Medicine of the Early and Later Middle Ages Lecture 3.

Medicine of the Medicine of the Early and Later Early and Later

Middle AgesMiddle Ages

Lecture 3Lecture 3

Lecture PlanLecture Plan

1.Introduction to the Medieval Medicine.

2.The Byzantine Medicine.

3.Medicine in Arab Caliphates.

4.Medicine in Medieval Europe.

MEDIEVAL MEDICINE MEDIEVAL MEDICINE TIMELINETIMELINE

Early Middle Ages 5th cent. A.D.

ancient Renaissance

Later Middle Ages 10th cent. A.D.

monks folk healers

university trained

physicians

Medieval MedicineMedieval Medicine

•The first medical university was founded in the tenth century in Salerno, Italy where Greek manuscripts written by such physicians as Hippocrates were studied.

Medieval Medicine Medieval Medicine and the Four Humors and the Four Humors

TheoryTheory

dry moist

sanguinecholer

melancholia phlegm

!notable!

Doctrine of Signatures

color of flowers and other properties of plants indicated their usefulness in treating

particular diseases

Devine Retribution

Due to this belief, many of the sick took pilgrimages in the

hopes of recovering by making peace with God.

This belief, however, did not stop the This belief, however, did not stop the monks, who were the most literate of the monks, who were the most literate of the general population, from applying what general population, from applying what they had learned by making copies of the they had learned by making copies of the ancient medical texts. Each monastery ancient medical texts. Each monastery had an infirmary where treatment was had an infirmary where treatment was available with herbal remedies, based on available with herbal remedies, based on those prescribed by Hippocrates and those prescribed by Hippocrates and others, made from plants cultivated in others, made from plants cultivated in their gardens. their gardens.

Thus, there were: Thus, there were: university trained physiciansuniversity trained physicians, all men, , all men,

who were based in towns and cities who were based in towns and cities and served the wealthyand served the wealthy

folk healersfolk healers, usually women, in the , usually women, in the rural areasrural areas

healers in the religious ordershealers in the religious orders, who , who incorporated both aspects of healing incorporated both aspects of healing into their practicesinto their practices

PhysiciansPhysicians were scholars who were scholars who studied at universities. In order studied at universities. In order to be declared a physician, a to be declared a physician, a student had to prove himself student had to prove himself able to recite, lecture and able to recite, lecture and debate the contents of his debate the contents of his studies. studies.

Medieval Medical Medieval Medical PractitionersPractitioners

SurgeonsSurgeons belonged to the working belonged to the working class and did the jobs that were class and did the jobs that were considered beneath physicians, such considered beneath physicians, such as bloodletting and pulling teeth. as bloodletting and pulling teeth. Most surgeries were performed by Most surgeries were performed by the barber/surgeon. The most the barber/surgeon. The most common operations were for hernias, common operations were for hernias, gallstones and cesarean section. gallstones and cesarean section.

During the early medieval centuries it was the During the early medieval centuries it was the monksmonks who copied out manuscripts of the who copied out manuscripts of the works of Hipocrates and other Greek or Latin works of Hipocrates and other Greek or Latin medical writers. There is evidence that they medical writers. There is evidence that they practiced the medical knowledge they practiced the medical knowledge they obtained as scribes. Each monastery had an obtained as scribes. Each monastery had an infirmary for its ailing and aged members. infirmary for its ailing and aged members. Medical aid would also be provided to the Medical aid would also be provided to the poor, travelers and pilgrims who visited. Some poor, travelers and pilgrims who visited. Some monks gained such a reputation for being monks gained such a reputation for being skilled healers that they were sought out by skilled healers that they were sought out by lay patients. In some cases the care of such lay patients. In some cases the care of such outsiders gave rise to hospitals apart from the outsiders gave rise to hospitals apart from the monks' infirmaries. monks' infirmaries.

Leeches Leeches were lay practitioners were lay practitioners whose training was more practical whose training was more practical than theoretical. Practicing without than theoretical. Practicing without proper education, they relied more proper education, they relied more on informal observation and folk on informal observation and folk medicine. They may have been medicine. They may have been apprenticed to a barber-surgeon or apprenticed to a barber-surgeon or physician at some point. physician at some point.

Dentatores Dentatores were the dentists of the were the dentists of the medieval era and were so expensive that medieval era and were so expensive that usually only the very rich could afford usually only the very rich could afford their services. They removed decay, their services. They removed decay, which was believed to be caused by which was believed to be caused by worms, and filled teeth with ground bone. worms, and filled teeth with ground bone. Gold was used for filling cavities by the Gold was used for filling cavities by the fifteenth century. They repaired loose fifteenth century. They repaired loose teeth with metal bindings and made teeth with metal bindings and made dentures from ox and other animal bones. dentures from ox and other animal bones.

Herbalists (Folk Healers). Herbalists (Folk Healers). Practitioners of Practitioners of popular healing varied widely from place to popular healing varied widely from place to place within Europe. In some areas the place within Europe. In some areas the healers were mostly women; in other they healers were mostly women; in other they were predominantly men. In some places the were predominantly men. In some places the secrets of healing were passed only from secrets of healing were passed only from woman to woman or from men to men, but in woman to woman or from men to men, but in other regions the gender alternated with each other regions the gender alternated with each transmission. In some places healers were transmission. In some places healers were thought to possess inherited skills and if an thought to possess inherited skills and if an attempt was made to pass these skills to attempt was made to pass these skills to people without these inherited gifts, they people without these inherited gifts, they would be ineffectual. would be ineffectual.

Midwives Midwives were taught their duties by were taught their duties by other midwives or were introduced into other midwives or were introduced into the craft by fathers or husbands who the craft by fathers or husbands who were medical men. Midwives were usually were medical men. Midwives were usually apprenticed to older more experienced apprenticed to older more experienced midwives. The only requirement for midwives. The only requirement for becoming a candidate for midwifery was a becoming a candidate for midwifery was a statement from the parish priest attesting statement from the parish priest attesting to the applicant's good character. to the applicant's good character.

Medieval Medieval nursesnurses were women who were women who attended to the more basic needs of the attended to the more basic needs of the ill in hospitals. Many joined monastic ill in hospitals. Many joined monastic orders, but there were secular nursing orders, but there were secular nursing orders as well, especially during the orders as well, especially during the Plague. As the disease spread women Plague. As the disease spread women from all socio-economic groups came from all socio-economic groups came forward to care for the sick. Noble-born forward to care for the sick. Noble-born women who became nurses of the poor women who became nurses of the poor or sick, were considered "nursing saints."or sick, were considered "nursing saints."

Byzantine MedicineByzantine Medicine

In Byzantine times (from about 400 AD to 1453 AD) medicine shows but little originality. The work handed down to us are all compilations, but as they frequently contain excerpts from lost works they are of some historical value.

Byzantine medicine drew largely on Ancient Greek and Roman

knowledge.

Byzantine physicians often compiled and standardized

medical knowledge into textbooks.

Arguably the first Byzantine Physician was the author of the Vienna Dioscurides manuscript,

created for the daughter of Emperor Olybrius around 515.

A gallery of birds from the Vienna Dioscurides Byzantine manuscript.

Oribasius, perhaps the greatest Byzantine compiler of medical knowledge, frequently made revisions noting where older methods had been incorrect.

Another Byzantine treatise, that of the thirteenth century Nicholas

Myrepsos, remained the principal pharmaceutical code of the

Parisian medical faculty until 1651.

The last great Byzantine Physician was Actuarius, who

lived in the early 14th Century in Constantinople. His works on

Urine laid much of the foundation for later study in that field.

An important contribution of Byzantium is arguably the fact that it

was the first Empire in which dedicated medical establishments -

usually set up by individual Churches or the State, which parallel modern Hospitals in many way, flourished.

The first hospital was built by Basil of Caesarea in the late fourth century,

and although these Institutions flourished, it was only throughout the 8th and 9th Centuries that they began to appear in Provincial Towns as well

as Cities.

Hospital hierarchy included:

•the Chief Physician (archiatroi)

•professional nurses (hypourgoi)

•orderlies (hyperetai)

Doctors themselves were well trained and most likely attended the

University of Constantinople as Medicine had become a truly

scholarly subject by the period of Byzantium.

The Byzantine doctor Myrepsos receiving the Patients, from a greek manuscript, 13th century

Christianity always played a key role in the building and maintaining of Hospitals, as it did with most other

areas of the Empire. Many Hospitals were built and maintained by Bishops

in their respective prefectures.

Christianity also played a key role in propagating the idea of charity, medicine was made

accessible to all and... simple.

Arabian MedicineArabian Medicine

A second reservoir of medical learning during those times was the great Muslim empire, which extended from Persia to Spain.

Avicenna’s (980–1037) principal medical work, The Canon of

Medicine, became a classic and was used at many medical

schools.

The greatest contribution of Arabian medicine was in

chemistry and in the knowledge and preparation of medicines.

At that period, and indeed throughout most historical times,

surgery was considered inferior to medicine, and surgeons were

held in low regard.

Medicine in Medieval Medicine in Medieval EuropeEurope

At about the same time that Arabian medicine flourished, the first organized medical school in

Europe was established at Salerno, in southern Italy.

Remarkably liberal in some of its views, Salerno

admitted women as medical students.

The Salernitan school also produced a literature of its own;

the best-known work, of uncertain date and of composite authorship,

was the “Salernitan Guide to Health”.

Salerno yielded its place as the premier medical school of Europe to Montpellier in

about 1200.

Medieval physicians analyzed symptoms, examined excreta,

and made their diagnoses. Then they might prescribe diet, rest,

sleep, exercise, or baths; or they could administer emetics and

purgatives or bleed the patient.

Surgeons could treat fractures and dislocations, repair hernias, and perform amputations and a few other operations. Some of

them prescribed opium, mandragora, or alcohol to deaden

Дякую за увагу!Дякую за увагу!

Thank you for your Thank you for your attention!attention!

Merci de votre attention!Merci de votre attention!

Dziękuję zaDziękuję za uwag uwagęę!!

Danke für IhreDanke für Ihre AufmerksamkeitAufmerksamkeit!!

Medicine of the Early and Later Middle Ages Lecture 3.

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