Medieval medicine - AbsoluteAstronomy.com

Medieval medicine in Western Europe

Western Europe

Western Europe is a loose term for the collection of countries in the western most region of the European continents, though this definition is context-dependent and carries cultural and political connotations. One definition describes Western Europe as a geographic entity—the region lying in the...

was composed of a mixture of existing ideas from antiquity, spiritual influences and what Claude Lévi-Strauss

Claude Lévi-Strauss

Claude Lévi-Strauss was a French anthropologist and ethnologist, and has been called, along with James George Frazer, the "father of modern anthropology"....

identifies as the "shamanistic complex" and "social consensus." In this era, there was no tradition of scientific medicine, and observations went hand-in-hand with spiritual

Spirituality

Spirituality can refer to an ultimate or an alleged immaterial reality; an inner path enabling a person to discover the essence of his/her being; or the “deepest values and meanings by which people live.” Spiritual practices, including meditation, prayer and contemplation, are intended to develop...

influences.

In the early Middle Ages

Middle Ages

The Middle Ages is a periodization of European history from the 5th century to the 15th century. The Middle Ages follows the fall of the Western Roman Empire in 476 and precedes the Early Modern Era. It is the middle period of a three-period division of Western history: Classic, Medieval and Modern...

, following the fall of the Roman Empire, standard medical knowledge was based chiefly upon surviving Greek

Ancient Greece

Ancient Greece is a civilization belonging to a period of Greek history that lasted from the Archaic period of the 8th to 6th centuries BC to the end of antiquity. Immediately following this period was the beginning of the Early Middle Ages and the Byzantine era. Included in Ancient Greece is the...

and Roman

Ancient Rome

Ancient Rome was a thriving civilization that grew on the Italian Peninsula as early as the 8th century BC. Located along the Mediterranean Sea and centered on the city of Rome, it expanded to one of the largest empires in the ancient world....

texts, preserved in monasteries and elsewhere. Ideas about the origin and cure of disease

Disease

A disease is an abnormal condition affecting the body of an organism. It is often construed to be a medical condition associated with specific symptoms and signs. It may be caused by external factors, such as infectious disease, or it may be caused by internal dysfunctions, such as autoimmune...

were not, however, purely secular, but were also based on a world view

World view

A comprehensive world view is the fundamental cognitive orientation of an individual or society encompassing the entirety of the individual or society's knowledge and point-of-view, including natural philosophy; fundamental, existential, and normative postulates; or themes, values, emotions, and...

in which factors such as destiny

Destiny

Destiny or fate refers to a predetermined course of events. It may be conceived as a predetermined future, whether in general or of an individual...

, sin

Sin

In religion, sin is the violation or deviation of an eternal divine law or standard. The term sin may also refer to the state of having committed such a violation. Christians believe the moral code of conduct is decreed by God In religion, sin (also called peccancy) is the violation or deviation...

, and astral influences

Astrology

Astrology consists of a number of belief systems which hold that there is a relationship between astronomical phenomena and events in the human world...

played as great a part as any physical cause. The efficacy of cures was similarly bound in the beliefs of patient and doctor rather than empirical evidence, so that remedia physicalia (physical remedies) were often subordinate to spiritual intervention.

Influences

As Christianity

Christianity

Christianity is a monotheistic religion based on the life and teachings of Jesus as presented in canonical gospels and other New Testament writings...

grew in influence, a tension developed under the church and folk-medicine, since much in folk medicine was magical, or mystical

Mysticism

Mysticism is the knowledge of, and especially the personal experience of, states of consciousness, i.e. levels of being, beyond normal human perception, including experience and even communion with a supreme being.-Classical origins:...

, and had its basis in sources that were not compatible with Christian faith. Spells and incantations were used in conjunction with herbs and other remedies. Such spells had to be separated from the physical remedies, or replaced with Christian prayers or devotions. Similarly, the dependence upon the power of herbs or gems needed to be explained through Christianity.

The church taught that God sometimes sent illness as a punishment, and that in these cases, repentance could lead to a recovery. This led to the practice of penance and pilgrimage as a means of curing illness. In the Middle Ages

Middle Ages

, some people did not consider medicine a profession suitable for Christians, as disease was often considered God-sent. God was considered to be the "divine physician" who sent illness or healing depending on his will. However, many monastic orders, particularly the Benedictines, considered the care of the sick as their chief work of mercy.

Medieval European medicine became more developed during the Renaissance of the 12th century

Renaissance of the 12th century

The Renaissance of the 12th century was a period of many changes at the outset of the High Middle Ages. It included social, political and economic transformations, and an intellectual revitalization of Western Europe with strong philosophical and scientific roots...

, when many medical texts both on ancient Greek medicine and on Islamic medicine

Islamic medicine

In the history of medicine, Islamic medicine, Arabic medicine or Arabian medicine refers to medicine developed in the Islamic Golden Age, and written in Arabic, the lingua franca of Islamic civilization....

were translated from Arabic

Arabic language

Arabic is a name applied to the descendants of the Classical Arabic language of the 6th century AD, used most prominently in the Quran, the Islamic Holy Book...

during the 12th century. The most influential among these texts was Avicenna

Avicenna

Abū ʿAlī al-Ḥusayn ibn ʿAbd Allāh ibn Sīnā , commonly known as Ibn Sīnā or by his Latinized name Avicenna, was a Persian polymath, who wrote almost 450 treatises on a wide range of subjects, of which around 240 have survived...

's The Canon of Medicine
The Canon of Medicine
The Canon of Medicine is an encyclopedia of Galenic medicine in five books compiled by Ibn Sīnā and completed in 1025. It presents a clear and organized summary of all the medical knowledge of the time...

, a medical encyclopedia written in circa 1030 which summarized the medicine of Greek, Indian

Ayurveda

Ayurveda or ayurvedic medicine is a system of traditional medicine native to India and a form of alternative medicine. In Sanskrit, words , meaning "longevity", and , meaning "knowledge" or "science". The earliest literature on Indian medical practice appeared during the Vedic period in India,...

and Muslim physicians up until that time. The Canon became an authoritative text in European medical education up until the early modern period

Early modern period

In history, the early modern period of modern history follows the late Middle Ages. Although the chronological limits of the period are open to debate, the timeframe spans the period after the late portion of the Middle Ages through the beginning of the Age of Revolutions...

. Other influential translated medical texts at the time included the Hippocratic Corpus

Hippocratic Corpus

The Hippocratic Corpus , or Hippocratic Collection, is a collection of around 60 early Ancient Greek medical works strongly associated with the physician Hippocrates and his teachings...

attributed to Hippocrates

Hippocrates

Hippocrates of Cos or Hippokrates of Kos was an ancient Greek physician of the Age of Pericles , and is considered one of the most outstanding figures in the history of medicine...

, Alkindus

Al-Kindi

' , known as "the Philosopher of the Arabs", was a Muslim Arab philosopher, mathematician, physician, and musician. Al-Kindi was the first of the Muslim peripatetic philosophers, and is unanimously hailed as the "father of Islamic or Arabic philosophy" for his synthesis, adaptation and promotion...

' De Gradibus
De Gradibus
De Gradibus was an Arabic book published by the Arab physician Al-Kindi . De gradibus is the Latinized name of the book. An alternative name for the book was Quia Primos....

, the Liber pantegni
Liber pantegni
The Liber pantegni is a medieval medical text compiled by Constantinus Africanus in ca. the 1080s, ascribed to Isaac Israeli ben Solomon . It is a compendium of Hellenistic and Islamic medicine, in large parts a translation of the kitab al-malaki "royal book" of Ali ibn al-Abbas...

of Haly Abbas

Ali ibn Abbas al-Majusi

Ali ibn al-'Abbas al-Majusi , also known as Masoudi, or Latinized as Haly Abbas, was a Persian physician and psychologist most famous for the Kitab al-Maliki or Complete Book of the Medical Art, his textbook on medicine and psychology.-Biography:He was born in Ahvaz, southwestern Persia, and...

and Isaac Israeli ben Solomon

Isaac Israeli ben Solomon

Isaac Israeli ben Solomon , also known as Isaac Israeli the Elder and Isaac Judaeus, was one of the foremost physicians and philosophers of his time. He is regarded as the father of medieval Jewish Neoplatonism...

, Abulcasis' Al-Tasrif
Al-Tasrif
The Kitab al-Tasrif was an Arabic encyclopedia on medicine and surgery, written near the year 1000 by Abu al-Qasim al-Zahrawi...

, and the writings of Galen

Galen

Aelius Galenus or Claudius Galenus , better known as Galen of Pergamon , was a prominent Roman physician, surgeon and philosopher...

The medieval system

Starting in the areas least affected by the disruption of the fall of the western empire, a unified theory of medicine began to develop, based largely on the writings of the Greek

Greece

Greece , officially the Hellenic Republic , and historically Hellas or the Republic of Greece in English, is a country in southeastern Europe....

physicians on physiology, hygiene

Hygiene

Hygiene refers to the set of practices perceived by a community to be associated with the preservation of health and healthy living. While in modern medical sciences there is a set of standards of hygiene recommended for different situations, what is considered hygienic or not can vary between...

, dietetics, pathology

Pathology

Pathology is the precise study and diagnosis of disease. The word pathology is from Ancient Greek , pathos, "feeling, suffering"; and , -logia, "the study of". Pathologization, to pathologize, refers to the process of defining a condition or behavior as pathological, e.g. pathological gambling....

, and pharmacology

Pharmacology

Pharmacology is the branch of medicine and biology concerned with the study of drug action. More specifically, it is the study of the interactions that occur between a living organism and chemicals that affect normal or abnormal biochemical function...

, and is credited with the discovery of how the spinal cord

Spinal cord

The spinal cord is a long, thin, tubular bundle of nervous tissue and support cells that extends from the brain . The brain and spinal cord together make up the central nervous system...

controls various muscle

Muscle

Muscle is a contractile tissue of animals and is derived from the mesodermal layer of embryonic germ cells. Muscle cells contain contractile filaments that move past each other and change the size of the cell. They are classified as skeletal, cardiac, or smooth muscles. Their function is to...

s. From Gentile's dissections, he described the heart

Heart

The heart is a myogenic muscular organ found in all animals with a circulatory system , that is responsible for pumping blood throughout the blood vessels by repeated, rhythmic contractions...

valves and determined the purpose of the bladder

Urinary bladder

The urinary bladder is the organ that collects urine excreted by the kidneys before disposal by urination. A hollow muscular, and distensible organ, the bladder sits on the pelvic floor...

and kidney

Kidney

The kidneys, organs with several functions, serve essential regulatory roles in most animals, including vertebrates and some invertebrates. They are essential in the urinary system and also serve homeostatic functions such as the regulation of electrolytes, maintenance of acid–base balance, and...

s.

Galen

Galen

Aelius Galenus or Claudius Galenus , better known as Galen of Pergamon , was a prominent Roman physician, surgeon and philosopher...

of Pergamum, also a Greek, was the most influential ancient physician during this period. In of his undisputed authority over medicine in the Middle Ages, his principal doctrines require some elaboration. Galen described the four classic symptoms of inflammation (redness, pain, heat, and swelling) and added much to the knowledge of infectious disease and pharmacology. His anatomic knowledge of humans was defective because it was based on dissection of pigs. Some of Galen's teachings tended to hold back medical progress. His theory, for example, that the blood carried the pneuma, or life spirit, which gave it its red colour, coupled with the erroneous notion that the blood passed through a porous wall between the ventricles of the heart, delayed the understanding of circulation and did much to discourage research in physiology. His most important work, however, was in the field of the form and function of muscles and the function of the areas of the spinal cord. He also excelled in diagnosis and prognosis. The importance of Galen's work cannot be overestimated, for through his writings knowledge of Greek medicine was subsequently transmitted to the Western world by the Arabs.

Anglo-Saxon translations of classical works like Dioscorides Herbal survive from the 10th Century, showing the persistence of elements of classical medical knowledge. Compendiums like Bald's Leechbook

Bald's Leechbook

The Leechbook of Bald is an Old English medical text probably compiled in the ninth-century, possibly under the influence of Alfred the Great's educational reforms....

(circa 900), include citations from a variety of classical works alongside local folk remedies.

Although in the Byzantine Empire

Byzantine Empire

The Byzantine Empire was the Eastern Roman Empire during the periods of Late Antiquity and the Middle Ages, centred on the capital of Constantinople. Known simply as the Roman Empire or Romania to its inhabitants and neighbours, the Empire was the direct continuation of the Ancient Roman State...

the organized practice of medicine never ceased (see Byzantine medicine

Byzantine medicine

Byzantine medicine is the medicine practiced in the Byzantine Empire from about 400 AD to 1453 AD. Medicine was one of the sciences in which the Byzantines improved on their Greco-Roman predecessors...

), the revival of methodical medical instruction from standard texts in the west can be traced to the church-run Schola Medica Salernitana

Schola Medica Salernitana

The Schola Medica Salernitana was the first medieval medical school in the cosmopolitan coastal south Italian city of Salerno, which provided the most important source of medical knowledge in Western Europe at the time...

in Southern Italy in the Eleventh century. At Salerno medical texts from Byzantium and the Arab world (see Medicine in medieval Islam) were readily available, translated from the Greek and Arabic at the nearby monastic centre of Monte Cassino

Monte Cassino

Monte Cassino is a rocky hill about southeast of Rome, Italy, c. to the west of the town of Cassino and altitude. St. Benedict of Nursia established his first monastery, the source of the Benedictine Order, here around 529. It was the site of Battle of Monte Cassino in 1944...

. The Salernitan masters gradually established a canon of writings, known as the ars medicinae (art of medicine) or articella
Articella
The Articella is a collection of medical treatises bounded together in one volume that was used mainly as textbook and reference manual between the 13th and the 16th centuries. In medieval times, several versions of this anthology circulated in manuscript form among medical students...

(little art), which became the basis of European medical education for several centuries.

From the founding of the Universities of Paris

University of Paris

The University of Paris was a university located in Paris, France and one of the earliest to be established in Europe. It was founded in the mid 12th century, and officially recognized as a university probably between 1160 and 1250...

(1150), Bologna

University of Bologna

The Alma Mater Studiorum - University of Bologna is the oldest continually operating university in the world, the word 'universitas' being first used by this institution at its foundation. The true date of its founding is uncertain, but believed by most accounts to have been 1088...

(1158), Oxford

University of Oxford

The University of Oxford is a university located in Oxford, United Kingdom. It is the second-oldest surviving university in the world and the oldest in the English-speaking world. Although its exact date of foundation is unclear, there is evidence of teaching as far back as 1096...

, (1167), Montpelier (1181) and Padua

University of Padua

The University of Padua is a premier Italian university located in the city of Padua, Italy. The University of Padua was founded in 1222 as a school of law and was one of the most prominent universities in early modern Europe. It is among the earliest universities of the world and the second...

(1222), the initial work of Salerno was extended across Europe, and by the Thirteenth century medical leadership had passed to these newer institutions. To qualify as a Doctor of Medicine took ten years including original Arts training, and so the numbers of such fully qualified physicians remained comparatively small.

During the Crusades

Crusades

The Crusades were a series of religious wars, blessed by the Pope and the Catholic Church with the main goal of restoring Christian access to the holy places in and near Jerusalem...

European medicine began to be influenced by Islamic medicine

Islamic medicine

. Much ink has been spilled on Usamah ibn Munqidh

Usamah ibn Munqidh

Majd ad-Dīn Usāma ibn Murshid ibn ʿAlī ibn Munqidh al-Kināni was a medieval Muslim poet, author, faris , and diplomat from the Banu Munqidh dynasty of Shaizar in northern Syria...

s supposed distaste of European medicine, but as anyone who reads the entire text of his autobiography will notice, his first-hand experience with European medicine is positive - he describes a European doctor successfully treating infected wounds with vinegar and recommends a treatment for scrofula

Scrofula

Tuberculous cervical lymphadenitis refers to a lymphadenitis of the cervical lymph nodes associated with tuberculosis. It was previously known as "scrofula".-The disease:...

demonstrated to him by an unnamed "Frank"http://www.fordham.edu/halsall/source/usamah2.html.

By the Thirteenth Century many European towns were demanding that physicians have several years of study or training before they could practice. Surgery

Surgery

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

had a lower status than pure medicine, beginning as a craft tradition until Roger Frugardi of Parma

Parma

Parma is a city in the Italian region of Emilia-Romagna famous for its ham, its cheese, its architecture and the fine countryside around it. This is the home of the University of Parma, one of the oldest universities in the world....

composed his treatise on Surgery around about 1180. A stream of Italian works of greater scope over the next hundred years, spread later into the rest of Europe. Between 1350 and 1365 Theodoric Borgognoni

Theodoric Borgognoni

Theodoric Borgognoni , also known as Teodorico de'Borgognoni, and Theodoric of Lucca, was an Italian who became one of the most significant surgeons of the medieval period...

produced a systematic four volume treatise on surgery, the Cyrurgia, which promoted important innovations as well as early forms of antiseptic practice in the treatment of injury, and surgical anaesthesia using a mixture of opiates and herbs.

The great crisis in European medicine came with the Black Death

Black Death

The Black Death was one of the most devastating pandemics in human history, peaking in Europe between 1348 and 1350. Of several competing theories, the dominant explanation for the Black Death is the plague theory, which attributes the outbreak to the bacterium Yersinia pestis. Thought to have...

epidemic in the 14th century. Prevailing medical theories focused on religious rather than scientific explanations.

Theories of medicine

The underlying principle of medieval medicine was the theory of humours

Humorism

Humorism, or humoralism, is a now discredited theory of the makeup and workings of the human body, adopted by Greek and Roman physicians and philosophers, positing that an excess or deficiency of any of four distinct bodily fluids in a person directly influences their temperament and health...

. This was derived from the ancient medical works, and dominated all western medicine up until the 19th century. The theory stated that within every individual there were four humours, or principal fluids - black bile, yellow bile, phlegm, and blood, these were produced by various organs in the body, and they had to be in balance for a person to remain healthy. Too much phlegm in the body, for example, caused lung problems; and the body tried to cough up the phlegm to restore a balance. The balance of humours in humans could be achieved by diet, medicines, and by blood-letting, using leeches. The four humours were also associated with the four seasons, black bile-autumn, yellow bile-summer, phlegm-winter and blood-spring.

HUMOUR	TEMPER	ORGAN	NATURE	ELEMENT
Black bile	Melancholic	Spleen Spleen The spleen is an organ found in virtually all vertebrate animals with important roles in regard to red blood cells and the immune system. In humans, it is located in the left upper quadrant of the abdomen. It removes old red blood cells and holds a reserve of blood in case of hemorrhagic shock...	Cold Dry	Earth
Phlegm Phlegm Phlegm is a liquid secreted by the mucous membranes of mammalians. Its definition is limited to the mucus produced by the respiratory system, excluding that from the nasal passages, and particularly that which is expelled by coughing . Phlegm is in essence a water-based gel consisting of...	Phlegmatic	Lungs Human lung The human lungs are the organs of respiration in humans. Humans have two lungs, with the left being divided into two lobes and the right into three lobes. Together, the lungs contain approximately of airways and 300 to 500 million alveoli, having a total surface area of about in...	Cold Wet	Water
Blood Blood Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....	Sanguine Sanguine Sanguine is chalk of a reddish color, often called the true colour of blood. tending to brown, used in drawing, The word also describes any drawing done in sanguine.-Technique:...	Head Human head In human anatomy, the head is the upper portion of the human body. It supports the face and is maintained by the skull, which itself encloses the brain.-Cultural importance:...	Warm Wet	Air
Yellow bile	Choleric	Gall Bladder	Warm Dry	Fire

The astrological

Astrology

Astrology consists of a number of belief systems which hold that there is a relationship between astronomical phenomena and events in the human world...

signs of the zodiac

Zodiac

In astronomy, the zodiac is a circle of twelve 30° divisions of celestial longitude which are centred upon the ecliptic: the apparent path of the Sun across the celestial sphere over the course of the year...

were also thought to be associated with certain humours. Even now, some still use words "choleric", "sanguine", "phlegmatic" and "melancholy" to describe personalities.

The use of herbs dovetailed naturally with this system, the success of herbal remedies being ascribed to their action upon the humours within the body. The use of herbs also drew upon the medieval Christian doctrine of signatures

Doctrine of signatures

The doctrine of signatures is a philosophy shared by herbalists from the time of Dioscurides and Galen. This doctrine states that herbs that resemble various parts of the body can be used to treat ailments of that part of the body. Examples include the plants liverwort; snakeroot, an antidote for...

which stated that God had provided some form of alleviation for every ill, and that these things, be they animal, vegetable or mineral, carried a mark or a signature upon them that gave an indication of their usefulness. For example, the seeds of skullcap

Scutellaria

Scutellaria is a genus of flowering plants in the mint family, Lamiaceae. It contains about 300 species, which are commonly known as skullcaps...

(used as a headache remedy) can appear to look like miniature skulls; and the white spotted leaves of Lungwort (used for tuberculosis) bear a similarity to the lungs of a diseased patient. A large number of such resemblances are believed to exist.

Most monasteries

Monastery

Monastery denotes the building, or complex of buildings, that houses a room reserved for prayer as well as the domestic quarters and workplace of monastics, whether monks or nuns, and whether living in community or alone .Monasteries may vary greatly in size – a small dwelling accommodating only...

developed herb gardens for use in the production of herbal cures, and these remained a part of folk medicine, as well as being used by some professional physicians. Books of herbal remedies were produced, one of the most famous being the Welsh, Red Book of Hergest
Red Book of Hergest
The Red Book of Hergest is a large vellum manuscript written shortly after 1382, which ranks as one of the most important medieval manuscripts written in the Welsh language. It preserves a collection of Welsh prose and poetry, notably the tales of the Mabinogion, Gogynfeirdd poetry...

, dating from around 1400.

The hospital system

In the Medieval period the term hospital encompassed hostels for travellers, dispensaries for poor relief, clinics and surgeries for the injured, and homes for the blind, lame, elderly, and mentally ill. Monastic hospitals developed many treatments, both therapeutic and spiritual.

During the thirteenth century an immense number of hospitals were built. The Italian cities were the leaders of the movement. Milan had no fewer than a dozen hospitals and Florence before the end of the Fourteenth century had some thirty hospitals. Some of these were very beautiful buildings. At Milan a portion of the general hospital was designed by Bramante
Donato Bramante
Donato Bramante was an Italian architect, who introduced the Early Renaissance style to Milan and the High Renaissance style to Rome, where his most famous design was St...

and another part of it by Michelangelo
Michelangelo
Michelangelo di Lodovico Buonarroti Simoni , commonly known as Michelangelo, was an Italian Renaissance painter, sculptor, architect, poet, and engineer who exerted an unparalleled influence on the development of Western art...

. The Hospital of Sienna, built in honor of St. Catherine
Catherine of Siena
Saint Catherine of Siena, T.O.S.D, was a tertiary of the Dominican Order, and a Scholastic philosopher and theologian. She also worked to bring the papacy of Gregory XI back to Rome from its displacement in France, and to establish peace among the Italian city-states. She was proclaimed a Doctor...

, has been famous ever since. Everywhere throughout Europe this hospital movement spread. Virchow
Rudolf Virchow
Rudolph Carl Virchow was a German doctor, anthropologist, pathologist, prehistorian, biologist and politician, known for his advancement of public health...

, the great German pathologist, in an article on hospitals, showed that every city of Germany of five thousand inhabitants had its hospital. He traced all of this hospital movement to Pope Innocent III
Pope Innocent III
Pope Innocent III was Pope from 8 January 1198 until his death. His birth name was Lotario dei Conti di Segni, sometimes anglicised to Lothar of Segni....

, and though he was least papistically inclined, Virchow did not hesitate to give extremely high praise to this pontiff for all that he had accomplished for the benefit of children and suffering mankind.

Hospitals began to appear in great numbers in France and England. Following the French Norman invasion into England

Norman conquest of England

The Norman conquest of England began on 28 September 1066 with the invasion of England by William, Duke of Normandy. William became known as William the Conqueror after his victory at the Battle of Hastings on 14 October 1066, defeating King Harold II of England...

, the explosion of French ideals led most Medieval monasteries to develop a hospitium or hospice for pilgrims. This hospitium eventually developed into what we now understand as a hospital, with various monks and lay helpers providing the medical care for sick pilgrims and victims of the numerous plagues and chronic diseases that afflicted Medieval Western Europe. Benjamin Gordon supports the theory that the hospital – as we know it - is a French invention, but that it was originally developed for isolating lepers and plague victims, and only later undergoing modification to serve the pilgrim.

Owing to a well-preserved 12th century account of the monk Eadmer of the Canterbury cathedral, there is an excellent account of Bishop Lanfranc's aim to establish and maintain examples of these early hospitals:

But I must not conclude my work by omitting what he did for the poor outside the walls of the city Canterbury. In brief, he constructed a decent and ample house of stone…for different needs and conveniences. He divided the main building into two, appointing one part for men oppressed by various kinds of infirmities and the other for women in a bad state of health. He also made arrangements for their clothing and daily food, appointing ministers and guardians to take all measures so that nothing should be lacking for them.

Later developments

High medieval surgeons like Mondino de Liuzzi

Mondino de Liuzzi

Mondino de Luzzi, or de Liuzzi or de Lucci, , also known as Mundinus, was an Italian physician, anatomist, and professor of surgery who lived and worked in Bologna...

pioneered anatomy in European universities and conducted systematic human dissections. Unlike pagan rome, high medieval Europe did not have a complete ban on human dissection. However, Galenic influence was still so prevalent that Mondino and his contemporaries attempted to fit their human findings into Galenic anatomy.

During the period of the Renaissance

Renaissance

The Renaissance was a cultural movement that spanned roughly the 14th to the 17th century, beginning in Italy in the Late Middle Ages and later spreading to the rest of Europe. The term is also used more loosely to refer to the historical era, but since the changes of the Renaissance were not...

from the mid 1450s onward, there were many advances in medical practice. The Italian Girolamo Fracastoro

Girolamo Fracastoro

Girolamo Fracastoro was an Italian physician, poet, and scholar in mathematics, geography and astronomy. Fracastoro subscribed to the philosophy of atomism, and rejected appeals to hidden causes in scientific investigation....

, 1478–1553, was the first to propose that epidemic diseases might be caused by objects outside the body

Body

With regard to living things, a body is the physical body of an individual. "Body" often is used in connection with appearance, health issues and death...

that could be transmitted by direct or indirect contact. He also proposed new treatments for diseases such as syphilis

Syphilis

Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...

.

In 1543 the Flemish Scholar Andreas Vesalius wrote the first complete textbook on human anatomy

Anatomy

Anatomy is a branch of biology and medicine that is the consideration of the structure of living things. It is a general term that includes human anatomy, animal anatomy , and plant anatomy...

: "De Humani Corporis Fabrica", meaning "On the Fabric of the Human Body". Much later, in 1628, William Harvey

William Harvey

William Harvey was an English physician who was the first person to describe completely and in detail the systemic circulation and properties of blood being pumped to the body by the heart...

explained the circulation of blood through the body in veins and arteries. It was previously thought that blood was the product of food and was absorbed by muscle tissue.

During the 16th century, Paracelsus

Paracelsus

Paracelsus was a German-Swiss Renaissance physician, botanist, alchemist, astrologer, and general occultist....

, like Girolamo

Girolamo Fracastoro

, discovered that illness was caused by agents outside the body such as bacteria, not by imbalances within the body.

Leonardo Da Vinci

Leonardo da Vinci

Leonardo di ser Piero da Vinci was an Italian Renaissance polymath: painter, sculptor, architect, musician, scientist, mathematician, engineer, inventor, anatomist, geologist, cartographer, botanist and writer whose genius, perhaps more than that of any other figure, epitomized the Renaissance...

also had a large impact on medical advances during the Renaissance. Born on April 15, 1452, Da Vinci's approach to science was based on detailed observation. He participated in several autopsies

Autopsy

An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...

and created many detailed anatomical drawings, planning a major work of comparative human anatomy.

The French army doctor Ambroise Paré

Ambroise Paré

Ambroise Paré was a French surgeon. He was the great official royal surgeon for kings Henry II, Francis II, Charles IX and Henry III and is considered as one of the fathers of surgery and modern forensic pathology. He was a leader in surgical techniques and battlefield medicine, especially the...

, born in 1510, revived the ancient Greek method of tying off blood vessels. After amputation the common procedure was to cauterize the open end of the amputated appendage to stop the haemorrhaging. This was done by heating oil

Oil

An oil is any substance that is liquid at ambient temperatures and does not mix with water but may mix with other oils and organic solvents. This general definition includes vegetable oils, volatile essential oils, petrochemical oils, and synthetic oils....

, water, or metal and touching it to the wound to seal off the blood vessels. Pare also believed in dressing wounds with clean bandages and ointments, including one he made himself composed of eggs

Egg (food)

Eggs are laid by females of many different species, including birds, reptiles, amphibians, and fish, and have probably been eaten by mankind for millennia. Bird and reptile eggs consist of a protective eggshell, albumen , and vitellus , contained within various thin membranes...

, oil of rose

Rose

A rose is a woody perennial of the genus Rosa, within the family Rosaceae. There are over 100 species. They form a group of erect shrubs, and climbing or trailing plants, with stems that are often armed with sharp prickles. Flowers are large and showy, in colours ranging from white through yellows...

s, and turpentine

Turpentine

Turpentine is a fluid obtained by the distillation of resin obtained from trees, mainly pine trees. It is composed of terpenes, mainly the monoterpenes alpha-pinene and beta-pinene...

. He was the first to design artificial hands and limbs

Limb (anatomy)

A limb is a jointed, or prehensile , appendage of the human or other animal body....

for amputation patients. On one of the artificial hands, the two pairs of fingers could be moved for simple grabbing and releasing tasks and the hand look perfectly natural underneath a glove.

Medical catastrophes were more common in the Renaissance than they are today. During the Renaissance, trade route

Trade route

A trade route is a logistical network identified as a series of pathways and stoppages used for the commercial transport of cargo. Allowing goods to reach distant markets, a single trade route contains long distance arteries which may further be connected to several smaller networks of commercial...

s were the perfect means of transportation for disease. Eight hundred years after the Plague of Justinian

Plague of Justinian

The Plague of Justinian was a pandemic that afflicted the Eastern Roman Empire , including its capital Constantinople, in 541–542 AD. It was one of the greatest plagues in history. The most commonly accepted cause of the pandemic is bubonic plague, which later became infamous for either causing or...

, the bubonic plague

Bubonic plague

Plague is a deadly infectious disease that is caused by the enterobacteria Yersinia pestis, named after the French-Swiss bacteriologist Alexandre Yersin. Primarily carried by rodents and spread to humans via fleas, the disease is notorious throughout history, due to the unrivaled scale of death...

returned to Europe. Starting in Asia, the Black Death

Black Death

reached Mediterranean and western Europe in 1348 (possibly from Italian merchants fleeing fighting in Crimea

Crimea

Crimea , or the Autonomous Republic of Crimea , is a sub-national unit, an autonomous republic, of Ukraine. It is located on the northern coast of the Black Sea, occupying a peninsula of the same name...

), and killed 25 million Europeans in six years, approximately 1/3 of the total population and up to a 2/3 in the worst-affected urban areas. Before Mongols

Golden Horde

The Golden Horde was a Mongol and later Turkicized khanate that formed the north-western sector of the Mongol Empire...

left besieged Crimean Kaffa the dead or dying bodies of the infected soldiers were loaded onto catapults and launched over Kaffa's walls to infect those inside. This incident was among the earliest known examples of biological warfare

Biological warfare

Biological warfare is the use of biological toxins or infectious agents such as bacteria, viruses, and fungi with intent to kill or incapacitate humans, animals or plants as an act of war...

and is credited as being the source of the spread of the Black Death into Europe.

The plague repeatedly returned to haunt Europe and the Mediterranean from 14th through 17th centuries. Notable later outbreaks include the Italian Plague of 1629-1631

Italian Plague of 1629-1631

The Italian Plague of 1629–1631 was a series of outbreaks of bubonic plague which occurred from 1629 through 1631 in northern Italy. This epidemic, often referred to as Great Plague of Milan, claimed the lives of approximately 280,000 people, with the cities of the Lombardy and Veneto regions...

, the Great Plague of Seville

Great Plague of Seville

The Great Plague of Seville was a massive outbreak of disease in Spain that killed up to a quarter of Seville's population.Unlike the plague of 1596–1602 which claimed 600,000 to 700,000 lives, or a little under 8% of the population, and initially struck northern and central Spain and Andalusía in...

(1647–1652), the Great Plague of London

Great Plague of London

The Great Plague was a massive outbreak of disease in the Kingdom of England that killed an estimated 100,000 people, 20% of London's population. The disease is identified as bubonic plague, an infection by the bacterium Yersinia pestis, transmitted through a flea vector...

(1665–1666), the Great Plague of Vienna

Great Plague of Vienna

The Great Plague of Vienna occurred in 1679 in Vienna, Austria, the imperial residence of the Austrian Habsburg rulers. From contemporary descriptions, the disease is believed to have been bubonic plague, which is caused by the bacterium Yersinia pestis, carried by fleas associated with the black...

(1679), the Great Plague of Marseille

Great Plague of Marseille

The Great Plague of Marseille was the last of the significant European outbreaks of bubonic plague. Arriving in Marseille, France in 1720, the disease killed 100,000 people in the city and the surrounding provinces. However, Marseille recovered quickly from the plague outbreak. Economic activity...

in 1720–1722 and the 1771 plague in Moscow

Plague Riot

Plague Riot was a riot in Moscow in 1771 between September 15 and September 17, caused by an outbreak of bubonic plague.-History:...

.

Before the Spanish came to America and Mexico, the deadly infections of smallpox

Smallpox

Smallpox was an infectious disease unique to humans, caused by either of two virus variants, Variola major and Variola minor. The disease is also known by the Latin names Variola or Variola vera, which is a derivative of the Latin varius, meaning "spotted", or varus, meaning "pimple"...

, measles

Measles

Measles, also known as rubeola or morbilli, is an infection of the respiratory system caused by a virus, specifically a paramyxovirus of the genus Morbillivirus. Morbilliviruses, like other paramyxoviruses, are enveloped, single-stranded, negative-sense RNA viruses...

, and influenza

Influenza

Influenza, commonly referred to as the flu, is an infectious disease caused by RNA viruses of the family Orthomyxoviridae , that affects birds and mammals...

were unheard of. The Native Americans

Indigenous peoples of the Americas

The indigenous peoples of the Americas are the pre-Columbian inhabitants of North and South America, their descendants and other ethnic groups who are identified with those peoples. Indigenous peoples are known in Canada as Aboriginal peoples, and in the United States as Native Americans...

did not have the immunities the Europeans

European ethnic groups

The ethnic groups in Europe are the various ethnic groups that reside in the nations of Europe. European ethnology is the field of anthropology focusing on Europe....

developed through long contact with the diseases. Christopher Columbus

Christopher Columbus

Christopher Columbus was an explorer, colonizer, and navigator, born in the Republic of Genoa, in northwestern Italy. Under the auspices of the Catholic Monarchs of Spain, he completed four voyages across the Atlantic Ocean that led to general European awareness of the American continents in the...

ended the Americas' isolation in 1492 while sailing under the flag of Castile

Crown of Castile

The Crown of Castile was a medieval and modern state in the Iberian Peninsula that formed in 1230 as a result of the third and definitive union of the crowns and parliaments of the kingdoms of Castile and León upon the accession of the then King Ferdinand III of Castile to the vacant Leonese throne...

, Spain. Deadly epidemic

Epidemic

In epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...

s swept across the Caribbean. Smallpox wiped out villages in a matter of months. The island of Hispaniola

Hispaniola

Hispaniola is a major island in the Caribbean, containing the two sovereign states of the Dominican Republic and Haiti. The island is located between the islands of Cuba to the west and Puerto Rico to the east, within the hurricane belt...

had a population of 250,000 Native Americans. 20 years later, the population had dramatically dropped to 6,000. 50 years later, it was estimated that approximately 500 Native Americans were left. Smallpox then spread to Mexico where it then helped destroy the Aztec Empire. In the 1st century of Spanish rule in Mexico, 1500–1600, Central and South Americans died by the millions. By 1650, the majority of Mexico's population had perished.

Contrary to popular belief bathing

Bathing

Bathing is the washing or cleansing of the body in a fluid, usually water or an aqueous solution. It may be practised for personal hygiene, religious ritual or therapeutic purposes or as a recreational activity....

and sanitation

Sanitation

Sanitation is the hygienic means of promoting health through prevention of human contact with the hazards of wastes. Hazards can be either physical, microbiological, biological or chemical agents of disease. Wastes that can cause health problems are human and animal feces, solid wastes, domestic...

were not lost in Europe with the collapse of the Roman Empire

Roman Empire

The Roman Empire was the post-Republican period of the ancient Roman civilization, characterised by an autocratic form of government and large territorial holdings in Europe and around the Mediterranean....

. Bathing in fact did not fall out of fashion in Europe until shortly after the Renaissance

Renaissance

, replaced by the heavy use of sweat-bathing and perfume

Perfume

Perfume is a mixture of fragrant essential oils and/or aroma compounds, fixatives, and solvents used to give the human body, animals, objects, and living spaces "a pleasant scent"...

, as it was thought in Europe that water could carry disease into the body through the skin. Medieval church authorities believed that public bathing

Public bathing

Public baths originated from a communal need for cleanliness. The term public may confuse some people, as some types of public baths are restricted depending on membership, gender, religious affiliation, or other reasons. As societies have changed, public baths have been replaced as private bathing...

created an environment open to immorality and disease. Roman Catholic Church

Roman Catholic Church

The Catholic Church, also known as the Roman Catholic Church, is the world's largest Christian church, with over a billion members. Led by the Pope, it defines its mission as spreading the gospel of Jesus Christ, administering the sacraments and exercising charity...

officials even banned public bathing in an unsuccessful effort to halt syphilis

Syphilis

epidemics from sweeping Europe.

External links

Medieval Medicine
"Index of Medieval Medical Images" UCLA Special Collections (accessed 2 September 2006).
"The Wise Woman" An overview of common ailments and their treatments from the Middle Ages presented in a slightly humorous light.
"MacKinney Collection of Medieval Medical Illustrations"
PODCAST: Professor Peregrine Horden (Royal Holloway University of London): 'What's wrong with medieval medicine?'
Walsh, James J. Medieval Medicine(1920), A & C Black, Ltd.