13th century Anatomical Illustration
13th century Anatomical Illustration
The Limitations of Medieval Medicine

Merryn Peatling, Dickson College 1996

The practice of medicine in the medieval period was limited by several factors; some of these were religious beliefs, a lack of scientific knowledge, the absence of formalized training and the influences of traditional practice. A medieval manuscript exists which contains ninety six illustrations of patients displaying their disorders to a doctor; these disorders appear to include bowel, thigh, groin, knee, feet and leg. The pictures have no captions and need to be explained by reference to the text. (Matthew1986: 155) This ancient book gives an indication of the limitations of medical knowledge and practice in the medieval period.

Religious beliefs and attitudes limited, to some extent, the study of medicine in the medieval period. The study of anatomy was frowned upon by the church, especially the practice of conducting autopsies and performing dissections. Since the bible taught that man was made in the image of God, the act of dissecting a human body was considered to be tantamount to dissecting God. This belief severely limited the amount of knowledge western doctors were able to acquire about the workings of the human body. (Heer 1974:239) Another stumbling block in the way of scientific investigations was the belief held at this time by many medieval christians (and still held today by some sects) that injury and illness were punishment for sin. God punished the wicked by plaguing them with disease or illness. (Comte 1978: 124) This belief and others such as the touch of a royal person restoring the afflicted to health meant that medicine did not have a practical base in the lay person's thinking. (Rooke 1984:36)

This attitude, although appearing somewhat superstitious to most people in the 'scientific' late twentieth century, should not be a point of criticism because the majority of the medieval population had a very strong belief in the existence of God and in His intimate involvement in their daily lives. (Nilsson 1987 chapt.1) Their attitudes and practices are a logical outcome of these.

Medieval Dentistry
Medieval Dentistry
Medieval medicine appears to lack a degree of scientific knowledge. Many of the roots of medieval medical knowledge were based on the classical learning of the ancient Greeks and what they believed the human body was like, with ideas such as the heart being the control centre for the body's activities not the brain. Some of the written information we have about medieval medicine is contained in the fifteen books that the Faculty of Medicine in Paris acquired in the thirteenth and fourteenth centuries. Portions of the fifteen books appear to be direct translations from classical writings by scholars such as Hippocrates. (Comte 1978:126-127)

What we would now consider as basic scientific principles, were not available to medieval researchers. The medieval practitioner had no idea that, for example, germs existed or that a healthy diet was important. Poor diet and lack of nutrition coupled with low hygiene standards played a significant role in the susceptibility of the public to illness and the high infant mortality rate. (Matthew 1986 part 3) Because medieval doctors had no real idea about the existence of bacteria and the like, disease and illness spread quickly through contagion, both patient and doctor being unwitting carriers. (Comte chapt:13)

Considering the lack of in-depth knowledge and the absence of pain killers and anaesthetics, the medieval surgeon performed remarkable procedures. It has been suggested that operations such as caesarian sections, bone re-breaking and setting, eye operations, cleaning and stitching of battle wounds and removal of internal cysts were being performed by medieval surgeons. (Comte 1978:13) Cleanliness does not appear to have been a very important part of everyday medieval life. When we consider that operations may well have been carried out by people who did not wash their hands, in homes where humans and animals shared the same small living space it is surprising that any patient managed to survive not only the ailment, but the cure as well. (Heer 1974 chapt:12)

The reservations shown by the church towards a scientific approach to medicine, as mentioned previously, meant that much of the study of the human body undertaken during the medieval period was conducted in the eastern, Islamic cultures. However, The School of Salerno was an exception to this. Salerno had been established as early as the tenth century A.D , making it at least two centuries older than the Faculty of
Medicine in Paris, and commanded much respect from both the eastern and western approaches to medical science. (Heer 1974:239) Salerno appears to have had quite a modern, empirical approach to medicine as a science. The School of Salerno housed not only works regarding classical Roman and Greek knowledge, but its library also included works in Arabic. (Heer 1974:239)

Astrological view of human anatomy
Astrological view of human anatomy
Western Europe was able to benefit from the research being undertaken in other parts of the world by the flourishing of trade in the middle ages. Foreign lands were far more accessible because of the development of international trade routes. This made travel and the exchange of knowledge much easier to obtain. (Notes supplied in
class.) The interaction of east and west during the Crusades may also have contributed the exchange of medical knowledge. (Nilsson 1987 chapt.1) Doctors and surgeons who were not trained professionally at institutes such as the Faculty of Medicine in Paris or The School of Salerno, appear to have picked up information as they went along, a type of apprenticeship with on-the-job training. Some doctors are even believed to have consulted the stars before making a diagnosis. Barbers often became quasi-surgeons, roaming the countryside performing operations where requested on both animals and humans.(Rooke 1985 chapt:15) The lack of medical training severely limited the effectiveness of a doctor or surgeon in the face of sickness and injury.

Medicine, particularly in Europe, was heavily influenced by traditional beliefs in folklore and magic. The use of spells and home made remedies appears to have been a common practice. (Matthew 1986:154) A source from the medieval period, Bald's Leechbook (leechbook means medical book), carried information regarding such
issues as fertility, baldness and nagging women. (Rooke 1984:36) It would appear that people during this period of history were somewhat wary of doctors and medicine, they seem to have been of the opinion that medicine had little scientific merit. (Rooke1984 chapt.2)

Thus it can be seen that there were severe limitations in the knowledge and practice of medicine in medieval times. Little was known about the structure and function of the human body; nothing was known about bacteria and viruses nor about the transmission of disease; the need for good nutrition and cleanliness were not yet acknowledged. Influences of the church, religious beliefs and traditional folk medicine all combined to limit the amount of medical knowledge available in the
medieval period.

Comte, Suzanne, 1978, Everyday Life in the Middle Ages, Liber Publishing, Italy
Heer, Frederich, 1974, Europe from 1100 to 1350, Cardinal, Great Britain
Matthew, Donald, 1986, Atlas of Medieval History, Phaidon Books, Oxford
Nilsson, Lennart, 1987, The Body Victorious, Faber and Faber, America
Rooke, Patrick, 1984, The Normans, Macdonald Educational, Cambridge