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
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
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
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.
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.
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
They could not bath either themselves or their possessions in a
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.
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
Aries, the Ram was related to the head.
Taurus, the Bull was related to the neck and shoulders.
Gemini, the Twins were related to the arms and hands.
Cancer, the Crab was related to the chest and "adjacent
Leo, the Lion was related to the heart and the opening of the stomach.
Virgo, the Virgin was related to intestinal track, the base of the
stomach and the umbilical regions.
Libra, the Balance was related to the kidneys.
Scorpio, the Scorpion was related to the genitals.
Sagittarius, the Archer was related to the hips.
Capricornus, the Goat was related to the legs.
Aquarius, the Water Carrier was related to the knees.
Pisces, the Fishes were related to the feet.
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.
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
If any of this information is incorrect or incomplete, please tell me and
I'll correct it as soon as I can.