Paper 1 Medicine Key topics 1 and 2 (1250-1500, 1500-1700) Year 11 GCSE History Paper 1 – Medicine Information booklet Medieval Renaissance 1250-1500 1500-1750 Enlightenment Modern 1900-present 1700-1900 Case study: WW1 1 Paper 1 Medicine Key topics 1 and 2 (1250-1500, 1500-1700) Key topic 1.1 – Causes of disease 1250-1500 At this time there were four main ideas to explain why someone might become ill. Religious reasons - The Church was very powerful at this time. People would attend church 2/3 times a week and nuns and monks would care for people if they became ill. The Church told people that the Devil could infect people with disease and the only way to get better was to pray to God. The Church also told people that God could give you a disease to test your faith in him or sometimes send a great plague to punish people for their sins. People had so much belief in the Church no-one questioned the power of the Church and many people had believed this explanation of illness for over 1,000 years. Astrology -After so many people in Britain died during the Black Death (1348-49) people began to look for new ways to explain why they became sick. At this time doctors were called physicians. They would check someone’s urine and judge if you were ill based on its colour. They also believed they could work out why disease you had by looking at where the planets were when you were born. They would check where the planets were and believed if they were in a bad order this could cause disease in people. Although the Church disagreed with it because it challenged their view that disease was caused by the Devil or God it became more popular after the Black Death. Miasma – this was the belief that when food or people rotted away they released a bad gas called miasma. This would enter the body and make the person sick. Therefore many people took great care to keep their home smelling nice. The Four Humours – this was an idea put forward by the Ancient Greeks and Romans. They saw that the natural world was balanced into four elements (earth, air, fire, water) and believed the human body must be the same. It was put forward by a Greek called Hippocrates and developed by a Roman called Galen. They believed there were four humours (liquids/elements) in the human body which were made from our food. Each person had their own balance of these humours, which would even affect your personality. If you ended up having too much of one humour you would become unbalanced and become sick. The four types were; Blood – from cuts, nosebleeds or when coughed up Phlegm – the thicker watery substance from your nose or eyes Black bile – clotted blood that you might find in excrement (poo) or vomit Yellow bile – vomit or pus from a wound This could explain both physical and mental problems. It was also linked to astrology as the stars and planets were linked to each. If you were sick you would go to a physician who would check the stars and tell you what the problem was with your balance based on this. Why did these ideas continue during this period? The Church controlled learning at this time so they made sure that only traditional ideas about medicine were taught. For example the Church taught physicians about the four humours so this is what they used to find out about disease. Because the Church trusted the work of Hippocrates they copied books by these men, used them to teach other physicians and stopped anyone challenging their ideas. However without the technology there was no real way to find out what actually caused diseases and nobody wanted to disagree with the church for fear of going to Hell by going against the idea of the Four Humours or the role of God in causing disease. 2 Paper 1 Medicine Key topics 1 and 2 (1250-1500, 1500-1700) 1.1 Key facts – causes of disease 1250-1500 • Medieval people did not understand the science behind how people became ill. They looked to the Church which told them it was a punishment from God • Others blamed a bad order of planets or miasma – bad air that came from rotting things that people believed entered your body and made you ill • The theory of the Four Humans came from the ancient work of Galen and Hippocrates • It said the body had four main fluids and if one was imbalanced it would make the person sick • The power of the Church and lack of scientific understanding saw little progress in understanding illness at this time. Key topic 1.2 – Prevention and treatment of illness 1250-1500 How did people treat diseases and try to prevent themselves becoming sick? The Church- people were told that illness was sent by God as punishment for sin so you would have to pray to God for forgiveness as well as get help. People would pray in Church, go on a pilgrimage to a holy place where saints had been buried hoping this would cure them and go without food (fasting) to show God how sorry you were about your sins. The Church taught people that only through God’s forgiveness would he take away your illness. Balancing out the humours - Today if someone is ill (e.g. coughing with a high temperature) we try and kill the germs causing the disease rather than just trying to stop the person coughing. In the Medieval period each symptom (and not the disease as they couldn’t detect this) would be treated. People believed an imbalance of your humours caused illness. People would do the opposite of the humour they had an imbalance of to correct this. For example if you had too much black bile, people would have a hot bath (check the diagram above). Phlebotomy – The most common form of treatment was called phlebotomy or bleeding. People would pay a barber surgeon or wise women to cut a vein in their arm, use leeches to suck blood from them or scratch their skin and use hot cups to suck the blood out. Many people actually died from having too much blood taken from them. This was done when physicians believed there was too much blood in someone’s system. Purging – people believed that the body used food to create the four humours so sometimes you would have to get rid of all the food in your body to start again. People would take something called an emetic (such as poison or bitter herbs) to make themselves vomit. They could take a laxative like linseeds. One physician would even squirt a special mixture up a person’s anus using a greased pipe attached to a pig’s bladder to help people go to the toilet more. This was called a clyster or enema. Thus was done when physicians believed there was too much yellow bile in someone. Remedies – people would also take herbal medicines if they were ill. A famous medicine was something called theriaca. It was made by apothecaries and contained 70 different ingredients such as ginger, pepper, viper flesh and opium (heroin). Because the famous Galen had written about this medicine, people believed it would work. Taking remedies was much cheaper than seeing a physician so most poor people tended to take these. How to prevent diseases? Everyone at this time was Christian and believed by going to Church, giving a tithe and trying not to sin God would not punish you with an illness. The Church also told people that being clean was almost as important as believing in God. People took advice from books Galen and Hippocrates had written about called the ‘regimen sanitatis1’. It told people to wash their hands before eating, do not overeat, bathe regularly and avoid extremes of heat, cold, dryness or humidity. As only the rich could afford private baths ordinary people would go to public baths or swim in rivers. The regimen sanitatis also told people to breathe clean air that did not contain miasma (rotting things) so people used sweet smelling herbs in their homes and some local towns even tried to organise the collection of rotting animals and cleaned smelly public toilets. 1 We can translate this as meaning have a clean regime or lifestyle 3 Paper 1 Medicine Key topics 1 and 2 (1250-1500, 1500-1700) What was Medieval medicine like? - Asking for medical advice was expensive and not guaranteed to work (due to their limited medical knowledge) so most people chose to be looked after at home by the women in their family. Physicians -However wealthy people could afford to pay for physicians (what doctors were called at this time). They only diagnosed why someone was ill and told them what to do, they would not treat the person themselves. First they would check the patient’s urine, blood and faeces. They would then find out when the person was born and check where the planets and stars were when they were born. They would then check their books and use these to tell them what they needed to do to re-balance their humours (e.g. bloodletting or purging). Most of the people educated to by physicians were priests who were not allowed to bleed patients. Only the wealthiest and members of the royal families could afford physicians. Apothecaries – they used their education, training and books like Materia Medica to make herbal remedies to give to people.