Approaches to disease (AQA GCSE History): Revision Notes
Approaches to disease in mediaeval Britain
Introduction
During mediaeval times in Britain, methods for treating and understanding disease were quite unreliable. Medical knowledge was limited, and explanations for illness were often based on supernatural beliefs rather than scientific evidence. However, some ideas did come from ancient Greek and Roman physicians like Hippocrates and Galen, whose work continued to influence mediaeval medicine.
The mediaeval period in Britain (roughly 1000-1500 CE) represents a fascinating blend of inherited classical knowledge and deeply held religious beliefs, creating a unique approach to understanding human health and disease.
Natural approaches to disease
Mediaeval physicians did attempt some rational, evidence-based approaches to treating illness, though these were often mixed with superstitious beliefs.
Apothecaries and herbal medicine
Apothecaries, who were essentially medicine-makers, created treatments using various herbs and plants. They believed that natural remedies could help cure different ailments. While some of these herbal treatments may have had genuine medicinal properties, the understanding of how they worked was limited.
Many mediaeval herbal remedies were passed down through oral traditions and practical experience. Some, like willow bark (containing salicin, similar to aspirin), actually had genuine therapeutic benefits, though mediaeval practitioners didn't understand the scientific mechanisms behind their effectiveness.
Miasma theory
Many people believed that disease was caused by "miasma" - bad air or unpleasant smells. To combat this, they would burn herbs to create sweet-smelling smoke, thinking this would drive away illness. This approach showed some logical thinking, as people were trying to identify and eliminate what they believed was the cause of disease.
Supernatural approaches to disease
Alongside natural remedies, mediaeval people strongly believed that supernatural forces played a major role in causing and curing illness.
Religious explanations
Many Christians believed that disease was a punishment sent by God for their sins. As a result, they would pray to God or to saints, hoping for divine intervention to cure their ailments. This religious approach to medicine was deeply embedded in mediaeval society.
The belief that illness was divine punishment had profound social consequences. Sick individuals often faced not only physical suffering but also social stigma, as their condition was seen as evidence of moral failing or insufficient faith.
Flagellation
Some people practised flagellation, which involved whipping themselves as a way of showing God that they were sorry for their sins. They believed that by demonstrating their repentance through physical suffering, God might remove their illness as a reward for their devotion.
Astrology
Mediaeval physicians often consulted the stars and planets when diagnosing patients. They believed that celestial bodies could influence human health and that the position of stars at the time of illness could explain why someone had become sick.
The Four Humours theory
The most influential medical theory in mediaeval Britain came from ancient Greek medicine, particularly the work of Hippocrates and later developed by Galen.
Basic concept
The Greeks believed that the human body contained four basic elements called the Four Humours. These were:
- Blood (associated with spring, hot and wet)
- Yellow bile (associated with summer, hot and dry)
- Black bile (associated with autumn, cold and dry)
- Phlegm (associated with winter, cold and wet)
According to this theory, when these four humours were properly balanced, a person remained healthy. However, when the humours became unbalanced, illness would result.
Worked Example: Applying the Four Humours Theory
A mediaeval physician examining a patient with a fever might reason as follows:
Step 1: Observe the symptoms - The patient has a high fever and appears flushed Step 2: Identify the imbalanced humour - Excess blood (hot and wet) is causing the fever Step 3: Choose appropriate treatment - Bloodletting to remove excess blood humour Step 4: Monitor the patient - Continue treatment until the fever subsides and balance is restored
This demonstrates how mediaeval doctors applied the theory systematically, even though the underlying science was incorrect.
Treatment methods
To restore the balance of humours, mediaeval physicians used several methods:
Purging: Making patients vomit or use their bowels to expel excess humours from the body.
Bleeding: Removing blood from patients either by cutting them or using leeches. This was thought to reduce excess blood humour.
Dietary changes: Adjusting what patients ate and drank to counteract imbalanced humours.
These treatments were often more harmful than helpful. Bloodletting, in particular, could weaken patients significantly and sometimes proved fatal. However, mediaeval practitioners genuinely believed they were following sound medical principles based on the best knowledge available to them.
Key historical figures
Hippocrates (c. 460 BCE)
Hippocrates was a Greek physician whose ideas greatly influenced mediaeval medicine. His most important contributions included:
Clinical observation: He encouraged doctors to carefully observe their patients and write down what they saw. This systematic approach to recording symptoms was revolutionary and is still used today.
The Hippocratic Oath: This was a promise made by new doctors to behave ethically and not harm their patients. The oath is still taken by doctors today, showing how influential Hippocrates' ideas about medical ethics were.
Hippocrates is often called the "Father of Medicine" because he was among the first to separate medicine from religion and superstition, advocating for natural causes of disease rather than purely supernatural explanations.
Galen (2nd century CE)
Galen was a Greek physician who studied medicine in Egypt and became a follower of Hippocrates. His contributions included:
Dissection: Although it was illegal in his hometown, Galen encouraged the dissection of bodies to better understand human anatomy. This hands-on approach helped doctors gain practical knowledge about how the body worked.
Theory of Opposites: Building on the Four Humours concept, Galen developed the idea that doctors should give patients the "opposite" of their symptoms. For example, if someone had too much phlegm (cold and wet), they should eat hot peppers to counteract this imbalance.
Medical texts: Galen wrote many books about medicine, which were later edited and preserved by Islamic scholars during the mediaeval period. These texts became standard references for European doctors.
Galen's influence on mediaeval medicine was so profound that questioning his teachings was often considered heretical. His anatomical knowledge, however, was largely based on animal dissection rather than human bodies, leading to some significant misconceptions that persisted for centuries.
Timeline of major events
- c. 460 BCE: Hippocrates born; develops clinical observation and Hippocratic Oath
- 2nd century CE: Galen develops Theory of Opposites, building on Four Humours theory
- Medieval period (c. 1000-1500): Four Humours theory dominates European medicine
- Throughout mediaeval period: Supernatural and natural approaches to disease coexist
- 19th century: Four Humours theory finally abandoned as medical knowledge advances
Key Points to Remember:
- Mediaeval approaches to disease mixed supernatural beliefs with some rational observation-based methods
- The Four Humours theory dominated medical thinking, suggesting illness came from imbalanced body elements
- Hippocrates introduced clinical observation and medical ethics that still influence doctors today
- Galen's Theory of Opposites aimed to restore humour balance by treating symptoms with their opposites
- Treatment methods included bleeding, purging, prayer, and herbal remedies, though their effectiveness was limited