Oh there is no doubt of that (hygine). My point was that the correlation between disease and dirt was known, the reasons were not understood.
Bleeding did work for some diseases (and is still used). IIRC it worked for droopsy and high blood pressure. The problem was when they tried it for everything
Could you name even one?
Seriously? You would be worse being treated by me than by a “doctor” who believes in cupping and bleeding and prayer as effective cures?
Can you name even one type of *effective *first aid that a HG would have had more experience with?
HGs may have had more experience of seeing people who had been injured or ill, though that is probably not true. But when the “First Aid” consisted of things like singing a song over someone suffering from vitamin deficiency, blowing smoke from certain tree leaves into the face of someone who has cholera, or cutting a girdle of skin from the leg of someone bitten by a snake, i doubt that makes them more effective at treating illness or disease.
Can you name one of these folk remedies that easily takes care of ailments?
On the contrary, it doesn’t seem to make any reference to the effectiveness fo treatments at all.
Indeed. Techniques including cupping and bleeding, burning to induce spirits to leave the body, and flaying boys alive and wearing their skins. While these are all undoubtedly surgical techniques, they do seem to have had the drawback of not actually working.
Did you actually read that article?
“Just after puncturing, the expert should irrigate the eye with breast-milk and foment it from outside with vāta-[wind-]alleviating tender leaves, irrespective of doṣa [defect] being stable or mobile, holding the instrument properly in position. Then the pupillary circle should be scraped with the tip of the instrument while the patient, closing the nostril of the side opposite to the punctured eye, should blow so that kapha [phlegm] located in the region be eliminated.”
So the “cataract surgery” consists the “surgeon” poking a hole in it with a stick, then washing the eye with milk, followed by a tea made of leaves that alleviate the wind element. Then scraping the inside of the pupil. This then allows the cataract to be blown out the nose as snot.
This is not cataract surgery, nor is it an effective treatment. A cataract is caused by the lens becoming milky. You can scrape the inside of the pupil all day, it won’t do a damn thing to cure a cataract. Nor is it ever possible to blow something inside the eyeball out through the freakin’ nose. Indeed, suggesting that someone with a pentrating eye injury should blow their nose is dangerous
What this is an excellent example of is the level of so-called surgery in the pre-modern world. It’s ineffective, dangerous in both the whole and the details and rife with sympathetic magic, such as treating a milky pupil with milk, using wind walleviating herbs because we all know that wind stings the eye, and blowing out the milky abnormality as milky snot. It is outright quackery.
Trepanning =/= brain surgery. Nor does that fact that someone cut into the skull mean that the treatment was in any way effective or even necessary.
Indeed. And those remarkable texts teach us, for example, that the best treatment for a sword wound is to wrap the wound in poultice made of ass dung and crocodile flesh.
The existence of medical texts is clearly not evidence of the existence of effective medical treatment.
Yep, herbal remedies such as the use of liquorice or comfrey. And these right alongside traditional remedies such as burying a dead cat under the floorboards.
The fact that a “remedy” has existed for a long time is hardly evidence that it is useful or even harmless.
Often? Can you name 6 examples?
Since virtually every plant in the world was used a herbal remedy in traditional medicine, it’s not surprising that some will have actual pharmcological properties, and some of those will have properties that corresponding to what they were used to treat.
What nobody has ever done is show evidence that the correspondence is any higher than random chance. IOW treating a patient with a random plant works about as well as treatment with traditional herbal remedies.
Bone setting wasn’t something the typical peasant could ever do.
Suturing wounds doesn’t require any particular knowledge or skill. It just needs a sharp needle and a steady hand. The best thing you could do is wash the wound with cooled, boiled water, apply an antiseptic, wash your hands before starting and bind the wound with boiled bandages and keep it clean. Those are all things any modern person would do without thinking, and all things that a medieval practitioner is very unlikely to do.
If the correlation was so well known, then why did so many “treatments” consist of adding mud, dung, rotten plants or putrid meat to the wound, and why did so few treatments make any attempt to clean a wound or keep it clean?
Is there any evidence that the correlation between disease and dirt was known?
Searing the flesh worked for some diseases, so did beating, ducking, fasting, smoking and prayer. There are so many diseases that any treatment at all will work for at least one of them. As Cecil said, even a blind squirrel will find a nut occasionally.
The question is whether the treatment works better then doing nothing at all for the patients it was applied to. Bleeding does not.
I always found it hard to believe how long it took Western medicine to understand or at least have a vague sense of the importance of hygiene.
It doesn’t match the advances that were made in other fields of science and technology.
Trephination - can reduce and remove bone from an injury to the skull causing a depressed fracture, pressure caused by intercranial subdural hematoma. AS evidenced by a number of skulls with obvious bone regrowth the patient lived for varying amounts of time postop.
And yes the cataract surgery as practiced by the Romans was effectively identical to what goes on today - removal of the lens, they just were not able to replace the lens however it did return a modicum of sight.
Many of our medications are derivatives of original herbal remedies - foxglove for heart issues, willow bark for pain, opium and marijuana for pain and anesthesia and my personal favorite, crocus for gout [and my pseudogout]
As was pointed out you don’t need to know germ theory to realize that washing your hands, equipment and surroundings help with overall health, and diet can help keep one healthy. The Tacuinum Sanitatis was a health regimen book in the 14th century [self help in the Middle Ages, who knew!] that touted diet, exercise, rest and keeping track of your heath and emotions and working on fixing what you were doing wrong which is pretty much like anything you can find today on the magazine rack.
Y’know, I actually do have a disease that’s legitimately treated by bloodletting… And I can still say that bloodletting is a load of hooey. Hemochromatosis affects something like 1 person in 300, and identifying it early enough that bloodletting will be good treatment requires a modern chemistry lab. You show me a treatment that has a 0.3% chance of making things better, and a 99.7% chance of making things worse, and you have no way of telling which it is, I’m going to say “Hell no”.
I think I might have read in GunsGerms&Steel that until the era of public sanitation (a very late event in human history except perhaps for the Roman period), simply living in the country was your best medicine. Hospitals were bacteria carnivals, and cities were so unhealthy that without constant population replenishment from rural areas they would have vanished.
Neither a medieval doctor nor you could save someone from cholera, plague, malaria, tetanus, or typhoid, without modern medications and sanitation. If your water source is contaminated, where are you going to go to wash your hands? If malaria-bearing mosquitoes are everywhere, and there’s no source of quinine? You go, genius modern guy.
I find the “we are sooooo much smarter than our ancestors” routine somewhat repellent. There is a lot of cherry-picking and a lot of smugness involved. Sure, some treatments were not effective, and some treatments were counter-productive. But without antibiotics you can die of sepsis just as easily today.
If the question was, would I, a 21st century ordinary citizen, do better than someone without knowledge of the germ theory of disease, but with experience in basic surgery and wound treatment, if I had no access to any modern medications, anaesthesia, or sterilizing agents, my answer would be, probably not. So maybe you could semi-sterilize your knife, your hands, and the surgical field in hard liquor, would you even know where to start, to reduce a fracture, or remove a kidney stone? Would you be able to competently cut open a person who was screaming and writhing? I know I would not.
Part of the problem was that, while physicians were ivory tower educated types, doctor barbers were often illiterate travelling “merchants” with minimal training beyond apprenticeship and folklore. Odds are their experience was cursory at best, and laden with meaningless folk remedies that at least had the appearance of doing something professional. What was that old poem about doctors,
If they recovered, they paid him well,
If they died, their heirs paid double…
As pointed out, germ theory and blood circulation, to name two important concepts, were not known. But, the majority of problems in those days were infectious diseases and there were no antibiotics. About all you could do, then or now, is keep the patient comfortable, We know a bit more nowadays about how important hydration and nourishment are, but even back then they tried to feed the patient, keep them cozy, etc. they weren’t that stupid. Aspirin (willow bark tea) might alleviate some of the fever symptoms, but in general, either you lived or died depending on your body’s vigor.
If you had a condition instead - appendicitis, gallstones blockage and pancreatic infection, tuberculosis, heart attack or angina - well all they could really do is watch you suffer and hope you pull through. Even when gout was common in the 1700’s and 1800’s, nobody had any real treatments for it. I suppose you or I, knowing what modern medicine does, could do a gall bladder, appendix, or kidney stone operation, especially if a friendly doctor showed us a cadaver for practical experience and orientation. There are so many gotchas though - even today, a nicked intestine is a real risk during abdominal surgery. With an amateur operation, even with sterilization, I suspect the risk is huge. I would only try it if the patient was going to die otherwise.
(For example - When I cut myself deeply, the blood gushes out. Does that stop after a little while? Or do modern operations use some technique to prevent the opening from turning into an opaque pool full of blood?)
Even knowing sterilization, IIRC alcohol distillation emerged about the 1500’s or later. The best anyone could have done for sterilization, even if they knew, was strong wine or boiling water. (Then what? hang bandages to dry in the open air? Put them in an oven but don’t burn them?) Modern medicine relies on an immense supply chain for materials simply not available on the 100-mile diet and medieval tech.
By the 1600’s when firepower started making a serious mess of a lot of soldiers, doctors (or even amateurs) were quite capable of removing a limb with minimal accessories and the patient often survived. Obviously also, sharia from the 600’s suggests removing extremities and except for the head, removal does not usually result in a dead patient. People understood the concepts of stemming blood loss even if they did not know why it was so important.
So that’s the real value of modern untrained first aid - we know enough to leave the person alone if that’s what’s called for, and let their body do the fighting.
[quote=“md2000, post:28, topic:670896”]
Even when gout was common in the 1700’s and 1800’s, nobody had any real treatments for it.
Granted it is from Google, but it is still reasonably accurate.
So gout has been treated with the crocus for 3500 years, and alcohol has been available to Europe since the 1100s. Probably generally used internally, however if you make a tincture of healing herbs to drink, it would seem sensible to also try applying them externally on cuts and abrasions. SCA “bruise juice” or tincture of arnica is a very old topical medicament for reducing bruises that is supposedly from some medieval manuscript.
The ancient Egyptians, Greeks, and Romans did pretty well by medicine. Some successful surgical techniques, some herbs that worked, understood that cleanliness mattered. Did okay by public health measures too. You’d not do as well as them. And doctors in the Islamic world after that did a fine job too. Medieval Europe through Western world up until the last century or so? You’d do better because you’d more often do nothing … which was better more often than not than what they’d subject people to.
Oh an example. Charles the Second had a mild stroke. You? You’d do nothing. Maybe recommend some diet changes and a course of something that looked like rehab. His care?
So an important element of being better than the ancients (or not so ancients) would be “do nothing,” which is a way of saying “first do no harm.” I can imagine myself as a modern person giving sick people lots of (boiled) water mixed with other non-problematic stuff like honey and herbs, plus a big dose of woo and mumbo-jumbo, and being pretty successful.
[quote=“aruvqan, post:29, topic:670896”]
Thanks. I was trying to recall off-hand when gin and such drinks first made a notorious appearance in England, I guess I was off by about 100 years. Any evidence that people knew its antiseptic qualities back then?
Reminds me of the old saw (never seen any cites) that wine was drunken so commonly in the bible because the alcoholic beverages were less prone to carrying disease than pure water - unless you listen to the puritan fundamentalist types who will assure you when it says Jesus or the apostles drank wine, they were actually only drinking non-alcoholic grape juice.
Yes there were herbal remedies mixed in with the old wives tales, and many of the herbs had some effect. (ASA from willow bark tea, for example). But there was as much misinformation about folk remedies, and no refereed journals and double-blind tests to report on he efficacy of remedies, no assurance of obtaining pure material let alone concentrated medicine, and no standard education to guarantee the selected sawbones would know of these specific remedies.
Really, without very fancy medicines, and even with them, things like strokes are pretty much untreatable. The best you can do hope something like willow bark tea has sufficient blood-thinning effects.
Off the top of my head I’m trying to imagine a technique for creating homemmade injection needles using medieval tech. ( somehow plate a metal like steel(?) around a fine copper wire, then melt the copper out?)
I’d like to get certified to perform Retro-Phrenology, but I can’t find any schools that offer training courses.
I fancy I would do a better job of diagnosis.
Treatment – maybe not so much. It would depend on what the ailment was. I think I could
*do a better or equal job of basic first aid – stopping bleeding, CPR, heimlich manoevre, teating stings and bites, cooling burns, dealing with hypothermia or treating the unconscious
*close to equal the ancients in basic surgery skills – suturing, setting bones, amputations
*do a better job of infection prevention through hygiene and sterilisation
*do a better job of preventing the spread of communicable diseases through appropriate quarantine measures
*do a much better job of avoiding treatments that actually harm the patient
*do a better job in recognising dietary problems and making necessary changes
*fail just as miserably at treating serious diseases and conditions that require modern medicines and techniques. Eg, cancer, diabetes, renal failure. (Although I might recognise a skin cancer as serious and be able to do something about it.)
*do a lesser job in obstetrics
*do a poorer job in pain treatments and other treatments using herbs and folk remedies
*be less effective in treating skin conditions using oils balms poultices and herbal remedies
*have a reasonable crack at treating optical conditions through corrective lenses. It might not be pretty, but it sure wouldn’t harm the patient and I might be able to help.
I am sure I have omitted something, but as I write this I am thinking that I might be an ok bet at least up until a couple of hundred years ago in the Western world.
[QUOTE=md2000]
Reminds me of the old saw (never seen any cites) that wine was drunken so commonly in the bible because the alcoholic beverages were less prone to carrying disease than pure water - unless you listen to the puritan fundamentalist types who will assure you when it says Jesus or the apostles drank wine, they were actually only drinking non-alcoholic grape juice.
[/QUOTE]
Cecil on using wine as an antiseptic. In medieval England water was so untrusted that even kids were given low alcohol beverages, ‘small ale’.
Wow, well at least the merry monarch died as he lived.
Don’t get me wrong, I’m no advocate of whig history. I’m not saying that Galen was a stupid idiot and I’m smarter than him, he was just ignorant of centuries of trial and error that we all take for granted. Maybe in a thousand years people will wonder how MDs these days would compare with their knowledge, with all the centuries of experimentation and research we couldn’t imagine. Saying that, it’s hard to think of something that could be as big of a game changer as germ theory of disease and cellular biology. Mind you our mutual ancestors probably thought the same about their ideas of divine wrath.
You might do a worse job than a midwife, but that’s one area where you’d be almost guaranteed to do better than a physician. The only thing you know that they don’t is that you’d wash your hands first… But that one thing would make a huge difference. Wash your hands, try not to panic too badly, and catch the baby when it comes out, and you’ll do fine.
Reading The Time Traveller’s Guide to Medieval England on health and hygiene reveals how dangerous childbirth was. 1 in 50 births ended with the mother dead, largely due to bloodloss afterwards. That statistic doesn’t sound that bad, but since the vast majority of women gave birth then more than once the odds become increasingly grim. More than 10% of babies were stillborn and one in six will be dead before their first birthday. Caesarian sections always killed the mother.
Medieval obstetrics was also without forceps.
There’s a psychological component here.
You’re standing in one corner, saying, “the best thing to do is nothing at all, just put him to bed.”
His expert doctors are in the other corner saying, “oh we have the remedy to that, no problem, let us at him.”
Who’s the king’s adviser going to go with?
I am no expert, but I completely disagree with this assessment. The simple fact that 11th century physicians had no concept of sanitation and germ theory.
I am working from memory here (and as mentioned not an expert) but I thought it was the late 19th century when physicians first realized the effects of anti-septic and sanitation? Perhaps Pasteur or Koch?
I recall a discovery around this time that showed women who gave child birth in “wards” had a much higher mortality rate that those in private rooms. It was determined that Doctor’s of the time did not practice good hygiene and would even cross contaminate from patients.
This is truly cringe worthy given it was a scant 125 years ago or less.
I would think on that knowledge alone, a lay person today with basic medial knowledge would be on par with the Louis Pasteur and the reigning medical experts of the time.