The Romans had got much of their knowledge from the Greeks, who came up with many theories about the cause of disease. The most popular was the Theory of the Four Humours, which stated that illness was caused by the body’s fluids getting out of balance. The Romans adopted this idea but they came up with very few theories of their own. Instead, they performed experiments and carefully observed patients as their illnesses progressed. In this way they made records of symptoms and treatments which were used throughout their Empire. By the Middle Ages, people had forgotten this knowledge, which was only developed in the Arab world. Instead, students of medicine studied the works of Hippocrates and Galen and didn’t perform experiments of their own account.
The influence of Christianity greatly reduced the progression of medical understanding. Human dissection was prohibited and to disagree with Hippocrates and Galen was seen as heretical, for which the punishment was death. The dissection of animals was permitted but that helped very little as the anatomy of a pig, which were usually used for this purpose, is very different to that of a human. This led to false assumptions which set medicine back even further as the information available about the human anatomy was incorrect. Doctors did not perform surgery, which was seen as a vulgar practise, but instead relied heavily on astrology and the examination of urine to diagnose illnesses and prescribe treatments. Indeed, many doctors never saw their patients but were only sent a sample of urine to examine. This was very ineffective and the cures offered by apothecaries were mostly useless in any case.
However, religion did help progression in the case of hospitals. Many were opened during the Middle Ages for the care of the sick. Although they were very small (most only had beds for 12 people as this was the same number as the disciple of Jesus) and only offered care, it was progression as the only hospitals in Roman times were for soldiers. Special hospitals were also opened for the care of lepers.
Universities were set up across Europe but they were only open to men and the religious orders to which students belonged continually disagreed and fought among themselves. The majority of students were second sons of knights and tradesmen who only attended university to make contacts and gain honour for their families before continuing in either a religious order or family trade. Students studied from books that were 1500 years old and no changes were made, however ineffectual the methods were.
The only surgery was performed by barbers or butchers and was very minor. Surgery meant the ancient practices of blood-letting and trephining or amputations. The importance of hygiene when performing surgery wasn’t known and surgeons used the same equipment time and time again without washing it and personal hygiene was never considered. Surgeons used the same clothes and aprons for performing surgery as they did for preparing meat or shaving.
There were few people who practised surgery exclusively and they had very little or no training and didn’t attend university. They were usually summoned by doctors. They also had no consideration for hygiene and most of their patients died from blood-loss, shock or infection. Anaesthetics and antiseptics didn’t exist and most surgeons simply gave their patients alcohol to numb the pain. This was clear regression from the Roman times as they regarded personal hygiene very highly and also developed mild anaesthetics and antiseptics from plants.
Public health had also regressed following the collapse of the Roman Empire. The Romans had built sewers and aqueducts throughout Britain but these fell into disrepair and eventually out of use. Public health wasn’t seen as a priority by subsequent rulers and the streets of Britain were filled with filth and refuse. Open sewers ran through the streets and large pits were opened in towns for the dumping of rubbish. Disease was rife and little was done to improve standards until the Black death, which killed 60% of the population of Europe. It was spread by flea-carrying rats from Asia, which came to Europe via trade routes and ships on the Mediterranean. People panicked and most resorted to prayer and life-size offering of candles. They believed that it came from God, who was punishing them for their sins. The wealthy fled to the countryside while the poor stayed in the overcrowded towns to die. People who caught the plague were shut inside their houses with their families. Many theories were developed about how the plague was spread. Most people thought it was spread by bad smells in the air and no one attributed it to the rats.
The Middle Ages was a time of serious regression and very little progress was made. This was mainly because of the influence of Christianity and the hysterical witch-hunts that led to people being too scared to oppose the rulings of the Church. Its influence was so powerful that until the time of Henry VIII the Church had more power then the King. People forgot the Roman ways of thinking and instead adopted and re-learned the pagan beliefs of Britain’s conquerors, including those which affected medicine.
