Well-Being: Health Practitioners

Sources

Preserving Ancient Knowledge. For the first half of the Middle Ages there were no great leaps in medical treatment, but old knowledge was preserved and disseminated by monasteries, where monks copied and recopied

RULES FOR GOOD HEALTH

The rules of the medical school at Salerno remained for centuries a popular source of advice for how to regulate one’s life and diet. There were even verse translations designed to make the rules easier to remember, including the following lines from an English translation attributed to Sir John Harington (1561–1612). (“Closing the stomach” means finishing a meal and starting the process of digestion.)

Although you mad yrink often while you dine,
Yet after dinner touch not once the cup,
I know that some Physicians do assign
To take some liquor straight before they sup:
But whether this is meant by broth or wine,
A controversy ’tis not yet ta’en up:
To close your stomach well, this order suits,
Cheese after flesh, Nuts after fish or fruits,
Yet some have said (believe them as you will),
One Nut doth good, two hurt, the third doth kill.

Source; Sir John Hadtigtort, tunns, The Englishman’s Doctor or, Tbe Saterm (London; Primed for John Helm dcjofm Busfcf Jr., 1607).

works of the ancient authors. They also extracted and epitomized the ideas of these authors in antidotaria (collections of antidotes) and receptaria (collections of prescriptions) for restorative and preventative health, respectively. In order to preserve and extend this knowledge, a medical school was established in Salerno, south of Rome, in the ninth century. Other medical schools followed at Montpelier (1181) and Padua (1222). There were also medieval faculties at the Universities of Paris, Bologna, and Oxford, founded in 1110, 1113, and 1167, respectively. Beginning in the twelfth century, as more and more ancient knowledge began to enter Europe, a desire to understand and extend the learning of the ancients (and their Arabic commentators) promoted a culture of experimentation at Salerno. As in mathematics and physics, Arabic scholars had preserved Greek knowledge of medicine and added to it Indian and even some Chinese learning. Salerno provided a center for the translation and dissemination of this knowledge.

Medical Treatment . Salernian doctors discoursed on the four-humor theory, but they also inquired into the fabric of the body. Dissections of pigs and other mammals shed light on skeletal structure, organ types and connections, the nervous system, musculature, and ophthalmological questions. Their antidotaria not only fixed the standards for preparing drugs (including the old apothecaries’ weights of grains, scruples, and drams) but also prescribed how these drugs were to be administered. The four standard delivery methods were plasters and ointments for absorption through the skin, syrups for imbibing plant extracts, fumigations for the inhalation of medicines, and “electuaries,” or powdered remedies, that could be taken internally. Begun as attempts to transmute metals, alchemical investigations also provided many of the skills and experimental procedures that healers needed to create new medicines.

Prevention . In general, people sought help from medical doctors only after the onset of sickness. One area of their expertise, however, was designed to be preventative: astrology. Universities provided astrological training along with medical training, and since both sought to understand and predict future events—such as the right time to conceive or embark on a trip and the restitution of the patient’s health—it was natural that they should be used together.

Practitioners . Learned doctors in the Roman period had largely divested themselves of the manual and messy routines of surgery, care, and prescribing medicaments to their patients. They concentrated on higher theory, a trend that continued until the sixteenth century. This division of theory and practice runs parallel to the steadfast separation of science from technology in the Middle Ages. To fill the need for medical practitioners who would care for the sick and injured, barber-surgeons took up the knife; midwives took care of obstetrical needs; apothecaries provided medicines; and nurses prepared healing cuisine for their patients. For traumatic injuries such as wounds in warfare, falls from roofs, or industrial accidents, there was often little doctors could do, but these limitations did not stop practitioners

RECIPE FOR A SURGICAL NARCOTIC

The following recipe for a surgical narcotic known as dwale was discovered in a late medieval English manuscript found in the Cambridge University Library and translated into modern English by Linda E. Voigts and Robert P. Hudson. Dwale includes a variety of potent sleep-inducing herbs, as well as swine gall and vinegar to help extract the active ingredients from the herbs. It would in fact render a patient unconscious.

To make a drink called dwale to make someone sleep while others carve [perform surgery] on him: Take three spoonfuls of the gall of a barrow swine [castrated boar] and for a woman of a gilt [immature sow], three spoonfuls of hemlock juice, three spoonfuls of wild nept [briony], three spoonfuls of lettuce [sap], three spoonfuls of poppy, three spoonfuls of henbane, and three of vinegar, and mix them all together, boil them a little, and mix … three spoonfuls [of the mixture] into half a gallon of good wine….

Source: Linda E. Voigts and Robert P. Hudson, “A drynkc that men callen dwale to make a man slepc whyle men kerven hini: A Surgical Anusthetic from Late Medieval England,” inHealth, Duease and Heeling in edieval Culture, edited by Sheila Campbell, Bert Hall, and Divid Klaus-ner (New York: St. Martin’s Press. 1992), pp. 34–50.

from trying. Dissection of humans and animals was practiced quite widely throughout the Middle Ages, so surgeons were knowledgeable about and quite adept at repairing soft-tissue damage. Damage to the internal organs, however, was more often than not fatal. While the ancient world knew how to perform such delicate operations as eye surgery and while this tradition continued in Islam, medieval European surgeons were not so knowledgeable or able. The Western medieval world made do with amputations and splints, and with trepanation, the process of boring holes in the skull to relieve excess pressure. Anesthetics based on opium, mandragora, or other narcotics made surgery bearable, but post-recovery infections were a serious problem.

Prayer. Linked to all medieval healing strategies was Christianity. Doctors, who were trained at medical schools, were also clerics, and their medical ministries were in no way distinct from their theological ministrations. Even lay medical practitioners used belief as the backbone to their ministrations. Patients with specific ills were given over to the care of individual saints who specialized in those ailments. For example, patients and practitioners prayed to St. Vitus to cure convulsions, to St. Blasius for respiratory and tracheal diseases, and to St. John for difficulties with the legs and feet. The reputation of many a saint was founded on stories of how he or she had brought about miraculous cures. Many ill people undertook pilgrimages to saints’ shrines, where they hoped to be cured by seeing, touching, or buying a relic. Consequently, many churches that housed saints’ relics were visited by large numbers of ailing pilgrims and set up infirmaries to treat or at least comfort them. These ecclesiastical infirmaries were often the basis for the formal hospitals that began to appear in the late Middle Ages.

Sources

Darrel W. Amundsen, Medicine, Society, and Faith in the Ancient and Medieval Worlds (Baltimore & London: Johns Hopkins University Press, 1996).

Vern L. Bullough, The Development of Medicine as a Profession: The Contribution of the Medieval University to Modern Medicine (New York: Press, 1996).

Peter Murray Jones, Medieval Medicine in Illuminated Manuscripts (London: British Library, 1998).

Nancy G. Siraisi and Luke Demaitre, eds. Science, Medicine and the University, 1200-1550: Essays in Honor of Pearl Kibre (St. Louis: Saint don: British Library, 1976).

Patricia Skinner, Health and Medicine in Early Medieval Southern Italy (Leiden & New York: E. J. Brill, 1997).