Middle Ages (1250-1500) medicine

The Four Humours 

• Hippocrates observed that when someone was ill, often a liquid would secrete from their body. 
• He believed these were humours and that they caused illness. 
• He said that there were four of these humours: phlegm, blood, yellow bile, and black bile.
• Hippocrates thought that when these four humours were not balanced, then it would cause an illness. 
• Galen, building on from the ideas of Hippocrates, said that the opposite would cure an imbalance of the humours. 
• For example, an illness described as cold and wet would be cured with something hot and dry - like peppers.

Fatalism 

• The Bible tells many stories of how  God sent down a disease in order to punish people for their sins.
• This idea would become known as Fatalism. 
• For example, Leprosy was long believed to be a punishment sent from God for sinners. 

Miasma 

• A simple belief that bad air contains harmful fumes that, when inhaled, would most likely cause illness. 
• Galen and Hippocrates both mentioned this theory within their own. 
• It linked to religion where pleasant smells were associated with spiritual cleanliness. 
• Associated bad smells with evil. 

Astrology 

• Some people believed that the allignment of the sun and stars (celestial bodies) could cause illness. 
• People composed specialist charts known as Almanacs which would be consulted to find out what type of disease people had (based upon the position of the celestial bodies and the birthday of the patient).
• The Church did not support this idea. 

Physicians 

• Trained and elite medical professionals. 
• Studied for 7 years at University. 
• Less than 100 worked in England during the 1300's. 
• They often charged expensive fees and were, consequently, employed by the rich. 
• Training at university was supervised closely by the Church and only taught ideas that the Church approved of. For example, Hippocrates and Galen.

Barber Surgeons 

• Did apprenticeships with other surgeons.
• Practiced and read books on the body. 
• One important guide that they used was called "wound man", and was an illustration that showed barber surgeons how to complete difficult surgeries. 
• Barber surgeons would complete basic surgeries such as bleeding, removing surface tumours, splinting broken bones, and sewing wounds. 
• They did all surgeries without anaesthetics. 

Women 

• Treated many illnesses. 
  
• Knew a wide range of remedies. 
• Some known as the "Wise Woman" who supported the community. 
• Some acted as midwives and in some towns were trained and licensed. 
• Women could work as surgeons but not as physicians. 

Herbal remedies 

• Obtained from apothecaries who mixed ingredients to create ointments and medicines. 
• These were either of their own design or under the instruction of a Physician. 
• Igredients included: herbs, minerals, and animal parts. 
• Sometimes these remedies included some elements of prayer and worship in certain cases. 
• Women were involved in the provision of herbal remedies, and were often capable of contructing their own handmade versions. 

Bleeding and purging 

• Used to rebalance the Humours.
  
• Complicated charts were established to guide the bleeding of patients. 
• These charts were supported using a "bleeding cup". 
• Leeches were also used to draw blood. 
• Purging was used by administering herbs to the patient which would lead to the emptying of the stomach and bowels. 

1. Cattle, Sheep, and Geese used to arrive into towns and villages to be sued for food. Additionally, Horses were the main form of transport. All this meant that dung was often left on the streets.   
1. Towns and cities employed rakers to clean the streets. Some cities, such as Newcastle, also paved their streets to make them easier to clean. 

2. Litter was often dropped and sometimes the streets were used as latrines. Butchers also threw waste and animal parts onto the streets. 
2. Cities passed laws to punish throwing waste onto the streets. Butchers had to dispose of waste outside of city walls and public latrines were built for use. 

3. Waste from the home and indistries was often put staright into the local water supply. 
3. Some cities, such as Gloucester, brought in clean water throug lead pipes whilst others, like Exeter, built aquaducts. 

4. Latrines and cesspits often linked together to store waste and they usually emptied straight into the local water supplies via seepage. 
4. Rules were introduced on where to build private latrines, cesspits were lined with stone, and night carts were started to collect waste.