limited, by law, to performing only specific treatments. Trained surgeons were also limited as to the treatments they could offer, because surgery was seen for what it was at the time, risky, highly-dangerous, and a last resort (other than bloodletting, amputations, and so forth). The stitching of wounds was allowed, but surgery to remove an implanted arrowhead, for example, often was not.

Surgeons were also understood to be liable for damage done. In an age when antiseptics and antibiotics were not available (nor understood), surgery was likely to result in infection, including gangrene, which inevitably killed the patient. More forward-thinking surgeons often treated wounds by dousing them with vinegar or brine, in an age where the only available painkiller was alcohol. That the same alcohol could be used to cleanse the wound was unknown to the surgeon, who likely would not have wasted it on external use anyway. Surgeons were also held in low regard for performing what was considered by many to be the barbaric practice of dissection of human cadavers, which led to the development of a new underworld career, that of the grave robber.

The Life of a Medieval Doctor
Hildegard of Binger was a philosopher, Christian saint, and leader of medical science during the medieval period. Wikimedia

9. Superstition ruled much of the medieval world

Medicine during the medieval period faced not only the enemy of disease. Superstition dominated all levels of society, in all cultures. Disease and even injury were often seen as either the just judgment of God or evil works of Satan and his minions. A leading Benedictine Abbess, Hildegard of Bingen, attributed imbalances in the bodily humors to the influence of the devil, the price of the wages of sin committed by the stricken (she also believed that the efficacy of bloodletting was dependent on the phase of the moon, and that certain precious stones contained healing powers).

As Christianity expanded across Europe it encountered pagan beliefs which it often displaced only with great difficulty. Medieval doctors in Anglo-Saxon cultures often encountered patients stricken with an illness known as elf-shot. Such victims had been shot with invisible arrows, launched by invisible elves, which caused pain in the extremities of the victim. The learned physician treated the afflicted with an application of a poultice made from the leaves of feverfew, or similar plants with arrow-shaped leaves. A sudden headache was often attributed to elf-shot, as was rheumatism and arthritis pain. The best cure was of course prevention, achieved through the carrying of a visible charm to deter the invisible elves.

The Life of a Medieval Doctor
A plant with flowers which resembled the eye was believed to have been provided by God to treat infirmities of the eyes, Wikimedia

10. The Christian view of herbalism was based on the Doctrine of Signatures

In the medieval period, Christians adapted existing herbal remedies and developed new ones of their own, following the Doctrine of Signatures. The doctrine was a Christian viewpoint which held that every infirmity which could be inflicted upon humanity had a corresponding cure, thoughtfully provided by the Creator. According to the men of learning who supported the theory plants and animals bore a signature indicating their use. The arrowhead-shaped leaves of feverfew were the signature which attested to its efficacy against the arrows launched by malignant invisible elves, for example. St. John’s Wort, with its porous leaves, was considered an effective treatment for skin ailments such as rashes.

Unfortunately, many of the plants and herbs identified by folk remedies and doctors as being effective treatments were in fact toxic, creating far worse conditions which were blamed on the original affliction, rather than the ineffective nature of the “cure”. Others did nothing, but gained the reputation for effectiveness when the condition improved as a simple act of nature. Many remain in place as alternative medicines or folk remedies. The concept of the doctrine of signatures was used in the time of Galen, though it was given its name during the seventeenth century by the German writer Jakob Brohme. It was a concept to which some continue to subscribe.

The Life of a Medieval Doctor
The four elements, humors and corresponding zodiacal signs are all illustrated in this medieval depiction. Wikimedia

11. All medicine was predicated upon the four humors of the body

The four humors corresponded to health in the human body when they were in balance. They related to the four elements (Earth, Water, Air, Fire,); the four seasons (Autumn, Winter, Spring, Summer, respectively); four organs of the body (Spleen, Lungs, Head, Gall Bladder); and four temperaments (Melancholy, Phlegmatic, Sanguine, Choleric). The humors in the body were also known as the principal fluids and were, correspondingly, Black Bile, Phlegm, Blood, and Yellow Bile. The humors were brought into perfect balance by diet and exercise, and when out of balance the physician based his diagnoses on their presence, or lack of presence. A problem with the lungs, for example, led to the coughing up of phlegm.

Fever was present, in the minds of the medieval physicians, because of too much blood in the body, and the removal of the same restored balance. Imbalances could be relieved and corrected through the use of teas brewed from the corresponding herbs and plants, or salves and plasters applied to the afflicted area of the body. Physicians of the period also prescribed prayer and penance, since the Christian belief was that sickness was a punishment from God. The use of medications and treatments without a corresponding commitment to prayer and penance was in itself considered sinful, as it was defiance of the will of God. Christian teaching influenced the development of medicine throughout the medieval period, both in the formal training in universities and hospitals and in the practice of folk remedies and cures.

The Life of a Medieval Doctor
A physician bleeds a patient while another examines his urine. Wikimedia

12. Cleansing the system to restore the balance of humors was a medical technique

Bleeding was just one method of tormenting a patient practiced by medieval doctors, with others applied as they were needed to ensure the ill were restored to balance. Sweating was another. Sweating was accomplished in a variety of ways, all of which were intended to cure regardless of the temporary discomfort they caused. One was through the repeated application of hot clothes. Another was simply building up the fire while bundling the patient in as many applications of clothes and blankets which happened to be available. Those fortunate enough to have a large tub on hand were immersed in hot water for as long as was necessary.

Purging the body of the excessive fluids which caused the imbalance was also achieved through inducing vomiting, or through ingestion of laxatives, or both. Patients deemed by their physician as too weak to endure bleeding from a vein were often treated by the application of leeches. Wine was often administered to the patient following any of the treatments, valued for its medicinal properties which were often immediately evident as indicated by the change in the patient’s mood. The application of various medicines was made as determined by the doctor present, sometimes prepared by him at the time, and sometimes obtained from the local apothecary or monastery.

The Life of a Medieval Doctor
A medieval physician at the bedside of a patient. Wikimedia

13. Wounds were a common problem encountered by medieval doctors

Wounds in the medieval period were common, and in the absence of antibiotics, with no knowledge of the causes of infection, were as likely to be fatal as not. Even an infected tooth, also relatively common, could easily be fatal. Although doctors understood the need to clean wounds before bandaging them to prevent further loss of blood, neither the bandages nor the doctor’s hands were likely to be clean. Soap was rare. Vinegar was often used as a cleansing agent for wounds, in the belief that it would help the wound heal more quickly. If there was no vinegar available brine might be substituted. Myrrh, rare and expensive, was another agent used to clean wounds, but only the wounds of the wealthy.

Yarrow, a group of common flowering plants, was used in Greek legends to treat the wounds of soldiers serving with Achilles, (hence the name Achillea for some varieties) and was often resorted to by medieval doctors for the same purpose. Regardless of how any wound was treated, healing was a hit-and-miss proposition. The overwhelming majority of wounds never saw the ministrations of a physician at all, and were instead treated, as they are today, by the sufferer on his or her own, applying whatever remedy was on hand and deemed suitable, and going on about their business.

The Life of a Medieval Doctor
A barber surgeon providing treatment for a foot disorder. Wikimedia

14. The hierarchy of the medical profession took form in medieval Europe

Physicians were considered to be at the pinnacle of the medical profession, as were, during the medieval period. They were educated, often from the upper classes of society (nobody else could afford an education), and were for the most part hard to find. From their lofty pinnacle, they looked down upon the surgeons, barber-surgeons, barbers, and apothecaries who made up the rest of what a later day would call the health care system. There were no nurses, other than monks and nuns, and midwives were considered to be servants rather than medical practitioners. At the bottom of the medical profession was its most common and often resorted to practitioner, the local wise woman.

Resembling the modern conception of a medieval witch, the local wise woman usually lived alone, either widowed or a spinster, and was wise in the ways of folk medicine and pagan cures. It was she who prepared many of the herbal salves and balms, teas and powders, used to treat those in her neighborhood who became ill. Less concerned with the learned concept of humors and more so with results, she was usually consulted by those without resort to a monastery or the funds to visit a doctor. She was also the one called to the home of the sick when infectious diseases reared their feared heads, sometimes helping to spread the contagion from home to home, albeit unwittingly.

The Life of a Medieval Doctor
An anatomy lecture does not take into account the personal hygiene common during the medieval period. Wikimedia

15. Medieval doctors were challenged by the lack of personal hygiene

Depending upon where one stood in terms of personal wealth, hygiene was a hit-or-miss affair in the medieval period, though it improved over time. People did wash, though not frequently, and most were aware of the need for cleaning their teeth, though the tools to do so efficiently were rare. Affluence and cleanliness went hand in hand, the presence of the latter descending with that of the former. Dental care, when confronted with a toothache, consisted of removing the offending tooth, a task that barber-surgeons were authorized to perform, but which was frequently done at home, without any form of anesthetic.

Erasmus, who lived in the late fifteenth to early sixteenth centuries, pointed out the threat to health presented by the habit in Europe’s northern regions and in England, of covering floors with straw and rushes. Though the straw was occasionally replaced by assiduous housekeepers, it was never completely so, and decades’ worth of detritus and debris was trapped in what remained, contributing to the less-than-healthy air in homes, as well as harboring fleas, ticks, lice, and other vermin. But the greatest threat to public health was the disposal of waste, including human waste, which was haphazard and for the most part unregulated, permeating water supplies and spreading disease in proportion to the population density of the region in which it was created.

The Life of a Medieval Doctor
An Arab doctor treats a patient – likely cauterizing a head wound – during the medieval period. Wikimedia

16. An examination by a doctor was a standardized practice

Those who could afford to be visited by a physician did not as a rule go to him. Instead, they sent a servant to bring the doctor. Nor was a doctor’s visit called for unless one was sick or injured. There were no routine physical examinations. Doctors were, in essence, repairmen sent for when the body was not working correctly. Doctors seldom asked questions directly of the patient, though peppering the servant with queries about the exhibited symptoms while traveling to his bedside was an accepted means of arriving at an early hypothesis, which also helped him maintain his air of wisdom once in the patient’s company.

Measuring the pulse and checking for fever were routine (pulse was often measured for heart rate using a minute glass) as were checking for skin eruptions or other visible signs. Medieval doctors took great care to examine a patient’s urine, it being a bodily fluid more readily obtained than most. Urine was examined for color, smell, and even taste. The doctor might have called for a barber-surgeon to bleed the patient, or he may have performed the operation himself. On the basis of his examination (and the information earlier extracted from the servant) he would pronounce his diagnosis and the care to be administered. In medieval times the presence of a doctor was often viewed as a harbinger of death, and preparations for mourning often began while the doctor was still present.

The Life of a Medieval Doctor
Although medieval doctors are often viewed as incompetent – as in here examining urine – they made advances in the treatment of burns still used, Wikimedia

17. Medieval doctors made advances in the treatment of burns

Burns were a common form of injury in medieval times, understandably given the open-hearth fires and the use of flame as a source of light. Flames and heated items were also weapons of war, flaming arrows were dispatched in the general direction of an enemy by archers, and bundles of burning faggots were tossed by catapults. Boiling water and oil were also used as weapons, and burn injuries from boiling pots and cauldrons were common in the home. Medieval doctors practiced advanced techniques in the treatment of burns, concentrating on preventing the injured area from becoming dry. Severe burns, those later called third-degree, were likely to be fatal. But lesser burns were successfully treated as often as not.

Doctors took steps to prevent the burn from blistering, keeping it moist by the application of salves and ointments prepared in advance for the purpose and kept in sealed jars. Using vinegar as a base, the salves included oils extracted from several herbs, as well as opium, oil of roses, and eggs used as a thickening agent. The ointment was applied and reapplied as necessary to keep the injured area from drying out and blisters arising on the skin. The treatment of burns was an early example of lessons learned by surgeons on the battlefield being applied to civilian medical practice, and one of the more successful developments of medicine during the medieval period.

The Life of a Medieval Doctor
Amputations were believed to save lives and their performance was high art in the minds of medieval surgeons. Wikimedia

18. Medieval surgeons made the practice of amputation an art form

Injured limbs, whether damaged by act of war or through an accident, often led to amputations as the surest way of ensuring the survival of the patient. Though some simple fractures could be set and allowed to heal over time with the support of splints, compound fractures could not, and the loss of the limb was all but certain. During the medieval period, surgeons traveling with contending armies considered speed to be the most important factor in performing amputations. The speed was not simply a point of personal pride, allowing bragging rights for the fastest. It was the factor which assured the best possible outcome for the patient, reducing both shock from pain and from loss of blood.

By the middle of the medieval period, a competent surgeon could complete the amputation of a leg in less than five minutes from the time he made his initial surgical cut. The leg itself was removed in less than a minute, the remaining time was required to control the bleeding. Cauterization became the means of stopping the bleeding, but medieval surgeons also restored the practice of using ligatures on blood vessels in some instances, which had been practiced by the ancient Greeks. Medieval surgeons also developed casts for broken limbs for those fortunate enough to not lose them. Made from a mixture of flour and eggs, the casts hardened enough to keep a broken leg set, though not enough to bear the weight of the person.

The Life of a Medieval Doctor
The influence of physicians from the Islamic world forever changed medicine – and philosophy – of Western Europe. Wikimedia

19. The knowledge of the Arab world was shared through the crusades

Medical knowledge from the Islamic world filtered its way into the Christian societies of Europe, carried back from the Arab lands by the soldiers and pilgrims of the Crusades. It was substantial. Geoffrey Chaucer cited Arab physicians in his prologue to the Canterbury Tales. Many of the texts written by ancient Greeks were first encountered in Arabic translations, and the Islamic physicians expanded upon them, especially in areas such as anatomy. In the ancient Arab world, mosques served as centers where learning and the sharing of acquired knowledge was essential part of culture. Through the eighth century, Islamic thought included the belief that the cure for all human ailments had been provided by God.

In the early tenth century, a Persian physician, Muhammad ibn Zakariya al-Razi, developed what became the medical discipline of pediatrics, producing The Diseases of Children. He was the first physician to determine that fever was in fact a defense of the body against infection. He was also the first known to have written on the subject of immunology. The works of al-Razi and other Islamic physicians were influential in the training of physicians in Europe by the thirteenth century, though their work had little impact on the barber-surgeons and apothecaries who by and large treated the general public.

The Life of a Medieval Doctor
Avicenna was the first to propose the scientific evaluation of pharmaceuticals by medical professionals. Wikimedia

20. Islamic physicians influenced the manner in which medicines were created

It was another Islamic physician and philosopher, Abu al-Husayn ibn Sina, whose name was Latinized in Europe to Avicenna, who wrote the Canon of Medicine during the medieval period. Enormously influential, the Canon included within its pages recommendations concerning the preparation and testing of medicines. Avicenna argued that all medicines should be as pure as possible, unadulterated with any ingredients which could cause harm or otherwise detract from its quality. It was Avicenna who first proposed what would at a later date be known as clinical trials for drugs, insisting that all new medicines be tested against more than one disease, since their efficacy could vary from one disease to another.

Islamic physicians were restricted by religious beliefs from dissection of human bodies, conducting for the most part research in anatomy on animals. Nonetheless, it was an Islamic physician, known as al-Nafis, who accurately described the circulation of blood in the human body, through the chambers of the heart, and through the lungs. In his description, he contradicted Galen and European physicians who followed his theories, including the belief that blood was created in and flowed from the liver. Islamic medical knowledge entered European thought when the texts were translated into Latin, beginning in Spain, and gradually displaced much of what had been derived from the ancient Greeks.

The Life of a Medieval Doctor
A comprehensive knowledge of astrology was a prerequisite for a doctor in the medieval world. Wikimedia

21. Medieval medicine included the practice of astrology

The signs of the zodiac were a major influence on medieval medicine, in all its forms, including folk medicine, pagan beliefs, and the education of physicians in formal schools. The signs of the zodiac were displayed in medical texts throughout the medieval world, corresponding to both the humors believed to be the basis of health and the parts of the body. The planets and other celestial bodies were also associated with parts of the body, with the sun associated with the heart; Mars with the arteries (as well as the nails and hair); Venus with the kidneys and digestion, and so on. Their influence was reflected in many ways, including the scheduling of treatments and surgeries, the planting and harvesting of medicinal plants, the manufacturing of medicines, and the administration of them.

The signs of the zodiac influenced a physician’s diagnosis, based on which sign the moon was in when symptoms first occurred. Aries (the first sign of the zodiac calendar) corresponded to the head and face; Pisces (the last) to the feet, with the rest of the signs corresponding to parts of the body in between. A physician noting the moon was in Gemini when a patient developed coughing symptoms would be likely to diagnose an illness of the lungs, though a moon in Taurus could direct him to consider a problem of the throat. Diagnosis was not based on astrology alone, but it was a major consideration for physicians when evaluating their patients throughout the medieval period.

The Life of a Medieval Doctor
Boring a hole in the skull to allow evil spirits to depart was an accepted medical technique. Wikimedia

22. The treatment of mental disorders was dominated by religious thought

Mental disorders were for the most part regarded in the medieval world as visitations from Satan or one of his many servants. They entered the body through the intercession of witches, warlocks, demons, imps, evil spirits and fairies, or even Satan himself. Many physicians of the medieval period were also priests of the church, or monks, and fought mental disorders by fighting the evil which created them. The only recognized spiritual cure came through prayer, incantations, or outright exorcisms. Lay physicians recognized that there could be other causes for mental disorders, related to the brain, and developed a treatment to release the problem which was, in their minds, also caused by an imbalance of the bodily humors.

Besides the medically accepted methods of rebalancing the humors, including bleeding, purging, and application of laxatives, surgeons developed a procedure to open the skull to allow the evil spirits within to exit the body. Known as trepanning, a hole was bored in the head, a procedure often prescribed for the treatment of epileptic fits and other convulsions or tremors. Women were adjudged to be much more prone to all forms of mental disorders, due to the menstrual cycle disrupting the balance of humors. Other physicians, particularly those who subscribed to the theories of Galen, linked mental disorders to malfunctioning organs, especially the heart, spleen, and liver.

The Life of a Medieval Doctor
A medieval visitor to the dentist could be sure of one thing – pain. Wikimedia

23. Dentistry emerged in the late medieval period

As with other medical intervention during the medieval period, dentistry was for the most part restricted to a response to existing problems rather than preventive treatment. Islamic physicians developed methods of responding to problems with the teeth, including the filing away of decay and filling the cavity. These procedures made their way to Europe, where they were available only to the wealthy, and only to those in the largest communities. Despite the existence of various means of cleaning teeth toothache was a common problem, as was the loss of teeth. By the fourteenth century false teeth, again available only to the rich, were fairly common.

Those without the resources to visit one of the professionals which became known as dentatores visited a barber-surgeon to have troublesome teeth pulled, or they simply let them rot away. Charms and potions were used against the pain of toothache, with results which can be imagined. Driving a nail upon which the words agla Sabaoth athanatos were inscribed into a tree was a Welsh cure for toothache (it had to be an oak tree) and one could cure the tooth pain of another by carving the victim’s name into the tree. Various gargles were known as well, used both to clean the teeth and ease pain. Many relied on wine as the main ingredient.

The Life of a Medieval Doctor
By the 13th century a man needed a license to call himself a doctor but not necessarily to treat patients. Wikimedia

24. Medical licensing began in medieval Europe

Licensed physicians emerged in medieval Europe, with different requirements of education and training based on location. Montpellier, in southern France, was the site of the great medical institutions by the fourteenth century; Bologna and Padua dominated in the Italian provinces. Through most of the medieval period, the University of Bologna was the only institution to award degrees in surgery. Most of the medical universities required their students to obtain a Master of Arts degree prior to undertaking medical training, and as has been seen, a comprehensive knowledge of Latin and Greek was necessary. At Montpellier, a student with a Masters of Arts degree undertook five years of medical study, followed by eight months of practice under supervision before obtaining a license as a physician.

The University of Bologna exemplified the importance of astrology to medical education, requiring its students to complete three years of study of the stars and planets, and four years of medical study. Another three years of the study of philosophy was required. Of course, throughout Europe, one could simply claim to be a doctor and practice, though it was necessary to either bribe or avoid the local authorities.

The Life of a Medieval Doctor
Medieval doctors, like all doctors throughout history, did what they could despite the limits of prevalent knowledge. Wikimedia

25. The use of mercury as a medicine was widespread

Near the end of the fifteenth century, the disease of syphilis was widespread in Europe, and printed materials describing its ravages indicate that it was one of the most dreaded diseases of the time. It was known as the Great Pox, though the English often referred to it as the French Disease, or the French Pox. With no antibiotics to treat it, physicians relied on mercury. Some physicians recognized the fact that mercury was toxic, unsuitable for oral consumption, and prescribed it in the form of an ointment, including Paracelsus in the late fifteenth century. Ointments containing mercury were prescribed for a wide variety of skin diseases as well, steadily poisoning the patient.

Mercury was believed to alleviate an imbalance of the four humors, particularly effective against bile, and thus its use was indicated to the learned physicians of the time. Besides being prescribed for syphilis, it was used to treat skin disorders, melancholia, constipation, parasites both internal and external, and even influenza. It continued to be used in the preparation known as calomel for centuries. As with all diseases, the presence of syphilis indicated an imbalance of the humors to a trained physician, a judgment of a wrathful but just God to moralists, and a painful and costly episode to the patient. The cure was often worse than the disease.


Where do we find this stuff? Here are our sources:

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