How successfully can we measure medical progress in the middle ages.
The middle ages were a period from the collapse of the Roman Empire to about 1400AD. The development of medicine both progressed and regressed and contributed prominently to historic events. Throughout this period, significant individuals arose and authorities and religions gained and lost power. Both the European and the Islamic world contributed to this. Due to Bad emperors, war, disunity and economic decline causing the fall of the Roman Empire, this impacted greatly on medicine. This period was controversially called the ???Dark Ages???
In the ???Dark ages??™, the education of doctors and the development of public health systems were disrupted. In Europe, the training of doctors was abandoned. This was mainly because amidst the war, copies of most important medical books, such as Galen??™s work, was destroyed, lost or hidden away for safe keeping. Surviving medical knowledge was mainly in the Muslim cities of the Middle East. Moreover, the new ???barbarian??™ rulers were vastly illiterate and uneducated and did not consider the education of doctors meaningful. Therefore, the only way in which people could to some extent be treated was to rely on ???folk medicine??™ which comprised of some herbal remedies but mainly superstitious treatment which was predominantly passed down by oral tradition. The individuals who supplied these treatments were the closest thing to a doctor in the ???Dark Ages??™. This overall change was a regress in Europe in the terms of the education of doctors. Things only started to progress after about 400 years later. Medical schools were starting to be set up in universities around the twelfth century. The oldest medical school in a university in Europe was founded in Salerno in 900AD. Other medical schools started to become popular like the Montpellier in France in 1200AD or Bongolia in Northern Italy. An early medical school was established in Salerno in south Italy which taught that careful observation of patients was essential and that cleanliness resulted in good health of the patient. Medical schools began to train doctors and ensured that they had qualifications before they become proper doctors. The work of Galen was re-taught after old manuscripts by Galen and other important writers were rediscovered and translated. This was a vast progress to the education of doctors. The teaching of students in these schools had students listening to the teach reading out a lecture which consisted of passages from Galen and other writers. This could also be seen as regress as it did not give students and firsthand experience into the human anatomy. Another regress was that women could not go into medicine in universities to be educated as doctors. Until the late nineteenth century, most universities had ban women from entering; they had seen women as unqualified to be treating someone. For example, in Paris in 1322, a woman called Jacoba was accused as working as a doctor without proper qualification even though many had said that she was very skilled and provided evidence. In spite of this, she was found guilty and fined ?60. The regress of the dislike from universities of women prevented an important, quicker change and progress in the education of women doctors.
There were not many factual explanations that the people produced for illnesses. There was very little change and much continuity in the middle ages for explanations of illness. Doctors generally accepted the Greek Hippocratic idea of the four humours and used methods that support this idea. For example, patients were frequently given laxatives to restore humour balance by emptying the bowels. Another prominent manner of balancing the humours was bloodletting. This involved the patients having their blood removed when they are perfectly healthy in order to keep the hours balanced. This use of deceptive methods prevented progress for a long period of time. This was also because the works of Galen, Hippocrates and other important medical ???ancient??™s??™ work was consider completely factual any arguments against them was denied and thought to be a mistake. This was a prevention of progress as the ideas of Hippocrates and Galen remained unchallenged for a long time. This was similarly the case in the Islamic world when the books of Hippocrates were translated into Arabic and doctors accepted this idea but as time progressed, individuals like Avenzoar and Ibn an Nafis began to challenge mistakes made in the work of the ancients and came up with alternative explanations and developed new ideas. In due course, the main explanation for illness in Europe was the belief that God and the Devil controlled disease. This was taught by the church and they said that illnesses were a punishment for sins. The church also taught that Saints could heal sick people through miracles. This picture shows the Saints Cosmas and Damian and Angels miraculously replacing a leg of a sick white man with the leg of a dead black man. The other main explanation of disease was the influence of astrology. Doctors, both European and Islamic believed that the body was influenced by the moon and the planets. Some thought that the planets and the moon were made up of the same for humours (earth, air, fire, water) that the body has and that the humours had to be in harmony for the body to operate. Charts and graphs were made to predict when the planets would be in certain positions as a method of diagnosis for illness. An example of this is the Zodiac chart which show when the position of planets is right for bloodletting. Some doctors thought that the position of the three big planets: Saturn, Jupiter, and Mars would have a great impact on health. For example, Guy de Chauliac, a French writer and the doctor of the Pope explained the Black Death by saying that the coming together of the three planets would be a sign of something wonderful of disastrous. This was a regressed change in the explanations of illness because it distracted doctors from finding and using new rational explanations. He also pointed out some accurate rational explanation like when he mentioned that bad digestion could cause illness. People also knew that there was a link between dirt/filth and healthiness although they did not know what that link was. Historians know this because during the Black Death, people cleared the streets of rubbish and waste. This was mainly a common sense explanation for illness.
After the fall of the Roman Empire, the European Government was left weak and unorganised in the sense of public health systems. There were no proper health system for training doctors and key medical documents and books were lost or destroyed. Technology was also destroyed or very limited. It befell a place where medical customs regressed instead of progressed. But after about 400 years, the introduction of medical schools in universities and the appearance of a vast number of hospitals created many opportunities for the development of medicine. Schools provided students with the chance to listen to lectures from surgeons and train to become doctors. Also, towns looked to clear the streets of rubbish to prevent disease. Nevertheless, the Islamic region had a significantly more government impact on the development of medicine .The rulers of the Islamic Empire known as the Caliph were very interested in science. They supplied the support needed for medical advancement. A centre for the translation of ancient documents and books was constructed in Bagdad in 850AD during the reign of Caliph Harun-al-Rashid. This progress allowed medical knowledge to develop through reading ancient medical knowledge and also preserved hundreds of important documents while the others were being destroyed in European war. In around 931AD, students had to pass medical test to be allowed to practice to become a doctor. This progressed medical development as it meant that the doctors were properly qualified to treat people and that they have to knowledge in which to do so. The Caliph also introduced the method of treat the patients at hospitals instead of just caring for them unlike Christian hospitals where they only sought to care and not to cure. Soon later, these new hospitals became known as ???bimaristans??™ which welcomed both men and women, rich and poor. Doctors were always present at these hospitals and medical students watched and learned from the doctors as they did their work. This general attitude was from the Islamic holy book, the Koran which tells Muslims that caring for the sick and needy was an important part of their faith. This increased the public health of the Islamic empire and also provided more opportunities for medicine to develop through more students learning through experience rather than being lectured by surgeons about anatomy.
Because of the constant war throughout the middle ages, communication was much disrupted and was also very dangerous; therefore the spread of ideas was very gradual and slow. Throughout the Middle Ages, the Christian church was at war with Islam, so important mistakes found in ancient works (like Galen??™s mistake about the heart) and new medical ideas very slowly, mostly just reaching Western Europe. This was a regress in medical communication as doctors could not be updated on new medical methods and treatment and would make it harder to introduce new methods and treatment.
Since medical information was translated and preserved in the Islamic Empire, it allowed individuals to more easily develop new ideas. A Persian scientist called Al-Razi contributed significantly to the Islamic medical knowledge. He was known as Rhazes, an influential writer. Like Galen, he stressed the need to perform carful observation and recording infomation of the patient before anything was done. This enabled him to finally distinguish for the first time the difference between smallpox and measles. This was an important medical breakthrough in the history of medicine. When he was given the chance to build a hospital, he built it where meat decayed the least in his city because he believed in the importance of a healthy environment. Another important medical individual was Ibn Sina or Avicenna as he was known in Europe. He produced a million work medical textbook called ???The Cannon of medicine??™ which covered all available aspects and knowledge of medicine. He summarised the writing of Galen and Hippocrates together with their own Islamic writers and knowledge creating a very important book in the history of medicine. The book was very detailed and comprehensive, for example it in includes section about anorexia and obesity. This was progress to medical knowledge because he also included the medical use of drugs of which he was very knowledgeable with like many Islamic doctors. New drugs from the Islamic world included substances which are still used in medicine today, such as Camphor, Laudanum, Naphtha and Senna. Ibn Sina??™s medical encyclopaedia listed the medical properties of 760 different drugs. Later on another doctor called Ibn Nafis challenged the work of Galen and recognized that Galen was wrong when he said that there is a invisible passage that the blood from the right to the left ventricles moved. Ibn Nafis corrected him as he suggested that the blood might travel via the lungs. This was also a very important breakthrough in the history of medicine however his book was not popular enough to be read in Europe so Europe continued to accept Galen??™s mistake until the seventeenth century. This was a regressive continuity that delayed further medical development however overall the important individuals of the Islamic world contributed greatly to medical progress.In conclusion, I think that medicine did progress greatly in the Middle Ages even though many regresses happened and appeared as though there was not much change from Ancient times. I think this is because the fall of the Roman Empire caused most previous medical development to be lost, like the destruction of libraries and medical documents, which led to Europe having to recover from this fall. However, since this was not the cases in the Islamic world where the fall of Rome did not affect the Islamic Empire because medical documents had already been translated into Arabic by Government and so this allowed more chances for medical developments and left no easy way to regress from ancient times. For this reason, I think the Islamic Empire progressed more that the European empire as it had a better chance to progress and also had the interest to develop by the government(like Caliph Harun-al-Rashid) and their practice of their religious faith such as the teachings of the Koran. I think this also because the Islamic Education of Doctors was better as all the students were properly qualified and would have had experience through observing real doctors at work rather that listening to a surgeon point at a body, lecturing about anatomy. The government of the Islamic empire was better as the Caliphs, rulers of the Islamic empire, were interested in medicine and science which also led to more progression. The hospitals were generally better in terms of contribution of medical development as the Islamic hospitals cared and also treated patients of which the European hospitals lacked. Also there were more medically contributing individuals like Al Rhazes, Ibn Sina and Ibn Nafis in the Islamic Empire than the Europe in which no particular medical individuals flourished. Despite these changes in these medical factors, there was more continuity than change in the explanation of disease because people throughout the Middle Ages adopted the main ideas of the ancients like the theories of Galen and Hippocrates and the influence of the church still remained for a long period of time. For both empires, they did not know what rationally caused the Black Death. Therefore, I think that there was progress and change in the Islamic empire to a greater extent than the European Empire.
How successfully can we measure medical progress in the middle ages.