Chapter 6 Health and Medicine

6.1 How Smelly were the Middle Age

They knew nothing about germs, So they were less fussy about living in smelly dirty places

How smelly were the middle  Sewage piled up in streets

age? Some examples  Few streets were paved, so gets muddy when rains
 Gong farmers were paid to clear away the filth
 Butchers dumped their waste in the rivers
 People used the rivers to remove own sewage and
other waste
 Bakeries and breweries use river to remove their waste
 Open ditch ran down the centre of the street to carry
away water and waste
 Wealthy people get servants to sweep outside their
house

Privies  Some toilets which were small sheds outside houses or

building with cesspit underneath where the sewage
was collected

Cesspit  A pit for the disposal of liquid waste and sewage.

How was the condition of  Homes had no floorboards or carpets (earth only
the houses and how smelly covered with straw)
were they?  Windows, if any, had holes in the wall with wooden
[important- please shutters to keep wind out.
memorise at least 4 -5  Centre of the room was a fire, smoke escaping through
points a hole in the roof
 During winter, due to cold, animals are kept inside the
house, makes the smell worse
 No taps to provide clean water for washing or drinking
water
 Water had to be fetched from stream, river or well
 No toilets, only bucket in the corner of room or hole
dug outside

Condition in town  Smelly
[important]  No rubbish collection during medieval times.
 People tipped it into the streets or dumped it into a pit
to rot away
 Few public toilets in town
 They use pots at night & next day threw out from
window

Better at some places
How did medieval people
tried to keep themselves
healthy ?
Did the people know about
germs?
What they think caused
illness and infection?
What effort was made by
King and authorities?
6.2A The Black Death: We’re all going to die! (very important)
In the spring of 1348, the people of Britain were gripped by fear. A killer disease was
What happened in spring of
1348?
Impact of The Black Death
on people
Symptoms
Boils
 There was a public toilet on London Bridge that
emptied straight into the River Thames
 Some town had public “bath houses” where small fee
was imposed to those who wants to use it
 Few places hired gong farmers to remove the filth
 Although some people made connection between the
rubbish and disease, they still didn’t know about germs
They thought it was the bad smell from rubbish that
carried infection
 Town councils introduced laws to try to keep the
environment cleaner.
 Eg a London council made households that use local
stream to pay a fee to have it cleaned each year

 People of Britain were gripped by fear as a killer disease
was spreading across Asia and Europe
 It was killing thousands and thousand of people and
whole village were being wiped out
 The disease was known as ‘The Black Death’ (kills one
out of every three people)
 Victims suffered from the symptoms such as
 Hot and sweaty
 Fever
 Muscles and bones ache
 Red, tender, painful lumps (boils) under armpit and in
grain
 Some boils as big as apple
 Red and black rashes
 Breath smells foul
 Swelled throat
 Evidence of a disease

 Painful lumps
6.2B The Black Death.: We’re all going to die! (very important)

The Black Death of the 14th Plague – a disease that spreads quickly
century was a plague

Plague A disease that spreads quickly

Experts studies  Black Death was two different plagues that struct at the
same time ie Bubonic Plague and Pneumonic Plague

Bubonic Plague  Caused by germs that lived in the blood of black rats
and in the fleas on their body
 This fleas would hop onto human body and bite them
passing on the disease

Symptoms  Victims get fever and large boils (called buboes) in their
(in order) armpit, groin and behind ears.
important
 Then they would develop a rash of red and black spots

 Illness will last for a week and then kills

Pneumonic Plague  Also caused by germs from black rat and fleas
 Caught by breathing infected air which attacked the
Symptoms (different and lungs, causing victims to cough up blood and spread
more deadly) deadly germs as they sneeze
(in orde)  Victims breath would smell as their lungs rotted inside
important them
 Victims would die within a week

Black Death was a deadly  Bubonic and pneumonic plague combined to make the
combination Black Death.
 Possible to get one plague without the other
 However, if caught pneumonic plague, probably die
 30% caught bubonic plague survived
 When caught both plague, no chance to survive

People’s thought that
caused the Black Death
[important]
As they don’t understand infections or how disease passed,
various ideas they had such as
 God uses plagues to terrify and torment people to drive
out people’s sin
Eg in England people behaviours are getting bad &
committing sin, God punished them through plague

 The long term cause is the position of the planets. Also

by evil smells which mixed with the air and spread on
 the wind. So when people breathe in the bad air, they
caught the plague

 It spread by contagion. If a healthy man visited a plague

victim, he usually died himself

Contagion the communication of disease from one person to another by

close contact.

How people dealt with Black Through few ways

Death
 Locking plague victims in their homes
 Praying
 Drinking vinegar and mercury (a silvery liquid metal)
 Plucking a chicken and strapping it to the boils
 Popping the boils
 Killing cats and dogs
 Killing a toad, drying it in the sun and holding it on the
boils
 Moving away fi they thought plague was coming
 Avoiding contact with people
 Lighting fires and spreading perfume in the air to drive
away bad smells
 Groups of people called flagellants walked around
whipping themselves hoping that this will show the God
how sorry they were for their sins in order for God to
forgive them and spare them

Flagellants Religious people who vigorously whipped themselves in public

as soughting forgiveness for sins made

6.3 How deadly was the Black Death (very important)

Was it bad?  It was the worst disaster

Killed 75 million people
 In Europe 25 million people died (half of its population)
 In Britain, 2 million died in one year (one third
population)
Where did the disease come
from?
(Important)
Why the disease spread fast
in Britain?
(Important)
What happened after that?
Short term consequences
Of Black Death disaster
Long term consequences of
Black Death
Very very important
* Ill give some resource to
read further on this
 Historian thought probably it started in Asia
 The disease was carried by fleas, rats and people on
ships and along trade routes that were transporting
goods like spice and cloth into Europe
 This disease attacked Italy, France, England
 In England, it began in Dorset
 From February to April 1349 (within a year) , it spread
greatly in London, 200 dead bodies daily
 Bodies buried in new Smithfield cemetery
 In May 1349 it stopped in London
 In towns, cities and ports people live close together and
didn’t know anything about how disease spreads. So it
was passed easily among the crowd
 People who buried the dead bodies spread it because
they didn’t protect themselves when they handled the
bodies
 In villages, bodies were buried quickly in shallow pits.
Wild animals dug up the bodies and spread infected
body parts around
 The filthy street gave rats the perfect environment to
breed. Although town council had laws to keep the
town clean, people often neglect it. So, the rats kept
multiplying and disease was spread.

The plague didn’t die out completely.
One outbreak in 1665 killed about 100,000 people in London.
This is knows as the ‘The Great Plague’
 Affected all sort of people – poor/rich/old/young
 No one was safe
 Whole villages were wiped out sometimes
 Fields and streets full of dead bodies
 Houses were quiet and empty
 Not enough people to look after farm animals and
harvest corps which led to food shortage where some
people even starved
 Fewer workers to do the jobs, thus the workers
demanded for more money to do work. Peasants began
to move around more because they were needed
across the country to do work.
 King passed law to stop wages going up; “Statute of
Labourers” act was passed where peasants won’t get
 high wage. This made the peasants angry
 Some said Peasants’ Revolt was also one of the cause
of Black Death because peasants got angry when King
reduced their wages

6.4A Who healed sick in the Middle Ages

When you’re ill, where do  Poor people go to wise woman or man in village. They
you go advised to try strange herbs, plants and potions

 Some people visit churches few times in the hope God will
cure the person.

 Some travel to nearest town to see doctor, if got money.

Wise woman skilled people in the use of natural herbal remedies and first aid

What are the popular
theories about the cause of
Black Death/disaster
Since people didn’t know about germs, so there were popular
theories
 Some blamed the position of planet. The study of how star
and planets might have made impact on their lives which is
called astrology.

 Bad smell causes the disease

 They believed the body contains four ‘humours’ or liquid.

When these liquids are out of balance, people become ill.

 Evil spirit cause illness

Astrology The study of how star and planets might have made impact on
people lives.

Theory of the four humours The idea was that a person’s body contains for liquid or humour;
Developed by Ancient Greeks blood, yellow bile, black bile and phlegm. When all present in equal
amount, then the person is healthy, if no balance then person
becomes ill

Supernatural Relating things to God, evil spirit, magic and astrology

How are the people treated  As seeing doctor is costly, many people treat themselves
….Getting treatment using traditional medicines since they have done so for
many years

Apothecaries
Beware
Quacks
Refer to pictures of them in
fairs drawn by writer Paul
Lacroix
6.4B Who healed the sick in the Middle Ages?
Trust me, I’m a doctor. Are
the doctors really qualified
and knows well about
sickness…Can they be
trusted?
Doctors’ resources. Where
they gain knowledges
How Medieval doctors
 They get advice from wise woman who has good
knowledge about herbal remedies and first aid. Their
knowledge was passed down by word of mouth and written
in books
 Apothecaries are specialist medicine makers who
experimented with plants such as poppies, willow leaves
and garlic to treat people
Modern scientists saw their book and concluded that over half
of their remedies to fight infections and to ease pain would
have worked
Poppies and willow leave – contains natural form of painkiller
Garlic – kills bacteria
Apothecaries and Wise woman knew lots of effective ways to
treat illness but some treatments are bizarre
Please read Source B at page 147
Specialist medicine makers who experimented with plants such as
poppies, willow leaves and garlic to treat people
Some people took advantage of people’s lack of knowledge
They are con artists that tried to trick people into buying
treatments that didn’t work. They sold their potions at fairs and
travelled through villages and towns
 Only rich would go to doctors.
 Doctors have spent 7 years studying at university.
 During this time, they would have learned mainly by listening
to lectures and debating what they had read about in books.
 Some doctors left university without ever actually treating a
patient
 Doctors read books written by Ancient Greeks (they were
more advanced in medical thinking)
 Doctors studied ideas from the Muslims, Indian and Chinese
worlds
 Medieval doctors treated their patients based on the “Theory
treated their patients of the four Humours” that was developed by Ancient Greek.
[important] Doctors use this ancient theory to explain most illnesses
 A doctor would carefully examine a patient (using all sorts of
method) and use special charts to work out a treatment

Investigating illness
How medieval doctors do it?
 To find out what’s the illness in a patient, doctors probably
will ask to urinate in a clear glass bottle. Then the urine will
be examined three times:-
1. When its fresh,
2. When cooled down after an hour,
3. Finally when it has gone completely cold.

He might even taste it to see if it is sweet or sour, bitter, or salty

Then he uses his chart and go through his books. Then the colour of
the urine would be matched against the shades on a special diagram
(doctors thought that every shade had a different meaning)

Besides, doctors would examine patient’s blood, tongue, pulse and

even faeces although he doesn’t know what he’s looking for.

What exactly must a doctor  He must know how to read so that he can understand
know? medical books
[important]  He must know to write and speak well so that he can explain
the diseases he is treating
 He must have a good mind to investigate and cure the causes
of disease
 Arithmetic is also important so that he can be a great help to
the sick
 He must know astronomy so that he can study the starts and
Why he must know the seasons because our bodies change with the planets and
astronomy? stars

Bad blood
Why does doctor examine  Many doctors thought that the answer was to make the
the blood? patient bleed, so that the bad blood would disappear and
their body would be in balance again. This is called
bloodletting

Special tools were also used to cut open a vein and bleed a patient

Bloodletting Making patients bleed so that their ‘bad blood’ would disappear, and
their body would be in balance. At times, leeches were used to suck
the blood out

Leech An organism that sucks out blood from body

Terrifying treatments  Doctors felt purging was the best way to get your humours
back in balance.
What is done?  So, they would give patients something to eat to make them
vomit or go to toilet a lot.

 The idea was to get the badness out of your body and to
Why balance the humours.

Purging To get rid of unwanted substance from bowel or body

Can women become doctors  No because they couldn’t go to universities

 They took the role of main carer, midwives and wise woman
(That’s why nurses are mostly women – for your own
knowledge KV)

Who were barber-surgeons? They are alternate options for patients to get treatment from as they
are cheaper than doctors

What do they do? They remove nasty boil or rotten tooth and have hair cut at the same
time
They are skilled at bloodletting

Trepanning A treatment that has been around for many years.

Drilling a hole in patient’s skull to let out evil spirit that were giving
the patient headache and making them fell unwell.

Why easy to spot barber- It had red and white pole outside (red representing blood and white
surgeon shop for bandages. This poles still exists till today in some barbers shop