Medicine in the Middle Ages AD 500–1400 The History of Medicine This icon indicates the slide contains activities created in Flash. These activities are not editable. For more detailed instructions, see the Getting Started presentation.

The fall of the Roman Empire The Roman Empire grew until it could no longer control its borders successfully. Barbarian tribes overran the western parts of the empire, and by AD 500 Europe consisted of many small, feuding tribal kingdoms. These kingdoms were often at war with each other. What effects do you think these wars had on the benefits that the Roman Empire had brought?

libraries and medical books were destroyed. The wars meant that many of the Roman developments were lost. Roman buildings, public health systems, libraries and medical books were destroyed. It was now dangerous to travel, so communications were limited, and there were far fewer opportunities for doctors to learn or train.

war communications education Can you explain how the factors of war, communications and education might have affected the progress of medicine at this time?

SOURCE A A zodiac chart. If the surgeons needed to operate, they would use a zodiac chart to find a safe date. Q1a. What can you learn from Source A about approaches to surgery in the Middle Ages? (4 marks)

Britain in the Dark Ages After the Romans left Britain in AD 410, society went back to its pre-Roman, uncultured ways. The next 500 years were known as the Dark Ages. During this time Britain experienced many invasions by different peoples, including the Saxons and Vikings. Some invaders took what they wanted and destroyed things they didn’t; many settled in Britain. What medical progress or regress would you expect to have seen at this time?

Norman Britain In 1066 the Normans invaded Britain. This period, the Middle Ages, brought some improvements to public health, travel became safer and trade increased. For the wealthy in society, such as lords and barons, living standards improved with stone-built castles and manor houses. For the majority, the peasants, however, home was usually a small house consisting of one room for the whole family. Inside it was dark, smoke-filled and damp. Peasants worked from dawn till dusk, usually in the fields, in all weathers. What effect do you think living conditions had on the health of the rich and the poor?

Religion and medicine in the Middle Ages After the Norman conquest the church also became wealthier and stronger all over Europe. The medieval church was a very powerful force during this time, and had a huge impact on the development of medicine. On the next slide you will learn about the main ways religion affected medicine during this period. Decide whether the church helped or hindered medical development in each case.

The church and medicine

How were people treated for illnesses? Do you think that all these types of treatments were available to all types of people?

Supernatural or natural?

How effective was herbal medicine? Many ordinary people were treated at home by their wife or mother. Doctors were very expensive, and herbal remedies handed down from mother to daughter were probably as effective as any treatment. Herbs have been used in healthcare throughout the history of medicine. As communications improved, new plants were discovered, and the range of herbal remedies expanded. In the Middle Ages, herbal remedies continued to be used and gradually became more effective. For herbs to have been used for so long, it is likely that they had some positive effects. We now know that about 50% of ancient herbal cures were effective, although those using them would not have understood why.

Herbal remedies – effective or not?

Hospitals provided a place where the sick could be cared for. Medical progress in the Middle Ages Although it may seem as if there was little medical progress during this period of history, there were some important developments. Hospitals provided a place where the sick could be cared for. Urine was analysed for the first time, an aid to diagnosis still used by doctors today. The establishment of schools for doctors improved the quality of medical care. Medical developments Wine was used as an antiseptic and drugs were used to numb pain in surgery.

The Black Death In 1348–49 Britain faced the worst crisis in its history. A deadly disease, originating in Asia, arrived from Europe. This disease was the bubonic plague. The symptoms were a fever, headache, tiredness and painful swellings (buboes) the size of apples in the groin and armpits. Small, oozing red and black spots appeared all over the body, giving the disease the name the Black Death. Many patients only lasted a few days before a painful death. Nearly 40% of the English population died.

What was believed to cause the Black Death? It was not until 1894 that it was discovered that the bubonic plague was caused by germs, carried by the fleas which live on black rats. Back in 1349 people had very different ideas about the cause of the disease. Look at the list of the causes people believed in on the next slide. Which beliefs have we seen already in prehistoric medicine? Which beliefs are new? Why do you think no one suspected the fleas?

What did people believe caused the Black Death? Breathing bad air (miasma) – medieval towns were very smelly and the smell was supposed to contain diseases. Annoying God – the plague was his punishment. Looking at a victim – the disease was spread by eye contact. Touching a victim. What did people believe caused the Black Death? The position of the planets – the relationship of the planets and the movement of the Sun affected health. Drinking from poisoned wells – Germans believed the Jews were poisoning drinking water to kill off non-Jews. An imbalance of the body’s four humours – Galen can’t be wrong!

How did people try to prevent or cure the Plague? On the next slide you will see some of the treatments people at the time tried to prevent or cure the Plague. What do the ideas on causes and treatments tell us about medieval people's medical knowledge?

Strap a live chicken (shaved) to the Plague sore. Eat arsenic powder. Kill all the dogs and cats in town. Run for the hills. Sit in a sewer – the bad air of the Plague will be driven away by the worse air of the drains. Drink 10-year-old treacle. How to prevent the Black Death Go from town to town flogging yourself with a whip. Let the blood out of the patient. Put herbs on the fire to make the air smell sweet. Eat crushed emeralds.

The effect of Arab medicine on the West The Dark Ages might have been a time of chaos for Europe, but further east a new, Islamic civilization was developing ancient Greek medical ideas. The Arabs admired the writings of Hippocrates and Galen. Medical students studied them carefully. New discoveries were made, some of which challenged Galen’s ideas.

The Muslims believed, however, that the Koran, their holy book, held all the knowledge needed and did not encourage the search for new discoveries. The Koran taught them to look after the sick, and many large hospitals were built. However, criticizing Galen was allowed, and so many new discoveries were made in the Arabian empire, more than were made in Europe at the time. When Europeans went on crusades to the Holy Land in the 12th and 13th centuries, their doctors gained first-hand knowledge of Arab medicine, which was advanced by Western standards.