Thursday, August 5, 2010
Medicine In The Middle Ages
The Heptameron by Marguerite de Navarre is a representation of the French society in the middle ages. She has depicted various social and cultural norms of the time in the stories. Her insight into the science of medical practiced in France in the Middle Ages is quite apparent Even though the importance of medicine as specialty was acknowledged among the intellectuals of Paris; the influence of the church remained a conduit for its advancement. Although the supremacy of supernatural over natural was obvious, a clear implication was established that the natural and supernatural world was separate if not independent. As a result what we see is an amalgamation of medical science, mysticism and religion in the middle age France.
Ancient physiologists believed that the body must always have a balance of these humors, for imbalance will cause ailments. Diagnosis was based on examining sample of blood and also colors of skin, urine and feces.
Medical treatment by trained physicians rare and very expensive as a result the elite class could only afforded it. The uncertainty and unavailability of academic treatment left no choice for the general population, but to turn towards certain charms, special prayers and specific Christian rituals. Thirteen century Paris had only a half dozen doctors in public employ, with little time to spend on individual patients. Practice of medicine was not restricted to a certain sect of people rather clergy and laymen, men and women were all able to practice medicine.
The physician often compounded and dispensed drugs in addition to practicing medicine. And apothecary often engaged in medical practice as well as compounding and dispensing. It is evident from the stories in heptameron that the drugs made by apothecaries could be very lethal at times as they did not have the proper knowledge. Also personal hygiene was not an important factor for an apothecary, live alone the common people.
Diet was thought to be extremely important in the treatment of illness and prescriptions would cover the minutest of details for all sorts of conditions. The greatest general reliance was placed on broths, milk and eggs. Today the importance of diet in medical science is felt extensively. Nutrition as a special branch of study has emerged. Dietitians and nutritionist are there to help physicians in treating patients who needs special diets. Plants and herbs were used in the preparation of digestives, laxatives, emetics, diuretics, diaphoretics, styptics etc. Drugs remain to be the major form of treatments today but with the advanced technology, pharmacology has become one of the leading businesses.
Surgery a last resort advised by a physician but also it was only accessible to the wealthy. Surgery was known to be successful in cases of fistula, hemorrhoids, gangrene and cataracts. Bloodletting was one of the most common forms of surgery and was recommended for fever, inflammation, and a variety of disease condition and ironically for hemorrhages as well. There were three main methods of bloodletting during the middle ages: leeching, venesection and cupping. Among these leeching is still used, though rare as a medical procedure by some physicians. Leeching helps to reduce tissue congestion where arterial input is maintained but venous return is blocked or slowed leeches act as an extra vein to relieve a dangerous build-up of blood. As a result leech therapy is finding its way into numerous reconstructive surgeries such as digit and limb reattachment, skin graft procedure, scalp avulsions, and breast surgeries and even into effective treatment of periorbital hematomas. Anesthesia and pain relievers were available but some of the potions used were lethal in itself. For example the hemlock juice was used, and it could easily cause death.
The diseases that were very common in the Middle Ages were dysentery, jaundices pneumonia, influenza and common cold. This could be largely attributed to the living condition of that time. Rural people largely lived in a one-room structure with a central fire or hearth and a central roof with a small opening which allowed some of the smoke to escape. Homes were dark damp and cold, with minimum sunlight and poor air circulation, a perfect breeding place for germs and bacteria. The climatic conditions and life style of the time with no proper facilities contributed to the lack of personal hygiene as well. It further escalated with population growth in the towns and cities. Also due to lack of advanced techniques, patients often died due to excessive blood loss after a surgery. Today personal hygiene is considered to be a key factor to live a disease free life.
With the latest technologies available infant mortality has reduced and longevity of humans has increased tremendously compared to middle ages. As we benefit from the sophisticated technologies of medical science, it is imperative that we acknowledge the contribution of our predecessors. What we are enjoying today is the fruits from the trees whose seeds were planted by our ancestor