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Healing and Hospitals

The medicine in the early middle ages was mostly based on the remaining Greek and Roman texts stored in monasteries, some schools, and courts. Most of the information contained in these texts were passed upon the students in the form of at most imperfect translations.

The most popular basis for medieval medicine was the medical treatise Galen from ancient Greece. Unfortunately, despite the great attention to the outer anatomy of a human, Galen does not contribute much to the actual processes that take place within a human body. His greater omission is that of blood circulation. On the other hand, he does attempt to describe the functions of human organism, such as breathing in a way, which contrasts with the previously widely believed theories of Plato. Galen takes under consideration the difference between voluntary and involuntary functions (such as the fact that breathing was voluntary - a big gap in Plato's reasoning), and also he points out the lack of synchronization between respiration and pulse. Unfortunately, this is as far as Galen goes in his analysis of a human body.

To the left we see a medieval depiction of muscle anatomy of a human.

Various leech books (physician's desk reference) were written compiling many illnesses, their symptoms, and treatments. Originally physicians would deal with their patient either in the patient's home, or the patient would be brought to the physician. This did not allow for free exchange of ideas or experiences among physicians and oftentimes advice on the treatment of a particular patient would be obtained by recording the symptoms in a letter and sending it to another physician. Hospitals did not have place until the later middle ages.

Leech books worth notice: Bald's Leechbook and Leechdoms, Wort curing, and Starcraft of Early England.

The diagnosis of a patient was usually incomplete. It consisted of inspection of blood, feces and urine, and taking the pulse, but only in rare cases all of the above were included. Blood was checked for viscosity, hotness or coldness, "greasiness", taste, foaminess, rapidity of coagulation, and the characteristics of the layers into which drawn it separated. Blood, feces, and urine measured the balance of humors within a person's body.

Diagnosis of diseases was achieved by using the concept of complexional imbalance as a fundamental explanatory mechanism to interpret clinical manifestations. Observation, though, consisted primarily of taking visual note of the patient's external appearance, listening to the patient's own narrative of the illness, and inspecting and smelling his or her excreta. Observation which would include all of the above was rare and more often than not, a physician would prescribe treatment based solely on written inquiries from colleagues or from the patients themselves.

The illustration on the right depicts a physician taking pulse of his patient. Taking of the pulse was not for the purpose of measuring the blood flow, since the medievals did not know of blood circulation, but rather of the strength of hearth spasms.

The leech books were to be consulted in order to figure out what kind of bloodletting was necessary (if any), whether the patient should rest more or exercise more, if change of diet were in order, or what medication or herbal remedies were necessary. It is interesting to point out, that "although arthritis and rheumatism were common disabilities, herbals and leech books prescribed more remedies for conditions affecting the eyes than for any other single complaint" (Kealy 5).

On the right - a medieval depiction of removing of a cataract.

Herbal remedies, mixtures, and gem therapy were often used in treatment, especially during the early Middle Ages. Of course, this sort of treatment had its limitations laid by the Catholic church to prevent pagan heresy from spreading.

Other examples of common treatments for particular ailments could be pounding henbane and hemlock and laying it on painful thighs, herbal potions to cure jaundice, vomiting and bloodletting for paralysis, and for belly disease - chewing laurel leaves, swallowing the juice, and laying the leaves on the navel. These examples are translations from Bald's Leechbook.

Bald's Leechbook, one of the few remaining, proposes a curious structure for the analysis of a human body. Book I of this leech book writes about leechdoms against affections of the head and goes down through eyes, ears, and throat to thighs, legs, and feet. It contains prescriptions for a various assortment of ailments, such as "tumours or abscesses, skin affections, paralysis, fevers, bites of snakes, wounds, intestical worms, and so on" (Wright 14). The second book deals with the "recognition of signs of disease and the occasional attempts at diagnosis" (Wright 15).

The medication of this time were mostly herbal substances. This combined with the diets, which specified the type and amount of food (possibly in unison with the principles of humors) and exercise to be applied. In addition, and usually in more advanced or severe cases, surgery would take place. This included but was not limited to practices such as blood letting, amputations, or setting bones.

Given the uncertainty of academic medicine, many a time the medieval person would turn towards certain charms, special prayers, or specific Christian rituals. It was not terribly uncommon to believe in cases of miraculous healing. Since most of the population of the medieval Europe did not live in the cities where they could take advantage of the learned un-superstitious university doctors, more often than not they turned for help to the local healers who were usually nurses, halfwives, or just plain experts of herbal remedies. In addition, a more wealthy resident of a city, after consulting the more learned doctors and obtaining no visible effects, would similarly turn for help to the supernatural way of healing, be it a prayer or a visit to the local herbal expert.

Hospitals, or rather centers for the sick became steadily more popular. Of course, the majority still received treatment at home. For the chosen few who had the cash to spend could use the services of the monasteries or the few hospitals in the more urban areas.

"Love of god, compassion for humanity, and concern for their own welfare encouraged people to build hospitals" (Kealy 82). With time, the houses adjacent to some monasteries evolved from shelters for the poor (xenodochia) into places where the sick were cared for by skilled physicians. The greatest development of hospitals occurred in the 12th century.

The term hospital was vital and flexible. It encompassed hotels for travelers and indigent students, dispensaries for poor relief, clinics and surgeries for the injured, homes for the blind, the lame, the elderly, the orphaned, and the mentally ill, and leprosaria for people of all ages and classes.

Almost one half of the built hospitals was directly affiliated with monasteries, priories, and churches. Many hospitals, imitating religious communities, formulated precise rules of conduct, required a uniform type of dress, and integrated several worship services into their daily routine.

However, the traditional spiritual context of the hospital enhanced, but did not overshadow, their genuine therapeutic achievements. "Adopting a religious model was not only the tradition of the times, it was also an eminently successful therapeutic device. Through prayer, patients were supposed to help each other and, indeed, to assist their relatives and friends and people everywhere. Many hospitals had definite local community responsibilities - education and housing students, feeding paupers, maintaining bridges, and sponsoring commercial fairs. All this was both good theology and good psychology" (Kealy 97).