On urines
May 21, 2021 6:00 PM Subscribe
Meet a Historian: Robin S. Reich on Making Sense of Medieval Medicine: Humors, Weird Animal Parts, and Experiential Knowledge The first of potentially many guest posts on (Metafilter fave) historian Bret Devereaux's blog takes a look at medieval medicine. Who—other than anyone who likes reading about history—could have known it was interesting, complicated, and mostly dependent on language issues?
Note from the Editor: I’m excited that I have our first (hopefully of many!) guest post to share with you and it is a fascinating topic to start with. The history of medicine (and the history of science more generally) is a captivating and important sub-field and a frequent reader-request, but also a place where non-specialists fear to tread because of the formidable demands in languages and expertise. So I am thrilled for Robin S. Reich to come and offer you all (and me) a primer on the complexities of discussing medieval medicine, presenting the contrast between its theory and practice but also encouraging us to think on the place of medicine in society.
Reich has her B.A. in History from Carleton College, M.A.’s in history from both Boston College and Columbia and is now finishing her Ph.D. in history at Columbia with a dissertation on “Materials and Science in Norman Sicily: Translation, transmission and trade in the central Mediterranean corridor” – which, if I may editorialize a bit further, is a fascinating dissertation subject if ever I have heard one! She also writes at her blog, Robin Writes, which is well worth checking out as well.
Bloodletting, leeches, cupping, and cautery were all popular methods of balancing humors, but they were only practiced by the elite. Cupping has been making a comeback in recent years, and leeches never really went away
Except that leeches do have some proven medicinal use whereas cupping has no value beyond placebo or sham therapy.
The whole humoral approach to medicine meant that medical care was largely about the maintenance of good health, not about the treatment of disease. Our system of modern medicine is more interested in curing disease than preventing it, although that is something that a lot of medical professionals are trying to change. Medieval medicine is the opposite.
Or maybe medieval medicine was focused on prevention because most people don't come down with any given ailment most of the time, and so any random "preventative" will appear to work most of the time ("Lisa, I want to buy yourrock medieval herbs"). It takes controlled trials and statistics to show otherwise, something medieval doctors almost certainly weren't doing. Compare that to treating a wound or disease, where efficacy (or lack thereof) is much more obvious, especially for cases that are normally fatal.
The article seems to suggest that we know-it-all moderns shouldn't judge medieval medicine because, essentially, "they wouldn't have done it if it didn't have value" and "there's a lot we don't know about medieval medicine, so we can't assume it was incorrect." Except that there is an enormous, well-established, and tragic history of quackery, pseudo-science, and just plain incorrect medicine (including huge chunks of 19th and 20th century medicine!) that proves that people will not only repeatedly try ineffective treatments, they will do so even at great cost and great harm to themselves, often out of ignorance, desperation, or deception. There is no particular reason to think that medieval medicine was particularly effective just because people kept doing it, or to assume that the parts we don't know about were any better than the parts we do.
posted by jedicus at 8:13 PM on May 21, 2021 [4 favorites]
Except that leeches do have some proven medicinal use whereas cupping has no value beyond placebo or sham therapy.
The whole humoral approach to medicine meant that medical care was largely about the maintenance of good health, not about the treatment of disease. Our system of modern medicine is more interested in curing disease than preventing it, although that is something that a lot of medical professionals are trying to change. Medieval medicine is the opposite.
Or maybe medieval medicine was focused on prevention because most people don't come down with any given ailment most of the time, and so any random "preventative" will appear to work most of the time ("Lisa, I want to buy your
The article seems to suggest that we know-it-all moderns shouldn't judge medieval medicine because, essentially, "they wouldn't have done it if it didn't have value" and "there's a lot we don't know about medieval medicine, so we can't assume it was incorrect." Except that there is an enormous, well-established, and tragic history of quackery, pseudo-science, and just plain incorrect medicine (including huge chunks of 19th and 20th century medicine!) that proves that people will not only repeatedly try ineffective treatments, they will do so even at great cost and great harm to themselves, often out of ignorance, desperation, or deception. There is no particular reason to think that medieval medicine was particularly effective just because people kept doing it, or to assume that the parts we don't know about were any better than the parts we do.
posted by jedicus at 8:13 PM on May 21, 2021 [4 favorites]
Avicenna was indeed one of the greatest influences upon medicine. Author mentions the 'al-Tibb al-Nabawi', or 'Medicine in the Tradition of the Prophet.' and rightly omits 'The book of healing' but still an important work, as if science was explored then medicine with theological tenets examined. Genuis. nice post.
posted by clavdivs at 9:29 PM on May 21, 2021 [1 favorite]
posted by clavdivs at 9:29 PM on May 21, 2021 [1 favorite]
> The article seems to suggest that we know-it-all moderns shouldn't judge medieval medicine because, essentially, "they wouldn't have done it if it didn't have value" and "there's a lot we don't know about medieval medicine, so we can't assume it was incorrect." Except that there is an enormous, well-established, and tragic history of quackery, pseudo-science, and just plain incorrect medicine (including huge chunks of 19th and 20th century medicine!) that proves that people will not only repeatedly try ineffective treatments, they will do so even at great cost and great harm to themselves, often out of ignorance, desperation, or deception. There is no particular reason to think that medieval medicine was particularly effective just because people kept doing it, or to assume that the parts we don't know about were any better than the parts we do.
Okay, but by the same token, our modern, empirically-tested medicine is also full of stubborn biases (particularly around sex and race), known fallacies (doctors just prescribe those antibiotics anyway!), and a emphasis on training physicians to focus on diagnosing and curing disease that misses the forest for the trees in terms of actual health. Look, I'm grateful for modern medicine and I Believe In Science and preventative cancer screening literally saved my life, but I think there's plenty of both consideration and judgement to apply to any era of medicine.
posted by desuetude at 11:37 PM on May 21, 2021 [7 favorites]
Okay, but by the same token, our modern, empirically-tested medicine is also full of stubborn biases (particularly around sex and race), known fallacies (doctors just prescribe those antibiotics anyway!), and a emphasis on training physicians to focus on diagnosing and curing disease that misses the forest for the trees in terms of actual health. Look, I'm grateful for modern medicine and I Believe In Science and preventative cancer screening literally saved my life, but I think there's plenty of both consideration and judgement to apply to any era of medicine.
posted by desuetude at 11:37 PM on May 21, 2021 [7 favorites]
At the very least this provides an interesting etymology of the expression piss poor.
posted by y2karl at 4:44 AM on May 22, 2021
posted by y2karl at 4:44 AM on May 22, 2021
any random "preventative" will appear to work most of the time ("Lisa, I want to buy your rock medieval herbs"). It takes controlled trials and statistics to show otherwise
First off, things can be observed to be effective without statistical evidence. On the specific assertion about disease prevention, Vasco da Gama was aware of the role of citrus fruits in preventing scurvy in the 15th century (slightly outside the time period, but a couple of centuries before Lind first applied statistics to the question), and is documented to have taken steps to procure them, and as identifying them as an antiscorbutic. So, yeah.
The article seems to suggest that we know-it-all moderns shouldn't judge medieval medicine because, essentially, "they wouldn't have done it if it didn't have value"
Sadly, this and your other quote* are reductive to the point of untruth. What the piece saying is that, to a significant extent, we don't even know what "value" means in this historical context. The point, which the author makes amply clear to the unbiased reader, is that studying mediaeval medicine as a historian is not about working out whether it "worked" from an ostensibly objective perspective, but rather trying to identify what purposes people believed medicine to serve, what purposes it actually served, and to what extent it was effective in doing these things. Understanding why sophisticated societies spent effort, intellect and resources on things that seem strange to us is an important part of doing cultural history. Not assuming that the answer is simply stupidity, rather than a range of contexts and intents which we may not have evidence about, or may not understand the evidence we do have, isn't neglecting the reality of superstition, wrongheadedness and quackery, or the fact that these are almost certainly major parts of the explanation (of any human practice). It is just doing proper, data-led research, rather than approaching the study of history as part of a modern culture war.
*n.b. not actual quotes
posted by howfar at 7:55 AM on May 22, 2021 [8 favorites]
First off, things can be observed to be effective without statistical evidence. On the specific assertion about disease prevention, Vasco da Gama was aware of the role of citrus fruits in preventing scurvy in the 15th century (slightly outside the time period, but a couple of centuries before Lind first applied statistics to the question), and is documented to have taken steps to procure them, and as identifying them as an antiscorbutic. So, yeah.
The article seems to suggest that we know-it-all moderns shouldn't judge medieval medicine because, essentially, "they wouldn't have done it if it didn't have value"
Sadly, this and your other quote* are reductive to the point of untruth. What the piece saying is that, to a significant extent, we don't even know what "value" means in this historical context. The point, which the author makes amply clear to the unbiased reader, is that studying mediaeval medicine as a historian is not about working out whether it "worked" from an ostensibly objective perspective, but rather trying to identify what purposes people believed medicine to serve, what purposes it actually served, and to what extent it was effective in doing these things. Understanding why sophisticated societies spent effort, intellect and resources on things that seem strange to us is an important part of doing cultural history. Not assuming that the answer is simply stupidity, rather than a range of contexts and intents which we may not have evidence about, or may not understand the evidence we do have, isn't neglecting the reality of superstition, wrongheadedness and quackery, or the fact that these are almost certainly major parts of the explanation (of any human practice). It is just doing proper, data-led research, rather than approaching the study of history as part of a modern culture war.
*n.b. not actual quotes
posted by howfar at 7:55 AM on May 22, 2021 [8 favorites]
I’ve only read a few of the recent entries, but her blog is absolutely worth your time.
posted by hototogisu at 3:05 PM on May 23, 2021 [2 favorites]
posted by hototogisu at 3:05 PM on May 23, 2021 [2 favorites]
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