3 Reasons Why You Wouldn’t Want to Receive Healthcare in Medieval Europe
Healthcare plays an increasingly important role in our lives. Most people across the globe have interacted in some way with some form of healthcare system. Trips to the hospital, navigating insurance, and visits to your local doctor, medicine man, apothecary or what have you. Sometimes it works out pretty well and things sail smoothly; successful operations, helpful brokers, or your local witch-doctor gives you the right poultice for your sprained ankle. Other times, not so much. Accidental amputations due to hospital mix-ups, insurers try to weasel out of paying claims, or your GP misdiagnoses your cancer. We all have bad days. But with the rising cost of health care eating away more and more of your paycheck, and the financial world crashing down, it seems like every day is becoming a struggle, especially for those with serious medical problems. But, regardless of the situation you find yourself, now is the time to take a load off, lighten up and remember; at least you’re not stuck in Medieval Europe or a bad Michael Crichton story.
While many historians would argue that the ‘Dark Ages’ were nowhere near as ‘dark’ as they may seem, Europe was not a paragon of technological and scientific advancement. While the Middle East enjoyed a Golden Age, Europe had built off an ancient Greek and Roman theory of medicine, called Humorism. The theory was that our bodies were comprised of a balance of four different humors; black bile, yellow bile, phlegm and blood. The idea being that each humor is linked to: a season of the year, an element (think of the Planeteers’ power minus the chump with Heart), a human organ and temperament, and also possesses its own qualities by being a combination of either warm or cold and moist or dry.
These four humors were created within the body and illness struck when the humors were out of balance. The procession of treatment usually started at checking dietary intake, then moving on to the use of drugs. If all that failed, then in order to right the balance, the doctor would often employ treatments to induce bleeding, vomiting, and evacuating your bowels in a most urgent manner. This is due to the time honored belief that expunging bodily fluids in horrible ways is, in fact, humorous. For others. Especially if your face looked like the ones below.
The four Temperaments and their humors (Clockwise from top right): choleric (yellow bile); melancholic (black bile); sanguine (blood); phlegmatic (phlegm).
So this is what our medical systems and theory was based on, pretty much right up until the 19th century, when we finally decided that medical science based on incorrect concepts of anatomy were just not doing us much good. Not, of course, that we didn’t know any better. In fact, this is in spite of the fact that humorism was disproved on at least three occasions between the 9th century and 13th century by Arabian scholars, who found that both treatments and illnesses (i.e. parasites like scabies) defied the theory. One of these individuals went so far as to discovered pulmonary and coronary circulation out of protest.
So why is this so bad? Surgery for bodily trauma was actually not too shabby, all things considered, as there is evidence people of the time had survived through both head trauma surgeries and operations to remove cataracts. Not half bad for the Middle Ages. However, from poorly informed theory comes poor practice, just look at US foreign policy. The problem with humorism as a disease theory is that you diagnose and treat symptoms according to their supposed humoral properties. Unfortunately, many things that diversely affect human health are not endemic to the human body and therefore can’t be remedied by balancing bodily processes and fluids. Without a doubt, there were medicines at the time that were indeed beneficial for some ailments, more than likely found through trial and error than scholarly study. But without the appropriate framework of medical theory to understand them, you’re never going to be able to understand the effect of parasites, fungi, bacteria and viruses. Your 100% organic, holistic potion may help with that overabundance of black bile, but the deadly nightshade, a hallucinogenic poison, in there may cause side effects ranging from bad dreams to death.
Now, while it’s awesome to think that your doctor will automatically look at your diet to see if there’s any quick and easy fix to why you feel under the weather, let’s be honest about the situation we’re supposing here. While village life was probably not as bad as could be imagined, the constant availability of nutritious food was an issue during the times. Most people were agrarians and survived by growing staple cereal crops within the village for both food and trade, but these were also supplemented with other crops grown by individuals for sustenance. In larger villages the inhabitants would rear pigs if they could afford it but were not allowed to hunt animals from forests, as they were reserved for royalty to hunt in. Although, some historians contend that pig rearing was done as much for sale as it was for eating the little porkers. It is quite apparent that there was a large schism between the diets of nobles and clergymen, which had an overabundant level of protein, and peasants who subsisted mostly on cereals.
It’s not all bread and bacon though, as there were some major health problems that stemmed from food intake at the time. Judging from forensic data obtained from skeletons alongside historical documentation of the time, some of the main problems of times were nutritional issues. While there is evidence of multiple famines and starvation, some of the most continual issues were iron deficiency, rickets and scurvy. The lack of readily available trace minerals resulted in numerous long lasting implications for the population, especially for children. Iron deficiency was also a widespread issue for menstruating women and women giving birth as they tended to lose a lot of iron through blood discharge. Considering around 20% of pre-menopausal women today suffer from iron deficiencies, which develop over time, it was probably enormously widespread during the Middle Ages. Odds are, you had one of these three problems, if not more than one, and they all make life pretty miserable. Iron deficiency can make you feel fatigued, weak and irritable, and if you upgrade to anemia you get bonus symptoms ranging from constipation, depression, breathlessness, muscle twitches, tingling and or burning sensations. If that doesn’t make you want to go eat a loaf of fortified bread I don’t know what will.
Rickets is equally as awesome as it usually strikes children, leaving them with reduced bone density. This can lead to general bone tenderness and pain, increased likelihood you’ll break bones, constantly, skeletal deformities of the legs, pelvis and spine and muscle weakness.
What Rickets does to your skeleton, scurvy is to your flesh. But worse, so much worse. The lack of vitamin C causes you to bleed from every mucous membrane you have. Care to venture a guess about what your mucous membranes are? Pretty much any cavity on your body that is exposed to both the external environment and internal organs. So yeah, you’re going to be spending a lot of time bleeding from your nostrils, lips, ears, genitals and anus. On top of that, your gums will go spongy leading to loss of teeth, your healed scars will open up and start bleeding again, any healed bone fractures would separate, and you will lose your nails and enjoy constant diarrhea. Don’t forget to hop back on the vitamin C bandwagon after this wild ride, because failure to do so invariably results in death.
Let’s not forget tuberculosis, which spreads like wildfire through the ranks of the malnourished masses. Interestingly enough, it’s thought that tuberculosis may have been one source of vampirism in folklore. The fact that you get red, swollen eyes that can be sensitive to bright light, pallid skin color, low body heat and coughing blood just screamed ‘blood sucker’ to the people of yore. Tell every vampire infatuated goth you know to go get TB today!
Oh, and before I forget, your plates were going to give you lead poisoning. Any food you didn’t get locally would have also probably been contaminated during transport.
This only recently understood disease still carries with it a certain stigma. We know now that it is nowhere near as contagious as we once thought. In fact, due to genetics, approximately 5 percent of the human population is susceptible to the bacterium that causes it. Unfortunately, due to the fact that we were treating things due to their humors, any illness, infection or parasite that presented itself in a remotely similar way, i.e. you had something on your skin. Pretty much everything from fungal infections and parasites to non-microorganism causes like psoriasis or eczema were classified as ‘leprosy’ as late as the 17th century. Even things that modernity has rendered quite mundane such as ringworm, which isn’t really a worm but the fungus that causes athletes foot, would have been lumped under ‘leprosy’.
Now, granted, you don’t want any of these things even now, as some of them are just plain old untreatable and really, really grotesquely disfiguring in some of the more serious cases. While, unfortunately, being incredibly ugly does still carry some social stigmas, I guarantee you it’s nothing compared to the scorn and hardships poured upon the sorry suckers who suffered these diseases during the Middle Ages. Not only were they looked upon with disgust and often ostracized and forced to live in leper colonies. While the colonies, or hospitals as they were also know, were often run along the same lines that monasteries of the time were, it was mostly to keep them quarantined and away from the general populace. In the 13th century a Benedictine monk estimated there were up to 19,000 leper hospitals across Europe. That’s a lot of people with skin problems.
Apparently, being ugly and an outcast was not enough, and as religion was very strong at the time, lepers were thought to be living through purgatory on earth. Purgatory being a state of purification of the soul for sins not bad enough to get you sent to hell, but bad enough to keep you out of heaven. At first, lepers were seen as a sort of holy half-dead, to steal a turn of phrase from The Chronicles of Riddick (good movie if you enjoy Vin Diesel and ridiculousness, as I do), which meant that they were declared dead by civil leaders, their property would be taken away and their spouse was expected to serve them until death, as per your sacramental wedding vows. They were however, sometimes looked after by the church as they were in a special religious group of their own.
This of course devolved into open hatred of ‘lepers’ as the ‘disease’ grew more prevalent and maybe due in large part to increased rhetoric from the church linking uncleanliness to sin. The obvious link was made between leprosy, uncleanliness and sin, and for eons afterwards the lepers were seen as having this unclean disease bestowed upon them by God for their wicked ways. Oddly enough the same language of uncleanliness and sin was also used in relation to homosexuals, witches and Jews. Of course, if you were rich and had leprosy you were considered a hero and a martyr if you succumbed to the disease. If you were poor? No, God just hated you, and everyone else simply followed suit.
And yes, I left out the Black Death and its outbreaks because we’ve already covered how miserable it was, all you need to know is that it happened a lot. As in, more than 100 epidemics up to the 1700s before it seemed to vanish like a fart in the wind in the 19th century. Rehashing it would just be a cheap shot.