Mediese behandeling in die Middeleeue

Mediese behandeling in die Middeleeue



We are searching data for your request:

Forums and discussions:
Manuals and reference books:
Data from registers:
Wait the end of the search in all databases.
Upon completion, a link will appear to access the found materials.

Baie mediese behandeling in die Middeleeue was gebaseer op idees wat deur die Grieke en Romeine ontwikkel is. Die belangrikste aspek hiervan was die teorie van die vier humours. Daar is aangevoer dat die liggaam vier humoure bevat: bloed, slym, geel gal en swart gal. Hierdie humor het verband gehou met verskillende dele van die liggaam en het verskillende eienskappe: bloed (hart: warm en klam); slym (brein: koud en klam); geel gal (lewer: warm en droog) en swart gal (milt: koud en droog).

Daar word geglo dat as iemand siek was, die vier humoure in die liggaam nie eweredig was nie. 'N Pasiënt word gewoonlik aangeraai om te rus sodat die liggaam sy natuurlike balans kan herstel. As dit nie slaag nie, is die pasiënt se dieet verander. As die pasiënt byvoorbeeld koud voel, sal hy of sy warm kos kry.

As die verandering in die dieet nie slaag nie, en die pasiënt redelik voorspoedig is, sal 'n chirurg ingeroep word. sal eerder gebruik word.

Die chirurg sou die pasiënt ondersoek en as hy of sy warmer as gewoonlik was, sou daar beweer word dat daar te veel bloed in die liggaam was. Die oplossing vir hierdie probleem was om van die bloed te verwyder deur die are van die pasiënt met 'n mes oop te maak. Behalwe bloedverlies, kan chirurge ook klein operasies uitvoer en eenvoudige beenbreuke hanteer.

Daar was ook hospitale in die vroeë Middeleeue. Hulle is egter hoofsaaklik gebruik om te isoleer eerder as om siekes te genees. Toe mense in 'n hospitaal opgaan, is hul eiendom weggegee omdat daar nie van hulle verwag sou word om te oorleef nie.
Een van die belangrikste maniere om siektes in die Middeleeue te hanteer, was deur gebed. Daar word geglo dat mense wat aan siektes ly, waarskynlik deur God gestraf word vir sondes wat hulle in die verlede gedoen het.

Die Swart Dood wat ongeveer 'n derde van die wêreld se bevolking doodgemaak het, het 'n dramatiese uitwerking op mense se houding teenoor mediese behandeling. Tradisionele metodes om siektes te behandel, soos bloedvergieting, suiwering met lakseermiddels, die dieet van die pasiënt, kruiemiddels, ens., Was heeltemal ondoeltreffend teen die siekte.

Daar is baie gesprekke gevoer oor die oorsaak van die Swart Dood. Dokters kon nie die regte antwoord kry nie. Verskeie het egter naby gekom om die oorsaak te identifiseer. Een dokter uit Persië beweer dat die
siekte is aan mense oorgedra deur 'muise en diere' wat normaalweg 'onder die aarde geleef' het. 'N Dokter uit Swede het aangevoer dat dit' vlooie en ongediertes 'was wat die Swart Dood veroorsaak het.

Dokters het bewus geword dat dit belangrik is om 'n groot hoeveelheid kennis oor siektes op te bou. Geleerdes het afskrifte van boeke wat deur dokters in ander lande geskryf is, bekom en in Engels laat vertaal. Dit was 'n belangrike ontwikkeling, aangesien mediese boeke in Engeland in die verlede slegs in Latyn beskikbaar was, wat die aantal mense wat dit kon lees, beperk het.

Op hierdie manier is inligting oorgedra oor die suksesvolle behandeling van siektes. Byvoorbeeld, die Hotel Dieu, 'n groot hospitaal in Parys, was 'n pionier in 'n nuwe benadering tot die hantering van pasiënte. Die hospitaal is in afdelings verdeel. Elke wyk het verskillende probleme hanteer. Mense met gebreekte bene sal in een saal behandel word, terwyl 'n ander aansteeklike siektes behandel.

Die Hotel Dieu het baie aandag gegee aan higiëne. Alle pasiënte het skoon japonne gekry en gereeld gebad. Soos alle hospitale, het pasiënte nog drie tot vier in die bed geslaap, maar die lakens is elke week omgeruil. Die vloere van die sale is skoon gehou en die mure met kalk afgespoel.

Inligting oor die suksesvolle behandeling van pasiënte in die Hotel Dieu het gou na ander lande versprei. Dit was nie lank voordat dokters soortgelyke hervormings in hul hospitale begin instel het nie.

Mense se oortuiging dat gebed hulle teen siektes sou beskerm, word ondermyn deur die Swart Dood. Sommige het die argument aanvaar dat die plaag 'n gawe van God was, en het hulle vroeë toegang tot die paradys gebied. Ander was van mening dat die Kerk hulle moes kon waarsku oor die naderende ramp. Daar is ook daarop gewys dat terwyl sommige priesters gebly en die mense in die dorp gehelp het, baie ander gevlug het. Een van die interessante gevolge van die Swart Dood was die groeiende neiging dat mense eerder geld in hul testamente aan hospitale as aan kerke oorlaat. Dit het 'n ekstra sewentig hospitale tussen 1350 en 1390 in Engeland gebou.

Tydens baie warm weer moet flebotomie (bloedvergieting) nie onderneem word nie, omdat humeur vinnig uitloop soos die slegte. Flebotomie moet ook nie in baie koue weer gedoen word nie, want die goeie humeur is in die liggaam gekompakteer en moeilik om uit te trek, en die goeie kom vinniger uit as die slegte ... As die bloed swart lyk, trek dit af totdat dit rooi word . As dit dik is, totdat dit uitdun: as dit waterig is, totdat dit dik word ... Flebotomie maak die verstand skoon, versterk die geheue, reinig die maag, verskerp die gehoor, ontwikkel die sintuie, bevorder vertering, produseer 'n musikale stem, voed die bloed, ontslae te raak van giftige materiaal, en bring 'n lang lewe. Dit raak ontslae van siektes, genees pyne, koors en verskillende siektes.

Die kennis van anatomie word op twee maniere verkry; die een is deur boeke ... die tweede manier is deur dooie liggame te ontleed, naamlik diegene wat onlangs onthoof of gehang is. Op hierdie manier leer ons die anatomie van die interne organe, die spiere, vel, are en senings.

Sy lê die bloedysters in die aar van Robin Hood
En steek die aar deur en laat die bloed uit,
En daarna die dun,
En toe goed geweet dat daar verraad binne was.

Siekte in die 14de eeu (antwoordkommentaar)

King Harold II en Stamford Bridge (antwoordkommentaar)

The Battle of Hastings (antwoordkommentaar)

William the Conqueror (Antwoordkommentaar)

Die feodale stelsel (antwoordkommentaar)

Die Domesday -opname (antwoordkommentaar)

Thomas Becket en Henry II (Antwoordkommentaar)

Waarom is Thomas Becket vermoor? (Antwoord kommentaar)

Verligte manuskripte in die Middeleeue (antwoordkommentaar)

Yalding: Middeleeuse dorpsprojek (differensiasie)


Gewilde mediese behandelings - koppie, bloeding en suiwering

Koppie, bloeding en suiwering was algemene metodes wat gebruik word om die balans tussen die humour te herstel.

Jost Amman: *Eygentliche Beschreibung aller Stände auff Erden *, Cupping, 1568

In die vroeë moderne era word gedink dat siektes veroorsaak word deur versteurings van die liggaam, wat, as dit heeltemal gesond was, in 'n innerlike toestand van harmonieuse balans was, soos die wêreld of die kosmos. Hierdie model kan beskou word as 'n verdere ontwikkeling van Galen se leer oor die vier humore, waarvolgens daar 'n balans moet wees tussen die vier kardinale vloeistowwe in die liggaam, dit wil sê bloed, slym en geel en swart gal. Enige obstruksie of viskositeit moes dus behandel word, en een van die gewildste en universele metodes om fisiese balans te herstel, was bloeding.

Bloeding is gebruik vir enige vorm van siekte, en selfs die gesondes het dit verskeie kere per jaar ondergaan as 'n voorkomende maatreël. Dit was meestal kapperchirurge wat hierdie taamlik gevaarlike behandeling toegedien het, en hul gebrek aan anatomiese kennis het die probleem dikwels vererger as wat hulle kon en soms slagoffers per ongeluk gesny het, en as die snye besmet raak, het die pasiënt se toestand dikwels versleg.

Daar word ook vermoed dat koppie oormatige humeur verwyder, maar hierdie behandeling was effens minder gevaarlik. 'N Spesiaal gevormde glas is verhit en op die vel aangebring. Die vakuum wat deur die glasverkoeling geskep is, was veronderstel om skadelike stowwe te onttrek; hierdie metode is dus ook gebruik na 'n matige verbruik van alkohol.

Suiwering is gebruik vir siektes van die maag en spysverteringskanaal. Emetika of klysters is toegedien, wat die liggaam reinig en die welsyn herstel.

In badhuise is aktiwiteite soos bad en sweet, 'transpirasie' en 'ventilasie' as sosiale geleenthede beskou.


Kruie en die eienskappe van plante

Een van die gewildste mediese tekste wat uit hierdie tydperk na Rome oorgebly het, is dié wat plantmiddels bevat, gesamentlik bekend as kruie. Kruie beskryf die eienskappe van verskillende plante en die gebruik daarvan, veral medisinale. Die bekendste kruie -outeur was die Griekse dokter Dioscorides (b. c. 40, d. 90), wat in die 1ste eeu aktief was. Dioscorides en rsquos se werk het in Europa bekend geword as die Herbarium, die woord vir & lsquoherbal & rsquo in Latyn. 'N Ander gewilde kruieteks in die vroeë Middeleeue was 'n aanpassing van die Herbarium toegeskryf aan 'n andersins onbekende wyle Antieke skrywer genaamd Pseudo-Apuleius. Pseudo-Apuleius en rsquos kruie is dikwels gekombineer met ander verhandelings, insluitend middels wat van diere verkry kan word, om te vorm wat vandag bekend staan ​​as die Pseudo-Apuleius-kompleks.

Dioscorides, Liber de virtutibus herbarium

'N Vroeë vertaling van die Herbarium van Dioscorides (BnF, Latyn 12995, f. 4r)


Geneeskunde, diagnose en behandeling in die Middeleeue

Die meeste Middeleeuse idees oor medisyne was gebaseer op die van die antieke werk, naamlik die werk van die Griekse dokters Galen (129 nC – 216) en Hippokrates (460 vC – 370 vC). Hulle idees bevat 'n teorie van die menslike liggaam wat betrekking het op die vier elemente (aarde, lug, vuur en water) en op vier liggaamlike humoure (bloed, slym, geel gal en swart gal). Daar word geglo dat die gesondheid gehandhaaf of herstel kan word deur die balans tussen humeur en die regulering van lug, dieet, oefening, slaap, ontruiming en emosie. Dokters het ook dikwels riskante indringende prosedures soos bloedvergieting aangeraai.

Mediese kennis wat uit die antieke teorie ontleen is, was grootliks beperk tot kloosters en hoogopgeleide persone. Vir gewone mense, veral diegene buite dorpe, sou dit moeilik gewees het om toegang tot professionele praktisyns te kry. Diegene wat mediese hulp nodig het, kan eerder na plaaslike mense gaan wat mediese kennis het, afkomstig van volksoorlewerings en praktiese ervaring.

Gildeboek van die Barber-Chirurge van die stad York

In die Middeleeue was kappers nie net verantwoordelik vir die sny van hare (om luise te verwyder nie), maar ook vir operasies soos tand-ekstraksie en amputasies. In Engeland, eers in 1745, is 'n aparte chirurgilde geskep, apart van die kappersgilde. Hierdie manuskrip is in die laat 15de eeu vir lede van die Guild of Barber Surgeons in York geskep en toon hoe mediese kennis en praktyk in die Middeleeue deur godsdiens en astrologie beïnvloed is.

Verdeel in twee dele, is dit laasgenoemde wat die mediese en astrologiese tekeninge en diagramme insluit, insluitend die van die Vein Man, die Zodiac Man, die Four Humours en 'n sirkelvormige zodiackaart, bekend as 'n volvelle, met bewegende dele. Die volvelle sou gebruik word om die beste tyd te voorspel om mediese behandeling te gee, en teen die einde van die 1500's sou dokters dit volgens wet gebruik om die posisie van die maan te bereken voordat hulle 'n operasie ondergaan. Die sukses van mediese behandeling word ook beskou as afhanklik van hulp van godsdienstige heiliges: die omring hier word omring deur Johannes die Doper, Johannes die Evangelis en die heiliges Cosmas en Damian, die beskermheiliges van dokters en chirurgie.

In die Middeleeue was die vier humore vermoedelik liggaamsvloeistowwe wat 'n persoon se gesondheid beïnvloed: bloed, slym, swart gal en geel gal. In die beeld word elkeen van die vier humor verpersoonlik en uitgebeeld rondom die sentrale beeld van die hoof van Christus. Elkeen is manlik en word geïdentifiseer deur onderskrifte wat ooreenstem met die vloeistowwe: Melankolie, sanguin, flegmaties en choleries.

Die tekening van die sterretjie man, met die naam 'Homo signorum', toon dele van die liggaam wat gekoppel is aan hul heersende zodiac -simbole. Hier kan ons sien Vis word geassosieer met die voete, Maagd met die maag en Stier met die nek.

Die sterre en planete

Middeleeuse astroloë het geglo dat die bewegings van die sterre talle dinge op aarde beïnvloed, van die weer en die groei van gewasse tot die persoonlikhede van pasgebore babas en die innerlike werking van die menslike liggaam. Dokters het dikwels spesiale almanakke (of kalenders) met geïllustreerde sterrekaarte rondgedra, sodat hulle die posisies van die sterre kon kontroleer voordat hulle 'n diagnose maak. Baie van hierdie almanakke bevat illustrasies wat help om ingewikkelde idees aan pasiënte te verduidelik. Die onderstaande foto toon 'n ‘ zodiac man ’ uit een van hierdie almanakke uit 1399. Die diagram was bedoel om te verduidelik hoe die astrologiese formasies (of sterretekens) oor elke liggaamsdeel heers. Die man se vinger wys as 'n waarskuwing teen die kragtige kragte van die sterre.

Antieke studies oor astrologie is in die 12de en 13de eeu van Arabies na Latyn vertaal en het spoedig deel geword van die alledaagse mediese praktyk in Europa. Teen die einde van die 1500's was dokters regoor Europa deur die wet verplig om die posisie van die maan te bereken voordat ingewikkelde mediese prosedures, soos chirurgie of bloeding, uitgevoer word.

Tekening van 'n mikrokosmiese man, uit 'n mediese verhandeling

Hierdie sirkeldiagram van 'n mikrokosmiese man, of 'n sterretjie, beskryf hoe astrologie verskillende dele van 'n menslike liggaam beïnvloed. Middeleeuse dokters sal hierdie kennis gebruik om die beste tyd te bepaal om middeleeuse behandelings uit te voer. Teen die einde van die 1500's moes dokters volgens die wet die posisie van die maan bereken voordat hulle geopereer is.

'N Diagram wat bekend staan ​​as die ‘zodiac man ’ het die toepaslike sterreteken op liggaamsdele aangebring in 'n manuskrip wat deur die Barber Surgeons of York besit word. volvelle) sodat die dokter die data kan aanpas volgens die posisie van die son en die maan.

Gildeboek van die Barber-Chirurge van die stad York

Ondersoek urine

Een van die belangrikste maniere waarop 'n dokter siektes sou diagnoseer, was deur ontlasting, bloed en veral urine te ondersoek: dokters word gereeld uitgebeeld in beelde wat 'n fles urine teen die lig hou.

Geskiedkundige voorletter van 'n dokter wat urine -ondersoek aan studente gee, van Hippocrates se Prognosticon

Dokters sou dikwels siektes diagnoseer deur urine te ondersoek en is geleer dat dit sou bewys dat die liggaam in wanbalans was, volgens die teorie van die vier humours. Hierdie middeleeuse benadering tot siekte, wat oorspronklik ontwikkel is deur antieke Griekse dokters Hippokrates en Galen, het verklaar dat siekte veroorsaak is toe een van die vier vloeistowwe (of humor), naamlik bloed, slym, swart gal en geel gal, uit balans geraak het.

Sommige mediese verhandelinge bevat illustrasies wat urine in verskillende kleure toon, wat die dokter help met die diagnose.

Briltekeninge met urine van verskillende kleure, uit 'n mediese verhandeling

Beelde soos hierdie met glase met verskillende kleure urine sou deur die Middeleeuse dokters gebruik gewees het om siektes te diagnoseer. Behalwe kleur, sou dokters die reuk en selfs die smaak nagaan om te bepaal of die liggaam uit balans was, volgens die teorie van die vier humoure. Hierdie middeleeuse benadering tot siekte, wat oorspronklik ontwikkel is deur antieke Griekse dokters Hippokrates en Galen, het gesê dat siekte ontstaan ​​het toe een van die vier vloeistowwe (of humoure), naamlik bloed, slym, swart gal en geel gal, uit balans geraak het.

Wonde, breuke en letsels

'N Ander gebied van mediese sorg was hoe wonde, breuke en letsels behandel moet word waarin die chirurg gespesialiseer het. Een geïllustreerde verhandeling demonstreer 'n prosedure vir 'n skedelbreuk, wat gepaard gaan met 'n verhaal van die lewe van Christus, en dat hierdie terselfdertyd 'n aanduiding kan wees van die behoefte aan goddelike hulp vir chirurg en pasiënt. Alhoewel dit onmoontlik is om die suksessyfer van sulke ingrepe te bepaal, toon die voortbestaan ​​van middeleeuse skedels met been wat bymekaar gebrei is na die behandeling van 'n besering dat selfs traumatiese kopwonde nie altyd dodelik was nie.

Volledige bladsy miniatuur van chirurgiese prosedures, van Roger Frugard van Parma ’s Chirurgia

Terwyl die eerste drie van hierdie nege illustrasies handel oor die aankondiging en die geboorte van Christus, demonstreer die oorblywende ses beelde maniere waarop 'n beskadigde of gebroke skedel deur 'n operasie herstel kan word, wat duidelik die verweefde aard van medisyne en godsdiens toon.

John Arderne (c.1307 – 77), 'n Engelse chirurg, het mediese werke saamgestel oor onderwerpe soos die behandeling van oë en die genesing van anale fistels, wat albei wyd versprei het. Die werke van Arderne is in 'n aantal opsigte fassinerend, veral die feit dat illustrasies 'n integrale deel daarvan is.

Tekening uit die mediese verhandeling van John Arderne

Mediese verhandelinge, soos hierdie werk deur die Engelse chirurg John Arderne, het geïllustreerde kennis verskaf van siektes en geneesmiddels wat wyd versprei sou word. Onderwerpe wat in die verhandeling behandel word, wissel van die behandeling van die oë tot die genesing van anale fistels. Hierdie manuskrip is 'n belangrike voorbeeld van die gekombineerde gebruik van teks en beeld om mediese prosedures te verduidelik en kan as 'n vroeë mediese handboek beskou word.

Geneeskunde en die Kerk

In die Middeleeuse Europa het geneeskunde oor die algemeen binne die konteks van die Christelike Kerk funksioneer. Hospitale wat bejaardes en siekes versorg het, word gereeld bestuur deur godsdienstige bevele, wat siektes vir hul eie lede kan onderhou en hospitale vir ander kan bedryf. Waar professionele geneeskunde nie kon help nie, het die gelowiges hulle dikwels tot heiliges gewend en heiliges besoek om heilige heiligdomme te besoek in die hoop op wonderbaarlike genesings. Die vensters van die Drie -eenheidskapel in die katedraal van Canterbury, voltooi omstreeks 1220, toon pelgrims wat aan siektes, beserings en selfs kranksinnigheid ly, en in sommige tonele na die heiligdom van Thomas Becket stroom, dokters met urinekolke draai wanhopig weg en kan nie die genesing ewenaar nie krag van die heilige.

Okkultiese genesing

Die siekes het moontlik ook na die okkulte gewend: die skeidslyn tussen magie en medisyne is nie altyd duidelik in die middeleeuse bronne nie, en baie mediese praktisyns gebruik okkultiese kennis om siekes op natuurlike maniere te genees (deur byvoorbeeld kruie te gebruik of siekte te voorkom of gevaar af te weer) of demoniese magie te gebruik, wat probeer het om diaboliese kragte te gebruik om met menslike aangeleenthede in te gryp.


Medisyne in die Middeleeue

Leer is 'n voortdurende proses en deur nuwe ontdekkings en uitvindings verbreed ons ons kennishorison elke dag. Deur die geskiedenis heen het die mens die wêreld verlig met kuns, wetenskap en filosofie en het hy ook vaardighede aangeleer om verskillende instrumente vir die voortbestaan ​​daarvan uit te vind en te ontdek. Een van die kragtigste ontdekkings wat ooit gemaak is, is die kennis van medisyne. Alhoewel die geskiedenis van die geneeskunde teruggevoer kan word na die primitiewe ouderdom, het medisyne as 'n gespesialiseerde studieveld nie voor die Middeleeue verloop nie. Op grond van Griekse en oosterse beginsels, versier Europese medisyne met die ontdekkings van die Middeleeue en lê die grondslag vir die hedendaagse medisyne.

The Heptameron deur Marguerite de Navarre is 'n voorstelling van die Franse samelewing in die Middeleeue. Sy het verskillende sosiale en kulturele norme van die tyd in die verhale uitgebeeld. Haar insig in die wetenskap van medies wat in die Middeleeue in Frankryk beoefen is, is duidelik duidelik Alhoewel die belangrikheid van medisyne as spesialiteit onder die intellektuele van Parys erken is, bly die invloed van die kerk 'n weg vir die bevordering daarvan. Alhoewel die oppergesag van bonatuurlik bo natuurlik duidelik was, is 'n duidelike implikasie vasgestel dat die natuurlike en bonatuurlike wêreld apart is, indien nie onafhanklik nie. (Geneeskunde, 'n geïllustreerde geskiedenis. Lyons, S. Albert. M.D., F.A.C.S en Petrucelli II, R. Joseph M.D.) As gevolg hiervan is 'n samesmelting van mediese wetenskap, mistiek en godsdiens in die middeljarige Frankryk.

Behandelings was gebaseer op die onderliggende beginsel van humors. (Vier verskillende liggaamsvloeistowwe) Ou fisioloë het geglo dat die liggaam altyd 'n balans van hierdie humors moet hê, want wanbalans veroorsaak siektes. Die diagnose was gebaseer op die ondersoek van bloedmonsters en ook die velkleur, urine en ontlasting. Kruiemiddels en bloedvergieting was redelik algemeen.

Mediese behandeling deur opgeleide dokters is skaars en baie duur, gevolglik kon die elite -klas dit slegs bekostig. Die onsekerheid en onbeskikbaarheid van akademiese behandeling het geen keuse vir die algemene bevolking gelaat nie, maar om na sekere sjarme, spesiale gebede en spesifieke Christelike rituele te draai. Parys in die dertien eeu het slegs 'n halfdosyn dokters in openbare diens gehad, met min tyd om aan individuele pasiënte te bestee. (Geneeskunde, 'n geïllustreerde geskiedenis. Lyons, S. Albert. MD, FACS en Petrucelli II, R. Joseph. MD) Die praktyk van medisyne was nie beperk tot 'n sekere sekte mense nie, eerder geestelikes en leke, mans en vroue kon almal beoefen medisyne.

Daar was geen duidelike onderskeid tussen 'n dokter en 'n apteker nie. Benewens die beoefening van medisyne, het die dokter dikwels medisyne saamgestel en uitgegee. En die apteker is dikwels betrokke by die mediese praktyk, sowel as by die versameling en reseptering. Uit die verhale in die heptameron blyk dit dat die medisyne wat deur apteke vervaardig word, soms baie dodelik kan wees, aangesien dit nie oor die regte kennis beskik nie. Persoonlike higiëne was ook nie 'n belangrike faktor vir 'n apteker nie, alleen woon die gewone mense.

Dieet is beskou as uiters belangrik vir die behandeling van siektes, en voorskrifte bevat die minste besonderhede vir allerhande toestande. Die grootste algemene vertroue was op sous, melk en eiers. (Geneeskunde, 'n geïllustreerde geskiedenis. Lyons, S. Albert. M.D., F.A.C.S en Petrucelli II, R. Joseph. M.D.) Vandag word die belangrikheid van dieet in die mediese wetenskap breedvoerig gevoel. Voeding as 'n spesiale studierigting het na vore gekom. Dieetkundiges en voedingkundiges is daar om dokters te help met die behandeling van pasiënte wat spesiale dieet benodig. Geneesmiddels was die belangrikste vorm van behandeling in die Middeleeue. Plante en kruie is gebruik vir die bereiding van verteringsmiddels, lakseermiddels, emetika, diuretika, diaforetika, styptika, ens. Geneesmiddels bly vandag nog die belangrikste vorm van behandelings, maar met die gevorderde tegnologie het farmakologie een van die toonaangewende ondernemings geword. (Geneeskunde, 'n geïllustreerde geskiedenis. Lyons, S. Albert. M.D., F.A.C.S en Petrucelli II, R. Joseph. M.D.)
Chirurgie is 'n laaste uitweg deur 'n dokter, maar dit was slegs toeganklik vir die rykes. Dit was bekend dat chirurgie suksesvol was in gevalle van fistel, aambeie, gangreen en katarak. Bloedverlating was een van die algemeenste operasies en word aanbeveel vir koors, inflammasie en 'n verskeidenheid siektetoestande, en ironies genoeg ook vir bloeding. Daar was drie hoofmetodes vir bloedverlating gedurende die Middeleeue: bloedsuiging, veneseksie en koppie. Onder hierdie bloedsuier word steeds gebruik, hoewel dit skaars is as 'n mediese prosedure deur sommige dokters. Leeching help om weefselopeenhoping te verminder waar arteriële insette behoue ​​bly, maar veneuse terugkeer geblokkeer word of stadiger bloedsuiers dien as 'n ekstra aar om 'n gevaarlike opeenhoping van bloed te verlig. As gevolg hiervan vind bloedsuierterapie sy weg na talle rekonstruktiewe operasies, soos die bevestiging van syfers en ledemate, 'n veloorplantingsprosedure, skubbe van die kopvel en borsoperasies en selfs tot effektiewe behandeling van periorbitale hematome. Narkose en pynstillers was beskikbaar, maar sommige van die gebruikte drankies was op sigself dodelik. Die hemlock -sap is byvoorbeeld gebruik en dit kan maklik die dood veroorsaak.

Die siektes wat in die Middeleeue baie algemeen was, was dysenterie, geelsug longontsteking, griep en verkoue. Dit kan grootliks toegeskryf word aan die lewensomstandighede van daardie tyd. Landelike mense woon grotendeels in 'n eenvertrekstruktuur met 'n sentrale vuur of haard en 'n sentrale dak met 'n klein opening wat van die rook laat ontsnap het. Huise was donker klam en koud, met minimum sonlig en swak lugsirkulasie, 'n perfekte broeiplek vir kieme en bakterieë. Die destydse klimaatstoestande en lewensstyl sonder die nodige geriewe, het ook daartoe bygedra dat daar nie persoonlike higiëne was nie. Dit het verder toegeneem met die bevolkingsgroei in die dorpe en stede. Kennis van kieme en bakterieë was nie beskikbaar nie en antibiotika is tot in die 1800's uitgevind. redelik algemeen. As gevolg van 'n gebrek aan gevorderde tegnieke, sterf pasiënte dikwels as gevolg van oormatige bloedverlies na 'n operasie. Persoonlike higiëne word deesdae beskou as 'n belangrike faktor om 'n siektevrye lewe te lei.

Met die nuutste beskikbare tegnologie het kindersterftes verminder en die lewensduur van mense het geweldig toegeneem in vergelyking met die Middeleeue. Aangesien ons baat by die gesofistikeerde tegnologie van die mediese wetenskap, is dit noodsaaklik dat ons die bydrae van ons voorgangers erken. Wat ons vandag geniet, is die vrugte van die bome waarvan die saad deur ons voorouer geplant is.


10 Middeleeuse behandelings, bisarre medisyne in die Middeleeue

Die mediese wetenskap het 'n lang geskiedenis oor die uitprobeer van geneesmiddels wat ons later as 'n gekheid beskou het. Wat is die gekste mediese praktyke uit die hele menslike geskiedenis? Kry die feite oor tien onkonvensionele behandelings en bisarre medisyne in die Middeleeue soos voorgeskryf deur die dokters uit die geskiedenis.

Hemiglossektomie, tongsny

Wat is die beste behandeling vir hakkel? Ons volg 'n paar medisyne, terapie en berading. Maar in die 18de en 19de eeu volg dokters 'n totaal ander behandeling; hulle sny die helfte van die stamper se tong af, hierdie behandeling word hemiglossektomie genoem. Hierdie bisarre behandeling word vandag nog steeds gebruik, maar slegs om mondkanker te behandel.

Hemiglossektomie, tongsny

Kwik om sifilis, bisarre medisyne in die Middeleeue te behandel

Soos ons weet, is kwik giftig, maar tot in die vroeë 20ste eeu is die beste behandeling van dokters om pasiënte met lewensgevaarlike kwik toe te dien, gebruik as 'n gewilde medisyne vir seksueel oordraagbare siektes, sifilis. Newe -effekte van hierdie behandeling sluit in ulserasies, tandverlies, neurologiese skade of pasiënte wat dikwels aan lewerskade en nierskade gesterf het as gevolg van kwikvergiftiging.

Kwik om sifilis te behandel

Sket in 'n pot

In die Middeleeue het sommige dokters geglo dat 'n soortgelyke geneesmiddel soos ”. So tydens die Swart Dood, wat vermoedelik deur dodelike dampe veroorsaak is, het sommige dokters mense aangemoedig om hul katte in potte te verseël en die potte oop te maak toe die plaag die stad tref. Ag, wat 'n middeleeuse logika.


'N Melaatse smeek om aalmoese uit die kantlyn van 'n Engelse pauslike c 1425 MS Lansdowne 451, fo 127r
© Britse biblioteek

In Middeleeuse Engeland, die ‘lepre ’, die ‘blynde ’, die ‘dumbe ’, die ‘doof ’, die ‘natuurlike dwaas ’, die ‘creple ’, die &# 8216lame ’ en die ‘lunatick ’ was 'n baie sigbare teenwoordigheid in die alledaagse lewe. Mense kan gebore word met 'n gestremdheid, of is gestremd deur siektes soos melaatsheid, of jare se terugbreekwerk. Hierdie verhaal word deur English Heritage vertel in 'n splinternuwe bron: A History of Disability: van 1050 tot hede:

Die houding tot gestremdheid was gemeng. Mense het gedink dit is 'n straf vir sonde, of die gevolg daarvan dat hulle gebore is onder die vyandige invloed van die planeet Saturnus. Ander het geglo dat gestremdes nader aan God was en dat hulle die vagevuur op aarde gehad het eerder as na die dood en dat hulle vroeër in die hemel sou kom, volgens ons in die teks:

Daar was geen staatsvoorsiening vir gestremdes nie. Die meeste woon en werk in hul gemeenskappe, ondersteun deur familie en vriende. As hulle nie kon werk nie, ondersteun hul dorp of dorp hulle, maar soms het mense gesmeek. Hulle is hoofsaaklik versorg deur monnike en nonne wat pelgrims en vreemdelinge as hul Christelike plig beskut het.

Die versorging van siekes en gestremdes was gebaseer op die leerstellings van die kerk. Die monnike en nonne sou die sewe gemaklike werke volg, wat behels het dat hulle die armes gevoed, geklee en gehuisves het, hulle besoek as hulle in die tronk was of siek was, drank aan die dorstiges aangebied het en begrawe het. Die sewe geestelike werke bevat raad en troos vir siekes. ”

Elkeen van hierdie temas word breedvoerig ondersoek met skakels na die Middeleeuse erfenis wat getuig van die versorging van gestremdes in 'n tyd wat gebrek aan finansiering, kennis en hulpbronne het.

Die eerste hospitale

Gedurende hierdie tydperk het landwye netwerke van hospitale in (of naby) godsdienstige instellings begin ontstaan. Gespesialiseerde hospitale vir melaatsheid, blindheid en liggaamlike gestremdheid is geskep. Engeland se eerste geestesinstelling, later bekend as ‘Bedlam ’, was oorspronklik die Bethlehem -hospitaal in die stad Londen. Terselfdertyd is aalmoesehuise gestig om 'n ondersteunende plek vir gestremdes en bejaardes te bied.

Baie van die geboue het verval of is vernietig tydens die ontbinding van die kloosters in die 1530's deur Henry VIII. Sommige bly egter oor, insluitend die oudste, St Nicholas Harbledown in Canterbury, Kent (1070's) St Mary Magdalene in Stourbridge naby Cambridge St Mary en St Margaret in Sprowston, Norwich, Norfolk en die hospitaal van St Mary the Virgin in Ilford, Groot -Londen. Ander oorleef as ruïnes of argeologiese terreine.

Vir hulself optree

Ons weet dat gestremdes te voet na die heilige plekke soos die heiligdom van Thomas Becket in Canterbury op pelgrimstogte gegaan het op soek na genesing of verligting. Soms moes gestremdes die onreg beveg. In 1297 het die inwoners van die melaatse huis in die dorpie Norfolk, West Somerton, gemut teen die diefde abt en sy manne, die geboue geplunder en gesloop en die waghond vermoor.

Die Middeleeuse nalatenskap

Die mense, godsdienstige instellings en dorpe van die Middeleeue was baanbrekers wat 'n gespesialiseerde reaksie op gestremdheid bied. Slegs 'n klein aantal van hul geboue bly oor, maar oor die volgende 500 jaar sou hul vroeë professionele benadering uiteindelik tot ons moderne stelsel van openbare dienste ontwikkel.

BRON:

'N Geskiedenis van gestremdheid: van 1050 tot vandag. Die bron skakel na 'n reeks geboue wat verband hou met die versorging van siekes en gestremdes.

LEES MEER:

Gestremdheid in die Middeleeue

Deur Joshua R. Eyler
Ashgate 2010
ISBN-10: 0754668223
ISBN-13: 978-0754668220

Wat bedoel ons as ons praat oor gestremdheid in die Middeleeue? Hierdie bundel bring dinamiese geleerdes bymekaar wat werk oor die onderwerp in die Middeleeuse literatuur en geskiedenis, wat die nuutste benaderings uit die veld gebruik om hierdie sentrale vraag aan te spreek. Bydraers bespreek sulke standaard Middeleeuse tekste soos die “Arthurian Legend ”, “The Canterbury Tales ” en “ Old Norse Sagas ”, wat 'n toeganklike toegangspunt tot die gebied van Middeleeuse gestremdheidstudies meer algemeen bied. The essays explore a wide variety of disabilities, including the more traditionally accepted classifications of blindness and deafness, as well as perceived disabilities such as madness, pregnancy and age. Adopting a ground-breaking new approach to the study of disability in the medieval period, this provocative book will be a must-read for medievalists and scholars of disability throughout history.

Disability in Medieval Europe: Thinking about Physical Impairment in the High Middle Ages, c.1100-c.1400

Series: Routledge Studies in Medieval Religion and Culture
by Irina Metzler
Routledge 2006
ISBN-10: 0415582040
ISBN-13: 978-0415582049

This impressive volume presents a thorough examination of all aspects of physical impairment and disability in medieval Europe. Examining a popular era that is of great interest to many historians and researchers, Irene Metzler presents a theoretical framework of disability and explores key areas such as: medieval theoretical concepts, theology and natural philosophy, notions of the physical body, medical theory and practice.

Bringing into play the modern day implications of medieval thought on the issue, this is a fascinating and informative addition to the research studies of medieval history, history of medicine and disability studies scholars the English-speaking world over.

On the Margins of a Minority: Leprosy, Madness, and Disability among the Jews of Medieval Europe

By Ephraim Shoham-Steiner (Author), Haim Watzman (Translator)
Wayne State University Press (June 1, 2014)
ISBN-10: 081433931X
ISBN-13: 978-0814339312

In medieval Europe, the much larger Christian population regarded Jews as their inferiors, but how did both Christians and Jews feel about those who were marginalized within the Ashkenazi Jewish community? In On the Margins of a Minority: Leprosy, Madness, and Disability among the Jews of Medieval Europe, author Ephraim Shoham-Steiner explores the life and plight of three of these groups. Shoham-Steiner draws on a wide variety of late-tenth- to fifteenth-century material from both internal (Jewish) as well as external (non-Jewish) sources to reconstruct social attitudes toward these “others,” including lepers, madmen, and the physically impaired. Shoham-Steiner considers how the outsiders were treated by their respective communities, while also maintaining a delicate balance with the surrounding non-Jewish community.

On the Margins of a Minority is structured in three pairs of chapters addressing each of these three marginal groups. The first pair deals with the moral attitude toward leprosy and its sufferers the second with the manifestations of madness and its causes as seen by medieval men and women, and the effect these signs had on the treatment of the insane the third with impaired and disabled individuals, including those with limited mobility, manual dysfunction, deafness, and blindness. Shoham-Steiner also addresses questions of the religious meaning of impairment in light of religious conceptions of the ideal body. He concludes with a bibliography of sources and studies that informed the research, including useful midrashic, exegetical, homiletic, ethical, and guidance literature, and texts from responsa and halakhic rulings.

Understanding and exploring attitudes toward groups and individuals considered “other” by mainstream society provides us with information about marginalized groups, as well as the inner social mechanisms at work in a larger society. On the Margins of a Minority will appeal to scholars of Jewish medieval history as well as readers interested in the growing field of disability studies.

Disability and Medieval Law: History, Literature, Society

By Cory James Rushton
Cambridge Scholars Publishing 2013
ISBN-10: 1443849731
ISBN-13: 978-1443849739

Disability and Medieval Law: History, Literature and Society is an intervention in the growing and complex field of medieval disability studies. The size of the field and the complexity of the subject lend themselves to the use of case studies: how a particular author imagines an injury, how a particular legal code deals with (and sometimes creates) injury to the human body. While many studies have fruitfully insisted on theoretical approaches, Disability and Medieval Law considers how medieval societies directly dealt with crime, punishment, oath-taking, and mental illness. When did medieval law take disability into account in setting punishment or responsibility? When did medieval law choose to cause disabilities? How did medieval authors use disability to discuss not only law, but social relationships and the nature of the human? The volume includes essays on topics as diverse as Francis of Assissi, Margery Kempe, La Manekine, Geoffrey Chaucer, early medieval law codes, and the definition of mental illness in English legal records, by Irina Metzler, Wendy J. Turner, Amanda Hopkins, Donna Trembinski, Marian Lupo and Cory James Rushton.

Difference and Disability in the Medieval Islamic World: Blighted Bodies

By Kristina Richardson
Edinburgh University Press Reprint edition 2014
ISBN-10: 0748695885
ISBN-13: 978-0748695881

Medieval Arab notions of physical difference can feel singularly arresting for modern audiences. Did you know that blue eyes, baldness, bad breath and boils were all considered bodily ‘blights’, as were cross eyes, lameness and deafness? What assumptions about bodies influenced this particular vision of physical difference? How did blighted people view their own bodies? Through close analyses of anecdotes, personal letters, (auto)biographies, erotic poetry, non-binding legal opinions, diaristic chronicles and theological tracts, the cultural views and experiences of disability and difference in the medieval Islamic world are brought to life.

Stumbling Blocks Before the Blind: Medieval Constructions of a Disability

by Edward Wheatley
Series: Corporealities: Discourses of Disability
University of Michigan Press 2010
ISBN-10: 0472117203
ISBN-13: 978-0472117208

Stumbling Blocks Before the Blind presents the first comprehensive exploration of a disability in the Middle Ages, drawing on the literature, history, art history, and religious discourse of England and France. It relates current theories of disability to the cultural and institutional constructions of blindness in the eleventh through fifteenth centuries, examining the surprising differences in the treatment of blind people and the responses to blindness in these two countries. The book shows that pernicious attitudes about blindness were partially offset by innovations and ameliorations—social literary and, to an extent, medical—that began to foster a fuller understanding and acceptance of blindness.

A number of practices and institutions in France, both positive and negative—blinding as punishment, the foundation of hospices for the blind, and some medical treatment—resulted in not only attitudes that commodified human sight but also inhumane satire against the blind in French literature, both secular and religious. Anglo-Saxon and later medieval England differed markedly in all three of these areas, and the less prominent position of blind people in society resulted in noticeably fewer cruel representations in literature.

This book will interest students of literature, history, art history, and religion because it will provide clear contexts for considering any medieval artifact relating to blindness—a literary text, a historical document, a theological treatise, or a work of art. For some readers, the book will serve as an introduction to the field of disability studies, an area of increasing interest both within and outside of the academy.

Edward Wheatley is Surtz Professor of Medieval Literature at Loyola University, Chicago.

Women and Disability in Medieval Literature

New Middle Ages
by Tory Vandeventer Pearman
Palgrave 2010
ISBN 9780230105119

This book serves as the first in its field to analyze how disability and gender both thematically and formally operate within late medieval popular literature. Reading romance, conduct manuals, and spiritual autobiography, the study proposes a “gendered model” for exploring the processes by which differences like gender and disability get coded as deviant

Leprosy in Medieval England

Carole Rawcliffe
Boydell Brewer Ltd, United Kingdom, 2009
ISBN 10: 1843834545
ISBN 13: 9781843834540

This is one of the most important publications for many years in the fields of medical, religious and social history. Rawcliffe s book completely overhauls our understanding of leprosy and contributes immensely to our knowledge of the English middle ages. This is a fascinating study that will be a seminal work in the history of leprosy for many years to come. Set firmly in the medical, religious and cultural milieu of the European Middle Ages, this book is the first serious, comprehensive study of a disease surrounded by misconceptions and prejudices. Even specialists will be surprised to learn that most of our stereotyped ideas about the segregation of medieval lepers originated in the nineteenth century that leprosy excited a vast range of responses, from admiration to revulsion that in the later Middle Ages it was diagnosed readily even by laity that a wide range of treatment was available, that medieval leper hospitals were no more austere than the monasteries on which they were modelled that the decline of leprosy was not monocausal but implied a complex web of factors – medical, environmental, social and legal. Written with consummate skill, subtlety and rigour, this book will change forever the image of the medieval leper. Carole Rawcliffe is Professor of Medieval History at the University of East Anglia.


10 of the Most Disgusting Jobs in History

[Photo credit: David Sidoux on Flickr] The 21st century certainly has its share of disgusting jobs, but in the times before mechanization, indoor plumbing, and electricity, our ancestors really bore the brunt of the literal dirty work. Here are 10 jobs found in Tony Robinson’s The Worst Jobs in History that are NSWE (not safe while eating).

1. Vomit collector. It’s a myth that the ancient Romans had dedicated rooms for regurgitating food, but it was common practice to vomit in order to consume more at the feast. Many individuals would throw up in special receptacles or simply on the floor to avoid interrupting the bacchanal. Of course, this required the services of a vomit collector who would clean it all up.

2. Leech collector. In the Middle Ages, medicine could barely be described as primitive, and methods such as bleeding were common practice for a multitude of medical ailments. One method of bleeding a patient called for applying leeches, which had to be collected from nearby ponds and bogs. A leech collector would simply wade into the water with bare legs and swish around until the dreaded creatures attached. They were then pulled off and dropped in a bucket to be sold to the town’s doctor, barber-surgeon, or other “medical professional.”

3. Fuller. Wool is a naturally waterproof material, thanks to the oils distributed through it from a sheep’s skin. This grease also was what made the harvesting, carding, spinning, and weaving processes run smoothly in the Middle Ages. But the cloth that resulted was coarse, had a wide mesh, and was easily frayed. To solve these problems, the grease had to be removed from the cloth with an alkaline solution, and the cheapest and most abundant alkaline solution at that time was stale urine. A fuller’s job was to place freshly woven lengths of wool cloth into a tub, pour in stale urine, and then stomp it with his or her feet. As if that weren’t bad enough, the urine used for this process came from multiple people — as many gallons were needed. Fullers had to collect it from public toilets and private homes. Have you ever been so grateful for modern chemistry?

4. Groom of the Stool. In the tradition of divine right — which placed kings on the level of gods — for centuries it was thought improper for a king to wipe his own bottom. Henry VIII was no exception, and the Groom of the Stool was a prestigious position assigned to a top-level aristocrat. Though prestigious, the job was humiliating. The groom was responsible for fetching the king’s toilet chair when needed, wiping his behind, and collecting his stool for examination and monitoring of his health. He also had the privilege of administering an enema should the king find himself constipated.

5. Violin string maker. Prior to the 17th century’s revolution in the technology of string-making for musical instruments, the industry was decidedly more disgusting. In order to make strings thick enough to play lower notes on a violin (which at the time had only three strings), the preferred method involved twisting strands of sheep innards together. String makers would have to butcher the sheep very carefully so as not to rupture the stomach or lower intestines and then spend painstaking hours trimming away fatty tissue, blood vessels, and muscle. Then the guts had to be soaked in a solution of wood ash to further clean them and constantly monitored so that they didn’t begin to rot. The innards were then thoroughly dried and twisted into bass strings.

6. Rat catcher. With rapid industrialization in the 19th century, cities became burgeoning hubs of filth and disease. Happily contributing to that were millions of rats. When the problem got out of hand in a certain household, the rat catcher was called in to sort things out. He rubbed oils of aniseed and thyme into his hands and clothing to attract rats, which he would try to catch with his bare hands. Most of these rats weren’t killed they were kept and sold as a tidy source of profit.

7. Match girl. “Matchmaker, matchmaker, make me a match…” — wait a minute! This isn’t the Russian shtetl, rather the factories of London (and there’s no yente involved). Manufacturing matches themselves wasn’t the disgusting part it consisted merely of dipping short sticks of wood into a phosphorous solution. The grossness happened after you’d been on the job for a few years. Inhaling the phosphorous caused an ailment known as “phossy jaw,” in which the gums began to abscess and give off a foul-smelling discharge. Eventually, the absorption of the phosphorous caused the women’s jaws to take on a eerie glow. The only known treatment was a harrowing operation to remove the jawbone.

8. Bone grubber. Victorian cities had a vast scavenging economy, and the bone grubber fell somewhere in the middle of it. These workers would scavenge rotting bones from butchers, garbage piles, and stockyards and sell them to dealers. Some of the bones would eventually be made into toothbrush handles, children’s teething rings, and other personal items. What couldn’t be sold were boiled down for soapmaking, and the remainder were ground into fertilizer.

9. Mudlark. At the bottom of the Victorian scavenging economy was the mudlark, a person who walked the river banks collecting bits of anything overlooked by other scavengers. These people toiled in extreme poverty, often barefoot, in the freezing water of a city’s rivers. There was no telling what they might find bits of metal, bone, or cloth could be sold to other scavengers. Dead bodies, human excrement, and rotting fish were occupational hazards.


Medical Treatment in the Middle Ages - History

“If it be a poor man”: medieval medical treatment for the rich and poor

Erin Connelly
Philadelphia, Pennsylvania, United States

Urine Wheel,” Almanack, Free Library of Philadelphia –
The Rosenbach, MS 1004/29, fol. 9 C (York, England, 1364),
courtesy of Bibliotheca Philadelphiensis. OPenn Repository

Great disparities in wealth and differences in access to healthcare between the top and bottom of society are hardly new experiences in human history. 1-4 Even before the Hippocratic Oath was standardized, there were various versions of professional codes of ethics and behavior toward the financial status of patients among medical practitioners. Many medieval medical texts set out the desired character traits of a good medical practitioner, especially as pertains to surgeons, with instructions on how to navigate payment depending on the patient’s situation. In a chapter on the qualities and etiquette expected of a surgeon, a Middle English translation of a text by Lanfranco of Milan advises the surgeon to “help the poor as much as possible and seek proper payment from wealthy patients.” 5 This concept is echoed in the writings of the influential medieval French surgeon, Henri de Mondeville: “I repeat that the surgeon ought to charge the rich as much as possible and to get all he can out of them, provided that he does all he can to cure the poor.” 6 A fifteenth-century Middle English translation of John Arderne (of Nottinghamshire) contains a lengthy opening statement about the key character traits of a good surgeon, including honesty, cleanliness, sobriety, charity to the poor, a good relationship with colleagues, and confidentiality. 7 Composed just beyond the medieval period in 1566, the laws and ordinances developed by the London Company of Barber-Surgeons ordered that members “shall go to the poor as well as to the rich.” 8 Concern for the medical needs of the poor is one of the main virtues for medical practitioners described in these early texts. However, in both historical and modern practice it is one matter to pronounce an oath to patient care in light of financial burdens, and another matter to deliver on those commitments when it comes to the complexities of medical treatments. Using the Middle English medical text Lylye of Medicynes as a starting point, it is possible to begin to build a picture of differences in recommended treatment plans based on a patient’s financial situation. In die Lylye, differences in treatment for the rich and the poor are mentioned more frequently than differences in treating men and women or in treating children and adults.

Die Lylye of Medicynes is a significant fifteenth-century Middle English translation of a Latin medical text, the Lilium Medicinae, which was written in the early fourteenth century by Bernard of Gordon, a highly-respected medical doctor and lecturer in the medical school of Montpellier. His works were translated into multiple languages, included on the curriculums of medical schools throughout the medieval period, and appear in printed editions well into the early modern period. The Middle English Lylye contains hundreds of remedies, arranged in seven books, for diseases of the entire body and mind.

Phlebotomy Diagram,” Almanack, Free Library of Philadelphia – The Rosenbach, MS 1004/29, fol. 8 D (York, England, 1364), courtesy of Bibliotheca Philadelphiensis

Different treatments are not provided for every illness, but those in which differences are noted can be summarized into two categories: 1. chronic conditions, and 2. diseases associated with poverty. It is not surprising that differences in treatment are mentioned for chronic conditions, such as epilepsy and leprosy, where the ability to afford long-term treatment becomes problematic for a low-income person. Furthermore, these chronic conditions were considered next to impossible to cure and difficult to treat, except by using a diverse plan of remedies and ingredients. A rich person was provided with a wide range of options and expensive medications. For instance, in the case of leprosy (or various skin conditions with the characteristics of leprosy), a rich person was offered electuaries made with pearls (diamarciaton) or ambergris (diambre), while a poor person received electuaries made with rosemary (dianthos) or aloes (dianisum). 9 The valuable ambergris again was a recommended treatment for a rich person suffering from stomach pain/vomiting, while a poor person was limited to standard, readily available ingredients, such as mint. 10

Coughing and lice were conditions associated with poverty. In the case of coughing, the Lylye states: “poor men are much afflicted with this condition.” 11 For lice, the text says that it is a condition of poverty (or the result of a religious vow) and provides remedies without ever mentioning wealthy counterparts. 12 Many of the available medieval medicines seem to be beyond the reach of the poor. For instance, to cure coughing in a poor person, the text suggests breath control exercises, such as: “let him hold his breath often as much as it is possible” or “blow the fire often.” 13 These treatments were surely affordable, but perhaps not all that effective in treating the condition.

The differences in treatment reviewed here from a select medieval text largely have to do with accessibility to ingredient choice. To reflect back on the words of the medieval surgeons Lanfrank and De Mondeville, who advised practitioners to ensure receipt of payment from wealthy patients (even as means to recover losses from cases of charity), it does raise the question about ingredient efficacy and considerations of expense. For instance, in the case of stomach pain given as an example above, perhaps the infusion of mint recommended for the poor person may be enough to settle an upset stomach over the expensive ambergris recommended for the rich person suffering from the same condition. This also raises questions about the potential advantage of a placebo effect from receiving a fancy, expensive medicine, as opposed to a common plant. As well as the great advantage for a wealthy person of having access to a physician’s time and full arsenal of cures, especially in the case of a chronic condition. Is there an analogy or even an answer to be found in these medieval pages for current disparities in access to healthcare? The medieval physician’s voice of the Lylye of Medicynes, and other medical texts, makes it clear that treatments often are not straightforward. However, perhaps the historical advice for treating the afflicted poor is as true today as it was in medieval times: “the cure may be by changing of his life.” 14

Eindnotas

  1. Diego Alejo Vázquez Pimentel, Iñigo Macías Aymar, and Max Lawson, Reward Work, Not Wealth (Oxford: Oxfam GB, 2018), 2, DOI: 10.21201/2017.1350
  2. Steffie Woolhandler and David U. Himmelstein, “The Relationship of Health Insurance and Mortality: Is Lack of Insurance Deadly?” Annals of Internal Medicine, 167, no. 6 (June 2017): 424-431, DOI: 10.7326/M17-1403
  3. Karen Dunnell, Colin Blakemore, Steven Haberman, Klim McPherson, and John Pattison, Life Expectancy: Is the Socio-Economic Gap Narrowing? (Longevity Science Panel, February 2018), https://www.longevitypanel.co.uk/_files/LSP_Report.pdf
  4. “A Modern Hippocratic Oath by Dr. Louis Lasagna,” Association of American Physicians and Surgeons, Inc., http://www.aapsonline.org/ethics/oaths.htm
  5. “pore men helpe he be hys myght, & of ryche men seke he gode rewarde” in Lanfranco of Milan, Lanfrank’s Science of Chirurgie, red. Robert von Fleischhacker (EETS O.S. 102, 1894 Reprint, Millwood, N.Y.: Kraus, 1973), 9 the translation is my own
  6. Quoted in: John Arderne, Treatises of Fistula in Ano, Haemorrhoids, and Clysters by John Arderne from an Early Fifteenth-Century Manuscript Translation, red. D’Arcy Power (London: EETS O.S. 139, 1910), xxiv
  7. Arderne, Fistula in Ano, 4-8
  8. Sidney Young, Annals of the Barber-Surgeons of London (London: Blades, East & Blades, 1890), 182
  9. Lylye of Medicynes, Oxford Bodleian Library, MS Ashmole 1505, fol. 32r the Modern English translations and edited Middle English quotes are my own
  10. Lylye, fol. 203v
  11. “pore men havyþ myche þis pascioun,” Lylye, fol. 144v
  12. Lylye, fol. 56v
  13. “lete hym holde ofte his breþe as myche as it is possible” or “blowe þe fuyre ofte,” Lylye, fol. 144r
  14. “þe cure herof may be by chaungynge of hys lyf,” Lylye, fol. 56v

ERIN CONNELLY, PhD, is a former CLIR-Mellon Postdoctoral Fellow for Data Curation in Medieval Studies in the Schoenberg Institute for Manuscript Studies, University of Pennsylvania Libraries. She has a special interest in medieval medical texts and the relevance of medieval medicine for modern infections (ancientbiotics). Her doctoral project was the first edition of the fifteenth-century Middle English translation of Bernard of Gordon’s Lilium medicinae, die Lylye of Medicynes. She collaborates on a wide range of interdisciplinary projects


A History of Medieval Medical Science and the Treatment of Wounds

When one thinks of a culture from the past, we may think of it as “unsophisticated” when compared to our own. It’s very easy for those of us in the twenty-first century to look at the stomach-churning medical treatments that were available to medical practitioners of the Middle Ages. Leeches plumped-up with a patient’s blood, draining the blood of an ill person, cathartics, emetics and doctors and priests reciting prayers over the injured and ill in an effort to have God (or the gods) intervene and heal the loved one. Diseases we hardly see today ran rampant in the Middle Ages. Malaria, liver flukes (which causes liver abscesses), dysentery, tooth abscesses, jaundice (probably caused by hepatitis), pneumonia and anemia were common, everyday diseases that one took in stride in that period. Influenza could be fatal, and even the common cold could be debilitating. This isn’t even taking into consideration the injuries sustained during the period. Fractures, lacerations (usually caused by swords and other weapons during the various battles that were fought), eye trauma, poisonings (either accidental or intentional) and childbirth were problems having to be dealt with daily. Throw in the Black Death and it’s amazing that the human race survived at all.

All-in-all, considering the knowledge at the time, doctors* did rather well. Their primary role was to comfort the patient and try to encourage the restoration of health…not much different from today’s health care providers.

Back in those days, the physician’s understanding of the human body was based on the “humoral theory”. A theory popularized by Hippocrates, it dominated medicine until the nineteenth century. The theory is based on the fact that all material in the universe, including the human body, was based on four elements: earth, water, fire and air. These humors must be kept in balance if they are not in harmony, disease results. Even today, with this theory abandoned, the basic ideas are still in our vocabulary. When someone is in a bad mood, he is in “ill humor” likewise, a person in a good or lighthearted mood is in “good humor”.

According to the humoral theory of illness, most health problems could be blamed on an excess of humor therefore, alleviating this excess would cure the illness. Bloodletting was the most common way of relieving an excess of humor. During the Middle Ages, there were three methods of bloodletting: leeching, venesection and cupping. In leeching, the physician would attach an annelid worm to that part of the body most affected by the patient’s condition. The worms would suck off a quantity of blood before falling off. Venesection was the direct opening of a vein for the draining of blood. Cupping, still practiced today by some Eastern cultures, involved the application of heated cups over the skin. As the cups cooled, blood would be drawn to the surface of the skin. Regardless of the method used, the purpose was to reduce the excess of blood in the body to restore balance and health.

One man considered himself the successor of Hippocrates. He was Claudius Galenus, whom we know today as Galen. He was born in A.D. 130 during the reign of Hadrian (famous for the wall in northern England). Galen studied philosophy and medicine all over the Roman empire. He was 35 when he became physician to the emperor Marcus Aurelius.

Galen believed anatomy was essential for a doctor. His writings show that he was a master of dissection. He probably did not dissect humans in Rome, but he did write about the dissection of animals. He had long lists of medications for diseases, and thus is considered the father of Pharmacy.1

Galen emphasized the therapeutic aspect of pus he understood that pus is a substance that requires elimination however, unfortunately and above all by Galen’s followers, this theory was exploited very narrowly. In fact, Galen’s writings were used to advocate the formation of pus in order to promote healing of wounds. This concept continued to be considered valid until the end of the 16th century. 2

The Early Middle Ages (800 – 1200 A.D.)

The collapse of the Roman Empire in the 5th Century ushered in the Dark Ages. Though many people think that the Dark Ages were a period of societal deterioration and was without innovation, some amazing concepts developed however, the development of medicine wasn’t among them. The practice of medicine declined, and it fell to healers to look to the sick and wounded. It wasn’t until the 9th Century that the true practice of medicine started on the road that evolved into the medical practice that we know today.

The Benedictines founded the cathedral schools during the reign of Charlemagne and he expanded their use. In 805 A.D. he ordered that medicine should be introduced into regular teaching programs.

It is recorded that the monastery of St. Gall in 820 A.D. had a medicinal herb garden, rooms for six sick people, a pharmacy and special lodging for a physician. This is probably our first example in Western Europe of a hospital. The Benedictine monasteries quickly expanded this trend and soon many monasteries in Europe had attached hospitals.

The High Middle Ages (1200 – 1400 A.D)

During the 13th and 14th centuries, medical teaching had progressed to the point where university degrees were required to practice medicine, graduating the first true “physicians”. The 13th century was a time of the birth of the great universities, the two greatest being the ones in Bologna and Montpellier.

William of Saliceto (1210 – 1280) was instrumental in setting up the first school of surgery. He recommended the use of knives instead of cautery during surgery and taught that pus was a bad thing, not a good thing.

Guy de Chauliac (1300 – 1368) was the most influential surgeon of the 14th and 15th centuries. He developed four conditions regarding the treatment of wounds: 3

1. Remove foreign bodies from the divided parts

2. To bring together the divided parts
3. To unite the parts drawn together
4. To conserve and preserve the tissue.

It is interesting to note that today, 600 years later, the same techniques are used for the treatment of wounds.

Theodoric, Bishop of Cervia (1205 – 1298), recommended the use of wine to clean wounds, and wrote that sponges should be soaked in narcotics such as opium and held over a patient’s nose to induce a “deep sleep”…one of the first recorded uses of preoperative anesthesia. 1 It was also during this time that the concept of cleanliness was beginning to evolve.

Then all hell broke loose in the middle of the 14th century.

In October 1347, a trading ship put into the harbor of Messina in Sicily. This was the beginning of an epidemic so appalling and destructive that it completely changed the social structure of Europe and left a permanent mark on human memory. The deadly cargo the ship carried from the East was a new disease, Yersinia pestis, also known as The Plague.
The diseased sailors showed strange black swellings the size of an egg in the armpits and groin. The swellings oozed blood and pus and were followed by spreading boils and black blotches all over the skin. The victim died five days later in pain. As the disease spread, another form with continuous fever and spitting blood appeared. These victims died within three days. With both types, anything which issued from the body smelled foul. Despair was the disease’s companion and before the end “death is seen seated on the face”. This disease spread with terrifying speed and could kill people within hours. 1
Within two years, the Plague (“pestilence” or “Great Death” as it was called at the time) had reached almost all of Europe. In some places, complete populations were destroyed. Twenty million people died…a third of Europe’s population.
The doctors at the time thought a person’s gaze or the stench of the disease could transmit it, and so they covered themselves with thick clothing and held a cloth to their noses. Some wore elaborate masks shaped like birds’ heads which had holders for burning incense in the beads.
One thing that should be addressed is the lasting social effects of the Plague. Peasants found that for once there was not enough human labor and banded together for higher wages and even their freedom. They began to understand that a human life might be worth something intrinsically. In short, the foundation of modern thinking in many areas was laid at this time.
Since this was a new disease, there were no writings “of the ancients” they could turn to in order to heal the disease. The doctors of the time had to do something that had not been done for almost 1200 years. They had to make their own observations and do their own experiments. This allowed future doctors the freedom to think for themselves and question the ancients. Thus was some of the foundation laid for the Renaissance. 1

THE LATE MIDDLE AGES AND RENAISSANCE (1400 – on)
Knowledge and learning spread far and wide during the 14th century, but the work done then was only a prelude to the amazing advances to come. The use of guns became more widespread in battle, therefore the art of surgery also advanced. Wounds were treated with warm, not boiling oil. Amputations were closed with a skin flap instead of being cauterized.
Ambroise Pare (1510-1590) was one of the great surgeons of the Renaissance. He found that a mixture of eggs, oil of roses and turpentine allowed wounds to heal better than scalding oil. His contemporaries discovered the tourniquet and found that arteries that were tied did better than ones that were cauterized.

Sometimes, of course, more drastic surgery was required. Broken bones, grievous wounds, terrible abscesses, and things such as bladder stones required surgery. And generally speaking, surgery was conducted without the benefit of anesthesia, as most means of “putting someone under” was as likely to kill them as was the surgery. And surgery was not conducted in anything remotely resembling a sterile field the concept of associating infection with germs or bacteria was entirely unknown during the Middle Ages. 4

So we can see that Medieval Medicine, viewed in the perspective of its day, worked pretty well. We in the twenty-first century may view medicine of the Middle Ages with horror. But the job of the Medieval physician was to bring comfort and hope to a patient and the patient’s family…not much different than that expected of today’s health care providers.

* in this article, the term “physician” or “doctor” is meant to imply a physician, midwife or any other healer


Kyk die video: Sofrologie voorbereiding op medische behandeling - Ondersteunende zorg bij kanker. La Roche-Posay