Medieval ideas about the cause of disease (the Four Humours, miasma, religion and astrology), approaches to prevention and treatment, who provided care, public health in towns and monasteries, and the response to the Black Death of 1348 to 1349.

What this dot point is asking

This is the opening period of Edexcel's Paper 1 thematic study, Medicine in Britain c1250 to present. You need to explain how medieval people understood the cause of disease, how they tried to prevent and treat it, who gave care, the state of public health, and how they responded to the Black Death. As a thematic study, the marks reward your grasp of why medicine changed so little here, which sets up the contrast with later periods.

Ideas about the cause of disease

Alongside this, people believed disease could be a punishment from God for sin, caused by miasma (bad or corrupted air), or caused by the movement of the planets and stars (astrology). These ideas coexisted, and a physician might use several at once. None identified the true cause of disease, which is the key to why so little changed.

The influence of Galen and the Church

Doctors also placed huge respect on ancient authority, trusting Galen and Hippocrates above their own observation. This combination, a powerful Church and unquestioned old authorities, is the heart of the Edexcel "why little changed" question.

Prevention, treatment and care

Prevention focused on keeping the humours balanced through regimen sanitatis: advice on diet, sleep, exercise and avoiding bad air. People purified the air with herbs and tried to avoid sin. Treatment mixed Galen's ideas with herbal remedies, bleeding and purging, charms and prayer.

Trained physicians were university educated, rare and expensive, and diagnosed using urine charts and the position of the planets. Most everyday care came from apothecaries (who mixed and sold remedies), barber surgeons (who did bleeding and minor surgery), and women treating the sick at home. Hospitals, often run by monasteries, mostly offered rest, warmth, food and prayer rather than cures, and many refused the seriously ill or infectious.

Public health

The Black Death, 1348 to 1349

Try this

Q1. Name the theory that said illness was an imbalance in the body. [Knowledge recall]

• Cue. The Theory of the Four Humours, developed by Galen.

Q2. Explain why medieval medical treatment changed so slowly. [Short explanation]

• Cue. A powerful Church taught Galen as near sacred and discouraged challenges, doctors respected ancient authority over observation, and nobody knew the true cause of disease, so treatments could not be improved.