Ancient medicine: medicine in medieval Islamic World
The Islamic civilization rose to primacy in medical science as its physicians contributed significantly to the field of medicine, including anatomy, ophthalmology, pharmacology, pharmacy, physiology, surgery and the pharmaceutical sciences. The Arabs were influenced by ancient Indian, Greek, Roman and Byzantine medical practices, and developed these further. Galen and Hippocrates were pre-eminent authorities. The translation of 129 of Galen’s works into Arabic by the Nestorian Christian Hunayn ibn Ishaq and his assistants, and in particular Galen’s insistence on a rational systematic approach to medicine, set the template for Islamic medicine, which rapidly spread throughout the arab Empire.
Ancient medicine: medieval medicine of Europe
After A.D. 400, the study and practice of medicine in the Western Roman Empire went into deep decline. Medical services were provided, especially for the poor, in the thousands of monastic hospitals that sprang up across Europe, but the care was rudimentary and mainly palliative.
Most of the writings of Galen and Hippocrates were lost to the West, with the summaries and compendia of St. Isidore of Seville being the primary channel for transmitting Greek medical ideas. The Carolingian renaissance brought increased contact with Byzantium and a greater awareness of ancient medicine, but only with the twelfth century renaissance and the new translations coming from Muslim and Jewish sources in Spain, and the fifteenth century flood of resources after the fall of Constantinople did the West fully recover its acquaintance with classical antiquity.
Wallis identifies a prestige hierarchy with university educated physicians on top, followed by learned surgeons; craft-trained surgeons; barber surgeons; itinerant specialists such as dentist and oculists; empirics; and midwives.
The first medical schools were opened in the 9th century, most notably the Schola Medica at Salerno in southern Italy. The cosmopolitan influences from Greek, Latin, Arabic, and Hebrew sources gave it an international reputation as the Hippocratic City. Students from wealthy families came for three years of preliminary studies and five of medical studies. By the thirteenth century the medical school at Montpellier began to eclipse the Salernitan school. In the 12th century universities were founded in Italy, France and England which soon developed schools of medicine. The University of Montpellier in France and Italy’s University of Padua and University of Bologna were leading schools. Nearly all the learning was from lectures and readings in Hippocrates, Galen, Avicenna and Aristotle. There was little clinical work or dissection.
The underlying principle of most medieval medicine was Galen’s theory of humours. This was derived from the ancient medical works, and dominated all western medicine until the 19th century. The theory stated that within every individual there were four humours, or principal fluids – black bile, yellow bile, phlegm, and blood, these were produced by various organs in the body, and they had to be in balance for a person to remain healthy. Too much phlegm in the body, for example, caused lung problems; and the body tried to cough up the phlegm to restore a balance. The balance of humours in humans could be achieved by diet, medicines, and by blood letting, using leeches. The four humours were also associated with the four seasons, black bile-autumn, yellow bile-summer, phlegm-winter and blood-spring.
Healing included both physical and spiritual therapeutics, such as the right herbs, a suitable diet, clean bedding, and the sense that care was always at hand. Other procedures used to help patients included the Mass, prayers, relics of saints, and music used to calm a troubled mind or quickened pulse.