A Distant Mirror_ The Calamitous 14th Century - Barbara W. Tuchman [72]
Doctors’ remedies in the 14th century ranged from the empiric and sensible to the magical, with little distinction made between one and the other. Though medicine was barred by the Church from investigation of anatomy and physiology and from dissection of corpses, the classical anatomy of Galen, transferred through Arab treatises, was kept alive in private anatomy lessons. The need for knowledge was able sometimes to defy the Church: in 1340 Montpellier authorized an anatomy class every two years which lasted for several days and consisted of a surgeon dissecting a cadaver while a doctor of medicine lectured.
Otherwise, the theory of humors, along with astrology, governed practice. All human temperaments were considered to belong to one or another of the four humors—sanguine, phlegmatic, choleric, and melancholic. In various permutations with the signs of the zodiac, each of which governed a particular part of the body, the humors and constellations determined the degrees of bodily heat, moisture, and proportion of masculinity and femininity of each person.
Notwithstanding all their charts and stars, and medicaments barely short of witches’ brews, doctors gave great attention to diet, bodily health, and mental attitude. Nor were they lacking in practical skills. They could set broken bones, extract teeth, remove bladder stones, remove cataracts of the eye with a silver needle, and restore a mutilated face by skin graft from the arm. They understood epilepsy and apoplexy as spasms of the brain. They used urinalysis and pulse beat for diagnosis, knew what substances served as laxatives and diuretics, applied a truss for hernia, a mixture of oil, vinegar, and sulfur for toothache, and ground peony root with oil of roses for headache.
For ills beyond their powers they fell back on the supernatural or on elaborate compounds of metallic, botanic, and animal substances. The offensive, like the expensive, had extra value. Ringworm was treated by washing the scalp with a boy’s urine, gout by a plaster of goat dung mixed with rosemary and honey. Relief of the patient was their object—cure being left to God—and psychological suggestion often their means. To prevent pockmarks, a smallpox patient would be wrapped in red cloth in a bed hung with red hangings. When surgery was unavailing, recourse was had to the aid of the Virgin or the relics of saints.
In their purple or red gowns and furred hoods, doctors were persons of important status. Allowed extra luxury by the sumptuary laws, they wore belts of silver thread, embroidered gloves, and, according to Petrarch’s annoyed report, presumptuously donned golden spurs when they rode to their visits attended by a servant. Their wives were permitted greater expenditure on clothes than other women, perhaps in recognition of the large fees doctors could command. Not all were learned professors. Boccaccio’s Doctor Simon was a proctologist who had a chamber pot painted over his door to indicate his specialty.
When it came to the plague, sufferers were treated by various measures designed to draw poison or infection from the body: by bleeding, purging with laxatives or enemas, lancing or cauterizing the buboes, or application of hot plasters. None of this was of much use. Medicines ranged from pills of powdered stag’s horn or myrrh and saffron to potions of potable gold. Compounds of rare spices and powdered pearls or emeralds were prescribed, possibly on the theory, not unknown to modern medicine, that a patient’s sense of therapeutic value is in proportion to the expense.
Doctors advised that floors should be sprinkled, and hands, mouth,