The Middle Ages www.bl.uk/the-middle-ages Teachers’ Notes Curriculum subject: History Key Stage: 2, 3 or 4 Theme: The Middle Ages Topic: Medieval medicine Rationale Medieval medical treatises provide a fascinating insight into the beliefs and practises concerning health, illness, surgery and disease in the Middle Ages. The British Library holds a wealth of medical texts from this period that can form the basis of an activity that explores medieval medicine. This lesson uses a range of primary sources and puts students in the shoes of medieval patients and practitioners. This activity can be differentiated for Key Stage 2 children who may be looking at a study of medicine through time as part of a chronological unit. It could also form part of a study of the medieval period in Key Stage 3, or part of a GCSE course on medicine through time. Content Historical sources: Source Use Zodiac chart Supernatural beliefs Zodiac Man Supernatural beliefs Examining Urine Scientific diagnostic practice Trepanning operation Surgery Fistula Operation Surgery Apothecary Shop Herbal remedies Caesarean section operation Surgery The British Library | www.bl.uk/the-middle-ages 1 Medicinal Plants Herbal remedies Physician and assistant mixing herbal Herbal remedies medicines Childbirth and midwifery Women in medicine Table for astrological computation of illness Supernatural beliefs Image showing doctor instructing on mixing Surgery medicine, operating on person with hands tied and use of cautery iron Doctor taking pulse Scientific diagnosis Vein Man Knowledge of anatomy Herbal showing properties of buttercups Herbal Remedies Deaths from Pestilence Black Death/disease Black Death Account Black Death impact Recommended reading (short articles): Medicine, diagnosis and treatment in the Middle Ages by Alixe Bovey Key questions What was it like to be a doctor or a patient in the Middle Ages? What did medieval people believe about the cause, treatment and cure of disease and illness? How advanced was medieval medicine? Were medieval doctors believed to be trustworthy? Activities A medieval doctor’s surgery (dressing up and scene setting are optional!) 1.) Set the scene: Use an old lab coat or art apron and smear with black, brown and red paint to look dirty. Fill some cups with apple juice or old tea. Borrow some rusty looking tools from the site manager, taking care to adhere to health and safety rules, and also have these on display. Welcome students to the St. Thomas Becket (controversial) memorial hospital (or use another name). Explain that you are almost ready for the hoards of patients that you will see today, although you still haven’t got rid of the urine you were testing yesterday yet. Explain that you will sell this to the lady in the village who dyes wool. Urine is particularly good for the process. Explain that you need to get your tools ready in case you have to carry out any operations. Pretend to clean your The British Library | www.bl.uk/the-middle-ages 2 tools by wiping them with your dirty coat/apron. Get out your medical observation notebook and talk about the fact that a true physician bases his work on observation of his patients. Then say a prayer and check the position of the planets to ensure they are aligned for todays’ patients. 2.) Following this introduction, carry out a short question and answer session with students. What is wrong here? How likely are you to survive if you get sick? Was medieval medical knowledge and practice really like this? Divide the class into two groups – doctors and patients. Each doctor should be given print outs of the sources listed at the start of this plan. The patients should be given the list of ailments and symptoms. Once paired up the patients should explain their symptoms to the doctor, who, using the print outs should make a diagnosis and recommend a course of action or treatment, which the patients write down. The patients should then consult with another doctor – and once again, make a note of the diagnosis and treatment. As a class encourage patients to share their illnesses, symptoms and diagnoses. Did the doctors accurately identify the illness? What were the recommended courses of treatment? Did they both agree? What are the likely side effects or implications of this treatment? As a class ask the doctors what they found difficult about the task. What sources did they use to diagnose the illness? How useful were they? Introduce the idea that these sources draw upon both the natural and supernatural . Ask your students to identify one of each of these. Discussion 3.) The zodiac chart clearly shows continued belief in the work of the Ancient Greek physicians, Galen and Hippocrates; yet this kind of knowledge would have been confined to highly educated people. These sources represent the height of medical knowledge at the time and are not necessarily representative of medical practice used by the majority. They would instead have routinely used herbs and probably resorted to praying and/or magical charms and spells. In addition, we do not know who is copying these texts. Monks often copied books, but the church had a difficult relationship with medicine. Many texts were also translated indicating room for error or misinterpretation. Also there are no images indicating the use of the occult or occult herbalism which was also common practice at the time. Why might this be? Where do the majority of these sources come from? (Europe). Is this level of medical knowledge indicative of knowledge throughout the world? 4.) Set the students a short research task to find out about the contributions of Rhazes, Ibn Nafis and Avicenna to medicine. 5.) Examine with students a quote from Italian poet Petrarch in which he writes about the Pope being ill: “I know that doctors are at your bedside and this fills me with fear. Their opinions are always conflicting…in order to make a name for themselves they gamble with our lives. They learn their art at our expense. O most gentle father, look upon them as a band of enemies.” 6.) Students are now ready for the debate: was Petrarch right to mistrust medieval doctors? Students should answer this referring to the sources they have encountered as The British Library | www.bl.uk/the-middle-ages 3 evidence. The most able students will also be able to set what they have learnt about medieval medical practice into the context of the time i.e. it may not have been good, but there were many factors in Europe that prevented further medical knowledge from developing, not least because religious rules at the time forbade the dissection of corpses to learn more about the human body and there were no microscopes to see or detect germs. Medical knowledge in the Arab world, while not completely accurate, was showing greater sign of development. The British Library | www.bl.uk/the-middle-ages 4 The British Library | www.bl.uk/the-middle-ages 5 Zodiac Sign Symbol Dates Part of the Body Aries Ram 21 March – 19 April Taurus Bull 20 April – 20 May Gemini Twins/two arms 21 May – 20 June Cancer Crab 21 June – 22 July Leo Lion 23 July – 22 August Virgo Maiden/Vase 23 August – 22 September Libra Scales 23 September – 22 October Scorpio Scorpion 23 October – 21 November Sagittarius Archer/Arrow 22 November – 21 December Capricorn Goat 22 December – 19 January Aquarius Waterman/Jug 20 January – 18 February Pisces Two fish 19 February – 20 March The British Library | www.bl.uk/the-middle-ages 6 Brown Urine = Too much bile Red Urine = Too much blood The British Library | www.bl.uk/the-middle-ages 7 The British Library | www.bl.uk/the-middle-ages 8 Describe each of the images in the series above. Why are the first three images significant? What is happening in the latter six images? What are the likely implications of this procedure? The British Library | www.bl.uk/the-middle-ages 9 What operation is shown in this image? The British Library | www.bl.uk/the-middle-ages 10 Images like these are often referred to as ‘Vein Men’ and show the points on the body considered the best for blood-letting, a treatment used in the Middle Ages to re-balance the four humors. The British Library | www.bl.uk/the-middle-ages 11 A=1, B=2 and so on. Write down your patients name and add up their score. Divide the number by 30. If the number is less than 5 then it falls into Christ, the top image, and the patient will survive. Anything else falls into Satan, the bottom picture, and the patient will die. The British Library | www.bl.uk/the-middle-ages 12 Aloe Vera sooths burns Arnica is an anti-inflammatory and can sooth swelling Dandelion can treat kidney and bladder disease. Licorice can empty your bowel Ginger relieves nausea The British Library | www.bl.uk/the-middle-ages 13 Patient Symptoms Treatment You feel scared. Every time you go to the toilet, it’s agony! You Patient 1 feel as if there are demons inside your bottom with Birthday – 25th December daggers! Your urine is dark red and it hurts when you go to the toilet. Patient 2 You are worried. What does this mean? Birthday – 8th April You are constipated, so much so it is making you feel sick! Patient 3 Please help Birthday – 20th September You have been in a battle and have an arrow lodged in your Patient 4 skull. You are worried its broken and are having terrible Birthday – 1st July headaches. You have a nasty swelling on your foot that is causing you Patient 5 discomfort.