ISTD by abbielewis

Warding Off Medieval Death

5th Death was at the centre of life in the Middle Ages in a way that might seem shocking to us today. With high rates of infant mortality, disease, famine, the constant presence of war, and the inability of medicine to deal with common injuries, death was a brutal part of most people's everyday experience. As a result, attitudes towards life were very much shaped by beliefs about death: indeed, according to Christian tradition, the very purpose of life was to prepare for the afterlife by avoiding sin, performing good works, taking part in the sacraments, and keeping to the teachings of the church. Time was measured out in saint's days, which commemorated the days on which the holiest men and women had died. Easter, the holiest feast day in the Christian calendar, celebrated the resurrection of Christ from the dead. The landscape was dominated by parish churches - the centre of the medieval community - and the churchyard was the principal burial site.

15th Century 5

THE MEDIEVAL

MIND

In the Middle Ages religion was an important part of everyday life. Many people dedicated their whole lives to God as Monks or Nuns, or worked as lay members of Monasteries and Nunneries. Men and women left their everyday lives to go on crusade or to take to the road as a Pilgrim. People believed in the devil and all his works and feared a very real hell.

Medieval man understood the world as a place of mystery, even enchantment

‘Why am I ill?’ and ‘How do I get better?’ Throughout history, the answers have been sought and provided through a mixture of natural, spiritual and moral meanings. People have rarely understood illness through just one of these components. In many ancient societies the spirits and gods were believed to make their presence known through disease. Treatment involved attempts to satisfy them with ritual chanting or sacrifice, though this was often combined with direct treatment of the sick person. In Egypt astrological explanations and advice sat alongside prescription of herbal medicines, or advice on diet and rest. In China a combination of drugs known as fang was prescribed to combat disease thought to be caused by angered spirits. Understandings of illness based on nature and the gods continued to complement one another into the Middle Ages. In Christianity the marks and symptoms of disease were seen as divine punishment: each of the seven deadly sins had its own corresponding illness. It was common for individuals to examine their moral conduct to determine how they had brought illness upon themselves, and a priest as well as a healer would have been consulted.

ILL NESS

HEA LTH 11

At the same time, spiritual explanations continued to be widely believed for centuries. The majority of Muslims still believed disease was caused by the spiritual jinn (‘genies’) and al-’ayn (‘evil eye’). They sought treatment from popular healers who prescribed herbal remedies and relied on charms and amulets to ward off spirits. Christians also continued to believe in spiritual causes and cures, despite the spread of Galenic medicine from Islamic countries. Ill individuals in medieval Europe generally also sought cures from popular healers such as wise women, who provided treatment based on the doctrine of signatures, believing that for every disease God sent he provided a cure in nature.

EVIL EYE CASUED DISEASE

Believed in supernatural or spiritual origin of disease

earth, air

Most medieval ideas about medicine were based on those of the ancient work, namely the work of Greek physicians Galen (AD 129 - 216) and Hippocrates (460 BC - 370 BC). Their ideas set out a theory of the human body relating to the four elements (earth, air, fire and water) and to four bodily humours (blood, phlegm, yellow bile and black bile). It was believed that health could be maintained or restored by balancing the humours, and by regulating air, diet, exercise, sleep, evacuation and emotion. Doctors also often advised risky invasive procedures like bloodletting. Medical knowledge derived from antique theory was largely confined to monasteries and the highly educated. For ordinary people, especially those outside towns, it would have been difficult to access professional practitioners. Those in need of medical assistance might instead turn to local people who had medical knowledge, derived from folk traditions and practical experience.

fire, water 15

HUMOne of the basic principles of medieval medicine was that of the four humors of which a human body was composed. Such balance and classification of the world was of utmost importance, hence the balance of humors within a human body was necessary for health. Balance of humors in humans was achieved by diet, medicines, and phlebotomy (blood-letting). The medicines in the Middle Ages more often than not would take the form of herbal remedies. In accordance with the humor theory, most plants, food substances, and commonly found house items were specified as either cold, hot, dry, or wet so that they could be used to modify the amounts of humors within a person. For example, pasta (warm) would be used for hot stomach, cold and dry linen could be applied to dry up ulcerations, and sugar (humid) produced â&#x20AC;&#x153;blood that [was] not that badâ&#x20AC;?.

ORS

0370

HERBAL REMEDIES 19

BAL ANC DISED EASE

AND UNDISABAL BILITY

ANC ED

Humoral theory, also known as humorism or the theory of the four humours, was a model for the workings of the human body. It was systemised in Ancient Greece, although its origins may go back further still. Essentially, this theory holds that the human body is filled with four basic substances, called humors, which are in balance when a person is healthy.

Diseases a n d disabilities supposedly resulted from an excess or deficit of one of these four humors. These deficits were thought to be caused by vapors inhaled or absorbed by the body. The four humors are black bile, yellow bile, phlegm, and blood. It may have origins in ancient Egypt or Mesopotamia, but it was the Greek physician Hippocrates (460–370 BC) who developed it into a medical theory. He believed certain human moods, emotions and behaviors were caused by an excess or lack of body fluids (called “humors”) 21

Blood is Hot and Wet or Warm and Moist It is the very essence of vitality and health, nutrition and growth. Blood is perfect nourishment perfectly digested. Its receptacle or home is in the arteries and blood vessels. Blood carries the Vital Force and Innate Heat, which power cellular metabolism. The essence of blood is exchange and contact, as it is the basic nutritional and metabolic currency of the organism. Blood has an Attractive virtue, or force, since all cells, organs and tissues have an absolute need for it, and are therefore attracted to it.

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The Phlegmatic humor is Cold and Wet. It includes not just phlegm, but all the other clear fluids of the body: mucus, saliva, plasma, lymph, and serous and interstitial fluids. Together, these fluids cool, moisten, nourish, lubricate, protect, and purify the organism. The Plegmatic humor has an Expulsive virtue, or force, which flushes out impurities, transports vital nutrients, and helps eliminate wastes. The home of the Phlegmatic humor is in the veins and lymphatics. The Phlegmatic humor nourishes the body on a deep and fundamental level.

gm 25

HOT & DRY The Choleric humor is Hot and Dry. It is produced by the liver and stored in the gall bladder. Bile has a hot, caustic nature and a Digestive virtue, or force, which gives it a strong affinity with the other digestive secretions of the middle GI tract. Fire and bile digest and consume, metabolize and transform. Digestively, bile powers digestion; digests, assimilates and excretes fats and cholesterol; and acts as a natural laxative to stimulate intestinal peristalsis and defecation. It also colors the stool brown. Systemically, Choleric residues in the bloodstream thin the blood, enabling it to penetrate through the finest capillaries; empowers the inflammatory response; and opens up the lungs and respiratory passages as a surfactant.

Yellow Bile

VE SI 28

W I DR TH M A E CH LA W OL NN Y

PE N It

en ut cou pr i r ag on , r ages m at ea pr is li ud m s en an m, ce d , pe ss im is m ca

Blackbile

Black Bile is Cold and Dry. Healthy black bile is a normal sediment of blood, or the Sanguine humor. Black Bile has a Retentive virtue or force, and a cooling, drying, astringing, precipitating, condensing, coagulating, solidifying effect on metabolism necessary for building the bones, teeth, and all dense, solid structural connective tissues of the body. Digestively, Black Bile awakens the stomach and appetite, solidifies the stool, and enables the digestive organs to hold on to their contents long enough to process them properly. Systemically, Melancholic residues in the bloodstream thicken the blood, enabling it to clot; this is vitally important in wound granulation, scar tissue formation, and all structural repair of the body. Black Bile also governs mineral metabolism and bone formation.

1/3 Women died during their child-bearing years.

WOMEN Prepared for

Death "The better the witch; the better the midwife"

The hazards of medieval pregnancy were met by attitudes that were a curious mixture of folklore, obstetrics, religion and common sense.

Child Birth

Childbirth in the Middle Ages was considered so deadly that the Church told pregnant women to prepare their shrouds and confess their sins in case of death. Midwives were important to the Church due to their role in emergency baptisms and were regulated by Roman Catholic law. A popular medieval saying was, "The better the witch; the better the midwife"; to guard against witchcraft, the Church required midwives to be licensed by a bishop and swear an oath not to use magic when assisting women through labour. In situations where a baby's abnormal birth position slowed its delivery, the birth attendant turned the infant inutero or shook the bed to attempt to reposition the fetus externally. A dead baby who failed to be delivered would be dismembered in the womb with sharp instruments and removed with a "squeezer." A retained placenta was delivered by means of counterweights, which pulled it out by force.

ENTRY OF NEW LIFE Many options were available for the woman who was birthing but none were particularly effective. Largely these consisted of herbal poultices, folk remedies and devout prayer. Invoking the name of Saint Margaret, the patron saint of childbirth, was always believed to ease labour pains and assure a safe delivery. Potions advocated for childbirth in the middle ages included rubbing the flanks of the expectant mother with rose oil, giving her vinegar and sugar to drink, or applying poultices of ivory or eagleâ&#x20AC;&#x2122;s dung.

If a woman and her baby survived the birth there were still dangers ahead. The midwife was allowed to baptise a baby so if it was sickly or close to death then its soul would go to heaven. The act of baptism would remove the natural sin and cleanse the soul. It was the only time that a woman was ever allowed to deliver one of the sacraments and only to be done if the child was going to die.

CAUSES ENTRY TO DEATH -

Young mothers, older mothers, poor or rich mothers, all could die not only in childbirth but also due to complications afterwards

S 38

COUGHS & SNEEZES SPREAD S DISEASES 39

HOW

OI N G ? THEY DID’NT

T WHA TH

HEY KNO T D W I D

LIFE OR

DEATH Some doctors made up their own cures to disesases that were not known or hadnt been seen before. They would look at the symptoms the person was having and try and make something up that could relieve that symptom. There wasnt really a way to tell if the cures worked or not. Usaully if a person tried a cure and still survived, it was just luck or a coincidence. People then tried the cures because they thought it worked but they didnt so they would still be left to suffer from the disease. The made up cures were a matter of life or death for most. If someone tried a cure and got a bit better they thought it was a sign that the cure worked, but if another person tried it and it didnt make them any better they thought it was the fault of the patient, not the cure. Medieval people werent very smart and most were very uneduducated so they were very gullable to believe that cures worked. Peasants were taught in churches that if they got a disease, it was because of sinful behaviour and god had punished them and they were left thinking they couldnt do anything bad otherwise theyâ&#x20AC;&#x2122;d get a disease. There were some smarter people called physicans who based their knowledge on human anatomy to tell people how they thought diseases were caused. They charged for their services and only rich people could afford them.

CRUDE, AND HORRIBLY 42

BLUNT PAINFUL! 43

WEIRD AND WONDERFUL REMEDIES 500 AD – 1500

in o

EMED MEIC S m ia n FOR Eat treacle.

DIES RINGCINE WORM THE Wash hair in a males urine.

Traditional potions and practices were based on superstition and had little, if any, medicinal benefits. Some were the result of mistaken assumptions. If a sick person were prescribed a particular remedy, and then got better, for instance, it was assumed the remedy was effective.

Medicine in the middle ages was dominated by religion. Sickness was believed to be a punishment from God for sins committed and the only way to cure someone was to pray for or other religious scholars. their forgiveness. Doctors in the Hospitals often sprang up in middle ages were usually priests monasteries and other religious establishments. The patients were given food and comforted by religious nursing staff but little else was done to cure their illness.Traditional cures, using herbal remedies and potions were seen as witchcraft and outlawed by the church. Laws stated that only trained and registered people could practice medicine. Schools and universities began to educate wealthy arts, law and medicine. Generally men, and occasionally a individuals in religion, the few women, were trained and allowed to become physicians. As universities developed, more and more came from a non-religious background and eventually it was not necessary to be a cleric to practice medicine.

Internal

Bleedi ng Wear a dried toad in a bag around the neck

Toothache Get a candle and burn it close to the tooth. The worms that are

gnawing the tooth will fall into a cup of water held by the mouth.

Eat ginger.

LOSS ME OF MORY Stuff mustard & onion up the

BLOCKED NOSE 51

ures Fa i the and

Medicine in the middle ages was dominated by religion. Sickness was believed to be a punishment from God for sins committed and the only way to cure someone was to pray for their forgiveness. Doctors in the middle ages were usually priests or other religious

st fo sick d dis

i ng

Breath the smoke of burnt feathers 53

B A D BLOOD This was when blood was drained from a certain spot in your body. The idea of this was similar to trepanning because it it would release bad blood from your body. Use of leeches was common for this but dirty knives were also used which only increased the risk of dying to the patient.external image health2.jpg This is a picture of leeches being used on royalty for blood-letting.

INFECTED AREAS Blood-letting allowed for the control of humors in a particular part of the body. Phlebotomy was administered in two ways, via derivation or revulsion. Derivation meant letting of blood at a point close to the affected area, and revulsion meant that blood was let at the most remote point to the affected area. Both methods had specific indication for use in the case of different illnesses and were widely employed by medieval physicians. The dangers of blood-letting are obvious; infection, weakening of the already sick organism, cutting up an artery instead of a vein causing unstoppable bleeding, accidental cutting of nerves, and the loss of consciousness by the patient were the most common issues a medieval doctor had to deal with while administering phlebotomy. More often than not, the result of blood-letting was either continual sickness or death of a patient.

SICKNESS OR DEATH 58

CAUTERI 60

DONT KNOW WHERE YOUâ&#x20AC;&#x2122;RE ILL FROM?

ISATION This is where a physician found that a certain part of your body was causing the sickness, it was cured by having red hot pokers put on the area.

TREPANNING

For Bad Spirits

In The

HEAD

This was when a surgeon cut a hole into the skull to let out evil spirits stuck in the brain. The operation can also include cutting out the part of the brain that had been â&#x20AC;&#x2DC;infectedâ&#x20AC;&#x2122; with these evil spirits. Incredibly, people are known to have survived operations similar to these as skulls have been found which show bone growth around the hole cut by a surgeon , a sign that someone did survive such an operation but only for a small amount of time. A set of trepanning instruments used to cut open the skull.

Clysters i

medicines into the anus

The medieval version of the enema was known as the clyster, which is really an instrument for injecting fluids into the body through the anus. The clyster was a long metallic tube with a cupped end, into which the medicinal fluid was poured. The other end, a dull point, which was drilled with several small holes, was inserted into the anus. Fluids were poured in and a plunger was used to inject the fluids into the colon area, using a pumping action. The most common fluid used was lukewarm water, though occasionally medical concoctions, such as thinned boarâ&#x20AC;&#x2122;s bile or vinegar, were used. In the 16th and 17th centuries, the medieval clyster was replaced by the more common bulb syringe. In France, the treatment became quite fashionable. King Louis XIV had over 2,000 enemas during his reign, sometimes holding court while the ceremony progressed.

AGONY

of the

ANUS

TREATED WITH HOT IRONS

hemorrhoids

Treatment of many diseases in the Middle Ages included prayers to patron saints for possible divine intervention. A seventh century Irish monk, St. Fiacre, was the patron saint for hemorrhoid sufferers. He developed hemorrhoids from digging in his garden, one day, and sat on a stone which gave him a miraculous cure. The stone survives to this day with the imprint of his hemorrhoids and is visited by many hoping for a similar cure.

Diseases In the Middle Ages The crowded and unhygienic living conditions offered a good possibility for diseases to spread. Rushes, boils, stomach troubles, fever and deficiency diseases were part of people's everyday life. Years of dearth, wars and cold winters increased the distruction of epidemics. Big epidemics decreased trading in Europe and could even make entire cities desolate. Among the most feared diseases were smallpox, dysentery, measles, leprocy, typhus and especially the plague. In the end of the Middle Ages also spotted fever and syphilis started to spread. For medieval man the fear of death was increased by the fact that the causes of the diseases were unknown; the illnesses were often thought to be caused by spirits, demons or the devil.

THE BLACK DEATH

The disastrous mortal disease known as the

Black Death spread across Europe in the years

1346-53 70

The Black Death was an epidemic of bubonic plague, a disease caused by the bacterium Yersinia pestis that circulates among wild rodents where they live in great numbers and density. Such an area is called a ‘plague focus’ or a ‘plague reservoir’. Thought to have started in China, it travelled along the Silk Road and had reached the Crimea by 1346. From there, probably carried by Oriental rat fleas residing on the black rats that were regular passengers on merchant ships, it spread throughout the Mediterranean and Europe.

Black Death Symptoms The symptoms of the Black Death were terrible and swift: Painful swellings (buboes) of the lymph nodes These swellings, or buboes, would appear in the armpits, legs, neck, or groin A bubo was at first a red color. The bubo then turned a dark purple color, or black Other symptoms of the Black Death included: a very high fever delirium the victim begins to vomit muscular pains bleeding in the lungs mental disorientation The plague also produced in the victim an intense desire to sleep, which, if yielded to, quickly proved fatal A victim would die quickly - victims only lived between 2 -4 days after contracting the deadly disease

The Black Death is estimated to have killed

30%74

-60% of Europe's population

Reducing the world's population from an estimated 450 million to between 350 and 375 million in 1400. It took 150 years for Europeâ&#x20AC;&#x2122;s population to recover. The plague returned at various times, killing more people, until it left Europe in the 19th century.

Having no de understanding o the pestilence, th and children onslaught wer panicked, a devast 76

efense and no of the cause of he men, women caught in its re bewildered, and finally tated. 77

RING A 78

N U O R

THE RO

E SI

A POCKET FULL OF POSIES The first line, “Ring around the Rosie,” or some variation, describes the buboes that formed. A bubo is a swelling in the lymph node. This swelling is often circular making up the “ring.” The center turns black and is surrounded by a red rash. The “rosie” is the center of this reddish ring. As the victim’s condition worsened, an odor emanated from them. The living began rotting before becoming a corpse. In response, healthy individuals used flowers to cover the odor. The poem recounts these attempts to disguise the smell in the second verse, “a pocket full of posies.” The posies represented fourteenth century air fresheners. The third stanza continues to recount symptoms. In the British version, children sing “Atch chew! Atch-chew!” copying the unmistakable sound of a sneeze. alyptic nature of the disease and the times. No one survives the apocalypse and no one survives the plague.

The American version altered the sneeze to “Ashes! Ashes!” Some believe ashes represent cremation. However, it could simply be an Americanization of the tale. After the disease runs its course, the victims usually die. The last line in the poem announces death’s arrival with a dramatic “we all fall down.” The use of “we” denotes the apoc alyptic nature of the disease and the times. No one survives the apocalypse and no one survives the plague. However, people did survive for one reason or another. Some folklorists doubt “Ring Around the Rosie” dates to the Black Death. The link between the poem and plague is made after World War II and some consider the ties tenuous at best. The lack of evidence is the best evidence against the poem coming from the plague generation. Folklorists have traced the poem to the 18th century, but not before. They argue that if the poem went back 650 years, then there should be a written copy of it dating back to the period, or at least before George Washington’s time.

A TISSUE , A TISSUE

WE ALL FALL DO W

Doctors were completely unable to prevent or cure the plague. 85

THE BLACK DEATH UN CURABLE DISEASE 86

due to the black death of people died

70 percent Death came swiftly, usually within a few days, for most people with the plague. Septicemia, or blood poisoning, sometimes resulted from germs entering the bloodstream after buboes were lanced. Some survived for as long as two weeks before succumbing. About 70 percent of people who contracted the Black Death died. Because a person could be contagious before showing any symptoms, it was impossible to avoid infection until it was too late. The only people truly safe from bubonic plague were those born with a genetic resistance to it which was about 0.2 percent of Europeans.

GOOD DEATH The Church taught that the fate of a person's soul was determined not only by his or her behaviour in life, but also by the manner of his or her death. Medieval Christians hoped for a 'good death', ideally at home in bed, surrounded by friends and family, and with a priest in attendance to administer the Last Rites, the final forgiveness of sin.

BAD DEATH

Sudden death - the 'bad death' - was greatly feared, as dying unprepared, without confessing one's sin and receiving the last rites, would increase the probability of a long 91 stay in Purgatory or, worse, Hell.