Middle Ages

Most Common Surgical Procedures in the Middle Ages

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After the collapse of the Roman Empire in 410 AD, and before the renaissance began in roughly 1485 AD, there was the period of European history called  the Middle Ages. This period was wrought with violence and pestilence as the political landscape was in constant flux.  Also during this time an up and coming Christian church was in conflict with the older pagan religions. This period is usually divided into two time frames, the early middle ages also known as “The Dark Ages” and the later middle ages known as the “medieval era”.

The Dark Ages

The Dark ages, also known as the early Middle Ages, refers to the timeframe between the collapse of the Roman Empire in 410 AD until somewhere near 1000 AD. In English history 1066 (the Battle of Hastings) is the date attributed to the end of the Dark Ages and the beginning of the Medieval era, also known as the later or high Middle Ages. This time was rife with destruction and warfare. Superstition ruled the day more than science and not much was available in the form of surgery and medicine other than some herbal remedies and crude ways to stop the bleeding.

Medieval Era

For this article we will go with the English date’s of 1066 AD (The battle of Hastings) as the start of the Medieval era of latter Middle Ages, until 1485 AD (Start of the Tudor line) which is when the renaissance began. Society was still engaged in warfare but the political lines were starting to solidify and there was a new enemy in what is now modern day Israel. There was much learned from the crusades. During this time there were some advances in science, engineering and medicine which we will discuss below.

Medieval Doctors

People who practiced some sort of medicine during the medieval era were divided into 5 categories:

-       Physicians: It took 10 years and formal university training in the classical ancient teachings of Aristotle and Hippocrates to become a physician. There were not many who could afford this training and that led to a shortage. Typically this group saw to the health of the wealthy and powerful who could afford their services.

-       Surgeons: Technically There was a group called “The Company of Barber Surgeons” this incorporated the trained Surgeons and the untrained barbers. The Surgeon had some medical training but was considered lesser than a physician. Surgeons performed crude caesarean births, set bones, removed bladder stones, dental procedures, bloodletting, cataract procedures, and tending to wounds created by swords and arrows.

-       Barbers: This group was untrained and considered a lesser surgeon. They cut hair as well as performed bloodletting, dentistry, and tended wounds contracted from violence i.e. sword and arrow wounds.

-       Apothecary: These people were the equivalent to modern day pharmacists. They belonged to a guild of grocers and sold perfumes and cosmetics as well as medicine and groceries.  

-       Wise Women: These women were the ones who tended the poor. They used herbs and potions to treat the infirmed.

Medieval Medicine and Surgery

The doctors of this time studied the teachings of Aristotle and Hippocrates. They paid interest to bodily fluid called humorism. There are 4 humours, each related to an element. The Humour phlegm is related to water, blood is related to air, black bile is related to earth and yellow bile is related to fire. If someone was sick, it was thought that their humours were out of balance. The physician would then examine the patients’ fluids and then begin bloodletting to bring the body back into balance by cutting or placing leeches.

There were crude surgeries performed during this time. Some patients died on the operating table, but a good majority died from infections at a later date due to the lack of antibiotics. Some of the more common types of surgeries were:

-       Bloodletting: This practice was either performed by placing leeches on the body in various locations to suck the blood from the body or cutting. When the patient was cut a small incision was made on the inside of the arm and allowed to drain into a bowl.  This was used to help bring the sickness out of the body and bring the humours back into balance.

-       Trepanning: This procedure was an attempt to cure mental illness and chronic headaches. This involved cutting a hole into the skull in an attempt to relieve inter-cranial pressure. Some skeletons from the time have shown evidence of bone re-growth, which indicated people did survive this operation.

-       Cauterization: This practice involved red hot pokers and plates of metal heated until red. They were used to seal a wound or amputation to stop the bleeding. This was a crude form of sanitizing the wound that actually worked.

Although the rudimentary medicine practiced in the Middle Ages killed almost as many as it healed, it was a necessary step in the evolution that has led to modern medical practices. In certain modern day situations trepanning and cauterization are procedures still performed, yet with modern tools and antibiotics. Who knows, hundreds of years in our future people may look back on this time and wince at the procedures performed thinking we too were a crude lot.

More about this author: Brian Lobb

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