The Middle Ages and the Four Humours

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Ages arteries barber-surgeons baths Black Death bleeding blood letting bowels Canon Church conjunction cupping Doubts Empire Galen Greek heart Hippocratic hospitals Humours Ibn al Nafis ideas impact Johannitius laxatives Medieval Monastery Nestorius observation opposites patient planets prevent purging Rhazes Roman seven smell supernatural treatments uroscopy vademecum venesection

The Middle followed the collapse of the Roman in about 500 AD. All the achievements in public health were lost, along with much of their medical knowledge. Until about 1200 Europe was very unsettled and violent, and trade and the exchange of declined.

What influence or did the four humours have during this time?
1. Individuals: The emphasis was on so his ideas of the humours and theory of persisted.
2. Causes: there was a physical cause - that is the theory of the Four Humours which was widely accepted. This was developed by (the examination of urine to make a diagnosis at this time). However approaches were still common as God was seen to cause and cure illness at this time. There was also the development of astrology in that the position of the was thought to cause dsease.
3. Cures were based around the Four such as bleeding or and many herbal remedies. However superstition or religious cures continued.
4. Doctors: Medical schools and were run by the and they encouraged the ideas of Galen.

A source by Peter Abelard, a French priest and teacher, writing in the early twelfth century said:

The infirmary of your convent must be equipped with everything necessary to look after the sick. Medicine must be provided and it is best done if the sister in charge has some knowledge about blood letting.

This source shows that even hospitals that were set up to care for the poor and give rest did give some based on the humours.

They continued to follow the ideas and so explanation of disease changed very little during this time. doctors accepted that an imbalance of the humours was often the cause of illness. The main means of diagnosis was uroscopy - the study of urine through the use of the doctor’s sense of sight, and taste. Some doctors made their complete diagnoses based on the urine and never saw the at all.

They also became interested in astrology towards the end of the Middle Ages. This meant they thought health was influenced by the position of the stars and planets. This was not an alternative to the Four Humours but was often done in . For example the was a book which had tables of the planets, a urine chart, and a set of rules for patients. Therefore we can see several ideas worked together.

Doctors were also telling people how to disease rather like the Hippocratic doctors and advised them accordingly. An aspect of preventative medicine that was used more in the Middle Ages was the custom of . People had their blood removed even when perfectly healthy as a way of keeping the humours in balance. records show that monks regularly underwent blood letting six or times a year. It was often seen as a treat as they were given time off to rest after the procedure. This was carried out by who were not always skilful. Complications could be death at the hands of an incompetent blood letter - by cutting instead of veins or by giving a lethal infection using dirty knives. The usual way to blood let was by (cutting a vein). However women and children and the elderly had blood taken through where the skin was scratched and blood drawn through when a hot cup was placed on the graze.

Blood letting was used to prevent disease and to restore health. Other ways doctors encouraged the humours back into balance were:
¨ Hot to steam out impurities
¨ Given to restore balance by emptying bowels
¨ Use of enemas to empty by squirting a purgative mixture into the anus using a pipe and bellows

People did not know what caused the but there were many theories and various treatments. The treatments were not effective and did not stop the spread but they tried physical and spiritual cures depending on what they thought caused it. Guy de Chauliac wrote in 1363 that
Bleeding and purges, cordials and medicinal powders can be used. The swellings should be softened with figs and cooked onions and then opened and treated like ulcers.
This shows that treatments like bleeding based on humours was still being used.

In Denmark the Bishop of Aarhus wrote in 1485
Plague sores are contagious because the humours of the body are infected and the reek of the sores poisons and corrupt the air.

Islamic Medicine linked to the Four Humours

After the collapse of the Roman Empire from the Eastern Empire the medical ideas spread to neighbouring countries. and his Christian followers translated the ancient medical texts like the Hippocratic Corpus and Galen’s works into Arabic. They moved eastwards to Persia taking the ideas with them. These ideas were further supported when spent two years travelling in Greece and collecting Greek texts. He returned to Baghdad and translated many of the works of Hippocrates and Galen into Arabic.

• Arab doctors like taught the importance of Hippocrates’ observation
• They preserved and translated Greek books and wrote ideas themselves
• They believed they should seek to improve the work of their masters
• Rhazes followed Galen’s ideas but actually wrote a book called ‘ about Galen’ showing they tried to bring their own observations
• identified Galen was wrong about how the worked - however this idea was not one of the Islamic books that was read in the West.
• A doctor called Avicenna stressed that medicine was a science and wrote about the 4 humours. His book called The of Medicine spread these ideas in Western Europe in the 12th century.

Arabic doctors adopted theories about diagnosing illness through an understanding of the four humous and the need to keep a balance. Most importantly they developed the idea of clinical as stressed by Hippocrates.

Therefore the Middle Ages saw the perpetuation of the thery of the Four Humours in bothe the east and the west.

The Middle Ages and the Four Humours

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