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Medicine and Religion in the Middle Ages - "The Cure Comes from God"

The religious aspects of medieval European peoples were a great consideration in the matters of the body and health care. The deep belief in God and destiny often affected the decision regarding personal health.

The Christian faith in respect to the well-being of a person slowly evolves from that of inability to intervene with God's will by treating the suffering ill towards that of the responsibility to take care of one's body as it is a creation of God.

At first, the basic principle of Christian faith in medieval Europe can be outlined as belief that God's creation is essentially good even if humans cannot perceive it as such. Everything comes from God and is part of a greater plan; everything happens for a reason. By this philosophy any sort of illness of suffering should be accepted for it may be a medium for creation of greater good. "Christians should not pamper the body at the expense of the sour or be consumed with the material and temporal to the detriment of the spiritual and eternal" (Amundsen 6).

With time, the Church's dogma turned more towards the philosophy that humanity in fact is damned but God has provided for man to sustain himself through the proper use of nature. At this point, medicine becomes more and more accepted into the life of a Christian person, for it is not apparent that all healing really comes from God in one way or another, and medicine is just a vessel for God's will, not an aberration of faith. "Health obtained through medicine is one of these things that has its origin and existence as a consequence of divine Providence as well as human cooperation" (Amundsen 135).

Eventually, the Catholic religion would take over the medical aspects of the society providing sources for the rituals during healing as well as ethical values to guide the physicians. One of the greatest promoters of the Christian faith was St. Augustine and his Confessions. Prior to his work, the philosophy of Christianity, which is not predominantly a religion of physical healing, was that of destiny - things occur because God wishes them to occur in a specific way. As mentioned before, this belief was slowly replaced by that of God's infinite benevolence. Before this realization, suicides, hatred of own flesh, and seeking martyrdom were popular. With time, this turned to careful appreciation of one's body as yet another creation of God to be cherished. St. Augustine's part in this can be summarized by his most famous quote "God, make me chaste, but not yet." This implied that one were to enjoy life on earth as much as that after death. Such point of view had powerful repercussion on freedom of medicine - from now on it became more accepted to heal the physical body, and medical treatments were not longer as harshly perceived as intervention with God's will but rather cooperation with it, for after all St. Augustine further claimed that "health is a blessing from God."

De Medicamentis Liber by Marcelli (1536) taught how to cure ills using plants, gems, and other natural substances. Although this was frowned upon by the Church, it was considered bearable as the importance of medications grew. The use of drugs was permitted as long as no non-Christian incantations were used.

The acceptance of the more scientific and less religiously rigorous methods of healing led to the skewed philosophy that some healing is a result of evil (such as herbal concoctions or incantations during treatment). Due to this fact, originally the church did not ban the form of pagan magic when used with healing. Only later, much more emphasis was put on the actual words uttered during administering of particular treatments, and only Christian faith-related words were allowed to be sang, muttered, or spoken. "Lord's prayer" substituted any form of pagan incantations.

The tension between the church and folk medicine arose had its basis in the dependence of the latter upon sources that were not compatible with Christian faith. Eventually, the use of incantations and spells in conjunction with folk remedies had to be replaced with Christian versions thereof. Also, the dependence upon the power of herbs, gems, etc. without reference to their Creator was regarded improper for a Christian.

As the Christian faith followers became more powerful in medieval Europe, forms of non-Christian religions were banned. Most forms of superstition were looked down upon. This included abnormal behavior of the non-formally educated healers. Pagan or magical models were declared illicit. The Church "legislated against witchcraft in secular and ecclestical law codes, [it] preached against it in homilies and saints' lives, [it] condemned it in penitentials and in pastoral letters" (Davies 41). Any sort of abnormal rituals were considered as having an origin in evil and were to be confessed. People who believed in such rituals were to repent and harsh penance was usually a result of this belief.

An example of questionable behavior would be as follows:

"When [the healer] approaches the house where the sick person lies, if [the healer] finds a stone lying nearby, [he turns] the stone over and looks in the place where the stone was lying [to see] if there anything living under it, and if [the healer] finds there a worm or a fly or an ant or anything that moves, they [the healer] avers that the sick person will recover." (From The Corrector & Physician).

The treatment of sicknesses during the Middle Ages was almost as controversial as its presumed cause - sin. The general view of a medieval society proposes that a common medieval person when fallen sick would blame his or her sins for the health shortcomings. This was only partially true, for the relationship between sin and sickness was complicated. Three categories of this relationship can be outlined:

  1. Sin was regarded by early medieval authors as the cause of sickness in the sense that without sin there would have been no material evil. This obviously does not imply that a sinful individual would become sick.
  2. One's own general sinfulness was often given as the cause of one's own sickness. This was more a result of a kind of a "guilt trip" rather than actual cause and effect occurrence.
  3. Sickness might result from specific sin - this point of view was usually taken in sermons directed at whole communities rather than individuals as a way of controlling the behavior of the populace in general.

Generally, a line was drawn between sickness as punishment for sin and one's sin as the cause of one's sickness. This lead to the development of medieval medical ethics. Since the desire for the cure of the body was to be combined with the cure of the soul as well. The medical ethics of the Middle Ages existed originally as a mix of the classical medical etiquette (such as the Hippocratic Corpus) embellished with the aspects of Christian ethics - those involving the soul and afterlife. Such mixture basically meant that although medicine was found useful, the sick were not encouraged to cling unto life desperately - instead faith in God and afterlife was greatly encouraged. The doctors' duty was to do everything in their power to help a patient, but this implied enlightening the patient about the more religious aspects of sickness and dying. With time though, treatment of dangerous and even desperate cases was generally not discouraged as it had traditionally been, and sometimes doctors who turned down a case were considered somewhat dishonored. (Such occurrence was common during the epidemic of Black Death.)

For more information on medieval medical ethics, please look up the The Rule of St. Benedict and the anonymous medieval work De Adventu Medici Aegrotum.

Surprisingly enough, despite the claimed benevolence of God, the Catholic church at first did not support the idea of public health. This was a great issue, for at least half of the educated physicians were members of the clergy. The general rule of thumb for a cleric was to treat no one outside of the monastery or treat any laymen. Only later, the idea of xenodochia (care houses for the poor usually adjacent to churches), which later evolved into hospitals, became more popular.

The Church though provided care for the poor and sick. Care of the poor was enjoined by various councils. It was the bishop's responsibility to administer the funds for the care of the poor and sick. Bishops were directed to provide accommodations for the destitute.

As the practice of medicine became gradually increasingly popular among the clergy, canon laws were created in order to regulate and/or limit such practice. And so in 1163, Pope Alexander III forbade monks and other regular clerics to leave their religious institutions for the study of medicine. In 1215, surgery was prohibited in holy orders (major orders - subdeacons, deacons, and priests) but still permitted in minor orders (porters, exorcists, and lectors). At the end of the Middle Ages, there was still no prohibition of the practice of medicine by clerics in canon law (despite the limitations on who medicine was practiced). Surgery, however, was a different matter. "Surgery involved the shedding of blood and much greater risk of harm to a patient, thus heightening the anger that a clerical practitioner might be held responsible for a patient's death" (Amundsen 197).

Medical practice among clergy continued throughout the Middle Ages, evolving from a paid service to a solely charitable one. Clerics were allowed to accept funds only from the rich to be used in treating the poor. In the late Middle Ages, a number of nursing orders arose whose members devoted their lives to caring for the destitute ill. This provided for the increment of the number of existing hospitals equipped with trained physicians.

As the greatest fear of the Church in clergymen practicing medicine was the effect of such practice on their spiritual obligations. Fortunately, as more and more secular physicians were trained in the universities, the issue of clerics as medical practitioners grew nearly moot. More and more non-clergy physicians eventually took over the duties before attributed to clergy physicians.