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Medical ideas in the medieval era were heavily influenced by the ancient Greeks and Romans, particularly Hippocrates and Galen. Although Galen had not been a Christian, he was accepted by the Church because he believed that humans have a soul and in his books he often referred to ‘the Creator’. To question Galen, therefore, was to challenge the Church’s teachings.

Galen and the four humours

Galen believed that the body contained four important liquids called humours. They were:

• phlegm
• blood
• yellow bile
• black bile

If the humours stayed in balance then a person remained healthy. However, if there was too much of one humour, then illness occurred. For example:

• if a patient had a runny nose, it was because of an excess of phlegm in the body
• if a patient had nose bleeds, it was because of an excess of blood in the body

It was important to keep the patient’s body in balance. Medieval doctors did this by removing excess fluid:

• excess blood was removed by bleeding into a bowl or using a leech
• excess bile could be removed with a purgative to make the patient vomit

Astrology

Medieval doctors also used astrology, as they believed that the movement of the stars affected people’s health. The modern word ‘influenza’ comes from a medieval Italian word meaning ‘influence’.

Each part of the body was associated with an astrological sign, and procedures such as bleeding would only be carried out when the moon was in the correct position. Physicians therefore needed knowledge of astrology as well as medicine to treat their patients.

Even medicinal plants were thought to be under the influence of the heavens. As late as the 17th century, Nicholas Culpeper, a famous London herbalist, wrote this advice about the dandelion in his book Complete Herbal:

In some ways, therefore, knowledge went into reverse in medieval Europe. Much of the knowledge of the Greeks and Romans was lost and replaced by superstition.

The role of superstition and religion

In addition to the use of astrology, people relied on superstition in other ways. They also turned to religion for help with medical problems. For example:

• Scrofula was known as the ‘King’s evil’. People thought that if a person with scrofula was touched by a monarch, they would be cured.
• Peasants turned to a priest or visited the local wise woman, who had experience that had been passed down through generations of her family, for help.

The influence of Islamic medicine

During the medieval period, there were wars over control of the Holy Land. These were called the Crusades. As a result of the Crusades, doctors frequently travelled to the Holy Land with the Crusaders and learned new ideas from Islamic kingdoms. This is an example of war helping medical ideas to progress.

Islamic doctors were more knowledgeable than their European counterparts, and the contact with the Islamic Empire brought some improvements in medical knowledge. Avicenna (Ibn Sina) was a Muslim writer who lived in Spain in the 11th century. His textbook, The Canon of Medicine, covered a wide range of medical topics. It was read by doctors throughout Europe and the Islamic countries of the Mediterranean and the Middle East.

Additionally, Rhazes (Al-Razi), a Persian scientist who lived in the 9th and 10th centuries, had written books on surgery. He was the first person to write accurately about smallpox. His books were also widely read in European universities.