Um...Why were you going to bleed me again?

You want to do what? And no pain meds? Oy!

Today on History Undressed we are discussing Medieval medicine. During Medieval times the church played a large role in medicine, as it did with most things. Monks were trained in colleges to become physicians, and followed strict rules in order to heal a person. A lot of their healing practices derived from Greek and Roman texts.

There were physicians who weren't monks however, and they did use some other ways of healing patients that monkes were against.Some laymen were also made into physicians by attending universities or joining a medical guild. Even these men in the medieval ages were sometimes ostracized because they were not of the church. However if they belonged to a guild they were often protected, if not… it was two groups against you. If they did go to school, they began at age 14 and went through school for about 12 years before they could begin practicing.

And I have to say that they did use pain meds sometimes, but the concoctions they made could kill you, so you might have chosen to go without. One particular concoction was made from lettuce, gall from a castrated boar, briony, opium, henbane, and hemlock juice. As most of you know, hemlock is poisonous…

In most cases surgery wasn’t even contemplated unless it was a life threatening situation.
Cesarean sections were performed on dead mothers in order to save the soul of the unborn infant. Most surgeons set broken bones, extracted arrows, and sewed up wounds. Laymen surgeons also took care of dentistry. (Click here for past post on dentistry)
Some other forms of surgery were to remove cataracts from the eyes, and trepanation. Trepanation was when a hole was made in the skull of a person to relieve pressure. It was often the cure for those who had seizures.

The monks didn’t believe in pagan healing ways, such as the use of herbal medicines, and intricate surgeries. A lot of women healers who used their herbal remedies to heal people were considered witches. They believed that everything happens because of God, everything happens for a reason. A lot of times they believed you had done something wrong and angered our Holy Father, so in most illnesses you would be rubbed with holy water, anointed oil, maybe have relics of the saints presented to you and they’d pray for you. If you died, I guess you deserved it.

(If you are really interested in the way the church played a role in medicine, Ken Follett’s book World Without End is a fabulous journey into the world of church, medicine and the plague.)

But this was very early on. Soon the church came to believe that God provided things in nature to help us heal. St. Augustine played a big part in changing the tune as did Marcelli with his book De Medicamentis Liber, which came out in 1536 (some consider the medieval era to have ended in 1400 to 1501, I like to think it lasted just a little longer) and discussed how to use certain plants, gems and other natural substances to cure the sick. However, these new curing methods were still seen as slightly skeptical and were only accepted if done while using Christian incantations.

Medieval medical practitioners believed in the four humors, blood (air), phlegm (water), yellow bile (fire) and black bile (earth). They believed that in order to be healthy all four needed to be in balance of one another. They balanced the humors by diet, medicines and blood-letting.

As far as diet, in the medieval ages, the majority of the population consisted of peasants. These people were too poor to afford a properly balanced diet, and ate mostly bread, meat or fish. In some cases they were able to get some fresh fruits and vegetables, and it was even harder to get cheese and butter. Needless to say, the wealthier folk had a much more balanced diet, and in most cases were on the healthier side.

Keeping the humors in balance depended on the seasons as well, hot, cold, wet or dry. Most plants, herbs and household goods were categorized according to this hot, cold, wet or dry theory. Moods were characterized by the four humors, Choleric (yellow bile), Sanguine (blood), Melancholic (black bile) and Phlegmatic (phlegm). They also counted a lot on astrology, compass directions and the four evangelists, Matthew, Mark, Luke and John. One major fault in the humor theory, was that they didn’t believe that blood circulated through the body.

When physicians came to call on a patient or the patient was brought to them, they often checked the blood, urine and feces of a patient to see if the humors were in balance of one another. Blood was checked for hot or cold. Was it greasy or foamy? How fast did it coagulate? They would take a persons pulse to see how strong their heart was. After thoroughly examining a patient and listening to the patients own version of events, the physician would commonly check their “leech” book, a popular one written in the 9th century was Bald's Leechbook. This would tell the physician if they needed to bleed the patient or not. Another book physicians relied on was Tacuinum Sanitatis (Handbook of Health).

Bleeding a patient would draw all of the noxious ails from their organs, and make the person well again. Choosing a specific vein depended on what humor was out of balance. The dangers of blood letting (and not using a leech) were vast. A physician could cut an artery instead of a vein and the patient could bleed to death. The incision could become infected, not to mention you are weakening the already sick person. Unfortunately, for most patients, if they were bled they either got sicker or died. I wonder why the docs didn’t realize this and stop bleeding their patients sooner? I know if I went to the doctor and he said to me, “I know you’ve been sick lately. Instead of prescribing antibiotics, this time we’re going to bleed you.” I’d run as fast and far away as I could!

The Tacuinum Sanitatis, listed six things essential elements to keep a person healthy: a healthy balanced diet, fresh air, getting a healthy amount of exercise, getting plenty of rest, secretions and excretions of the humors, and your mental state. As long of all of these things were in balance you should be healthy.

In the case of the Black Death in the 14th century, medical practitioners came to realize you could catch the illness by breathing the air of a sick individual, hence the quarantining of families, and sometimes whole cities.

Lepers were another group who were ostracized. They were banned to leper colonies or hospitals.

Most hospitals (not for lepers) were at monasteries. It provided for some of the income for the monks, but not only that, the Rule of St. Benedict was “before and above all things, care must be taken of the sick, that they be served in very truth as Christ is served.”

Another type of hospital to mention is the Knights Hospitaller run by the Order of St. John. It began in Jerusalem during the crusades and took care of the sick, poor and injured pilgrims of the Holy War. These hospitallers soon spread across Europe. (In 1119 the Hospitallers joined with the Knights Templar.)

It is also important to point out that many women practiced medicine as well. Much more than was recorded. Women became physicians, nurses and midwives. However a female physician was often controversial and she would most probably have been ostracized quite a bit.

In 1150, Abbess Hildegard of Bingen wrote a book titled, Causae et Curae (Causes and Cures), which discussed her medical advice and philosophies. Another physician who specialized in females was Trotula of Salerno and her work, De Passionibus mulierum (The Diseases of Women) written in the 12th century. Some obstetricians today even say how great the work is and her knowledge of the female body was vast.

Midwives and nurses were very important for female health. Especially since monks, who consisted of most of the physicians at the time, were not allowed to touch females let along examine them. These women often used the more natural cures for ailments. In order to become a midwife, you either learned a practiced with an older and more experienced midwife, or you grew up with a male physician as your father or guardian who introduced you into the field.