(thing) by Lorinthean Sat Jul 17 2004 at 22:37:46

In the Middle Ages, 500-1000 A.D., before it was legal to dissect corpses, doctors had to use logic and guesswork to figure out how the human body worked. Doctors in the Middle Ages had to use speculation to cure patients. They created detailed texts about their discoveries that were studied in the medical universities. The physicians collected data about how the body looked, the response of the patient’s body to their techniques, the after-effects of the techniques, and the indications of different diseases. Their attempts to heal wounds, to mend broken limbs, and to assist in childbirth provided information, which aided doctors in learning about human body structure. Although the Medieval doctors speculated about the human body, they also used what knowledge they had gained from their medical practices, developing an approach to medicine that included theory and practical experience.

Bookworms

One of the most famous medical bookworms was Galen of Pergamon. He lived between 129-199 A.D. and, although he didn't live during the Dark Ages, he greatly influenced the medieval medicine that was practiced during the Dark Ages. He was one of the people who used speculation and estimation to fix the body's problems. One of his accomplishments was the Ars Magnus. This is a famous medical book (published first around 150 A.D.), which held many of Galen's ideas about how the human body functioned. I'll briefly describe the contents of this book, but please try to hold on your laughter at how ridiculous some of these ideas are now seem. 1

Dr. Galen's Speculations 2

Galen speculated that the brain generated vital spirits, which were essential to moving the arms and other appendages. The vital spirits traveled through nerves to the muscles to activate them in the desired movement. Galen had many ideas about the origin of disease. He thought that disease was caused by an unbalance of the four fluids of the body phlegm, blood, choler, and black bile. Disease could be a punishment for a person's sins, the diseased could be possessed by the devil, or the person could be practicing or infected by witchcraft. The Ars Magnus also covers blood circulation, saying that the blood starts in the liver, goes through veins to all the organs, and ends up in the right ventricle of the heart. The blood goes from the heart through two main arteries to the lungs and the other side of the heart. The blood ends up in the liver again. The Ars Magnus has some comical explanation about the stomach. Apparently, the stomach is a pot in which the food is cooked, and if there is too much food in the stomach, then it boils over and leaves the food uncooked. The heat for the stomach is provided by the liver, and the food from the stomach goes to the liver to be turned into blood.

Rationalists

Confused Quacks

Prior to Galen's time, monks served as doctors and composed texts of medical practice, but in 1130 the Council of Clermont passed a law, which made it illegal for monks to practice medicine. As a result of this, the role of "doctor" was placed in the hands of barbers and the secular clergy. It was up to them to cure the peoples' diseases as best they could.

Although doctors were very powerful, they did have some limitations. Doctors did not attend childbirth (that was the work of the midwives). Barber-surgeons also acted as early dentists. During the Middle Ages, physicians were also known as "leeches", because they would come and cure your disease, but then they would make you pay as much as they possibly thought they could get out of you, using all methods necessary. The main reason why the doctors were able to set their prices so high was that there were very few educated doctors, so their services were in great demand.

In order to heal the diseased, the doctor had several tools at his disposal. He could use: cauterization, diet, medical drugs and herbs, and surgery. Cauterization uses heat to destroy any abnormal cells and to seal off the flesh from other diseases. Diet controlled the foods the patient ate, in order to provide him with proper nutrition according to a variety of real and imaginary criteria. Surgery was a very dangerous operation in the Dark Ages. Since the doctors didn't know about germs, they used the same dirty, rusted blade on many patients with just a quick wash between surgeries. Anesthetics in the Dark Ages were based primarily on opium,which sometimes didn't last throughout the operation. When it didn't, the surgeons were advised to just keep on cutting. Another danger was that the doctors used tourniquets to cut off blood flow. It is now known that tourniquets often actually hurt the patient rather than help them.

A plague on both your houses

There were two main diseases during the Dark Ages, Leprosy and The Black Death. These two ravaged the cities, and infected much of the populace.

Leprosy increased greatly after the 6th century. As there were more and more lepers, the need for order increased. Although usually there was peace between lepers and townsfolk, there were sometimes riots and hangings. So to quarantine the disease and to separate the lepers from the townsfolk, they set up leper colonies, where lepers went to live away from the townsfolk. After a leper went to a colony they were considered dead. There was a small ceremony for a leper going to a colony, someone in the clergy would wash them, then they would be carried on a platform through the streets and to the entrance of the colony. The lepers had rules for their behavior:

  • They had to stand downwind from a person they were talking to

  • If they went out they had to wear clothes that covered all of their body

  • They could not bath either themselves or their possessions in a stream

  • They couldn't go into any crowded area

  • A person had to speak to them first before they could speak to anyone.

The symptoms of leprosy are loss of body hair, muscular weakness, lesions on the skin which have a decreased sense of touch and haven't healed after weeks or months, and a loss of sensitivity of the skin. The latter leads to the loss of appendages over longer spans of time, as loss of sensitivity in nerve endings causes the skin to degrade and rot away without the infected person realizing it.

The Black Death first struck in 1347 killing 25,000,000 people between 1347 and 1351 (about one-third of the European population). Most people who caught the death died within three to four days, but if someone lasted the whole week they would experience aches and chills, swelling under the arm and/or in the groin, internal hemorrhaging, and collapse of the nervous system. Because this event was so catastrophic, people started to point fingers in a variety of directions. Some thought that the Jews had poisoned the water, others thought that corrupt vapors were infecting peoples' bodies. The more frightful and violent religious groups, the Flagellants, described the Bubonic Plague as Judgement Day. On the other hand, the clergy explained it as a punishment for sins and a call for redemption, which was a lighter and forgiving explination. They were all wrong, as the real cause was a bacteria called Pasteurella pestis.

With these symptoms and list of suggested causes, the physicians went to work on finding a cure. They suggested that people stay away from dark and damp areas, improve (or indulge in) personal hygiene, and follow a diet of onions, pomegranates, lemon juices, eggs with vinegar, lentils, indian peas, pumpkin seeds. They also suggested that people burn scented wood. Either because these cures weren't working or because the governments had become panicked and decided to take action, cities quarantined the infected people for at first 14 days, then 30 days, and then finally 40 days. Most trading cities closed their ports to any suspicious-looking people, vehicles and ships. To keep the disease from getting out of the ground, graves for the dead had to be at least five feet deep.

Leprosy and The Black Death (the bacteria causing it are now called Yersinia Pestis)are still around in the world (there are about 7,000 identified leprosy cases and ten to twenty cases of Black Death, per year, in the US alone), but for the most part the diseases are non-existent. Not only are the number of cases small, but modern doctors also have cures for both diseases.

Some other important medical issues of the day were smallpox, cataracts, epilepsy, and dancing mania. Smallpox was as deadly a killer back then as it was in more recent times. Cataracts cause blindness when a layer of dead cells that are caught in a capsule form over the eye lens. It was very common then as it is now and, although there was an operation process, it usually turned out worse for the patient than before. Epilepsy is a disease of the nervous system. The primarily known symptom is seizures that are caused when the normal "barriers" to electrical nerve activity collapse causing electrical surges throughout the brain and send nerve signals to many or all of the nerve endings. This causes the patient to have spastic and jerky movements. These effects are the symptoms of a seizure. Julius Caesar was an epileptic and was unable to control his bowels. This guy was pretty messed up by the age of 50. Of course the doctors of the Medieval time did not know this information. They thought that a person with epilepsy was possessed by demons and if a person observed an epileptic during a seizure, they would "catch" the disease. Epileptics were feared and ignored within the Medieval society. Doctors tried to cure this disease, not only through classic medicine, but they also tried sorcery.

Dancing mania was a very intriguing disease, of great concern to medieval doctors. It was caused by the consumption of the ergot fungus, which caused the patient to spontaneously stand up and start wildly dancing. No one in the time period knew what caused the disease though they speculated that it was either witchcraft or possession by demons. The thing that gives me the BIGGEST willies is that, as they were dancing they would start screaming about devils and rivers of blood. After a while, they would fall down and wrap cloth tightly around their waists, to try and stop the pain.

Fixer-upper

Herbs and drugs were the primary methods of healing. The herbs of the time were made from many ingredients, which were very carefully collected and accurately prepared. Medieval doctors created the recipes for these medicines through rationale and experimentation, but superstition also influenced the ingredients greatly.

One important superstition included the relations between constellations and the major parts of the human body.

If a doctor wanted to cure a disease of the kidneys, the doctor would collect an herb while Libra was hovering above him in the sky. If a patient had a chest disease, like tuberculosis (though they wouldn't have called it that, more like "blood-spitting disease" or the Greek term, phthisis meaning "consumption"), the doctors would either give or suggest the patient attain a supplementary herb collected under Taurus' eyes. Some examples of ingredients mixed with these herbs were dung beetles, powered earthworms, or bat droppings.

Along with the connections between the constellations and the parts of the human body is another method of healing called humoral pathology. This relates different humors to different main body parts and conditions.

  • Blood was related to the heart and was considered hot and wet.

  • Phlegm was related to the brain and was considered cold and wet.

  • Black Bile was related to the spleen and was considered cold and dry.

  • Yellow Bile was related to the liver and was considered hot and dry.

If a doctor wanted to cure patient, they would first determine what conditions the wound was and then counter it with the opposite conditions. If a wound was considered cold and dry, then the doctor would put something hot and wet on the wound like a warm, bloody piece of ferret meat. Or if the disease had something to with blood, the doctor would just remove some of it. This seems rather easy because it is just relating opposites, but it gets more complicated. Everything is given a condition. Mornings are considered cold, midday is considered medium and night is considered hot. Foods have conditions, oranges are cold and soup is hot. So people had to be careful not to eat a cold food during the night or at midday or they would get sick or die.

Wrapping it up

Medieval doctors did a remarkably good job considering their serious miscalculations and lack of important knowledge. Without these imperative pools of knowledge (mainly because the dissection of cadavers was illegal), the doctors learned to improve their skills through different means. To gain hard knowledge, the Medieval doctors read lots of thick dusty medical books with ideas and observations of past doctors. Experimenting, they tested out different diets and ingredients on patients. If they worked they used them again, if they didn't then they speculated about why and tried to fix the problem. They used these methods in an attempt to improve their techniques.

Sources

1Although some of Galen's ideas have a logical basis, for the most part, stick to books made in the same millennium as you were born. Just as an act of precaution.

2It's actually quite curious, doctors in the Middle Ages would have one person dissecting a body (after it became legal), while the other reading and pointing out what Galen saw, even if they saw something completely different.

If any of this information is incorrect or incomplete, please tell me and I'll correct it as soon as I can.

I like it! 5 C!s