Medieval medicine of Western Europe
In the Middle Ages, the medicine of Western Europe was composed of a mixture of existing ideas from antiquity. In the Early Middle Ages, following the fall of the Western Roman Empire, standard medical knowledge was based chiefly upon surviving Greek and Roman texts, preserved in monasteries and elsewhere. Medieval medicine is widely misunderstood, thought of as a uniform attitude composed of placing hopes in the church and God to heal all sicknesses, while sickness itself exists as a product of destiny, sin, and astral influences as physical causes. On the other hand, medieval medicine, especially in the second half of the medieval period (c. 1100–1500 AD), became a formal body of theoretical knowledge and was institutionalized in the universities. Medieval medicine attributed illnesses, and disease, not to sinful behavior, but to natural causes, and sin was connected to illness only in a more general sense of the view that disease manifested in humanity as a result of its fallen state from God. Medieval medicine also recognized that illnesses spread from person to person, that certain lifestyles may cause ill health, and some people have a greater predisposition towards bad health than others.[1]
Medical universities in medieval Europe[edit]
Medicine was not a formal area of study in the early medieval era, but it grew in response to the proliferation of translated Greek and Arabic medical texts in the 11th century.[69] Western Europe also experienced economic, population and urban growth in the 12th and 13th centuries leading to the ascent of medieval medical universities.[69] The University of Salerno was considered to be a renowned provenance of medical practitioners in the 9th and 10th centuries, but was not recognized as an official medical university until 1231.[70][71] The founding of the Universities of Bologna (1088), Paris (1150), Oxford (1167), Montpellier (1181), Padua (1222) and Lleida (1297) extended the initial work of Salerno across Europe, and by the 13th century, medical leadership had passed to these newer institutions. Despite Salerno's important contributions to the foundation of the medical curriculum, scholars do not consider Salerno to be one of the medieval medical universities. This is because the formal establishment of a medical curriculum occurred after the decline of Salerno's grandeur of being a center for academic medicine.[71][72]
The medieval medical universities' central concept concentrated on the balance between the humors and "in the substances used for therapeutic purposes".[73] The curriculum's secondary concept focused on medical astrology, where celestial events were thought to influence health and disease.[73] The medical curriculum was designed to train practitioners.[74] Teachers of medical students were often successful physicians, practicing in conjunction with teaching. The curriculum of academic medicine was fundamentally based on translated texts and treatises attributed to Hippocrates and Galen as well as Arabic medical texts.[75] At Montpellier's Faculty of Medicine professors were required in 1309 to possess Galen's books which described humors, De complexionibus, De virtutibus naturalibus, De criticis diebu so that they could teach students about Galen's medical theory.[76] The translated works of Hippocrates and Galen were often incomplete, and were mediated with Arabic medical texts for their "independent contributions to treatment and to herbal pharmacology".[77] Although anatomy was taught in academic medicine through the dissection of cadavers, surgery was largely independent from medical universities.[78] The University of Bologna was the only university to grant degrees in surgery. Academic medicine also focused on actual medical practice where students would study individual cases and observe the professor visiting patients.[74]
The required number of years to become a licensed physician varied among universities. Montpellier required students without their masters of arts to complete three and a half years of formal study and six months of outside medical practice.[79][80] In 1309, the curriculum of Montpellier was changed to six years of study and eight months of outside medical practice for those without a masters of arts, whereas those with a masters of arts were only subjected to five years of study with eight months of outside medical practice.[80] The university of Bologna required three years of philosophy, three years of astrology, and four years of attending medical lectures.[80]
Medical practitioners[edit]
Members of religious orders were major sources of medical knowledge and cures. There appears to have been some controversy regarding the appropriateness of medical practice for members of religious orders. The Decree of the Second Lateran Council of 1139 advised the religious to avoid medicine because it was a well-paying job with higher social status than was appropriate for the clergy. However, this official policy was not often enforced in practice and many religious continued to practice medicine.[49]
There were many other medical practitioners besides clergy. Academically trained doctors were particularly important in cities with universities. Medical faculty at universities figured prominently in defining medical guilds and accepted practices as well as the required qualifications for physicians.[49] Beneath these university-educated physicians there existed a whole hierarchy of practitioners. Wallis suggests a social hierarchy with these university educated physicians on top, followed by "learned surgeons; craft-trained surgeons; barber surgeons, who combined bloodletting with the removal of "superfluities" from the skin and head; itinerant specialist such as dentist and oculists; empirics; midwives; clergy who dispensed charitable advice and help; and, finally, ordinary family and neighbors".[49] Each of these groups practiced medicine in their own capacity and contributed to the overall culture of medicine.
Battlefield medicine[edit]
Camp and movement[edit]
In order for an army to be in good fighting condition, it must maintain the health of its soldiers. One way of doing this is knowing the proper location to set up camp. Military camps were not to be set up in any sort of marshy region.[89] Marsh lands tend to have standing water, which can draw in mosquitos. Mosquitos, in turn, can carry deadly disease, such as malaria. As the camp and troops were needed to be moved, the troops would be wearing heavy soled shoes in order to prevent wear on soldiers' feet.[89] Waterborne illness has also remained an issue throughout the centuries. When soldiers would look for water they would be searching for some sort of natural spring or other forms of flowing water. When water sources were found, any type of rotting wood, or plant material, would be removed before the water was used for drinking. If these features could not be removed, then water would be drawn from a different part of the source.[89] By doing this the soldiers were more likely to be drinking from a safe source of water. Thus, water borne bacteria had less chance of making soldiers ill. One process used to check for dirty water was to moisten a fine white linen cloth with the water and leave it out to dry. If the cloth had any type of stain, it would be considered to be diseased. If the cloth was clean, the water was healthy and drinkable.[89] Freshwater also assists with sewage disposal, as well as wound care. Thus, a source of fresh water was a preemptive measure taken to defeat disease and keep men healthy once they were wounded.