Medieval Medicine: Ideas and Treatments

For most of the Middle Ages (c1000–c1500), people in Britain had no idea that germs caused disease. When someone fell ill, they reached for two different kinds of explanation, and usually mixed both together.

• Natural explanations blamed something physical: an imbalance of the body's fluids, or bad air.
• Supernatural explanations blamed forces beyond the physical world: God, sin, the planets, or witchcraft.

Type of belief	Example cause of illness	Typical response
Natural	The Four Humours became unbalanced	Bleeding, purging, changing diet
Natural	Miasma (bad air) from rotting matter	Sweet herbs, cleaning the streets
Supernatural	Punishment from God for sin	Prayer, pilgrimage, giving to the poor
Supernatural	The movement of the planets and stars	Consulting an astrological chart

Because no one could see the real cause, these ideas went unchallenged for centuries. This is a key theme of the whole thematic study: for a long time, medicine stood still.

The most important natural theory was the Theory of the Four Humours, first set out by the ancient Greek doctor Hippocrates (c460–c370 BC). He argued that the body contained four fluids, or humours, and that good health depended on keeping them in balance.

Humour	Linked element	Linked season
Blood	Air	Spring
Phlegm	Water	Winter
Yellow bile	Fire	Summer
Black bile	Earth	Autumn

Illness was thought to happen when one humour built up too much. A fever, for example, was blamed on too much blood. The Greek doctor Galen (c129–c216 AD) later developed this into the Theory of Opposites: treat an imbalance with its opposite.

Theory of Opposites: if a patient had too much of a hot, wet humour (blood), the cure was something cold and dry. Too much phlegm (cold and wet) might be treated with hot peppers.

Hippocrates' approach had one real strength: it was rational, based on observing the body rather than on superstition. But it was also wrong, and because it became accepted as the truth, it acted like a straitjacket that held back better ideas for over a thousand years.

A trained physician was rare and expensive, so most people were treated by family, a local "wise woman", an apothecary (who mixed remedies), or a barber-surgeon. The physician learned his trade at university by reading the works of Hippocrates and Galen, not by examining many patients or dissecting bodies.

Diagnosis relied on tools we would find useless today:

• Urine charts — the physician matched the colour, smell and even taste of a patient's urine against a chart to judge which humour was out of balance.
• The zodiac — physicians consulted astrological charts, believing the position of the planets affected different parts of the body.
• Checking the pulse and the balance of humours.

Common treatments followed directly from the theory:

• Bloodletting (phlebotomy) — cutting a vein or using leeches to remove "excess" blood.
• Purging — using laxatives or making the patient vomit to clear out excess humours.
• Herbal remedies — plants such as chamomile and mint, some of which had genuine soothing effects.

Most of these did little good and bloodletting could be dangerous, but they made sense if you believed in the humours.

While medicine in Britain changed little, the Islamic world experienced a golden age of learning. In cities such as Baghdad, Cairo and Isfahan, Muslim scholars translated and preserved the Greek texts of Hippocrates and Galen that might otherwise have been lost, and then built on them.

Two individuals are named in the specification and should be learned closely:

Physician	Dates (approx.)	Contribution
Al-Razi (Rhazes)	c854–c925	Wrote hundreds of medical books; was the first to distinguish measles from smallpox; stressed observing the patient.
Ibn Sina (Avicenna)	c980–1037	Wrote the Canon of Medicine, a huge medical encyclopaedia used as a textbook in European universities for centuries.

Islamic medicine was often more evidence-based than European practice, and Islamic doctors built well-organised hospitals called bimaristans, which offered care, teaching and early forms of pharmacy. When these texts reached Europe, they became core teaching material — a clear example of the factor of communication spreading knowledge.

The spec names Islamic medicine and surgery, so surgery must be learned too. The greatest Islamic surgeon was Al-Zahrawi (Albucasis), who worked in Córdoba around 1000. His encyclopaedia Al-Tasrif included a detailed surgical section describing operations, cauterisation to stop bleeding, and dozens of the surgical instruments he designed. Translated into Latin, it became a standard surgical textbook in Europe for centuries — showing Islamic surgery directly advanced European practice.

The Christian Church was the most powerful institution in medieval Britain, and its influence on medicine pulled in two directions at once.

How the Church helped:

• Monasteries cared for the sick, grew herb gardens, and often had clean water and drainage.
• The Church funded hospitals, which offered rest, food, warmth and prayer — focused on care, not cure.
• Monks copied and preserved ancient medical texts.

How the Church held medicine back:

• The Church taught that illness could be a punishment from God, so prayer and pilgrimage were seen as proper "treatments".
• Galen's ideas fitted Christian belief in a single Creator, so the Church approved of Galen and treated his work as almost sacred.
• Questioning Galen was discouraged, which meant dissection and new investigation were rare.

This double role — supporting care while discouraging new ideas — makes religion one of the most important factors to weigh up in the whole Health thematic.

1. Treating medieval people as simply "stupid"

The Four Humours was a rational theory based on observation, not mere superstition. Marks come from explaining why people believed it and why it was hard to challenge, not from mocking it.

2. Confusing natural and supernatural beliefs

Keep them separate and use both. The Four Humours and miasma are natural; God's punishment, sin, and the zodiac are supernatural. Strong answers show that most people held both kinds of belief at once.

3. Ignoring the Church's positive role

The Church is not only a brake on progress. It also provided hospitals, monastic care and preserved texts. A one-sided answer that only criticises the Church misses easy marks on the factor of religion.

4. Muddling Al-Razi and Ibn Sina

Al-Razi (Rhazes) distinguished measles from smallpox. Ibn Sina (Avicenna) wrote the Canon of Medicine. Attach the right achievement to the right name.

5. Forgetting to link content to factors

The 16-mark essay tests factors such as religion, the individual and communication. Whenever you learn a fact, note which factor it illustrates — for example, Islamic texts reaching Europe is the factor of communication.