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Where did ideas about Medieval come from?

What can we learn about pre-medieval medicine from the images?

a) Stone Age people could successfully perform operations. b) People in the Indus Valley understood something about hygiene and tried to keep places clean (and built ways of doing it). c) (& f) Ancient Egyptians and later, Arabs, attempted to treat illness & disease and had specially ‘trained’ people to do so. d) Ancient Greeks had places of healing. e) Romans understood the importance of having clean water (and went to great lengths to make sure people had access to it). *Asclepion = a temple dedicated to the God of healing, Asclepious. Where did medieval ideas about health come from? Two men, perhaps more than any others, contributed to the Western view of medicine and health at this time. They were and Galen.

The theory of the Four Humours Hippocrates wrote: 'The contains blood, phlegm, yellow bile and black bile. These are the things that make up its constitution and cause its pains and health. Health is primarily that state in which these constituent substances are in the correct proportion to each other, both in strength and quantity, and are well mixed. Pain occurs when one of the substances presents either a deficiency or an excess, or is separated in the body and not mixed with others.'

It was believed that the body had four humours (fluids in our bodies) and if these became unbalanced you got ill. Doctors studied a patient’s urine to detect if there was any unbalance.

To remain healthy the body needed to keep all four humours in balance. The warm humours would create sweating illnesses and the cold humours would have the opposite effect. Food and seasons also affected the humours. It was important to do all things in moderation to keep the body in balance.

This was an evidence-based but wrong approach; it has merit in not being based on superstition but became an widely held belief that slowed development of ideas. The influence of Galen Galen's work arrived in via Islamic texts and beliefs. Greek were made in Salerno, in Italy (the first medical dating from around AD900), and rapidly became accepted as university medical texts. Church leaders looked carefully at Galen's works and decided that they fitted with Christian ideas because throughout he referred to 'the Creator'. Doctors believed his ideas were correct and that it was nearly impossible to improve his work. As Salerno was a common stopping-off point en route to the Holy Land, Galen's ideas rapidly spread throughout Europe and became accepted as medical orthodoxy. Even was taught from Galen's book while an assistant would point to the relevant part of the body – and remember Galen was only allowed to dissect animals! Galen, AD130-c210 Hippocrates, 460–370BC • Born in what is now , in • Born in Kos, , in 460BC. AD130. • The first to regard the body • Studied medicine in Egypt as a whole, to be treated as a whole, before moving to . rather than individual parts. • Took Hippocrates' ideas further. • Based his thinking around the Four • He practised the dissection of Humours. These were to be kept in animals in order to better balance if a person was to be healthy. understand the human body. • He believed in the importance of • He worked for three years as a observation. doctor in a school • Around 60 texts are attributed to where his knowledge and Hippocrates, although many may have techniques developed. been written by his followers. • He used the theory of the Four • He believed that diet and rest were Humours, and emphasised the hugely important for a patient's importance of listening to a recovery. patient's . • Regarded by many as the father of • His ideas profoundly influenced modern medicine. Western ideas of medicine for a • Even today, new doctors around the very long time. world still take the HIPPOCRATIC OATH. Hippocrates

Hippocrates made such an impression on medical history that his name is still very much associated with medicine today. All newly qualified doctors take what is called the ‘Hippocratic Oath’ and some see Hippocrates as the father of modern medicine even though he did most of his work some 430 years before the birth of Christ.

Greek doctors had started to look at the issue of poor health and disease by using a process of reasoning and observation. The most famous of these was Hippocrates. He is thought to have been born in Kos in 460 BC. Very little is known about Hippocrates as a person but his fame was such that and wrote about him.

Hippocrates and other Greek doctors believed that the work done by a doctor should be kept separate from the work done by a priest. They believed that observation of a patient was a vital aspect of medical care. Ancient Greek doctors did examine their patients but Hippocrates wanted a more systematic period of observation and the recording of what was observed. Galen Galen was a physician, writer and philosopher who became the most famous doctor in the and whose theories dominated European medicine for 1,500 years.

Claudius Galen was born in Pergamum (modern-day Turkey) of Greek parents. He studied in Greece, in Alexandria and other parts of Minor and returned home to become chief physician to the gladiator school in Pergamum, gaining much experience of treating .

In the early AD, Galen moved to Rome to work and spent the remainder of his life in the Roman capital. He became physician to the emperor and successive emperors.

Galen was the originator of the experimental method in medical investigation, and throughout his life dissected animals in his quest to understand how the body functions. Some of his anatomical and physiological observations were accurate - for example, he proved that urine was formed in the . His most important discovery was that carry blood although he did not discover circulation. Hippocrates

1. Copy the diagram of the Four Humours. 2. Explain how the four humours were supposed to have worked. 3. Why did Hippocrates (and others) believe his ideas were correct? 4. What was significance of Hippocrates’ ideas?

Galen 1. Which of Hippocrates’s ideas did Galen continue to believe? 2. Why were Galen’s ideas significant? Who was more significant in influencing medieval medicine: Hippocrates or Galen?

1. Using the preceding slides, create a profile for each. Include dates, ideas, developments, their legacy. You can add pictures later. 2. Is there anything else you can add from extra research. 3. Use your profiles to answer the key question above.

https://www.classtools.net/FB/home-page Which contributed more to medical progress: Islam or Christianity?

Key words & concepts: almshouses; leper; ; Al-Razi P RO G R E S S

Islamic medicine has brought Our knowledge of health is

much progress …. improving all the time …

CHRISTIANITY ISLAM

Yes, and Christian medical Islam holds back medical practice has stagnated … progress …

S T A G N A T I O N In & on: Medieval Medicine 1 – how many can you answer? (back of books)

1. Who did most medieval people visit in villages for medical help? 2. Name one medical practitioner who was required to serve an apprenticeship. 3. What was the main method of treatment in medieval hospitals? 4. Who ran hospitals in medieval England? 5. How were they paid for? 6. Which medical practitioner studied at medical school? 7. What was the name given to bad smells believed to cause disease? 8. How did Galen study ? 9. Name one idea of Galen’s which turned out to be accurate. 10.Name the Four Humours. 11.Apart from bleeding, what else might a barber do? 12.What surgical procedure was used to keep the humours in balance? 13.What creature might also be used in this procedure? 14.What would a medieval physician test (by observation or smell / taste) to diagnose illness? 15.From what were most / ointments created? 16.Which scholar’s work was widely circulated at this time? 17.How did his ideas reach Engalnd? 18.Name one way in which Arabic medicine was better than Western medicine at this time. 19.What did the Church forbid that restricted medical progress? 20.Which ancient Greek developed the theory of the Four Humours? In & on: Medieval Medicine 1 – how many can you answer? (back of books)

1. Who did most medieval people visit in villages for medical help? (wise woman) 2. Name one medical practitioner who was required to serve an apprenticeship. (barber-surgeon, apothecary) 3. What was the main method of treatment in medieval hospitals? (prayer) 4. Who ran hospitals in medieval England? (monks / monasteries / Church) 5. How were they paid for? (charity) 6. Which medical practitioner studied at medical school? (physician / doctor) 7. What was the name given to bad smells believed to cause disease? (miasma) 8. How did Galen study anatomy? (dissected animals) 9. Name one idea of Galen’s which turned out to be accurate. (Arteries carried blood, urine formed in the kidneys) 10.Name the Four Humours. (black bile, yellow bile, phlegm, blood) 11.Apart from bleeding, what else might a barber surgeon do? (set broken bones, tooth extraction) 12.What surgical procedure was used to keep the humours in balance? (bleeding) 13.What creature might also be used in this procedure? (leeches) 14.What would a medieval physician test (by observation or smell / taste) to diagnose illness? (urine) 15.From what were most medicines / ointments created? ( / plants) 16.Which Arabic scholar’s work was widely circulated at this time? (Avicenna) 17.How did his ideas reach Engalnd? (through trade routes) 18.Name one way in which Arabic medicine was better than Western medicine at this time. (education / libraries, cleanliness, practical training. 19.What did the Church forbid that restricted medical progress? (dissection) 20.Which ancient Greek developed the theory of the Four Humours? (Hippocrates)