1. World medicine in the middle ages (V – XVII cent. A. D.)

2. Lecture Plan 1. Introduction to the Medieval Medicine. 2. The Byzantine Medicine. 3. Medicine in Arab Caliphates. 4. Medicine in Medieval Europe. Renaissance Medicine. 5. Renaissance Medicine.

3. MEDIEVAL MEDICINE TIMELINE Early Middle Ages 5 th cent. A.D. ancient Renaissance Later Middle Ages 10 th cent. A.D.

4. monksfolk healersuniversity trained physicians Medieval Medicine

5. The first medical university was founded in the tenth century in Salerno, Italy where Greek manuscripts written by such physicians as Hippocrates were studied.

6. Medieval Medicine and the Four Humors Theory drymoist hot cold sanguine choler melancholia phlegm

7. !notable! Doctrine of Signatures colour of flowers and other properties of plants indicated their usefulness in treating particular diseases Medieval Medicine

8. Devine Retribution Due to this belief, many of the sick took pilgrimages in the hopes of recovering by making peace with God. Medieval Medicine

9. This belief, however, did not stop the monks, who were the most literate of the general population, from applying what they had learned by making copies of the ancient medical texts. Each monastery had an infirmary where treatment was available with herbal remedies, based on those prescribed by Hippocrates and others, made from plants cultivated in their gardens. This belief, however, did not stop the monks, who were the most literate of the general population, from applying what they had learned by making copies of the ancient medical texts. Each monastery had an infirmary where treatment was available with herbal remedies, based on those prescribed by Hippocrates and others, made from plants cultivated in their gardens. Medieval Medicine

12. Thus, there were: university trained physicians, all men, who were based in towns and cities and served the wealthy university trained physicians, all men, who were based in towns and cities and served the wealthy folk healers, usually women, in the rural areas folk healers, usually women, in the rural areas healers in the religious orders, who incorporated both aspects of healing into their practices healers in the religious orders, who incorporated both aspects of healing into their practices Medieval Medicine

17. Physicians were scholars who studied at universities. In order to be declared a physician, a student had to prove himself able to recite, lecture and debate the contents of his studies. Physicians were scholars who studied at universities. In order to be declared a physician, a student had to prove himself able to recite, lecture and debate the contents of his studies. Medieval Medical Practitioners

19. Surgeons belonged to the working class and did the jobs that were considered beneath physicians, such as bloodletting and pulling teeth. Most surgeries were performed by the barber/surgeon. The most common operations were for hernias, gallstones and cesarean section. Surgeons belonged to the working class and did the jobs that were considered beneath physicians, such as bloodletting and pulling teeth. Most surgeries were performed by the barber/surgeon. The most common operations were for hernias, gallstones and cesarean section. Medieval Medical Practitioners

22. During the early medieval centuries it was the monks who copied out manuscripts of the works of Hipocrates and other Greek or Latin medical writers. There is evidence that they practiced the medical knowledge they obtained as scribes. Each monastery had an infirmary for its ailing and aged members. Medical aid would also be provided to the poor, travelers and pilgrims who visited. Some monks gained such a reputation for being skilled healers that they were sought out by lay patients. In some cases the care of such outsiders gave rise to hospitals apart from the monks' infirmaries. During the early medieval centuries it was the monks who copied out manuscripts of the works of Hipocrates and other Greek or Latin medical writers. There is evidence that they practiced the medical knowledge they obtained as scribes. Each monastery had an infirmary for its ailing and aged members. Medical aid would also be provided to the poor, travelers and pilgrims who visited. Some monks gained such a reputation for being skilled healers that they were sought out by lay patients. In some cases the care of such outsiders gave rise to hospitals apart from the monks' infirmaries. Medieval Medical Practitioners

25. Dentatores were the dentists of the medieval era and were so expensive that usually only the very rich could afford their services. They removed decay, which was believed to be caused by worms, and filled teeth with ground bone. Gold was used for filling cavities by the fifteenth century. They repaired loose teeth with metal bindings and made dentures from ox and other animal bones. Dentatores were the dentists of the medieval era and were so expensive that usually only the very rich could afford their services. They removed decay, which was believed to be caused by worms, and filled teeth with ground bone. Gold was used for filling cavities by the fifteenth century. They repaired loose teeth with metal bindings and made dentures from ox and other animal bones. Medieval Medical Practitioners

27. Herbalists (Folk Healers). Practitioners of popular healing varied widely from place to place within Europe. In some areas the healers were mostly women; in other they were predominantly men. In some places the secrets of healing were passed only from woman to woman or from men to men, but in other regions the gender alternated with each transmission. In some places healers were thought to possess inherited skills and if an attempt was made to pass these skills to people without these inherited gifts, they would be ineffectual. Herbalists (Folk Healers). Practitioners of popular healing varied widely from place to place within Europe. In some areas the healers were mostly women; in other they were predominantly men. In some places the secrets of healing were passed only from woman to woman or from men to men, but in other regions the gender alternated with each transmission. In some places healers were thought to possess inherited skills and if an attempt was made to pass these skills to people without these inherited gifts, they would be ineffectual. Medieval Medical Practitioners

29. Midwives were taught their duties by other midwives or were introduced into the craft by fathers or husbands who were medical men. Midwives were usually apprenticed to older more experienced midwives. The only requirement for becoming a candidate for midwifery was a statement from the parish priest attesting to the applicant's good character. Midwives were taught their duties by other midwives or were introduced into the craft by fathers or husbands who were medical men. Midwives were usually apprenticed to older more experienced midwives. The only requirement for becoming a candidate for midwifery was a statement from the parish priest attesting to the applicant's good character. Medieval Medical Practitioners

33. Byzantine Medicine In Byzantine times (from about 400 AD to 1453 AD) medicine shows, but little originality. The work handed down to us are all compilations, but as they frequently contain excerpts from lost works they are of some historical value.

34. Byzantine Medicine Byzantine physicians often compiled and standardized medical knowledge into textbooks.

39. Byzantine Medicine A gallery of birds from the Vienna Dioscurides Byzantine manuscript.

40. Byzantine Medicine Oribasius, perhaps the greatest Byzantine compiler of medical knowledge, frequently made revisions noting where older methods had been incorrect. Another Byzantine treatise, that of the thirteenth century Nicholas Myrepsos, remained the principal pharmaceutical code of the Parisian medical faculty until 1651.

42. Byzantine Medicine An important contribution of Byzantium is arguably the fact that it was the first Empire in which dedicated medical establishments - usually set up by individual Churches or the State, which parallel modern Hospitals in many way, flourished.

45. Byzantine Medicine The first hospital was built by Basil of Caesarea in the late fourth century, and although these Institutions flourished, it was only throughout the 8th and 9th Centuries that they began to appear in Provincial Towns as well as Cities.

48. Byzantine Medicine Doctors themselves were well trained and most likely attended the University of Constantinople as Medicine had become a truly scholarly subject by the period of Byzantium.

49. Byzantine Medicine The Byzantine doctor Myrepsos receiving the Patients, from a greek manuscript, 13th century

50. Byzantine Medicine Christianity also played a key role in propagating the idea of charity, medicine was made accessible to all and... simple.

51. Arabian Medicine Avicenna’s (980–1037) principal medical work, The Canon of Medicine, became a classic and was used at many medical schools. The greatest contribution of Arabian medicine was in chemistry and in the knowledge and preparation of medicines.

57. Arabian Medicine At that period, and indeed throughout most historical times, surgery was considered inferior to medicine, and surgeons were held in low regard.

59. Medicine in Medieval Europe At about the same time that Arabian medicine flourished, the first organized medical school in Europe was established at Salerno, in southern Italy.

60. Medicine in Medieval Europe The Salernitan school also produced a literature of its own; the best-known work, of uncertain date and of composite authorship, was the “Salernitan Guide to Health”.

61. Medicine in Medieval Europe Surgeons could treat fractures and dislocations, repair hernias, and perform amputations and a few other operations. Some of them prescribed opium, mandragora, or alcohol to deaden pain.

62. invention of printing press dissection of human body experimental investigation Renaissance Medicine

63. Leonardo da Vinci made detailed drawings from human bodies that he dissected.

65. As the understanding of the body increased, so did the development of new medicines. Building on knowledge of herbs and minerals taken from Arabic writings, Renaissance pharmacists experimented with new plants brought from distant lands by explorers like Christopher Columbus. As the understanding of the body increased, so did the development of new medicines. Building on knowledge of herbs and minerals taken from Arabic writings, Renaissance pharmacists experimented with new plants brought from distant lands by explorers like Christopher Columbus. Renaissance Medicine

67. Hospitals and healthcare Hospitals and healthcare The majority of people were too poor to be treated by trained doctors. Major cities had hospitals. For example, the Santa Maria Nuova in Florence, treated wealthy patients. Renaissance Medicine

69. Surgical instruments remained basic. A surgeon would perform operations with the most basic set of instruments: a drill, a saw, forceps and pliers for removing teeth. Surgical instruments remained basic. A surgeon would perform operations with the most basic set of instruments: a drill, a saw, forceps and pliers for removing teeth. Renaissance Medicine

73. Surgeons belonged to the working class and did the jobs that were considered beneath physicians, such as bloodletting and pulling teeth. Most surgeries were performed by the barber/surgeon. The most common operations were for hernias, gallstones and cesarean section. Surgeons belonged to the working class and did the jobs that were considered beneath physicians, such as bloodletting and pulling teeth. Most surgeries were performed by the barber/surgeon. The most common operations were for hernias, gallstones and cesarean section. Renaissance Medicine

77. Andreas Vesalius wrote what is considered to be one of the most important books in the history of medicine, The Fabric of the Human Body (1543). It was a complete map of the human body, complete with life like illustrations. It showed many of Galen’s ideas to be wrong, and soon Vesalius’ view of anatomy (the study of the structure of the body) became accepted by doctors and surgeons. Andreas Vesalius wrote what is considered to be one of the most important books in the history of medicine, The Fabric of the Human Body (1543). It was a complete map of the human body, complete with life like illustrations. It showed many of Galen’s ideas to be wrong, and soon Vesalius’ view of anatomy (the study of the structure of the body) became accepted by doctors and surgeons. Renaissance Medicine

79. Vesalius was so successful that he became Professor of Surgery (responsible for teaching anatomy) at Padua University when he was just 23. At this time, the Catholic Church said that the works of Galen were inspired by God. So, in the universities of Europe, anatomy was taught by professors who simply read aloud from Galen’s books. Vesalius was so successful that he became Professor of Surgery (responsible for teaching anatomy) at Padua University when he was just 23. At this time, the Catholic Church said that the works of Galen were inspired by God. So, in the universities of Europe, anatomy was taught by professors who simply read aloud from Galen’s books. Renaissance Medicine

81. In contrast, Vesalius gave lectures in which he carried out dissections in front of his students, explaining his own theories and not relying on those of Galen. Hundreds came to watch each lecture. He also encouraged his students to examine the human body for themselves. In contrast, Vesalius gave lectures in which he carried out dissections in front of his students, explaining his own theories and not relying on those of Galen. Hundreds came to watch each lecture. He also encouraged his students to examine the human body for themselves. Renaissance Medicine

84. In 1543, his masterpiece, The Fabric of the Human Body, was published. It was a very detailed study of anatomy, illustrated throughout by some of the most accomplished artists of the Renaissance. It was based on knowledge gained from human dissections. It provided a complete map of the human body. It showed for the first time how nerves are connected to muscles, how bones are nourished, and the complex structure of the brain. In 1543, his masterpiece, The Fabric of the Human Body, was published. It was a very detailed study of anatomy, illustrated throughout by some of the most accomplished artists of the Renaissance. It was based on knowledge gained from human dissections. It provided a complete map of the human body. It showed for the first time how nerves are connected to muscles, how bones are nourished, and the complex structure of the brain. Renaissance Medicine

94. Ambroise Pare is a key individual in the history of medicine who has been called the founder of modern surgery as he significantly changed the way people thought about surgery. Ambroise Pare is a key individual in the history of medicine who has been called the founder of modern surgery as he significantly changed the way people thought about surgery. Renaissance Medicine

95. Ambroise Pare

97. Three main problems faced surgeons at this time. They were pain, infection and bleeding. These 3 factors caused many patients to die. The musket (a form of gun) was becoming the most widely used weapon, but the method of treating the wounds – cauterisation – caused a lot of pain. Pare wanted to find a way to overcome this problem. Three main problems faced surgeons at this time. They were pain, infection and bleeding. These 3 factors caused many patients to die. The musket (a form of gun) was becoming the most widely used weapon, but the method of treating the wounds – cauterisation – caused a lot of pain. Pare wanted to find a way to overcome this problem. Renaissance Medicine

99. The ways of treating gunshot wounds before Pare. The ways of treating gunshot wounds before Pare. 1) If the wound was not too serious, it was filled with boiling oil to stop the bleeding. 2) If the patient needed an amputation, the area would be burnt with a red hot iron, called a cautery iron, to stop the bleeding. Renaissance Medicine

105. Pare’s method, although groundbreaking, still left some problems to be solved in the future. Pare’s method, although groundbreaking, still left some problems to be solved in the future. * Even though Pare’s use of a digestive (ointment) when treating wounds reduced the risk of infection, many patients still died from infection as effective antiseptics had not yet been invented. * Pare’s method of using silk thread to tie off arteries could actually cause infection. Instruments used during operations were not often clean – there was no knowledge of germs – therefore bacteria on those instruments (and the silk thread) was often transferred to the wound and sealed inside. Renaissance Medicine

107. William Harvey was very interested in anatomy, particularly the work of Vesalius. After leaving university he worked as a doctor at St Bartholomew’s Hospital, London, and then as a lecturer in anatomy at the Royal College of Surgeons. He was also physician to both James I and Charles I. William Harvey was very interested in anatomy, particularly the work of Vesalius. After leaving university he worked as a doctor at St Bartholomew’s Hospital, London, and then as a lecturer in anatomy at the Royal College of Surgeons. He was also physician to both James I and Charles I. Renaissance Medicine

108. William Harvey

110. Like Pare and Vesalius, Harvey believed in the importance of careful observation, dissection and experiments in order to improve his knowledge of how the body worked. In 1615 Harvey began to work on the idea that blood circulated around the body. Around this time, water pumps were invented. This gave Harvey the idea that perhaps the heart worked in the same way as a water pump, and pumped blood around the body. Like Pare and Vesalius, Harvey believed in the importance of careful observation, dissection and experiments in order to improve his knowledge of how the body worked. In 1615 Harvey began to work on the idea that blood circulated around the body. Around this time, water pumps were invented. This gave Harvey the idea that perhaps the heart worked in the same way as a water pump, and pumped blood around the body. Renaissance Medicine

113. William Harvey observed how blood flowed around the body. Drawings like this demonstrate that veins have valves and return blood to the heart.

115. Harvey’s theory met with opposition because it suggested that if there was a fixed amount of blood in the body, then there was no need for the practice of bloodletting. Bloodletting was a very common and well respected medical practice, which had been used ever since ancient times. Harvey’s theory met with opposition because it suggested that if there was a fixed amount of blood in the body, then there was no need for the practice of bloodletting. Bloodletting was a very common and well respected medical practice, which had been used ever since ancient times. Renaissance Medicine

116. Medical practices in the Renaissance were not changed by Harvey’s work. Blood letting still continued to be a popular practice, and it was only in the 1900’s that doctors realised the importance of checking a patient’s blood flow by checking their pulse. Medical practices in the Renaissance were not changed by Harvey’s work. Blood letting still continued to be a popular practice, and it was only in the 1900’s that doctors realised the importance of checking a patient’s blood flow by checking their pulse. Renaissance Medicine

117. Thank you for your attention!