03: Medicine

Some problems for modern students of early medicine

how do we account for continued use of medical practitioners (though we find most of their practices ineffective at best)?

  • many diseases self-limiting
  • emphasis on prevention
  • some of their advice seems better than inclinations of patients

how do we understand their claims about causes of disease? Points of difficulty for us:

  • No “germ” theory (but we also know micro-organisms are not sole cause of disease)
  • ideas about sanitation are affected by no germ theory
  • so are ideas about transmission, cures of common ailments

            What about university trained practitioners versus others? did they follow similar concepts or did they use different ones?

            Religion and medicine—in opposition or not?

For us: how do food and diet figure as part of how they understand health and illness?

The ancient legacy: Greek and Roman Medicine

Hippocratic texts (5th c BCE)

Aristotle  (384-322 BCE)

Galen (ca. 129-210)

Greek: language use lost in Latin world in late antiquity

Islamic world: continued medical advances

Avicenna (Ibn Sina 980-1037)

Recovery of Medical Texts: 1100-1300; 1470-1600

Universities: Paris, Bologna

Arts course; medicine, law, theology

Siraisi’s book: ca 1100-1470

      health:   normal condition of the body

What affects health: factors include naturals and non-naturals

Seven Naturals

  • elements –earth water fire air
  • qualities  –hot cold wet dry
  • humors   blood phlegm choler melancholer
  • members or parts
  • virtues or faculties   vital  natural psychic generative
  • spirits
  • operations or functions

  Functions in balance.   4 humors, 4 qualities

Associations with other aspects of natural world, including seasons:

  • blood     spring
  •  phlegm    winter
  •   black bile (melancholy). autumn
  •   yellow bile summer

  illness:  imbalance

        temperament: basic balance of these humors in an individual person

“typical” balance varies by gender, age

 basic physiology: three systems

brain and nerves     sensation and thought

 

heart and arteries  life-giving energy

 

liver  and veins        nutrition and growth

  The Non-Naturals: environmental factors that can be regulated

  • Air
  • Food and drink
  • Exercise and rest
  • Sleep and waking
  • Evacuation and repletion (including sex)
  • Passions of the soul

Health: balance

Illness: imbalance

pepsis             process of humors coming into balance, harmony

        crisis                   turning point at which pepsis is complete

breathing from world-pneuma of air

From lung: to left ventricle of heart

  meets the blood, becomes red arterial blood

  Food:

  First digestion: To Stomach. 

  Then to Small Intestine: Becomes chyle: mix with digestive juices and fluids of meal.

Then to liver: with pneuma or “natural spirit”— becomes venous blood   Venous Blood   carries all humors within it

Second digestion: BLOOD HUMOR ARISES (Hot & Moist)

Third digestion: 

  • PHLEGM HUMOR (Cold & Moist)
  • YELLOW BILE (BILIOUS) HUMOR (Hot & Dry)
  • BLACK BILE (ATRABILIOUS) HUMOR (Cold & Dry)

Fourth digestion: Abnormal humor  passed out as ash or admixes with blood humor and other humors, producing morbid conditions

    Most:   back to liver, leaving fumes with impurities, expelled by lungs

    Rest:  drips slowly into left ventricle, meets air from lung

    Some venous blood: to rete mirabile at base of brain,  charged with  animal spirit from brain distributed by nerves

British Library, Egerton 2572, f.50
Vein or Blood-letting Man
Title of Work: Guild Book of the Barber Surgeons of York
York, 1486, with additions to 1768