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Flashcards in Medicine stands still 1000-1500 Deck (21):

Who treated the sick?

Barber surgeons in towns (bloodletting & amputations; minor operations), wise women in villages (herbal remedies), monks in monasteries (herbs, prayer and rest), trained doctors (very expensive, used ideas of Hippocrates & Galen)


What were the different types of treatments offered by doctors?

Clinical observation (pulse & urine), balancing four humours; some also checked the position of stars or recommended praying


What were the key obstacles to medical progress during this period?

Doctors lacked scientific knowledge to explain the causes of disease & medical training involved reading Church-approved texts such as Galen


Explain the influence of Hippocrates on diagnosis and treatment

Hippocrates (460-370BC) emphasizes the importance of clinical observation; his Theory of the Four Humours and the need to balance them dominated medical thinking up to 1800. Bleeding was a very common practice to prevent or treat illness.


What were the Four Humours?

Blood, phlegm, black bile and yellow bile; when someone became ill, doctors thought these humours were out of balance


Explain the influence of Galen on training and treatment

Galen dissected animals to improve knowledge of human anatomy since he believed in design theory (that God designed humans), the Church banned people from questioning his work. His work in a gladiator school allowed him to develop his techniques. He used the Four Humours theory and stressed the importance of listening to a patient's pulse.


Explain the influence of the Church on medicine

The Church taught that illness was sent as a punishment by God for sinful behaviour; the Church also controlled
universities where doctors studied (with a clear focus on
Hippocrates and Galen); finally it banned human dissection, thereby restricting knowledge of anatomy. It also recommended pilgrimages to visit shrines containing the relics of saints where hopefully miracle cures could be gained. The Church arrested one 13C monk, Roger Bacon, for suggesting that doctors should do original research and not trust old books. Yet it also ensured over 700 hospitals were set up between 1000 and 1500.


Explain the function of hospitals in the Middle Ages

Hospitals were mainly a place for people to rest and recover; many were linked to monasteries. Monks provided nursing care (helped by the often better sanitation) and offered herbal treatments, grown in their physic gardens.


Explain how Islamic medicine was more advanced than the West

Islamic doctors wrote medical texts which spread to Britain via crusaders / trade. Avicenna wrote the Canon of Medicine which remained an important text for medical students until the 1700s — in this were listed the medical properties of 760 different drugs. Islamic hospitals also treated patients and trained doctors, and were not just places for caring for them as in the West.


Describe some typical medieval surgical procedures

Bloodletting, amputation, trepanning (drilling a hole into the skull for epilepsy, severe headaches or possession by an evil spirit), cauterization (burning a wound to stop the flow of blood using a hot iron). Anaesthetics involved mandrake root, opium and hemlock, although too much could kill a patient.


Who was John of Arderne?

The most famous medieval surgeon in England who
established the Guild of Surgeons in 1368. His surgical manual was based on Greek and Arab knowledge and his experience of warfare. He specialized in operations for anal abscesses, a condition common in knights who spent long periods on horseback. He developed a painkilling ointment made from hemlock and opium —this helped healing and stopped the need for cauterizing wounds. He urged doctors to trust their
own judgement and not to rely on old texts.


Explain how warfare helped surgeons to improve their skills

Continuous fighting enabled surgeons to seal wounds more effectively, carry out quicker amputations, new tools including the arrow cup (designed to remove an arrow head from the body without causing further damage), improved ointments (such as John Arderne's painkiller)


What were the main public health problems in many Medieval towns?

Most towns had poor sanitation (water supply and waste
disposal); since the cause of disease was unknown (they believed it was caused by bad air), regulations tended to be very ineffective — it was not the job of the monarch, for example, to improve public health. Streets were very dirty and cesspits could overflow into roads and rivers. Both leather tanners and butchers dumped chemicals and waste blood & guts respectively into rivers


Was there any sign of progress in this period?

Some towns such as Coventry did become proactive in
cleaning up their streets, often in response to an epidemic. In Coventry, waste disposal sites were established outside of the town, and latrines were moved away from streams. In some towns bath houses existed for those who could afford them.


Why did monasteries have superior public health systems to towns?

Fresh water supplies were considered a priority when deciding the sites of monasteries; fresh water was piped to wash rooms and sewers took away dirty water. Kitchens were built away from privies (toilets) to avoid contamination. Monks also had to bathe every month.


What caused the Black Death?

It began in Asia and traveled along trade routes, reaching England in 1348. It was a combination of bubonic plague (spread by rats and fleas) and pneumonic plague (spread by coughing and close contact)


Which ideas were put forward to explain the Black Death?

It was a punishment from God; it was caused by astrology and the alignment of the planets; it was blamed on Jewish people poisoning water supplies; it was caused by miasma.


Why did the Black Death spread so rapidly?

Dirty streets encouraged rats, and there was insufficient waste disposal. There were very few regulations and ignorance of germs and the true causes of disease was widespread.


Which prevention methods were used to avoid the Black Death?

The monarch ordered the Church to organise special services and processions asking for God's forgiveness; ordinary people prayed for forgiveness; flagellants whipped themselves to show they had repented their sins


Which treatments were used for the Black Death?

In some towns, there were orders to clean up the streets and in some towns quarantine was attempted; bleeding was used to treat some victims; other remedies included the use of herbs. Some drank mercury which was poisonous.


What was the impact of the Black Death?

In Britain at least 1.5m died between 1348 and 1350. Since there were fewer peasants, those who did survive demanded higher wages and better treatment from their lords.