Supernatural and Religious Explanations

• Supernatural Beliefs: Diseases were often believed to be caused by evil spirits or demonic possession. Witchcraft was also considered a source of illness.
• Religious Beliefs: Illness was seen as a punishment from God for sins. People believed that prayer, fasting, and pilgrimages could cure disease. The Church held significant influence over medical explanations and treatments.

Rational Explanations

• Theory of the Four Humours: Developed by Hippocrates, furthered by Galen. The body is made up of four humours: blood, phlegm, yellow bile, and black bile. Health is maintained by balancing these humours. Imbalance leads to illness; treatments included bloodletting and purging.
• Miasma Theory: Belief that diseases were caused by "bad air" or miasmas. Foul-smelling air from decomposing material or swamps was thought to cause illness. Cleaning and purifying air became a method of prevention.
• Influence of Galen: Galen’s ideas were dominant in medieval Europe. His works were aligned with the Church, reinforcing the religious view of disease. Focused on balancing the humours, anatomy, and patient observation.

Prevention and Treatment Methods

• Religious Actions: Prayer and fasting to seek God’s forgiveness. Pilgrimages to holy sites.
• Bloodletting and Purging: Used to balance the four humours. Common practices included using leeches or making incisions.
• Purifying the Air: Burning herbs or carrying posies to ward off miasma. Cleaning streets and removing waste to improve air quality.

Medical Training and Traditional Care

• Physicians: Trained at universities, studying texts by Galen and Hippocrates. Diagnosed and recommended treatments based on humoural theory.
• Apothecaries: Prepared and sold medicines, herbs, and potions. Less formally trained than physicians.
• Barber Surgeons: Performed minor surgeries, bloodletting, and tooth extractions. Often apprenticed rather than formally trained.
• Hospitals: Run by the Church, focused on care rather than cure. Provided shelter and basic nursing.
• Community and Home Care: Family members and local women provided care using herbal remedies. Herbal treatments were common and varied by region.

Table of Roles and Responsibilities

Approaches to Treatment

• Religious Responses: Flagellation: public self-punishment to atone for sins. Processions and prayers to seek divine intervention.
• Rational Responses: Bloodletting and purging to balance the humours. Use of herbal remedies and poultices.

Attempts to Prevent Spread

• Quarantine Measures: Isolating infected individuals. Closing city gates and restricting movement.
• Public Health Measures: Cleaning streets, removing waste and dead bodies. Burning aromatic herbs to purify the air.

Timeline of Key Events

• 1347: Black Death arrives in Europe.
• 1348: Reaches England, first cases in Dorset.
• 1348-49: Rapid spread across England.
• 1349: Quarantine measures implemented, public health actions taken.