A Doctor's Education
by Friar Thomas Bacon (David Moreno)
Orignally published in the June 1998, A.S. XXXIII issue of the Dragonflyre, a publication of the Barony of Vatavia.
During the Middle Ages, the field of medicine was covered by three disparate groups. They were the herbalist, the barber/surgeons, and doctors. The herbalist were the dispensers of "home remedies", those time tested potions and brews that were handed down each generation. They rarely had any formal training, or any understanding why their remedies worked. But for the vast majority of the population this was the source for any treatment they might get. The barber/surgeons had more formal training with apprenticeships, but they like the herbalist were still numbered among the lower class. The province of the barber/surgeons is what nowadays goes under the rubric of trauma. When cutting upon the human body, there were called in, and their techniques were only slightly more refined then those of ordinary butchers. The doctors were they only ones with formal academic training. This put them at a higher class, so their higher fees resulted in their being used only by the upper class. This article will look at a doctor's education.
The first medical university was founded in Salerno in the 10th century. The texts at this university were ancient Greek and Roman writings that that been re-introduced from the Islamic world. As time went on, addition Arabic texts were introduced in the curriculum. New material from European sources did not show up till the end of the Renaissance. Unlike the herbalists and the barber/surgeons, doctors had very "little hands" on training. Their approach to medicine was very scholastic with a heavy dose of mysticism.
The central theory of medicine was that of the four humours, not unlike the four elements of physical theory. The four humours were choler, phlegm, black bile, and blood. A person's health and character were determined by the relative balance of these humours. Illness was the result of one these humours being out of balance. The doctor's job was to determine which humour was out of balance and remove the excess or replace the deficient.
Choler, also known as yellow bile, is associated with fire and made people temperamental and irritable. Such a person is said to be choleric. Phlegm is associated with water and made people sluggish or unemotional. Such a person is said to be phlegmatic. Black bile is associated with earth and made people gloomy or depressed. Such a person is said to be melancholic which derives from Greek for black bile. Blood is associated with air and made people passionate or cheerful. Such a person is said to be sanguine which derives from the Latin word for blood.
It should be noted that the above humours are not exactly the same as the actual bodily fluids for which they share the same name, but are an ideal abstraction of these fluids. To explain further would require a side discussion of Platonic philosophy and Universals. Since the bodily fluid blood carries all four of these humours throughout the body, it became common practice to conduct blood-letting to release the excess of some humour. Diagrams for blood-letting are reminiscent of diagrams for acupuncture.
Blood-letting was not the only means of restoring the humour balance. Various potations, brews, and foods could be given. Whole books were written to detail the presumed effects of each: hot or cold, wet or dry. This in turn would enhance or suppress the production of the given humour.
Inherent in the four humours theory was the concept that man was a mini-cosmos. As such he was connected to the larger cosmos, and so events in the larger cosmos had effects on man. By this thinking that the use of astrology played a part in the practice of medicine. The timing of the accident or illness affected the prognosis as it did the efficacious of the treatment. It was widely expected that doctors be as conversant in the texts of astrology as in the texts of medicine.
To a lesser extent, doctors also got involved in alchemy. While the pursuit of making gold is the best known effort of the alchemists, right behind, and to some alchemists the more important, was the search for the elixir of life, said to cure all illnesses and prolong life. Just as modern chemistry arose from the efforts to transmute items to gold, the search for the elixir would lead to the pharmaceutical industry.
The state of medicine remained unchanged throughout the Middle Ages. The principle cause of this was the church's ideas on the Resurrection. It was strongly believed that the promise of Resurrection was literal, and so the body itself was sacrosanct. Thus dissections were outlawed, sharply constraining the study of the body. Nor did it help that the Council of Reims in 1125 and Lateran in 1139 discourage the study of medicine by clerics, and in 1215 prohibited clergy from any activity that could result in shedding blood. It was only with the coming of the Renaissance and the loosing of the hold the Church had on the intellectual mind did medicine resume its advance.
Bibliography
Arano, Luisa Cogliati. Medieval Health Handbook (Tacuinum Sanitatis). Trans. Oscar Ratti and Adele Westbrook. New York: George Braziller, 1976.
Chase, Melissa P. "Fevers, Poisons, and Apostemes: Authority and Experience in Montpellier Plague Treatises." Science and Technology in Medieval Society. New York: The New York Academy of Sciences, 1985.
Coulton, G.G. Medieval Panorama. New York: W. W. Norton & Co., 1974.
Nasr, Seyyed Hossein. Science and Civilization in Islam. New York: Barnes & Nobles Books, 1992.
Rawcliffe, Carole. Medicine and Society in Later Medieval England. Stroud: Sutton, 1995.
White, Jr., Lynn Townsend. "Medical Astrologers and Late Medieval Technology." Medieval Religion and Technology: Collected Essays. Berkeley-Los Angeles: University of California Press, 1986.
Copyright © 1997 - present His Lordship Friar Thomas Bacon (David Moreno). All rights reserved.