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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

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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

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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.

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Zodiac Sign Symbol Dates Part of the Body

Aries Ram 21 March – 19 April Bull 20 April – 20 May Twins/two arms 21 May – 20 June Crab 21 June – 22 July Lion 23 July – 22 August Maiden/Vase 23 August – 22 September Scales 23 September – 22 October Scorpion 23 October – 21 November Archer/Arrow 22 November – 21 December Goat 22 December – 19 January Waterman/Jug 20 January – 18 February Two fish 19 February – 20 March

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Brown Urine = Too much bile Red Urine = Too much blood

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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?

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What operation is shown in this image?

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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.

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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.

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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

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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. You are having

trouble walking and are unable Birthday – 20th April to work. Help!

You have a nasty cough and have been coughing up blood. Patient 6 Is this normal? You are very

worried. Please help. Birthday – 28th November

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Patient Symptoms Treatment

Perform a fistula operation, although without antiseptic, infection could set in and the patient could die.

You feel scared. Every time you Let out some blood, but not Patient 1 go to the toilet, it’s agony! You from a place that zodiac signs feel as if there are demons and the planets say should be Capricorn inside your bottom with avoided. daggers! Advise on the likelihood of survival (according to their life and death score) and pray for them accordingly.

Check the urine against your colour charts. Make sure you hold it up to the light for the best colour match. Advise the

patient they have too much Your urine is dark red and it Patient 2 blood and recommend blood hurts when you go to the toilet. letting. You are worried. What does this mean? Ensure that you let blood from

a place that is appropriate to their star sign.

Give the patient some licorice to clear the bowels followed by ginger to calm sickness. They will be cured in no time.

Patient 3 You are constipated, so much Tell the patient that they clearly so it is making you feel sick! have an imbalance of their 4 Virgo Please help humours. You could try some blood letting to rebalance the humours. Avoid letting blood from a place that does not suit their star sign.

Patient 4 You have been in a battle and Carry out an operation to Cancer have an arrow lodged in your remove the arrow from the

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skull. You are worried its skull, treat with natural herbs broken and are having terrible and stitch up the wound. headaches. Try letting some blood - it might work, but not if the patient is an Aries.

Calculate the patients’ name sum and advise them whether they will live or die according to whether the number is with Christ or Satan. Pray accordingly.

A swelling might mean there is

too much blood. Try letting You have a nasty swelling on some blood out of the swelling Patient 5 your foot that is causing you on the foot, unless the patient discomfort. You are having is a Pisces. Taurus trouble walking and are unable

to work. Help! Treat with Arnica which should

take away the swelling.

Examine the patients’ phlegm. Advise the patient that they have too much blood and try blood letting, although be careful to choose a place that does not interfere with their You have a nasty cough and star sign. Patient 6 have been coughing up blood.

Is this normal? You are very It could be that this blood is a Sagittarius worried. Please help. sign…it might be best to calculate whether the patient is with Christ or Satan by adding up the sum of their name. If they are with Christ, they will live, if with Satan they will die. Pray for them accordingly.

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