Early medieval medicine originated in around the 4th to 5th centuries AD and tied in greatly with the Christian practice of that time. Rules were made requiring the ill to be treated and cared for as part of standard religious orders. This procedure was overseen by the founder of the monks of the West, St. Benedict (480 – 543).
Some of the first written documents detailing the subject of medieval medicine were from St. Benedict. He set aside a space in the monastery to serve as an infirmary for those who were ill, and in firm wording required the Abbot to take particular care of these people as part of their religious duty. St. Benedict reasoned that those in the monastery were to serve others as though they were directly serving Christ Himself. As such, it was of utmost importance that the Abbot took care of the sick above and before any other duty.
Along with this, other regulations were passed to ensure that the ailing were looked after. St. Benedict emphasized that the infirmarian had o be thoroughly reliable, possessing the virtues of piety, diligence and solicitude for his charges. Additionally, baths were to be provided for the ill as often as they needed them.
This rule caught on thanks to Cassiodorus, who was the prime minister of the Ostrogoth Emperors. Taking inspiration from St. Benedict’s decree, he promoted the study of herbs for use in medicine, particularly how multiple species could be combined to benefit human health. However, he stated one caveat: that one should not place their entire trust in herbs or human counsel, but instead turn to God since He created medicine and restores life.
Some centuries after, medical practitioners progressed from infirmaries to medical schools. The first medical school in medieval history was called Salerno. It was founded in the 9th century and formally organized in the 10th century. At Salerno, medicine was taken to high standards, requiring students to complete three years of college work before they could even embark on studying medicine. They would then go on to complete four years of medical studies and then a year of apprenticeship with a physician, before spending an additional year studying anatomy if the students desired to practice surgery. All these studies had to be completed before any student would be awarded a license to practice medicine. Salerno was where many medical observations and breakthroughs happened in the medieval period.
The medical school taught that it was important to rise early, have cold water and cleanse thoroughly. It was believed that getting fresh air and sunlight was beneficial; as such, exercise in the open air was good, but one should not cool down suddenly after that. There were other beliefs among these, such as not taking midday naps, as it was suggested that one would feel worse rather than better by sleeping in the middle of the day. Meals should not be taken until one was sure their stomach was definitely empty, and suppers should always be kept light. Some of the recommended foods were milk and eggs, except if one has a headache or a fever. Herbs were traditionally taken to treat various ailments, such as mint, sage, nettle, mallow, mustard, saffron, pepper, vervaine, henbane, fennel, hyssop, elecampane, pennyroyal, celandine and cresses. Violet would be taken for headaches while leeks would be taken to cure sterility.
Another key contributor to the medical field was the medical school of Montpellier, established in 1289 and situated to the south of France. Montpellier was the go-to center for anyone requiring medical aid. Due to the large number of patients coming to it, many physicians settled there. Students were also taught medicine, increasing the number of practitioners. It was on these grounds that Montpellier became famous and a well-known health center in the region. The success of Montpellier in forming medical solutions can be attributed to the school’s strategic location near Marseilles, which saw large influence from the Greeks. This region enjoyed higher artistic and intellectual advancements than most other parts of Europe in the early Middle Ages.
Montpellier was the alma mater of a number of well-known figures in the history of medicine, such as Guy de Chauliac, Mondeville and Nostradamus. The medical school served as a beacon in west Europe to students, physicians and patients alike. Today, the University of Montpellier is still in operation.
One notable physician during this time was the Jew Maimonides (1135 – 1204), who was known for coming up with the rule that one should eat fruits before a meal. He believed that fruits should not be mixed with other food, and since fruit were easily digestible, one should eat them first, followed by other foods that were more difficult to digest. According to him, “so long as a man is able to be active and vigorous, does not eat until he is over full, and does not suffer from constipation, he is not liable to disease”.
During the high Middle Ages, more medical schools were established all over Italy and west Europe, mostly with an affiliation to a university in the area. The study of medicine in these schools focused more on scientific backing and less on therapeutics or old wives’ tales.
Some medical advancements made during this period included antiseptic and anesthesia. The North Italian surgeons started to use wine in place of ointments to clean wounds. They realized that wine possessed the ability to clean and prevent the growth of germs. Pouring oil on the wound would then protect it from dust and dirt. We can still see the influence of this practice today in modern alcohol swabs.
The topic of anesthesia was commonly experimented on by medieval physicians and surgeons. They attempted to create substances with the effects of anesthesia using mandragora as a base and sometimes combining it with opium. These early anesthetics would dull the senses and usually cause the patient to sleep. When anesthesia was not available, practitioners would use narcotics instead. Other non-medical methods included hypnosis, using ice to numb the wound and acupuncture. Early anesthetics were applied through inhalation and were able to render the patient unconscious if all went well. However, it was still far from ideal, with the danger of causing addiction or being insufficient to numb the pain.
Towards the 13th century, medical practitioners began to do their work in hospitals instead of medical schools. There were hundreds of hospitals built in England during the medieval period, but they were not exactly hospitals in the modern sense. The word “hospital” came from the Latin hospitalis, which meant to be concerned with guests. As such, early medieval hospitals were mainly for the purpose of providing shelter for guests, although they usually also provided accommodation for the sick. Some hospitals were almshouses intended for the poor and the elderly, while others were bedehouses, where those who resided there long-term would pray daily for the well-being of all its occupants. The 13th century hospitals were usually one story tall, with high ceilings and large windows. Cleansing was very important and the hospitals were typically located near a water source to facilitate the cleansing of the residents and for sewage to be carried off. They also had tiled floors for effective cleansing purposes.