WESTERN EUROPE, 1215
Physician to the rich and powerful
High-end physicians in the Middle Ages were university educated and their medicine was rooted in the writings of ancient Greeks such as Hippocrates and early medieval Arab physicians. They treated aristocrats and royalty, explaining illness as an imbalance of the four humours (or distinct bodily fluids): black bile, yellow bile, phlegm and blood.
A BUNCH OF POSIES
It was widely thought that diseases were carried by smell so physicians would seek to protect themselves by masking any stench. Posies were a popular choice but oranges were also used. Flowers also came in handy for treating smallpox – as well as giving patients red food and drinks and wrapping them in red cloths, physicians would ground red roses with bamboo juice.
There were some extreme cures for disease. Inflamed lymph nodes within the armpit or groin areas would be sliced open to allow the pus to drain, while trepanation would see a hole drilled into the patient’s skull so that blood build up could be relieved or intracranial diseases cured. Being made to vomit – another way of balancing the body – seemed tame in comparison.
JAR OF URINE
Patients would be asked to provide a urine sample and this formed a fundamental part of a physician’s diagnosis (together with an examination of blood and stools). They would compare the colour of the urine with a chart in a medical treatise, holding the flask up to the light for a good look. Diagnoses would be looked up in a vade mecum book.
Physicians saw no distinction between medicine and faith, and disease could also be attributed to everything from demons and sin to the stars and punishment from God. Although they were recognised as a distinct professional class in 1215, their treatments – be they bloodletting or herbal remedies – went handin-hand with prayer and relics. To the medieval worldview, all things had a spiritual dimension.
Physicians would always charge high fees for their services, with renowned practitioners in England typically commanding 100 marks for their treatments (a mark being a medieval unit of account worth 160 pence). This would be the equivalent of some £48,000 today, with many physicians put on a retainer fee that attached them to a royal or noble household.
DRAWING OF BLOOD
Working on the basis that fire, water, earth and air controlled the humours, physicians believed the body would be ‘balanced’ by removing ‘bad blood’ (they thought blood was static and stagnated in certain parts of the body). Ailments were therefore treated by clamping leeches to the patient’s skin (sometimes to the eyes). Over time, physicians themselves were nicknamed leeches.