Medicine, Physick, and Surgery

In the

Late Middle Ages,  and Renaissance

  • Introduction
  • Background
    • Ancient
      • Babylonian / Egyptian / Assyrian, etc
      • Strong grounding in physical treatment
      • BUT,  magical / non-rational vs disease
    • Classical Greek
      • Beginnings of rational thought / logical reasoning – Not just about medicine
      • Hippocrates  --  “I’ve got a start, you carry on” gets corrupted into dogma
      • Dioscorides – actually practiced in Rome – Materia Medica
    • Roman
      • Galen (actually Greek living in Rome) – beginnings of anatomical study
      • Again, knew perfectly well that his animals weren’t exactly the same as humans. However, his caveats and qualifications get corrupted into MORE dogma.
    • Arabs
      • Preservation of Greco-Roman knowledge through the Dark Ages
      • Beginnings of some research and discoveries as well.
  • Situation
    • Three Branches of Health Care
      • Physician
      • Surgeon
      • Apothecary
    • Return / Resurrection of Ancient Knowledge
    • Beginnings of Empirical study
  • Physician
    • University-trained, upper-crust if not upper-class
    • Learned in Wisdom of the Ancients
    • Astrology, herbs, Hippocrates, Galen, et al.
    • Examines, diagnoses, and prescribes
    • Generally DOESN’T get hands dirty
  • Apothecary
    • Tradesman (or woman) who’s undergone an apprenticeship
    • Field of knowledge is herbs and remedies, and the compounding of medicines
    • In addition to herbal medicine, there is some chemical (or alchemical) material being used.
    • Dabbled somewhat in midwifery and surgery. Also dispensed medical advice, and patent medicines.
  • Surgeon
    • Again, a tradesman – apprenticed anywhere from 7 to 14 years
    • In places like England and France, certified by sitting for a board of the College of Surgeons
    • Widely variable in skill, training, and social class
      • Mountebanks and itinerant tooth-pullers
      • Barber-Surgeons
      • Military and Court Surgeons
    • Area of expertise is physical problems, and the repair thereof.
      • Small-town barber-surgeon – major business is going to be haircuts and shaves, with the occasional bleeding, purging, or tooth-drawing

  • (Surgeon, cont’d)
      •  
      • Military surgeon – equivalent to a modern trauma surgeon. Has to deal with everything from bullets to bill-hooks.
      • Ship’s surgeon – will be packing some physick in the chest, since nearest physician or apothecary’s possibly on the other side of the ocean
  • Medical theory of the times
    • Transition, ca 500-300 BCE, from superstition to rational thought / logical analysis
    • Four Bodily Humours
      • Blood: Hot and Moist
      • Phlegm: Cold and Moist
      • Melancholy aka Black Bile: Cold and Dry
    • Choler aka Yellow Bile: Hot and Dry
    • Imbalance in Humours can cause illness; treatment involves re-balancing.
    • Treatment with herbs or chemicals – treat by sympathy, using medicines  that push the condition to its conclusion; or treat by antipathy, using medicines to fight the condition
    • Excess of phlegm, for example, might be treated by hot, dry herbs.
    • Physical treatment – bleeding for fevers, blistering for phlegm, etcetera
  • Medicines – some worked, some didn’t
    • Yarrow – Comfrey – Willow Bark – St John’s Wort – Clove Oil – Quinine / Chinchona – compounds like Laudanum
    • Items with strong physiological effects, but hazardous – Wormwood – Belladonna – Tobacco
    • Items of dubious effect – lettuce juice (wild yes, domestic no) – plantain –oddball items like pigeon poop or deer’s antler
    •  Experimentation, vs “Wisdom”
    • Administration
      • With no IVs or hypodermics, what does one do?
      • 4 ways – Inhaled / Sniffed; Swallowed; Skin Absorption; Per Rectum
      • Example of Tobacco: Inhaled to purge Phlegm; Swallowed as a Vomit; Poultice for stings and “green wounds”; Injected as a Parasiticide
  • Surgery
    • Anesthesia / Pain Control
      • Laudanum
      • Bite Sticks and Restraints
    • Cleanliness / Infection
      • Microscopes 1699, Germ Theory of Disease, mid 19th C
      • Empirical evidence: Clean = good
      • Styptics, Astringents, & Antiseptics
    • Practical issues
      • Speed
      • Controlling bleeding
      • Drains and Infection
      • Finer points
    • Gory stuff
      • Trephination
      • Amputation
      • Dentistry
      • Bleedings

SOURCES

(Much more useful than this small class outline)

Quick References: Wikipedia, with doses of Salt as Appropriate

Culpeper, Nicholas,  Culpeper's Complete Herbal and English Physician  originally 1640s (Paperback - Mar 1987)

Galen, 131-201CE, On the Natural Faculties.  Translated by A. J. Brock.  University of Adelaide, at http://etext.library.adelaide.edu.au/g/galen/g15nf/ Galen, while more of a theorist than Hippocrates, does display analytical thinking about medicine, rather than the magical thinking of pre-rational medicine.

Hippocrates, 460-377BCE, Works. Translated by Francis Adams. Available at the University of Adelaide, http://etext.library.adelaide.edu.au/h/hippocrates/  Hippocrates runs to practical applications for various ailments.

Longrigg, James, 1934-, Greek rational medicine [electronic resource] : philosophy and medicine from Alcmaeon to the Alexandrians.  The link for the book is http://www.netLibrary.com/urlapi.asp?action=summary&v=1&bookid=79901.  Book covers the development of medicine in Greece from pre-rational, deriving from Egyptian and Babylonian sources, through classical-period beginnings of rational practice.

Magner, Lois N., 1943-, A History Of Medicine.   Second Edition, Publisher: Taylor & Francis, Pub date: c2005.

National Institutes of Health, Greek Medicine from the Gods to Galen” (2002). Located at http://www.nlm.nih.gov/hmd/greek/index.html. This is an online exhibit giving a brief overview of  Greek medicine, starting with divine / pre-rational concepts and progressing forward.

Paré, Ambroise, 1510-1590, The Apologie and Treatise of AmbroiseParé. Published by the Classics of Medicine Library, 1984.

Rawcliffe, Carole,  Medicine & Society in Later Medieval England.  Sutton Illustrated History Paperbacks Paperback - Mar 1998

 Woodall, John, The Surgions Mate. Originally published 1617. Current ed. By John Kirkup, 1978.