Medical knowledge in the Middle Ages must have appeared to have stood still. While the Ancient Romans, Greeks and Egyptians had pushed forward medical knowledge, after the demise of these civilisations, the momentum started by these people tended to stagnate and it did not develop at the same pace until the Seventeenth/Eighteenth Centuries. In Britain, as an example, most things linked to the Romans was destroyed – villas were covered up as the Ancient Britons believed that they contained ghosts and evil spirits. With this approach, it is not surprising that anything medical linked to the Romans fell into disuse in Britain.

By the 14th Century, universities had developed in Western Europe that could be classed as medical schools where students could study under a master physician. The University of Montpelier was one such university. Dissections of human bodies were carried out in these universities so anyone wanting to study medicine in the Middle Ages was not totally ignorant of facts about the human body. Public debates were also encouraged about medical issues and it is known that some medical schools encouraged students to actually challenge the ideas of Galen and Hippocrates. As a result of this refusal to take what Galen and Hippocrates had stated at face value some progress was made in the medical world during this time.

However, medicine became steeped in superstition and the Roman Catholic Church effectively dominated what direction the medical world took. Any views different from the established Roman Catholic Church view could veer towards heresy with the punishments that entailed. Therefore, when the Roman Catholic Church stated that illnesses were punishments from God and that those who were ill were so because they were sinners, few argued otherwise.

Medical practitioners were also still heavily influenced by Galen 1000 years after his death. Mondino’s book on the anatomy, “Anathomia”, still relied on observations made by Galen and other Greek writers of medicine.

The diagnosis of disease

No-one knew what really caused diseases. For the Roman Catholic Church they were a punishment from God for sinful behaviour. However, some progress was made in certain areas.

The first authentic description of the symptoms of smallpox were recorded by Rhazes who lived from 860 to 932 AD. However, society was many centuries away from a cure.

Urine charts were also used to help physicians diagnose illnesses. Certain coloured urine indicated certain illnesses. Combined with a table of the planets, these gave physicians enough information to diagnose a disease. Once the disease had been diagnosed, a treatment was decided on.

Physicians still believed that an imbalance of humours played a major part in illnesses. When this happened:

“Several kinds of medicine may be good such as diet, drink, hot bath (whence sweat is growing), with purging, vomiting and letting blood. These taken in due time, not overflowing each malady and infection is withstood.” From a poem from the 11th Century.

Blood letting was a popular treatment for many diseases. Many diseases were thought to be caused by an excess of blood in the body and blood letting was seen as the obvious cure. When a large quantity of blood was required, the appropriate vein was cut. If only a small amount was needed, a leech would be used.

Diagnosis was also influenced by astrology. Medical charts informed physicians what not to do for people born under a certain start sign.

Aries Avoid incisions in the head and face and cut no vein in the head.
Taurus Avoid incisions in the neck and throat and cut no veins there.
Gemini Avoid incisions in the shoulders, arms or hands and cut no vein.
Cancer Avoid incisions in the breasts, sides, stomach and lungs and cut no vein that goes to the spleen.
Leo Avoid incisions of the nerves, lesions of the sides and bones, and do not cut the back either by opening and bleeding.
Virgo Avoid opening a wound in the belly and in the internal parts.
Libra Avoid opening wounds in the umbellicus and parts of the belly and do not open a vein in the back or do cupping.
Scorpio Avoid cutting the testicles and anus.
Sagittarius Avoid incisions in the thighs and fingers and do not cut blemishes and growths.
Capricorn Avoid cutting the knees or the veins and sinews in these places.
Aquarius Avoid cutting the knees or the veins and veins in these places.
Pisces Avoid cutting the feet.

Some Greek and Muslim physicians believed that the moon and planets played an important part in good health and this belief was continued in the Middle Ages. They believed that the human body and the planets were made up of the same four elements (earth, fire, air and water). For the body to operate well, all four elements had to be in harmony with no imbalances. It was believed that the Moon had the greatest influence on fluids on Earth and that it was the Moon that had the ability to affect positively or negatively the four elements in your body. Where the Moon and planets were – and a knowledge of this – was considered important when making a diagnosis and deciding on a course of treatment. Physicians needed to know when to treat a patient and when not to and where the planets were determined this. A so-called Zodiac Chart also determined when blood letting should be done as it was believed by some that the Moon and planets determined this as well.

Remedies for diseases were still crude and based on herbs, potions or more drastic cures.

There were people in the time of the plague (the Black Death) who believed that they had sinned. They believed that the only way to show their true repentance was to inflict pain on themselves. These were the so-called flaggellants who whipped themselves to show their love of God and their true sorry at being a sinner. Clearly, this was no cure for the plague.