Tuesday, September 23, 2014

Medieval Medicine

As I noted earlier in my post on health and hygiene, we don't know how lucky we are to live in an era of modern medicine.  Essentially until the middle of the twentieth century, doctors essentially tried to keep people warm and dry and fed and hoped their immune systems would kick in soon.  (The image above is the thirteenth-century hospital at Tonnerre, where they sought to do the same.)  There were nineteenth-century advances like anesthetics and vaccination (thank you, Louis Pasteur), but until maybe seventy-five years ago medicine wasn't radically different than it had been in the Middle Ages.

The biggest difference was probably the difference in how medical workers were trained.  Medical doctors in the Middle Ages were trained at medical universities, Salerno and Montpellier, where they were given a largely theoretic training.  Some of what they learned came from the Arabs, but a lot (including a lot of the Arabic learning) came eventually from Aristotle, who seems to have based a lot of his own understanding of the human anatomy on pig anatomy.

The whole practice of medicine was based on the idea of "humors" and their relationship.  If your blood, bile, black bile, and phlegm got out of balance, all sorts of diseases were supposed to result.  Regular bleeding kept the blood from getting out of hand, and leeches might also be used in an infected area.

For practical, day-to-day medicine, one might prefer the barber-surgeons.  They had been trained as apprentices and journeymen to wield sharp instruments.  They would both shave people and perform surgery.  Things like a gangrenous hand would be cut off, with cauterization to stop the bleeding.  Medieval theologians routinely said that heresy was a "cancer" that would have to be "cut out," so medieval surgeons clearly operated for cancer, though one wonders with what success.  They would also cauterize skin lesions.

Midwives, not doctors, assisted in childbirth.  Women gave birth sitting up, not lying down, so that gravity would help.  They also did so without anesthesia.  Cesarian sections, which are now very common, were performed only as a last resort, to attempt to save the life of the child when it was obvious that it would be impossible to save the life of the mother.  Without modern sterile operating rooms and micro-clamps, the kind of abdominal surgery involved in Cesarians led almost immediately to death.

Medieval people, even without knowing about germs, understood the need for sterility--even if it was often hard to achieve.  Before cutting into someone, for example, a barber-surgeon would pass his knife through a flame.  Washing wounds in wine was common, and the alcohol may have helped against infection.

Every monastery would have a big herb garden and an infirmerian who knew herb-craft.  Some of the herbs may indeed have helped, though there were also all sorts of theoretic discussions which we would now reject--for example, if the Middle Ages had had kidney beans (which they did not), they would certainly have "known" they were good for kidney disease.  Remedies like mustard-plasters and steam for congestion can't have hurt.

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