# What conditions would a pre-modern doctor be able to treat effectively? **URL:** \ **Category:** Factual Questions\ **Created:** [June 24, 2017, 6:39pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774 "2017-06-24T18:39:31Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [June 26, 2017, 12:29am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/21 "2017-06-26T00:29:37Z")
> [@Chronos](#): > > It’s kind of funny, given your actual clientele, to think of you as “family practice”. We’ve had father/son pairs in prison at the same time before. And I’ve a handful of pregnant female patients. They’re on buprenorphine for the duration of their pregnancy, and that takes special licensing which only I have in our system. In addition I get called on juvenile patients at times, from our juvenile system. But I must admit I don’t do a lot of well child checks or birth control appointments anymore. I miss the kids, they were fun. The parents were often a PITA though. Yeah, draining abscesses goes way back. But doing it with emphasis on antisepsis is what would improve my overall patient outcomes. And I don’t see myself making chloramphenicol or mercurochrome or gentian violet or penicillin based on what knowledge I carry in my head. Though if supplied with gentian root I suppose I could experiment a little. Basically the biggest benefits I’d bring to bear would involve better hygiene and water and sewer arrangements, and not harming people with ineffective treatments. ---
**Author:** ![griffin1977](https://avatars.discourse-cdn.com/v4/letter/g/977dab/32.png) [@griffin1977](https://boards.straightdope.com/u/griffin1977)\ **Post date:** [June 26, 2017, 12:43am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/22 "2017-06-26T00:43:04Z")
> [@Qadgop\_the\_Mercotan](#): > > If I, as a modern Family Medicine physician, were transported back a few hundred years in time, I would bring a few useful skills back with me. > > Mainly antisepsis in treating wounds. Just washing my hands and washing wounds with soap and water would save lots of lives. Particularly for compound fractures where bone fragments are exposed to open air. And certainly for childbirth. > > Incising and draining abscesses would also resolve a lot of infections that would otherwise go on to cause many to sicken further, and often to die. > > Using hollow needles to drain fluid accumulations outside the lung or in the abdomen could help in some cases. > > If I could get coca leaves, I could make topical anesthetics, enabling me to do more careful and anatomically correct laceration and other injury repairs, which leads to better healing and less disability. > > Just promoting better hygiene and boiling water before drinking it in my community would markedly reduce illness and death rates. > > I’d also be helpful by **not** bleeding or purging patients. Or giving them poisons like mercury and other toxic compounds in vain pursuits to cure illnesses. > > Promoting the use of condoms for contraception and disease prevention would also help the public health, if it didn’t get me lynched. > > Those are the most obvious advantages I’d have in comparison to the practices of other health professionals of the time. > > Frankly, I wouldn’t have a lot to offer from a pharmaceutical point of view. Pain control via coca or the tears of the poppy or hemp would be the most likely useful products. Aspirin is a bit of a bitch to extract. As are antibiotics. That’s a pretty good summary. But to be clear I wasn’t talking about a time travelling modern doctor. But an actual pre-modern doctor with the technology and knowledge available to them at the time. ---
**Author:** ![elfkin477](https://avatars.discourse-cdn.com/v4/letter/e/a9a28c/32.png) [@elfkin477](https://boards.straightdope.com/u/elfkin477)\ **Post date:** [June 26, 2017, 12:54am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/23 "2017-06-26T00:54:10Z")
> [@TriPolar](#): > > Cauterization goes far back in history. However[the wiki](https://en.wikipedia.org/wiki/Cauterization)indicates it may not have been greatly effective at preventing infection. I thought the main reason wounds were cauterized was to keep you from bleeding to death? ---
**Author:** ![Qadgop\_the\_Mercotan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/qadgop_the_mercotan/32/83_2.png) [@Qadgop\_the\_Mercotan](https://boards.straightdope.com/u/Qadgop_the_Mercotan)\ **Post date:** [June 26, 2017, 12:54am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/24 "2017-06-26T00:54:17Z")
> [@griffin1977](#): > > to be clear I wasn’t talking about a time travelling modern doctor. But an actual pre-modern doctor with the technology and knowledge available to them at the time. Whoops. Sorry for the inadvertent hijack. ---
**Author:** ![Weisshund](https://avatars.discourse-cdn.com/v4/letter/w/ba8739/32.png) [@Weisshund](https://boards.straightdope.com/u/Weisshund)\ **Post date:** [June 26, 2017, 1:11am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/25 "2017-06-26T01:11:46Z")
> [@Qadgop\_the\_Mercotan](#): > > And I don’t see myself making chloramphenicol or mercurochrome or gentian violet or penicillin based on what knowledge I carry in my head. Though if supplied with gentian root I suppose I could experiment a little. Well penicillin you’d kind of be in luck for, it wasnt exactly totally unknown, you just might wanna isolate it and bottle in in pink liquid form instead of rotten bread form. Aspirin your good, even though it may have a barky woody taste 😃 ---
**Author:** ![Weisshund](https://avatars.discourse-cdn.com/v4/letter/w/ba8739/32.png) [@Weisshund](https://boards.straightdope.com/u/Weisshund)\ **Post date:** [June 26, 2017, 1:16am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/26 "2017-06-26T01:16:54Z")
> [@griffin1977](#): > > That’s a pretty good summary. But to be clear I wasn’t talking about a time travelling modern doctor. But an actual pre-modern doctor with the technology and knowledge available to them at the time. Well, if said Doctor could somehow collect the various known things from other areas he might be in pretty good shape for his time, long as no one burns him for being a witch, heretic, unbeliever or what not to what ever deity is in charge. Said doctor is going to need some world traveling ability though. ---
**Author:** ![TriPolar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tripolar/32/3008_2.png) [@TriPolar](https://boards.straightdope.com/u/TriPolar)\ **Post date:** [June 26, 2017, 1:18am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/27 "2017-06-26T01:18:25Z")
> [@elfkin477](#): > > I thought the main reason wounds were cauterized was to keep you from bleeding to death? Yes, you’ll see in the wiki I linked to that it was effective for that. Infection isn’t a major concern if you bleed to death first. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [June 26, 2017, 3:28am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/28 "2017-06-26T03:28:47Z")
> [@](#): > > Quoth **Weisshund** : > > Aspirin your good, even though it may have a barky woody taste The compound in willow bark is salicylic acid. Aspirin is acetylsalicylic acid, a closely-related compound derived from it. Both have similar benefits, but the side effects from salicylic acid are much worse, especially on the digestive system. And it’s not easy to process salicylic acid into acetylsalicylic acid. Likewise, it’s easy to get bread mold, but that does you very little good. One particular strain of one particular species of bread mold produces a very safe and effective antibiotic. Other strains or species of mold produce other substances, some of them more or less similar to that antibiotic. Some of those substances aren’t safe to humans, some aren’t very effective versus bacteria, and some are neither. And I don’t think it’s even known how common the “good” strain is in the wild: It’s very common now due to us going to great lengths to cultivate it, because it’s so useful to us, but we don’t know exactly how lucky Fleming was to have that particular strain growing in his petri dish. Don’t read too much into the fact that premodern doctors used moldy bread in poultices, by the way. They did, but then, they used just about everything imaginable in poultices, including various sorts of dung. It’s conceivable that some few patients in history might have gotten lucky and ended up with the good strain of penicillium in their moldy-bread poultice, but overall, people would have been much better off with poultices of just boiled cotton cloth with no mold (or honey or dung or whatever) at all. ---
**Author:** ![hajario](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hajario/32/171_2.png) [@hajario](https://boards.straightdope.com/u/hajario)\ **Post date:** [June 26, 2017, 3:52am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/29 "2017-06-26T03:52:07Z")
> [@Qadgop\_the\_Mercotan](#): > > Whoops. Sorry for the inadvertent hijack. Don’t be. That was very interesting. ---
**Author:** ![griffin1977](https://avatars.discourse-cdn.com/v4/letter/g/977dab/32.png) [@griffin1977](https://boards.straightdope.com/u/griffin1977)\ **Post date:** [June 26, 2017, 4:21am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/30 "2017-06-26T04:21:06Z")
> [@Weisshund](#): > > Well, if said Doctor could somehow collect the various known things from other areas > he might be in pretty good shape for his time, long as no one burns him for being a witch, heretic, unbeliever or what not to what ever deity is in charge. > Said doctor is going to need some world traveling ability though. Would that help too much? I know there were times that one region was ahead of others (I would rather be treated by a Arab doctor than his European counter-part during the dark ages). But other than a few things where knowledge was more advanced (or possibly a general tendency to treat holistically rather than go poking around with dirty fingers) would it have made it much difference? The big things that made a difference (germ theory, antiseptics, anesthetics and antibiotics) were not AFAIK invented anywhere prior to the Europe in the modern age. ---
**Author:** ![Nava](https://avatars.discourse-cdn.com/v4/letter/n/da6949/32.png) [@Nava](https://boards.straightdope.com/u/Nava)\ **Post date:** [June 26, 2017, 10:25am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/31 "2017-06-26T10:25:01Z")
> [@Chronos](#): > > The compound in willow bark is salicylic acid. Aspirin is acetylsalicylic acid, a closely-related compound derived from it. Both have similar benefits, but the side effects from salicylic acid are much worse, especially on the digestive system. And it’s not easy to process salicylic acid into acetylsalicylic acid. Figuring how to do that was one of the biggest discoveries in the history of chemistry: protected reactions. If you try to do it the obvious way it doesn’t work, the acetyl group sticks in the wrong place. You have to protect this wrong site, then add the acetyl and then deprotect. This has now become routine, allowing many synthesis which would be impossible by the apparent direct routes. ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [June 26, 2017, 11:02am UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/32 "2017-06-26T11:02:47Z")
The secret to old timey medical practice would be specialization. **Dr kayaker** , specializing in the treatment of self limiting diseases and conditions. By appointment only. No billing. ---
**Author:** ![Mikeisskeptical](https://avatars.discourse-cdn.com/v4/letter/m/c0e974/32.png) [@Mikeisskeptical](https://boards.straightdope.com/u/Mikeisskeptical)\ **Post date:** [June 26, 2017, 12:05pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/33 "2017-06-26T12:05:59Z")
Effective dentistry has been practiced for thousands of years. ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [June 26, 2017, 12:08pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/34 "2017-06-26T12:08:16Z")
> [@Hari\_Seldon](#): > > I was about to say something exactly like this. There were a limited number of things a doctor could actually help with. There was aspirin and, given anesthetics, a surgeon could remove a sick appendix, but by and large the most they could do was hold your hand and make a prognosis. Folks, you certainly CAN do surgery without anesthesia. I don’t know where you get this notion that no one removed anything from a human body before anesthesia. Lots of surgeons did lots of surgery before anesthesia. It sucked if you were the patient, of course, and there would be several people holding you down so you did thrash too much, and surgeons got used to ignoring the screaming and got the job done as quickly as possible. But surgery did occur back in the old days. It helped often enough that desperate people continued to undergo it when necessary. > [@sirwired](#): > > Carbolic acid is a disinfectant, like for cleaning surgical instruments, it’s not something you take as a drug to treat infections. (It does have some use as a drug; it’s the active ingredient (in small, dilute, doses) in throat spray.) Lister used carbolic acid in dressings and the like, so it was at least used topically. Of course, it also tended to damage healing tissues as well as killing bacteria but it still beat devastating infections and sepsis. ---
**Author:** ![zimaane](https://avatars.discourse-cdn.com/v4/letter/z/a3d4f5/32.png) [@zimaane](https://boards.straightdope.com/u/zimaane)\ **Post date:** [June 26, 2017, 1:54pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/35 "2017-06-26T13:54:50Z")
traditional bonesetters were (and in a few parts of the world, still are) effective, especially for simple (closed) fractures and dislocations ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [June 26, 2017, 2:04pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/36 "2017-06-26T14:04:38Z")
**griffen1977** , the advantage to travel would not be in gathering knowledge from around the world (a time-traveling doctor would already have more of that than the entire world combined), but rather gathering pharmaceuticals. There are some plants which have useful medicinal properties in their natural form, and others which can be easily processed into useful forms (as well as some that are processed only with difficulty, but those aren’t relevant here). But the problem is that those useful plants grow in many different places. ---
**Author:** ![scr4](https://avatars.discourse-cdn.com/v4/letter/s/59ef9b/32.png) [@scr4](https://boards.straightdope.com/u/scr4)\ **Post date:** [June 26, 2017, 5:44pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/37 "2017-06-26T17:44:20Z")
The story of the [royal fistula](http://www.bilan.ch/garry-littman/english-room/royal-fistula-changed-face-surgery) seems relevant. To summarize: King Louis XIV (1638-1715) suffered from an anal fistula. Charles-François Felix, a barber-surgeon, was tasked to perform an operation. He asked for 6 months to prepare, during which time he experimented on 75 prisoners and peasants (many of whom didn’t survive), then successfully treated the King. “The king was sitting up in bed within a month and was back on his horse within three months.” ---
**Author:** ![griffin1977](https://avatars.discourse-cdn.com/v4/letter/g/977dab/32.png) [@griffin1977](https://boards.straightdope.com/u/griffin1977)\ **Post date:** [June 26, 2017, 7:31pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/38 "2017-06-26T19:31:03Z")
> [@scr4](#): > > The story of the [royal fistula](http://www.bilan.ch/garry-littman/english-room/royal-fistula-changed-face-surgery) seems relevant. To summarize: King Louis XIV (1638-1715) suffered from an anal fistula. Charles-François Felix, a barber-surgeon, was tasked to perform an operation. He asked for 6 months to prepare, during which time he experimented on 75 prisoners and peasants (many of whom didn’t survive), then successfully treated the King. “The king was sitting up in bed within a month and was back on his horse within three months.” That’s actually the example that prompted the OP. Actually it was a discussed on [QI](https://www.theguardian.com/culture/video/2016/feb/18/stephen-frys-best-moments-as-qi-host-video) and how following the operation having anal fistula was very de rigueur among the french aristocracy! There obviously some cases where even fairly invasive surgery could be completed successfully (though presumably the king’s survival was probably the result of good luck and a good immune system.) ---
**Author:** ![griffin1977](https://avatars.discourse-cdn.com/v4/letter/g/977dab/32.png) [@griffin1977](https://boards.straightdope.com/u/griffin1977)\ **Post date:** [June 26, 2017, 7:34pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/39 "2017-06-26T19:34:15Z")
> [@Broomstick](#): > > It sucked if you were the patient, of course, and there would be several people holding you down so you did thrash too much, and surgeons got used to ignoring the screaming and got the job done as quickly as possible. But surgery did occur back in the old days. It helped often enough that desperate people continued to undergo it when necessary. For all the horror involved, and the slim chances of survival, amputation of gangrenous limbs probably counts as “effective treatment”. As your slim chances during and after amputation, were still better than your chances with untreated gangrene. ---
**Author:** ![bonzer](https://avatars.discourse-cdn.com/v4/letter/b/45deac/32.png) [@bonzer](https://boards.straightdope.com/u/bonzer)\ **Post date:** [June 26, 2017, 10:31pm UTC](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774/40 "2017-06-26T22:31:08Z")
> [@scr4](#): > > The story of the [royal fistula](http://www.bilan.ch/garry-littman/english-room/royal-fistula-changed-face-surgery) seems relevant. To summarize: King Louis XIV (1638-1715) suffered from an anal fistula. Charles-François Felix, a barber-surgeon, was tasked to perform an operation. He asked for 6 months to prepare, during which time he experimented on 75 prisoners and peasants (many of whom didn’t survive), then successfully treated the King. “The king was sitting up in bed within a month and was back on his horse within three months.” [Off Topic]Being familiar with the story, when I skimmed that link in the OP what leapt out to me personally was its claim that the instruments used are on display at Versailles. No, they’re not - or at least they weren’t when I saw them in the collections of the [Musée d’Histoire de la Médecine](http://www.coolstuffinparis.com/musee-dhistoire-de-la-medecine.php) on the Left Bank, about a decade ago. Googling to confirm led me to [this post](http://partylike1660.com/the-royal-fistula/). Really does look as if one of these two pages is somewhat plagiarising the other. At least the second does get the current location of the instruments correct. (Other links confirm they’re still in the Paris museum, rather than Versailles.)[/Off Topic] [Previous page](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774.md?page=1) [Next page](https://boards.straightdope.com/t/what-conditions-would-a-pre-modern-doctor-be-able-to-treat-effectively/789774.md?page=3)