LECTURE 3 Medieval medicine. Byzantine medicine Byzantine medicine Arabic medicine Arabic medicine The Middle Ages The Middle Ages

LECTURE 3LECTURE 3

Medieval Medieval medicinemedicine

Byzantine medicineByzantine medicineArabic medicineArabic medicineThe Middle AgesThe Middle Ages

Medieval MedicineMedieval Medicine

Byzantine medicineByzantine medicine The Fall of Rome to the Goths in 476 and the Fall of The Fall of Rome to the Goths in 476 and the Fall of

Constantinopole in 1453 to the Turks are often considered Constantinopole in 1453 to the Turks are often considered as marking the beginning and end of the Middle Ages.as marking the beginning and end of the Middle Ages.

In spite of the dissolution of Western Roman Empire, In spite of the dissolution of Western Roman Empire, immediately following the Fall of Rome to the Goths, immediately following the Fall of Rome to the Goths, many Roman institutions appear to have survived, even if many Roman institutions appear to have survived, even if no longer under the authority of Rome.no longer under the authority of Rome.

The character and quality of medical practice during this The character and quality of medical practice during this period, almost totally dominated by Church, has been period, almost totally dominated by Church, has been unsatisfactory unsatisfactory

The physician had become a part of the monastic The physician had become a part of the monastic environment and their labour was devoted to unscientific environment and their labour was devoted to unscientific methods such as prayers, exorcisings, use of amulets, methods such as prayers, exorcisings, use of amulets, holy oil, relics of the saintsholy oil, relics of the saints. .


As the medieval Church relied more and more on the As the medieval Church relied more and more on the intercession of saints, they gained increased significance intercession of saints, they gained increased significance and consideration in Church writings and consideration in Church writings

The growing significance of superstition and magic in The growing significance of superstition and magic in medieval Europe is often attributed to the anarchy medieval Europe is often attributed to the anarchy following the fall of Western Roman Empire. However, following the fall of Western Roman Empire. However, similar superstitious developments can be found in similar superstitious developments can be found in Constantinopole and the East Constantinopole and the East

Some of the physicians trained in the Byzantine Empire Some of the physicians trained in the Byzantine Empire were Aetius of Amida, Paulos of Aegina and Nicolaos were Aetius of Amida, Paulos of Aegina and Nicolaos Alexandrinos. The last one, also called "Myrepsos", wrote Alexandrinos. The last one, also called "Myrepsos", wrote a vast treatise on pharmacology, "Dynameron", in which a vast treatise on pharmacology, "Dynameron", in which he described 2656 prescriptions and their way of action. he described 2656 prescriptions and their way of action. His work was well appreciated in Europe/ especially at the His work was well appreciated in Europe/ especially at the universities of Salerno and Paris, where it was considered universities of Salerno and Paris, where it was considered the "official pharmacology" until the seventeenth centurythe "official pharmacology" until the seventeenth century..


Arabic medicineArabic medicine During the first five centuries of the Christian era, the During the first five centuries of the Christian era, the

barbarian invasions of Europe, the disasters and plagues, barbarian invasions of Europe, the disasters and plagues, and the anti-Hellenism of the Christian Church led to the and the anti-Hellenism of the Christian Church led to the loss of much of the Greek and Roman writings. In the loss of much of the Greek and Roman writings. In the seventh century the expansion of the Arabs contributed to seventh century the expansion of the Arabs contributed to the preservation of the classical learning still extant.the preservation of the classical learning still extant.

The Arabic world had had previous contact with Greek The Arabic world had had previous contact with Greek culture, including medicine, before Muhammad's founding of culture, including medicine, before Muhammad's founding of Islam. Islam.

Over several hundred years, Islam extended into Africa, Over several hundred years, Islam extended into Africa, Spain and part of France. There were three caliphates: in Spain and part of France. There were three caliphates: in Baghdad, in Cordova (Spain) and in Cairo.Baghdad, in Cordova (Spain) and in Cairo.

Although physicians often continued to prepare their own Although physicians often continued to prepare their own medications, pharmacy became a separate profession.medications, pharmacy became a separate profession.

The important role of the Arabists in developing modern The important role of the Arabists in developing modern chemistry is remembered in the significant number of chemistry is remembered in the significant number of current terms derived from Arabic: alkali, alcohol, elixir, current terms derived from Arabic: alkali, alcohol, elixir, syrup.syrup.


The attitude of Islam toward the origin of disease was The attitude of Islam toward the origin of disease was similar to the Judaeo-Christian idea in that Allah caused similar to the Judaeo-Christian idea in that Allah caused illness as punishment for a person's sins. The Islamic illness as punishment for a person's sins. The Islamic religion considered that there was an afterlife: the soul religion considered that there was an afterlife: the soul that remained in the human body after death was that remained in the human body after death was reawakened and rewarded appropriately in paradise. reawakened and rewarded appropriately in paradise. Because of this, dissection of human body was forbidden Because of this, dissection of human body was forbidden and Arabic physicians relied on Galen for their anatomical and Arabic physicians relied on Galen for their anatomical knowledge.knowledge.

The practitioners used essentially the same methods as the The practitioners used essentially the same methods as the Greeks and Romans. Diagnosis was based on the patient's Greeks and Romans. Diagnosis was based on the patient's behaviour, the excretions, the character and location of behaviour, the excretions, the character and location of pain, the properties of the pulse. Even the influence of the pain, the properties of the pulse. Even the influence of the stars over health and disease was taken into consideration. stars over health and disease was taken into consideration. Because of the importance given on examining urine, the Because of the importance given on examining urine, the half-filled urine flask became a symbol of the physician. half-filled urine flask became a symbol of the physician. The urine's colour, consistency, sediments, smell and taste The urine's colour, consistency, sediments, smell and taste helped to determine what was wrong with a patient, to helped to determine what was wrong with a patient, to predict his prognosis and to guide treatment.predict his prognosis and to guide treatment.


Since surgery was condemned, much of the cutting, Since surgery was condemned, much of the cutting, cauterizing, bandaging and bleeding was done by untrained cauterizing, bandaging and bleeding was done by untrained doctors and charlatans. Nevertheless, some physicians doctors and charlatans. Nevertheless, some physicians practiced surgery and wrote about it. The most common practiced surgery and wrote about it. The most common surgical technique was cauterization.surgical technique was cauterization.

A characteristic of Arabist therapy was the wide A characteristic of Arabist therapy was the wide employment of drugs of all kinds. New medications, employment of drugs of all kinds. New medications, including mineral as well as vegetable and animal including mineral as well as vegetable and animal substances, were added to materia medica. Some of these substances, were added to materia medica. Some of these substances may have originated in China or India.substances may have originated in China or India.

In the early years of Islam, medical practice was carried on In the early years of Islam, medical practice was carried on by Christian and Jewish physicians. Muslim physicians came by Christian and Jewish physicians. Muslim physicians came upon the scene when Alexandria, Gundishapur and other upon the scene when Alexandria, Gundishapur and other cities became centres of Muslim intellectual life.cities became centres of Muslim intellectual life.

One of the most famous healers in the eastern caliphate was One of the most famous healers in the eastern caliphate was the Persian Rhazes (abu-Bakr Muhammad ibn-Zakariya al-the Persian Rhazes (abu-Bakr Muhammad ibn-Zakariya al-Razi, 850-923?). Razi, 850-923?).

A large part of his work was a compilation of the theories of A large part of his work was a compilation of the theories of Hippocrates, Galen and others. Through the clarity of his Hippocrates, Galen and others. Through the clarity of his writings and his influence over students and physicians he writings and his influence over students and physicians he brought much of Greek medicine to the Arabic world. brought much of Greek medicine to the Arabic world.


The most influential Arabic contributor to medicine was The most influential Arabic contributor to medicine was Avicenna (abu-Ali al-Husayn ibn-Sina, 980-1037), also called Avicenna (abu-Ali al-Husayn ibn-Sina, 980-1037), also called "the prince of physicians" and "the flower of Arabic culture”. "the prince of physicians" and "the flower of Arabic culture”.

His main contribution in medicine was as a compiler and His main contribution in medicine was as a compiler and commentator. The most renowned of his approximately one commentator. The most renowned of his approximately one hundred books was "The Canon" (Al-Qanum). Considered a hundred books was "The Canon" (Al-Qanum). Considered a "medical bible", Avicenna's "Canon" was for centuries the "medical bible", Avicenna's "Canon" was for centuries the standard if not the only accepted text-book of general standard if not the only accepted text-book of general medicine. Much of it was derived from classical Greek sources, medicine. Much of it was derived from classical Greek sources, of which even the worst were better than anything that the of which even the worst were better than anything that the Europe of the time had to offer. The book had five sections: Europe of the time had to offer. The book had five sections: theoretical medicine, simple remedies, and their treatment, theoretical medicine, simple remedies, and their treatment, general illness and pharmacology .general illness and pharmacology .

The most famous Jewish physician in Arabic medicine was The most famous Jewish physician in Arabic medicine was Maimonides (Moses ben Maimon, 1135-1204). Born in Maimonides (Moses ben Maimon, 1135-1204). Born in Cordova, he emigrated in Morocco together with other Jews Cordova, he emigrated in Morocco together with other Jews when the Muslim dynasty of the Almohades began to persecute when the Muslim dynasty of the Almohades began to persecute nonbelievers. He later went to Palestine and then to Cairo nonbelievers. He later went to Palestine and then to Cairo where financial needs forced him to enter medicine as a career. where financial needs forced him to enter medicine as a career.


The general health of the population and its hygienic The general health of the population and its hygienic conditions probably were the same in Latin Europe conditions probably were the same in Latin Europe and in the Muslim world. Medical treatises of the era and in the Muslim world. Medical treatises of the era reveal a concern with the same diseases, acute and reveal a concern with the same diseases, acute and chronic. The Arabic descriptions of epidemics chronic. The Arabic descriptions of epidemics marked by skin eruptions may indicate that such marked by skin eruptions may indicate that such plagues were as prevalent in the world of Islam as in plagues were as prevalent in the world of Islam as in Christian countries.Christian countries.

The best-known of the great hospitals in the Middle The best-known of the great hospitals in the Middle Ages were at Baghdad, Damascus and Cairo. In Ages were at Baghdad, Damascus and Cairo. In Baghdad clinical reports of cases were collected and Baghdad clinical reports of cases were collected and preserved for teaching. The hospital and medical preserved for teaching. The hospital and medical school at Damascus had elegant rooms and an school at Damascus had elegant rooms and an extensive library.extensive library.

Probably the largest was the Mansur Hospital in Probably the largest was the Mansur Hospital in Cairo, founded in the thirteenth century. Separate Cairo, founded in the thirteenth century. Separate sections were built for different diseases, such as sections were built for different diseases, such as fevers, eye conditions, diarrhea, wounds and female fevers, eye conditions, diarrhea, wounds and female disorders. disorders.


The Arabic medicine had an important contribution in The Arabic medicine had an important contribution in keeping alive the spirit of inquiry that had died in keeping alive the spirit of inquiry that had died in Europe at the end of the second century with Galen Europe at the end of the second century with Galen and in preserving the great medical books of antiquity.and in preserving the great medical books of antiquity.

The Middle AgesThe Middle Ages By the year 1200 the orders of the Dominicans and By the year 1200 the orders of the Dominicans and

Franciscans controlled the intellectual life of Paris. Franciscans controlled the intellectual life of Paris. The Church continued to play a central role in the The Church continued to play a central role in the feudal society. The growing power of the monastic feudal society. The growing power of the monastic orders led more directly to Rome than the orders led more directly to Rome than the legendary roads of the ancient Roman Empire legendary roads of the ancient Roman Empire

Physicians trained in the universities were Physicians trained in the universities were available only to the higher ranks of society. The available only to the higher ranks of society. The poor continued to rely on folk-healers, as well as poor continued to rely on folk-healers, as well as barber-surgeons. Childbirth remained in the hands barber-surgeons. Childbirth remained in the hands of midwives.of midwives.

In contrast to the complex medicinal formulations In contrast to the complex medicinal formulations of trained physicians, folk-healers relied on simple of trained physicians, folk-healers relied on simple remedies and rudimentary magic. With the growth remedies and rudimentary magic. With the growth of cities in the twelfth and thirteenth centuries, of cities in the twelfth and thirteenth centuries, there was an increase in the number of there was an increase in the number of apothecaries and pharmacies.apothecaries and pharmacies.


Although the Church retained control of the universities Although the Church retained control of the universities throughout the Middle Ages, monastic medicine declined throughout the Middle Ages, monastic medicine declined rapidly. In the twelfth and thirteenth centuries, control of rapidly. In the twelfth and thirteenth centuries, control of hospitals and infirmaries was transferred from the Church to hospitals and infirmaries was transferred from the Church to municipalities by mutual agreement. Some of the great municipalities by mutual agreement. Some of the great hospitals in Europe were founded now: the Hotel-Dieu in hospitals in Europe were founded now: the Hotel-Dieu in Paris, Santo Spirito in Rome and St. Thomas's and St. Paris, Santo Spirito in Rome and St. Thomas's and St. Bartholomew's in England.Bartholomew's in England.

Throughout the period of the declining Roman Empire and the Throughout the period of the declining Roman Empire and the Dark Ages, leprosy was endemic at low levels in Western Dark Ages, leprosy was endemic at low levels in Western Europe. After the Crusaders began coming back home the Europe. After the Crusaders began coming back home the number of lepers increased tremendously. During the Middle number of lepers increased tremendously. During the Middle Ages, the stigma of leprosy was not restricted to the disease as Ages, the stigma of leprosy was not restricted to the disease as we know it today but was applied to a variety of dermatologic we know it today but was applied to a variety of dermatologic diseases. Nevertheless, all individuals called lepers were diseases. Nevertheless, all individuals called lepers were rejected and isolated by the society and forced to wear rejected and isolated by the society and forced to wear distinctive clothing. However, the Order of Lazarus was so distinctive clothing. However, the Order of Lazarus was so sympathetic to the care of lepers that their house was called sympathetic to the care of lepers that their house was called "leprosarium" and thousands were soon built throughout "leprosarium" and thousands were soon built throughout EuropeEurope..


The most notorious epidemic imported from the East was The most notorious epidemic imported from the East was that of the Black Death or bubonic plague.that of the Black Death or bubonic plague.

Although plague had been known in Europe since ancient Although plague had been known in Europe since ancient times, its reappearance in the mid-fourteenth century times, its reappearance in the mid-fourteenth century was dramatic and devastating. was dramatic and devastating.

Throughout Europe, physicians, when available, Throughout Europe, physicians, when available, protected themselves in elaborate clothes and masks with protected themselves in elaborate clothes and masks with pointed beaks in which they kept vinegar and sweat-pointed beaks in which they kept vinegar and sweat-smelling solutions to counteract the smell of pus and smelling solutions to counteract the smell of pus and decaying bodies.decaying bodies.

In 1485, a new disease characterized by severe sweating In 1485, a new disease characterized by severe sweating appeared in England, known as ,,sudor anglicus”, it appeared in England, known as ,,sudor anglicus”, it brought death within days.brought death within days.

Famine was common and malnutrition as well.Famine was common and malnutrition as well. In the Middle Ages there was a virtual explosion of cults In the Middle Ages there was a virtual explosion of cults

devoted to all kinds of saints who might help cure saints. devoted to all kinds of saints who might help cure saints.


The general population had little contact with The general population had little contact with physicians and these rules were followed: diet was very physicians and these rules were followed: diet was very important in the treatment of illness, drugs were often important in the treatment of illness, drugs were often used, mysticism became prevalent and amulets were used, mysticism became prevalent and amulets were commonly used.commonly used.

Surgery was limited to wounds, fractures, dislocations, Surgery was limited to wounds, fractures, dislocations, amputations and the opening of abscesses. amputations and the opening of abscesses.

During the Middle Ages many public baths were During the Middle Ages many public baths were established. Some of them used stream therapeutically. established. Some of them used stream therapeutically.

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LECTURE 3 Medieval medicine. Byzantine medicine Byzantine medicine Arabic medicine Arabic medicine The Middle Ages The Middle Ages