GCSE History Medicine

dissection of humans was forbidden in the Roman empire, so Roman anatomists such as Galen had to rely mainly on dissections of animals to further their knowledge. Galen recommended dissecting monkeys that walked on two legs, like men.

Roman Medicine.

Galen's books show a good knowledge of bone structure. He also studied the lungs, the muscles, the heart and blood and the nervous system. He conducted experiments on pigs, and when he cut the spinal cord in different places he realised how the nervous system takes messages from the brain to the muscles.Galen accepted the Greek theory of the four humours as the cause of disease. However, the Romans did not continue the Greeks' investigations into disease and rejected Greek ideas, so Roman knowledge of disease did not progress.Roman ideas about disease were muddled. For example: Crinas of Massilia thought illness was caused by the stars (astrology). Varro blamed creatures too tiny to be seen. Columella blamed poisonous vapours in the swamps. All these ideas survived until the 19th century.

Galen based most of his information about anatomy on what he saw when he dissected the bodies of animals. This led him to make mistakes. Some of his errors were: He thought that muscles attach to the bone in the same way in humans and in dogs. He thought that blood was created in the liver. He realised that it flowed round the body, but said it was burned up as fuel for the muscles. He thought he saw holes through the septum, which allowed the blood to flow from one side of the heart to the other. He made mistakes about the blood vessels in the brain. He thought the human jaw-bone was made up of two bones, like a dog's. He was mistaken about the shape of the human liver.

Through their work with gladiators and wounded soldiers, Roman doctors became experts at practical first aid and external surgery.They could do a large number of simple external operations, such as removing polyps up the nose and goitres from the neck.We have no evidence that Roman surgeons successfully operated inside the body. Roman doctors did not have anaesthetics, and had only herbal antiseptics - so successful surgical operations would have been extremely difficult for them to perform.

The Romans developed the first-ever system of public health.Three important factors combined to cause them to create a public health system. Their suspicion of Greek doctors, their realisation that the army needed hygienic conditions to keep their soldiers healthy, and their engineering abilities.Like the Greeks, the Romans believed in personal health and hygiene - the writer Juvenal coined the phrase "a healthy mind in a healthy body". The Roman writer Celsus advised exercises before a meal, and bathing weak parts of the body (copying Hippocrates's, 'Programme for Health'). Galen prescribed gym exercises and deep breathing as a way to health.Settlements such as army camps, were sited in healthy places (not near swamps). In other places marshes were drained (Julius Caesar drained the Codetan swamp near Rome), which reduced malaria.

Baths Rome had nine public baths. Many of them were luxurious, 'covered with mirrors buried in glass lined with marble and silver'. For a fee of one sixteenth of a denarius bathers went from the hot 'caldarium' to the lukewarm 'tepidarium' and then dipped in the cold 'frigidarium'. Many baths had gymnasia and massage rooms attached. Government officials called aediles monitored cleanliness and behaviour. Sewers Rome had seven sewers (notably the Cloaca Maxima, which was large enough for a laden wagon to pass through) flushed by streams, and public latrines (seating up to 60 people). There was a force of 300 slaves who cleaned the streets and latrines at night while people were asleep. Hospitals The Romans built the first real hospitals in order to look after their soldiers. The first hospitals in Rome were the valetudinaria (free hospitals) for former soldiers.

The most famous Roman doctor was Galen, who came from Pergamum and had been trained at Alexandria. Galen learned his trade at a school of gladiators.The Romans neglected to develop further the Greeks' ideas about the nature of disease, and in some ways medicine regressed under their rule. However, Roman doctors did develop ideas of bad air and tiny creatures as causes of disease, and these ideas were to have a great impact on the history of medicine.The Romans also developed hospitals, and employed trained military nursescalled medici. They were skilled surgeons, and they built on the Greeks' knowledge of anatomy and physiology

Knowledge went into reverse in the west in Medieval times - many of the books of the Greeks and Romans were lost, and the knowledge they contained was replaced by mere speculation and superstition.Even when universities developed, after 1100 (Montpellier, Bologna and Salerno had famous medical schools), lectures on anatomy were rudimentary. They consisted simply of a butcher pointing to the different parts of a body, while the lecturer read a text by an authority such as Galen.Although students did debate the ideas of Galen, any new ideas were judged on the debating skills of the student, not on scientific proof. The Church said that Galen's ideas were so correct that there was no need to investigate any further.Generally, the Church forbade the dissection of human bodies, so knowledge was hard to come by - and ignorance led to numerous errors and misunderstandings on the part of Medieval doctors.

Medieval Medicine

Although many Medieval doctors continued to believe in the theory of the four humours, they also said disease was caused by demons, sin, bad smells, astrology and the stars, stagnant water, the Jewish people etc.Ultimately, they believed that life was controlled by God and his saints, and a plague such as the Black Death was seen as a punishment from God. Guy de Chauliac, the Pope's doctor, blamed the Black Death on a conjunction of Saturn, Jupiter and Mars.

Medieval towns did not have systems of sewers or water pipes like Rome had. Medieval towns were probably filthy. Garbage and human waste was thrown into the streets. Houses were made of wood, mud and dung.Rats, lice and fleas flourished in the rushes strewn over the clay floors of people's houses (often changed only once a year).However, we can't conclude that Medieval people were personally filthy, or careless of their health: They had their own version of the Greek's Programme for Health. The doctor Alderotti advised people to stretch their limbs, wash their face, clean their teeth, exercise etc. Guy de Chauliac (the Pope's doctor) realised the importance of a good diet, and that a poor diet made people more vulnerable to the plague. Monasteries developed comprehensive systems of public health, including fresh running water, 'lavers' (wash rooms), flush 'reredorters' (latrines) with running sewers, clean towels and a compulsory bath four times a year. Nobles took regular baths (perhaps two a year). Towns had bath houses (which were also restaurants and brothels). People realised that a room next to a privy was unhealthy, and towns paid 'gongfermers' to clear out the cess pits. Medieval kings passed laws requiring people to keep the streets clean. Leaders in Venice realised that sexually transmitted diseases were infectious, and ordered checks on the city's prostitutes. During the time of the plague many towns developed quarantine laws, and boarded up the houses of infected people. People with leprosy, likewise, were confined to lazar houses (a place for people with infectious diseases).

Medieval doctors flattered to deceive, although there were developments that gave the appearance of progress: Schools of medicine were set up in Universities such as Bologna and Salerno, and there were lectures in anatomy. New writings of Muslim doctors (such as Rhazes) became available. Doctors debated the best methods of treating disease. Padua University (alone) insisted that doctors visited the sick during their training.

These signs, however, were deceiving . For example: The anatomy 'lectures' consisted only of the doctor reading from a book while a prosector pointed to parts of the body. The ancients were held unquestioningly as the true authorities, any debates was seen merely as an opportunity to practice the art of arguing. Doctors had a terrible reputation. During the Black Death, "...doctors were useless and indeed shameful as they dared not visit the sick for fear of becoming infected" wrote Guy de Chauliac.

Roman medicine

medieval