Medieval Medicine

Influence of Christianity and Islam

Influence of communications between Medieval west and the Arabic world

Hierarchy of causes

Rise of university medicine blended with ongoing practices of surgeons, barber-surgeons, itinerant practioners, midwives, magic and superstition

Plague

Influence of Religion

Increasing power of Christianity in the Roman world after its legalization in 313

Islam founded in 7th century

Despite their serious conflicts, shared an opposition to Manicheanism (good and evil forces created and perpetually in conflict vs. perfect world created by one God)

Religion, continued

By 1000, monotheistic religions (Christianity and Islam) were significant influence on what texts were preserved

Galen was acceptable to both because of his suggestion of one creator

Mind-body dualism posed a challenge to the practice of medicine—complementary but also conflicting

Islamic Medicine key preserver of Galen and Hippocrates

Maintained philosophical tradition (medicine and philosophy must be a blend) but also

Anglo-Saxon and Medieval medicine in England

Selected texts preserved and reproduced by monks

Emphasis on practical medicine

Blend of religion and practical medicine

Patron saints of particular illnesses

"belt books" and visual images for diagnosis

 

Hierarchy of Practitioners

  

  • Learned Physicians
  • Universities developed from 1200s on in Salerno, Bologna,Montpellier, Padua, etc.

    Tiny group

  • Barber-surgeons
  •  

  • Healers inc. women, sorcerers, quacks
  •  

    Hierarchy of causes

  • God
  • Illness is punishment for sins or a test of the faithful (see Job, Boccaccio)

  • Natural causes from the cosmos to the air
  • Planetary influences

    Miasmas in the air from stagnant water, decaying bodies, dung, sick people’s breath, poisons attributed to "outsiders"

  • Individual constitution and receptivity (Galen)
  • See assigned readings on lepers and pox for examples

     

    Practices based on beliefs

    If God is cause, acts of contrition, prayer, Masses, processions, fasting, self-flagellation

    If other, physicians used astronomy and diagnosis of constitutional and environmental ills

    Hot and wet at risk: pregnant women, young and libidinous in steamy cities, etc.

     

    The Black Death

    Social, medical, and spiritual contexts and effects

     

    The Black Death 1347-1351

    Took place in the High Middle Ages

    (circa.1000-1400)

    Most famous of all epidemics

    Killed approximately 25% of population of Europe

    Population of Florence (Boccaccio’s home) dropped nearly 75%

    Why was this plague different?

    Plague had occurred before, but not for 800 years

    For the 300-400 years after the Black Death, repeated regional epidemics

     

    What is "bubonic" plague?

    Three major types of plague:

    Bubonic – transmitted by fleas

    Pneumonic – transmitted by droplets of saliva, etc.

    Septicaemic – transmitted by insects; etiology less known

    All three caused by Yersinia pestis (y. pestis), a complex series of bacterial strains

    Y. pestis lives in digestive tract of fleas (rat fleas but also human fleas)

    Humans not preferred meal

     

     

    Bubonic Plague (Black Death)

    Most common type

    Transmitted to humans by flea bites

    1st symptom pustule (gavocciolo)

    Enlargement of lymph nodes follows

    Subcutaneous hemorrhage next

    Cell necrosis and intoxication of nervous system leads to neurological and psychological disorders

    6-day incubation period

    Highly lethal (50-60 percent die) but not as toxic as other types

    Has not disappeared from the world at all but is unlikely to recur in the US because of public health practices

     

    Images of the Plague

     

    Boccaccio

    One of three greatest poets of his time (Dante, Petrarch, Boccaccio)

    Influenced Geoffrey Chaucer (major British writer of the Middle Ages, who in turn influenced Shakespeare)

    One of the most popular books of all time

    Influenced the development of the novella and later the novel

    The Decameron

    Frame given by "master narrator) enclosing inner narratives told by characters (like The Canterbury Tales – Chaucer—which it influenced)

    10 days, 10 tales per day, 100 stories

    Like Canterbury Tales, the relationships among the stories (and tellers) and between the frame (Introduction) and the inner stories

    The Decameron (1351)

    Some of the work written before the plague

    Later, Boccaccio regretted the more erotic parts of the work and shared in a melancholy and ascetic cast to the literature and art of the period following the Plague.

    Our focus:

    Introduction (one of the most famous descriptions of the Black Death)

    One tale that represents a recurrent but not singular emphasis on death and dismemberment in the Decameron

    This is one example of how issues of the plague show up in the Decameron despite plague itself not being mentioned after the Introduction.





    Day 4 Novel 5 – Lisabetta

    (painting Isabella and the Pot of Basil
    by William Holman Hunt
    1866-8)