GCSE History Medicine Through Time Revision Cards


Disease and the Supernatural

Mnay people believed that disease was a punishment from God for people's sins. They thought that disease existed to show them the error of their ways and to make them become better people. Therefore, they thought the way to cure disease was through prayer and repentance.

Disease was also thought tobe caused by evil supernatural beings, like demons or witches. Witches were believed to behind outbreaks of disease-many people were tried as witches and executed.

People believed that some diseases could be caused by evil spirits living inside someone. Members of the Church performed exorcisms, using chants to remove the spirit from the person's body.

1 of 35

Disease and the Supernatural

The Roman Catholic Church was an extremely powerful organisation in medieval Europe. It dominated the way people studied and thought about a range of topics, including medicine.

The Church encouraged people to believe that disease was a punishment from God, rather than having a natural cause. This prevented people from trying to find cures for disease-if disease was a punishment from God, all you could do was pray and repent.

The Church made sure that scholars of medicine learned the works of Galen as his ideas fit the Christian belief that God created human bodies and made them to be perfect. It also stopped anyone from disagreeing with Galen.

The Church outlawed dissection. This meant that medieval doctors couldn't discover ideas about human anatomy for themselves-they instead had to learn Galen's incorrect ideas.

2 of 35

Disease and the Supernatural

Astrology is the idea that the movements of the planets and stars have an affect on the Earth and on people. Astrologers in medieval England believed that these movements could cause disease.

Astrology was a new way of diagnosing disease. It was developed in Arabic medicine and brought to Europe between 1100 and 1300.

Medieval doctors owned a type of calendar (called an almanc) which included information about where particular planets and stars were at any given time. The doctor then used this information to predict how patients' health could be affected.

Different star signs were thought to affect different parts of the body. 

3 of 35

Natural Explanations

After the fall of the Roman Empire, much Ancient Greek and Roam medical knowledge was lost in the West. The Theory of the Four Humours was eventually brought back to western Europe via the Islamic world. Many medieval doctors based their diagnosis and treatment on this theory.

The Theory of the Four Humours was created by the Ancient Greek doctor Hippocrates (c.460-c.377 B.C.). Hippocrates believed that the body was made up of four fluids (or humours)-blood, phlegm, yellow bile and black bile. These werelinked to the four seasons and the four elements. They needed to be in balance for good health.

The Theory of the Four Humours was developed further by another Greek doctor, Galen, who was born in AD 129 and worked for much of his career in Rome.

Galen believed that diseases could be treated using opposites. He thought that different foods, drinks, herbs and spices had a humour, which could balance the excessive humour that was causing the disease. 

4 of 35

Natural Explanations

The miasma theory is the idea that bad air (or miasma) causes disease when someone breathes it in. This bad air may come from human waste or dead bodies-anything that creates a bad smell.

The miasma theory originated in Ancient Greece and Rome, and was incorporated by Galen into the Theory of the Four Humours. The idea became extremely popular in medieval Britain.

The miasma theory was so influential that it lasted until the 1860s, when it was repaced by the Germ Theory. Miasma often prompted people to do hygenic things, like cleaning the streets, which sometimes helped to stop the spread of disease (but for the wrong reasons). 

5 of 35

Natural Explanations

The work of Hippocrates and Galen was extremely influential in medical diagnosis and treatment.

Hippocrates and Galen wrote down their beliefa about medicine. These were translated into Latin books, which were considered important texts by the Roman Catholic Church. Like the Bible, Hippocrates' and Galen's ideas were considered the absolute truth.

Many of their ideas were taught for centuries after their deaths, including the incorrect ones. For example, Galen only ever dissected animals-animal and human bodies are very different, so some of his ideas about anatomy were wrong. Medieval doctors were not allowed to perform their own dissections, so they continued to learn Galen's incorrect ideas.

Some of Hippocrates' and Galen's ideas were so influential that they continue to be used today. The HIppocratic Oath is the promise made by doctors to obey rules of behaviour in their professional lives-a version of it is till in use today. Hippocrates and Galen also believed tht doctors should observe their patients as they treat them. 

6 of 35

Islamic Medicine

While a lot of medical knowledge was lost in the West after the fall of the Roman Empire, medical ideas like the Four Humours and treatment by opposites were kept alive by Islamic scholars.

In the 9th century, Hunain ibn Ishaq (also known by his Latin name Johannitius) travelled from Baghdad to Byzantium to collect Greek medical texts. He translated these into Arabic.

This classical knowledge was eventually brought to Europe by Avicenna (or Ibn Sina), a persian who lived from around AD 980-1037. Avicenna wrote the 'Canon of Medicine', which brought together the ideas of Galen and Hippocrates, and was the most important way that classical ideas got back into Western Europe.

This work and other Islamic texts were translated into Latin in Spain (which was partly Christian and partly Islamic) or Italy. The Crusades also made Europeans aware of the scientific knowledge of Islaic doctors.

7 of 35

Islamic Medicine

Albucasis (or Abu al-Qasim, born c.AD 936) wrote a well thought-out book describing amputations, the removal of baldder stones and dental surgery-as well as methods for handling fractures, dislocarions and the stitching of wounds.

In the 12th century, Avenzoar (or Ibn Zuhr) described the parasite that causes scabies and began to question the reliability of Galen.

Ibn al-Nafis, wholived in the 13th century, also questioned Galen's ideas. He suggested (correctly) that blood flows from one side of the heart to the other via the lungs-and doesn't cross the septum (the dividing wall between the left and right sides of the heart). Ibn al-Nafis' work wasn't recognised in the West until the 20th century.

8 of 35

Islamic Medicine

Alchemy was the attempt to turn base (ordinary) metals into gold and discover the elixir of eternal life.

Alchemy traces its origins back to the Egyptians and it was preserved in the Islamic world.

Unlike modern chemisty, much superstition was included-an unseccessful experiment was as likely to be blamed on the position of the stars or the spiritual purity of the alchemist as anything else.

Even so, Arabic alchemists invented useful techniques such as distillation and sublimation, and prepared drugs such as laudanum, benzion and camphor.

9 of 35

Treating Disease

Disease was believed to be a punshment from God, so sick people were encpuraged to pray. The sick often prayed to saints, in the hope they would intervene and stop the illness. Medieval people also believed that pilgrimages to holy shrines (e.g. sites containing the remains of saints) could cure illness.

Others took their repentance one step further. Flagellants were people who whipped themselves in public in order to show God that they were sorry for their past actions. They were particularly common during epidemics, such as the Black Death.

Many doctors has superstitious beliefs-e.g. some used astrology to diagnose and treat illness, or believed that saying certain words while giving a treatment could make that treatment more effective.

10 of 35

Treating Disease

Bloodletting and purging were popular treatments because they fitted in with the Four Humours Theory.

If someone apparently had too much blood inside them, the doctor would take blood out of their body through bloodletting-they might make a small cut to remove the blood or use blood-sucking leeches.

Some people were accidentally killed because too much blood was taken.

Purging is the act of getting rid of other fluids from the body by excreting-doctors gave their patients laxatives to help the purging process.

11 of 35

Treating Disease

The miasma theory led people to believe in the power of purifying or cleaning the air to prevent sickness and improve health.

Physicians carried posies or oranges around with them when visiting patients to protect themselves from catching a disease.

During the Black Death, juniper, myrrh and incense were burned so the smoke or scent would fill the room and stop bad air from bringing disease inside.

12 of 35

Treating Disease

Remedies bought from an apothecary, local 'wise women' or made at home were all popular in medieval Britain and contained herbs, spices, animal parts and minerals.

These remedies were either passed down or written in books explaining how to kix them together. Some of these books were called 'Herbals'.

Other remedies were based on superstition, like lucky charms containing 'powdered unicorn's horn'.

13 of 35

Treating Disease

Physicians were male doctors who had trained at university for at least seven years. They read ancient texts as well as writings from the Islamic world but their training involved little practical experience. They used handbooks (vademecums) and clinical observation to check patients' conditions. But there were fewer than 100 physicians in England in 1300, and they were very expensive.

Most people saw an apothecary, who prepared and sold remedies, and gave advice on how best to use them. Apothecaries were the most common form of treatment in Briatin as they were the most accessible for those who could not afford a physician.

Apothecaries were trained through apprenticeships. Most apothecaries were men, but there were alos many so-called 'wise women', who cold herbal remedies.

14 of 35

Treating Disease

Most public hospitals were set up and run by the Church. There were relatively few such hospitals, but they were very popular and highly regarded.

The main purpose of hospitals was not to treat disease, but to care for the sick and elderly. The hospital provided its patients with food, water and a warm place to stay. Most hospitals were also more hygenic than elsewhere, because they had developed water and sewerage systems.

Some monasteries also cared for the sick, the elderly or the poor.

Most sick people were treated at home by members of their family.

15 of 35

Treating Disease

Medieval surgery was very dangerous-there was no way to prevent blood loss, infection or pain. It was therefore only attemped rarely and for very minor procedures, e.g. treating hernias or cataracts.

There were a few university-trained, highly paid surgeons, but surgery as a whole was not a respected profession in medieval times-most operations were carried out by barber-surgeons (who also cut hair).

16 of 35

Treating Disease

Hugh of Lucca and his son Theodoric worked as surgeons in Italy in the early 13th century. They recognised the importance of practical experience and observation, and questioned some of Galen's ideas-their thoughts appear in Theodoric's textbooks.

They began dressing wounds with bandages soaked in wine because they noticed that the wine helped to keep wounds clean and prevent infection. They made this discovery by chance.

They also realised that pus was not a healthy sign, unlike other doctors at the time who might try to cause wounds to pus because they believed it would release toxins from the body.

Some surgeons tried to find ways to reduce pain during operations.For example, John of Arderne created a recipe for an anaesthetic in 1376 which included hemlock, opium and henbane (a relative of deadly nightshade). In carefully controlled doses this may have worked-but was very likely to kill.

17 of 35

Health in Towns and Monasteries

Most towns were small, especially after the Black Death when a lot of people died. Houses were usually made of wool and were crammed together-overcrowding and fires were common problems.

A lot of towns didn't have clean water supplies or sewerage systems-waste was chucked into the street or into rivers to be washed away. Sewage from latrines leaked into the ground and got into wells.

Businesses and homes weren't separated-butchers, tanners and dyers threw toxic waste into rivers and residential streets. People had to get their drinking water from rivers and wells that were contaminated.

In the 13th century, a water channel called the Great Conduit was built to bring clean water into London, as the Thames was getting too toxic.

In 1388, the government ordered town authorities to keep the streets free of waste. Towns introduced public health measures to tackle waste, sewage and pollution and to create a clean water supply.

18 of 35

Health in Towns and Monasteries

York and London both banned people from dumping waste in the street. These cities also built latrines over rivers so that sewage could be carried away.

London eventually banned any waste from being thrown into the Thames-carters were hired to collect waste and take it out of the city.

Many towns, like York, ordered toxic businesses like butchers, tanners, fishmongers and dyers to move outside the city walls.

19 of 35

Health in Towns and Monastaries

Monastaries had cleaner water than towns and had good systems for getting rid of waste and sewage. Monks also had access to books on healing and they knew how to grow herbs and make herbal remedies.

It was easier to create healthy living conditions in monastaries than it was in towns.

Monastaries were wealthy, so they could afford to build infrastructure like latrine buildings and waterways to keep their water clean. Towns had to rely on wealthy individuals to fund these kinds of projects.

Monastery populations were small and had one leader (the abbott)-he had the power to enforce rules about clenliness and waste disposal. Getting hundreds of townspeople to adopt cleaner habits was trickier-towns didn't have one person in charge who could easily enforce public health measures.

20 of 35

Health in Towns and Monastaries

Monastaries separated clean and dirty water. They had one water supply for cooking and drinking and one for drainage and washing, so people didn't have to drink dirty water like they did in towns.

Most monastaries were built near rivers. If there was no river, man-made waterways were built to supply clean water.

Sick monks were cared for in infirmaries. These infirmaries normally had their own kitchen that served good meals and meat to help sick monks to recover.

Some monastaries had hospitals that cared for poor peopke from the local community when they were sick and gave shelter to travellers. Benedictine monks believed caring for the sick was the most important Christian duty.

Latrines were put in separate buildings, which were often built over streams of running water that carried sewage away.

21 of 35

The Black Death in Britain

The Black Death was a series of plagues that swept Europe in the 14th century. 

It was really two illnesses:

1) Bubonic plague, spread by the bites of fleas from rats carried on ships. This caused headaches and a high temperature, followed by pus-filled swellings on the skin.

2) Pneumonic plague was airborne-it was spread by coughs and sneezes. It attacked the lungs, making it painful to breathe and causing victims to cough up blood.

The disease first arrived in Britain in 1348. Some historians think at least a third of the British population died as a result of the Black Death in 1348-50. There were further outbreaks of the Black Death throughout the Middle Ages. 

22 of 35

The Black Death in Britain

No-one at time knew what had caused the plague.

Some people believed that the Black Death was a judgement from God. They thought the cause of the disease was sin, so they tried to prevent the spread of the disease through prayer and fasting.

Some blamed humour imbalance, so tried to get rid of the Black Death through bloodletting and purging. Those who thought that the disease was caused by miasma carried strong smelling herbs or lit fires to purify the air.

Some people also carried charms of used 'magic' potions containing arsenic.

23 of 35

The Black Death in Britain

Some people in Winchester thought that you could catch the plague from being too close to the bodies of dead victims. When the town's cemetery became too full to take any more plague victims, the townspeople refused to let the bishop extend the cemetery in the town centre. Instead, they insisted that new cemeteries be built outside of town, away fromt he houses.

The town of Gloucester tried to shut itself off from the outside world after hearing the Black Death had reached Bristol. This suggests that they thought the plague was spread by human contact. The attempt at prevention was unsuccessful-many people in the town died of the Black Death 

In November 1348, the disease reached London. In January 1349, King Edward III closed Parliament.

24 of 35

The Black Death in Britain

After the Black Death, there were fewer workers around. This meant that they could demand higher wages from their employers, and move around to find better work. The cost of land also decreased, allowing some peasants to buy land for the first time.

These changes threatened the power of the elites.The government created laws, such as the 1349 Ordinance of Labourers, to try and stop peasants moving around the country.

Some people think the Black Death helped cause the Peasants' Revolt in 1381, and, eventually, the collapse of the feudal system in Britain.

25 of 35

The Black Death in Britain

In 1348 a ship docked in Melcombe in Dorset, bringing with it the Black Death.  People must have known it was coming as it had spread INEXORABLY across the known world from Asia. Its impact was devastating. In some places whole villages were wiped out. Historians disagree about just how many people were killed by the epidemic of 1348–49, but estimates vary from 50 to 66 per cent.

26 of 35

The Black Death in Britain

To avoid infection:

1. March through the streets praying to God to spare us from the Plague: by order of the King.

2. Protect yourself by making candles as tall as yourself, and burning them in church.

3. Avoid eating too much.

4. Avoid taking a bath as opening the pores of the skin will let in the disease.

5. Avoid having sex as too much excitement can weaken you and make you more likely to catch the Plague.

6. Avoid all Plague victims.

7. Clean all filth from the streets: by order of the King.

8. Carry a posy of sweet-smelling herbs and spices to keep away the evil smells.

9. Attend church and pray for your soul every day to keep you healthy.

10. Bathe in urine three times a day, or drink it once a day to protect you from harm. 

27 of 35

The Black Death in Britain

For those who are infected:

1. Pop open the buboes (the swellings in the armpits) to release the disease.

2. Attach a live chicken (or pigeon) to the buboes to drive away the disease.

3. Drink a mixture of vinegar and mercury.

4. Carry out flagellation (walking through the streets praying to God for forgiveness and whipping yourself).

5. Bleeding will release the evils inside the body.

28 of 35

The Black Death in Britain

It is important to remember that historians today still debate the exact causes of the black death. The prevailing argument is that it was bubonic plague spread by rats. However, others suggest it was spread by close contact between humans. Archaeologists justr haven't found lots of rat bones, suggesting the plague wasn't spread by rats, and the fact that mortality rose in winter suggests the Black Plague may have been something other than bubonic plague all together. If we find it difficult to understand what caused the disease, what chance did the people in the middle ages have of understanding the cause, and then effectively curing, such a rampant disease?

29 of 35

Inoculation and Vaccination

in medieval China and other parts of Asia, people had been using a basic form of inoculation to prevent smallpox. They scratched pus or scabs from a smallpox victim onto healthy people's skin: they didn't realise it but it gave them a mild dose of the disease, which allowed them to build up resistance against attacks of the full, killer form of the disease. In 1721, smallpox inoculation was in demand in Britain when a fashionable aristocrat named Lady Mary Wortley Montagu had her children inoculated. She had seen it done in Turkey.

Incoulation became very profitable. For example, in the 1760s, a father and don surgeon team, Robert and Daniel Sutton, devised an easier way of inoculation and earned a fortune. only the rich could afford the treatment though. By the end of the 1770s, more and more doctors used the 'Sutton' method, and it became the normal practice for preventing smallpox. However there were problems with inoculation.

30 of 35

Inoculation and Vaccination

There were strong religious objections: some people still argued that God sent illness to test people's faith or to punish them for their sin, so preventing sickness with inoculation was wrong.

As germs and infection were not understood well at the time, it was hard for people to accept the idea of giving a small amount of disease to prevent a bigger disease. Doctors argued about the risk of dying from smallpox compared with that of dying after inoculation.

Sometimes inoculation gave people a strong dose of smallpox which could kill them.

The poorest people could not afford inoculation, so they were not protected.

However, the practice of inoculation slowly became more common in the 1740s and 1750s.

31 of 35

Inoculation and Vaccination

Smallpox inoculation was a well-known treatment before Edward jenner became a surgeon. Jenner may have heard stories thet milkmaids who caught cowpox (a similar, but milder version of smallpox that commonly affected cows) were protected against smallpox, and he decided to test this theory out.

The Gloucestershire in 1796, Jenner carried out an experiment: he inserted cowpox into a poor eight year old boy. If the cowpox worked then the child would not react to the follow up smallpox inoculation; if it failed, then he would develop smallpox scabs in the normal way. Six weeks later, he gave the boy smallpox inoculation: no disease followed.

jenner called his cowpox inoculation technique vaccination, based on the Latin word for cow (vacca). To prove that vaccination against smallpox worked without the need for someone to catch cowpox directly from a cow, Jenner gave cowpox to another patient, and then took cowpox pus from that patient to vaccinate a new patient. He tested this 16 times over several weeks. None of the patients reacted to smallpox inoculation, which allowed Jenner to conclude that cowpox protected humans from smallpox. 

32 of 35

Inoculation and Vaccination

Jenner published his vaccination findings in 1798, but he could not explain how vaccination worked, which made it difficult for others to accept it. Many doctors profited from smallpox inoculation, so they disliked his findings. In the London Smallpox Hospital, William Woodville and George Pearson carried out tests using cowpox, but their equipment was contaminated and one of their patients died, so they concluded that Jenner was wrong, and that there was little difference between smallpox inoculation and vaccination. Also, Jenner was not a fashionable city doctor, so their was snobbery against him. Despite criticisms Jenner had powerful supporters, especially when members of the royal family were vaccinated, and parliament agreed to give Jenner £10000 for his research in 1802.

Attitudes changed as people eventually realised that vaccination was more effective and less dangerous than inoculation. Although a few other people had used cowpox to prevent smallpox before Jenner, he had a greater impact because he proved his theories using scientific methods and carefully identified the cowpox disease. Jenner may not have discovered vaccination, but he made others notice it. By the 1800s, doctors were using his technique in America and Europe, and in 1853, the British government made smallpox vaccination compulsory,

33 of 35

The Renaissance

The Renaissance was a time of new ideas and fresh thinking. People began to challenge old beliefs, and there were many new developments in doctors' knowledge and skills.

In the Renaissance there was a rediscovery of knowledge from classical Greek and Roman times. Western doctors gained access to the original writings of Hippocrates, Galen and Avicenna (a persian physician who lived between 980 and 1037 AD). These hadn't been available in the medieval period. They led to greater interest in the Four Humours Theory and treatment by opposites.

But the Renaissance also saw the emergence of science as we know it from the magic and mysticism of medieval medicine. People thought about how the human body worked basedon direct observation and experimentation.

This was partly because many of the new books that had been found said that anatomy and dissections were very important. This encouraged people to examine the body themselves, and to come to their own conclusions about the causes of disease. 

34 of 35

The Renaissance

People began to question Galen's thinking and that of other ancient doctors. However, his writings continued to be studied.

Protestant Christianity spread across Europe during the Reformation, reducing the influence of the Catholic Church. Although religion was still important, the Church no longer had so much control over medical teaching.

Many doctors in the Renaissance trained at the College of Physicians, which had been set up in 1518. Here they read books by Galen, but also studied recent medical developments. Dissections - showing how the body actually worked - also became a key part of medical training.

The College of Physicians encouraged the licensing of doctors to stop the influence of quacks, who sold fake medicines. Some of the college's physicians (such as Harvey) made important discoveries about disease and the human body.

New weapons like cannons and guns were being used in war. This meant that doctors and surgeons had to treat injuries they hadn'tseen before, forcing them to create and find new treatments quickly.

35 of 35


No comments have yet been made

Similar History resources:

See all History resources »See all c.1000-c.1500: Medicine in Medieval Britain resources »