Medieval Medicine

Medieval Medicine: A Theory-Based Approach to Health 

Modern medicine began to emerge in the 18th century after the Industrial Revolution. But before then, people still questioned the ailments that inflicted people every day. 

Medieval Diseases 

Bald's Leechbook [10]

Many diseases and illnesses harmed thousands of people throughout medieval times and the Middle Ages. Among poorer individuals, such as peasants and townspeople, skin infections were common. This was due to fleas and bed bugs coupled with poor hygiene and no running water. Poor diets and bad food were the source of scurvy, diarrhea, typhoid fever, and cholera. During medieval times, the lack of medicine and vaccines caused people to spread these diseases through contact. People died quickly and frequently of measles, smallpox, influenza, and whooping cough [1]. Epidemics swept across populations with mortalities of anywhere from 5-20% [3]. However, at the beginning of the medieval period, it was not easy for people to access practitioners. So instead they would turn to local people who had medical knowledge based on antique theory and folk traditions [9]. To the right is Bald's Leechbook. Written in old English, the book is a collection of medical treatments from the medieval period. The book addressed remedies and supernatural problems [10].  

The Four Humours Origin

 

The personification of the Four Humours [8]

Humor comes from Latin, meaning "liquid" or "fluid". Hippocrates first introduced the idea of the four humors at a time when people were using naturalistic knowledge, philosophy, and ancient science to understand the human body. Philosophers of the time wanted to not only understand the human body but also how it interacted with the world. The Four Humours were: blood, phlegm, choler (yellow bile), and melancholy (black bile). It was believed that the concentrations of each humor in the body determined one's physical and mental qualities. In order to be considered the ideal person, the four humours were perfectly balanced in the human body. Having too much or an excess of one or more humours, caused diseases. The humours originated from a combination of hot, cold, dry, and moist, the primary qualities, and the four elements: air, fire, water, and earth [4]. 

Yellow Bile [16]

Yellow Bile

It was said that yellow bile is located on the right side of the body, under the liver. Yellow bile is hot and makes someone vibrant and phlegmatic in the winter months but drains a person in the summer. The heat of the yellow bile rises in the body and can cause migraines. During medieval times, choleric people were described as having round faces, bulging eyes, and a rough throat. If someone had too much yellow bile, they were said to be hot-tempered or suffer from insomnia due to the excessive heat in their bodies. Treatment for too much yellow bile was cold water to cool the heat [2]. The associated element is fire and hot, dry qualities [5]. 

Black Bile

Black Bile [16]

 Black bile was on one's left side, under the spleen. Too much black bile was said to rise to their brain causing dizziness and "dripping of   the uvuala" in the winter season. Other symptoms were depression,   arthritis, and constipation. Characteristically, people with excessive   black bile were described as having a long face, dark eyes, and being introspective and solemn [2]. Black bile was associated with cold, dry qualities, and the element, Earth [5]. 

Phlegm

Phlegm [16]

The Phlegm humor is located in the head and chest, with some in the kidneys [2]. These people were passive, calm, and sometimes seen as unemotional. Phlegm was responsible for white hair and forgetfulness. The phlegm humor was associated with the element water and the qualities, of cold and moist. When a person suffered from coughing, colds, or respiratory problems, this was likely due to too much phlegm in the chest. To treat this humor, doctors just suggested more fluids and rest [6]. 

Blood

Blood [16]

Blood was thought to be the most important of the four humors, as declared by Galen of Peragmum. Excess blood was associated with summer when people were red in the face. It was associated with the spring and the air element. People who had too much blood were described as having a sanguine temperament. Meaning they were powerful, strong, and conflict-oriented [5]. The treatment for too much blood was bloodletting. 

Bloodletting

Fleam [13]

As previously mentioned, an imbalance in the humors was what gave way to illnesses in a person's life. A popular medical treatment was bloodletting. This was the process of removing blood from the body by cutting a vein at the knee or elbow [7] by using a lancet or fleams[12]. Lancets were small, double-edged instruments, and were carried around in the doctor's pocket [12]. Fleams were instruments with multiple blades, similar to today's pocketknife [12].  Leeches were also used, as a leach can ingest up to 10mL of blood. It was thought to remove any impurities in the body and help cure the person of their ailments. The biggest risk with bloodletting was death. Losing too much blood could 

send the body into shock and

Thumb Lancet [14]

kill the patients before their diseases did. By the 1600s, doctors began to question the effectiveness of bloodletting, and in the late 1800s, studies were done to support the notion that bloodletting wasn't effective in curing diseases [7]. 

Alderlasskalander [11]

Famous Bloodletting

Bloodletting was popular for a good while in history. Physicians used an Alderlasskalander, or a bleeding calendar, to assess the best times to remove blood from the body [11].  There were some famous people later in bloodletting's reign who underwent the procedure. Charles II had suffered a seizure and was immediately taken to start the process of removing his blood. The doctors removed around twenty-four ounces of blood before he died. One bloodletting that raised a lot of controversy was George Washington. He had become sick with a fever and respiratory issues. His physicians removed 40% of his blood volume gave him laxatives to remove the toxins in his body. George Washington died the next day [12]. 

To learn more about George Washington's death: www.pbs.org/newshour/show/bloodletting-blisters-solving-medical-mystery-george-washingtons-death.

Work Cited

[2] Wallis, Faith, Medieval Medicine: A Reader. Toronto, University of Toronto Press. 2010. 

[1] Elliot, Lynne. Medieval Medicine and the Plague. Crabtree Publishing Company, 2006. 

[3] Robb, John, et al. "The Greatest Health Problem of the Middle Ages? Estimating the Burden of Disease in Medieval England." International Journal of Paleopathology, Elsevier, 5 July 2021, www.sciencedirect.com/science/article/abs/pii/S1879981721000590

[4] Moreau, Elisabeth. "Complexion, temperament, and four humor theory in the Renaissance." Encyclopedia of Renaissance Philosophy (2020): 1-3

[5] "Four humours." Share and Discover Knowledge on SlideShare, www.slideshare.net/stewby_123/four-humors. Accessed 14 Sept 2023. 

[6] "Medieval Medicine: The Four Humors." Kidzworld, 19 Aug. 2015, www.kidzworld.com/article/29547-medieval-medicine-the-four-humors/.  

[7] Zimlich, Rachael. "Bloodletting through History: What Was It Supposed to Treat?" Healthline, Healthline Media, 3 May 2021, www.healthline.com/health/bloodletting#was-it-effective.

[8] Wight, C. Image of an Item from the British Library catalogue of Illuminated Manuscripts. The British Library, 25 Aug 2005, www.bl.uk/catalogues/illuminatedmanuscripts/ILLUMIN.ASP?Size=mid&IllID=12899. 

[9] "Medicine in the Middle Ages" British Library, www.bl.uk/the-middle-ages/articles/medicine-diagnosis-and-treatment-in-the-middle-ages. Accessed 11 Sept. 2023. 

[10] British Library, www.bl.uk/collectio-items/balds-leechbook. Accessed 12 Sept 2023. 

[11] Klein, Joel. "The Wisdom of Premodern Medicine." The Huntington, huntington.org/verso/202/10/wisdom-premodern-medicine. Accessed 14 Sept, 2023. 

[12] Greenstone, Gerry. "The history of Bloodletting. BCMJ, Vol. 52, No. 1, January, February 2010, Page 12-14 - Premise" bcmj.org/premise/history-bloodletting. Accessed Sept 10 2023. 

[13]/[14] Doug Arbittier, Michael Echols. "Bloodletting Antiques." Antique Bloodletting and Leeching INstruments, medicalantiques.com/medical/Scarifications_and_Bleeder_Medical_Antiques.htm. Accessed 9 Sept 2023. 

[16] Sidorova, Irina. "4 Humours." www.behance.net/gallery/539062/4-Humours- Accessed 9 Sept. 2023. 

[15] "Bloodletting and Blisters: Solving the Medical Mystery of George Washington's Death." Public Broadcasting Service, 16 Dec 2014, www.pbs.org/newhour/show/bloodletting-blisters-solving-medical-mystery-george-washingtom-death.