Regardless of its earliest forms, [trepanation] was still used in the Middle Ages as a treatment for madness.
This is true, but with some important caveats, according to the article "Insanity, Treatment of" in the
Dictionary of the Middle Ages.
First, when mental patients in the care of medieval doctors were trepanned, it had nothing to do with "letting demons out" of their heads, as you suggested in an earlier post. According to the
DMA, "Insanity may have been characterized by different names and attributed to various causes during the Middle Ages, but it was evidently recognized as a disease." Medieval physicians expressly rejected supernatural etiologies of mental illness, even if sometimes they would assent, as a last resort, to allowing their patients to be treated with "folk/empirical recipes and ... magical rites and incantations. They often justified this by adding [in their therapeutic accounts], 'so that something may be done' when purely human attempts proved futile."
Interestingly, although such desperate measures sometimes involved appeals to religious powers, according to the
DMA, "Contrary to modern assumption, these did not consist of exorcisms[.]"
Next, the article indicates that trepanning was not only viewed as drastic, but also suggests that it was done only where head trauma was diagnosed as the cause of mental disorder or disruption: "trepanation [was performed] to drain blood that had accumulated after a blow to the head". And as we know from the earlier BBC article, medieval trepanation was at least sometimes a successful and even life-saving operation. Indeed, the purposes for which trepanation seems generally to have been used in the Middle Ages are essentially the same purposes for which it is still used today.
No demons there.
Darat said:
And that is exactly what Randi was commenting on! That such beliefs don't belong in the 21st century, that we have made so many advances in understanding the world - that if someone believes in this they are employing a mindset much more akin to the mindset that existed in the dark ages rather then in an age where anti-antibiotics, chemotherapy, heart transplants, anti-histamines, jet planes, computers, men walking on the moon all exist because that mindset was proved to be inaccurate in describing the real world.
For the sake of accuracy, Randi used the term "Middle Ages" rather than "Dark Ages" (this time, at least). Recall that the basic mindset (rational inquiry, scientific method, etc.) that gave rise to all those things arose during the Middle Ages, not the modern era, as the modern historians I've cited here and elsewhere have pointed out. Obviously, the specific material advances you're referring to came later. However, since that mindset appears to share the stage with quackery to a very great extent in the 21st century, it is hardly surprising to observe that it has done so since the Middle Ages and before. That doesn't mean that a given form of quackery belongs in the Middle Ages.
What is an "anti-antibiotic"?
Darat said:
Well unless you show me that the vast majority of people with access to Randi's commentaries believe that the Internet works because someone casts a spell on the wires then again his comment was relevant to the audience.
I hope few people with access to Randi's commentaries believe that, although I would venture to guess that, roughly speaking, half or more of them believe in their horoscopes or in psychics. But really, what is the relevance of believing that the Internet works because someone casts a spell on the wires? Are you suggesting, for example, that medieval people tended to believe that the tools they used worked because someone had enchanted the tools?
Darat said:
Which is why Randi's comment was quite accurate.
It means your comment was
inaccurate, doesn't it? People who buy homeopathic remedies
do kind of believe - in a manner of speaking - that they work because the homeopath used sympathetic magic.
Darat said:
Nope we both just asserted our beliefs about [whether that spells, magic and such were part of standard medieval medical theory].
OK. I decided to hit the books again, particularly since no one else seems to want to do it.
In the rather lengthy
DMA encyclopedia entry on medieval medicine ("Medicine, History of", as well as a companion piece on Byzantine medicine), I searched in vain for any reference to spells, demons, or anything of that sort. The closest thing to superstition in the customary sense was a couple of references to the occasional influence of astrology.
We learn a few interesting facts about the state of the medical art in the Middle Ages:
Next to the influence of Hippocrates and Galen, that of Alexander of Tralles was the greatest in the Middle Ages in both the East and the West. His writings were translated into Syriac, Arabic, Hebrew, and Latin. His Twelve Books on Medicine has been described as a masterpiece and became a required textbook at the University of Paris in the High Middle Ages. He was more original than his predecessors and maintained an independent judgment based on great learning and personal observation. He advised that "choice of drugs should be guided by reason but even more by experiment."
Paul of Aegina ... is the author of a [7th century!] seven-book encyclopedia, which provides information on surgery, pediatrics, lung diseases, gout, sclerosis of the kidneys, encephalitis, and other illnesses. His book on surgery was a prescribed textbook at the University of Paris for many years. He wrote on catheterization, tracheotomy, excision of tonsils, nasal polyps, lithotomy, hemorrhoidectomy, and several other forms of surgery. He had extracted cataracts and had operated for trichiasis, cysts, and staphyloma, among other maladies. His work, too, was translated into Arabic and had a considerable influence on Arabic medicine, especially in the areas of gynecology and surgery.
According to the
DMA, even before the twelfth century, Western physicians had a "confirmed ... belief" that "medicine should be studied as a rational system with close ties to [natural] philosophy, grounded in logical order and susceptible of methodological investigation."
As I suggested earlier, the central concepts of medieval medical theory were pretty far removed from magic or supernaturalism:
If we read through the heavily schematic Isagoge, it will serve us as an introduction to Galenic medical theory, as it did so many students in the Middle Ages. We learn first about the res naturales, whose normalcy constitutes health: the four elements, the four primary qualities; the four humors or bodily fluids ... These "things natural" provide the basis for understanding the physiological and psychological activity of the body, and thus health: Every body, indeed every member of the body, has its own normal balance or proper temperament of qualities and humors, and illness arises when imbalance is so great as to distort function. The six nonnaturals, of which we learn next, are the cases external to the body that we or the physician can manipulate to preserve or sometimes to restore health: air, food and drink, excretion, exercise, sleep, and the emotions. Finally we learn of pathology: of disease, its causes and consequences (etiology and semiotics) - the res contra naturam. Diseases are classified sometimes by the part of the body they affect, sometimes by the symptoms they manifest, and sometimes by their supposed cause.
... [T]he Isagoge summarizes medical practice for the beginning student: "The practice of medicine deals with the right ordering of the nonnaturals, with giving of drugs, and of surgery" - to be essayed in that order, no doubt, by the consulting physician; of these the administration of drugs, mostly botanical, seems to have dominated medical practice.
So, as I suggested earlier, it was humoralism, not magic, that provided the underpinnings of medical practice in the Middle Ages (the article "Humoralism" by medical historian Vivian Nutton in Volume 1 of the
Companion Encyclopedia of the History of Medicine confirms that "Historically, humoralism formed the basis for the Western tradition of medicine down to the nineteenth century.") Medieval medical treatments were primarily centered around manipulation of diet and regimen on the one hand, and pharmaceutical therapy on the other. Conspicuously absent (at least, from the standpoint of modern historical myths) were magical rituals or appeals to the supernatural.
The topic of humoralism brings me to another point I wanted to make: medieval medical practitioners, regardless of their therapeutic skill or effectiveness, were overwhelmingly
allopaths. If for no other reason than this, it is problematic to assert that homeopathy "belongs" in the Middle Ages, for homeopathic theory would have clashed with the prevailing medical theories of the day. Indeed, it is hard to imagine homeopathy gaining any significant foothold prior to the theoretical speculations of Paracelsus in the 16th century. Thus, there is a better case for saying that homeopathy belongs in the Renaissance than for saying it belongs in the Middle Ages.
Surgery, as the earlier-cited medieval textbook points out, was the third area of medical practice. The
DMA notes:
The branch of thirteenth-century medicine that has received most praise for its empirical and "progressive" quality is surgery ... The first medieval compilation on the subject was the so-called Bamberg Surgery of the early twelfth century...; it was supplanted by the text of Roger Frugardi, fifty years later, which in Guido d'Arezzo's rearrangement of 1170 dealt with certain operations, the treatment of wounds, fractures, and dislocations in a systematic and widely useful fashion... The thirteenth century surgical literature is plainly marked by the immediacy of direct experience, on the battlefield or in urban practice, which unquestionably led to some concrete advances.
The article goes on to assert that medieval people under the care of a doctor "were probably healthier than others, relatively speaking; their therapy was generally moderate and sensible and did not go to the heroic extremes of, say, the early nineteenth-century[.]" Here, I suspect the author may have phlebotomy in mind: it was not uncommon for late eighteenth- and early nineteenth-century patients to be bled literally to death by their doctors, at the height of the medical establishment's love affair with phlebotomy. The
DMA suggests that this would have occurred rarely in the Middle Ages.
By the way, would you be inclined to say that people relying on the care of a homeopath are "probably healthier than others" or that "their therapy is sensible"? If not, then that's another reason for concluding that homeopathy would be out of place in the context of medieval medical practice.
Darat said:
Which has no relevance to what I initially described as "where superstition and faith defined the world view of the majority of the people."
Then what exactly did you intend by saying that "Homeopathy was developed in a time when its primary underpinnings (spells) had already been discarded by the sciences"? Are you suggesting that, say, the underpinnings of the sciences of the 13th century included spells?
Also, unless I am completely misinterpreting you, you are attempting to relate the "historical appropriateness" of homeopathy to a prevailing worldview that is defined by faith and/or superstition. Have you considered whether the currently growing popularity of homeopathy might be due to the fact that the 21st-century worldview has an awful lot of faith and/or superstition in it? Yours doesn't, mine doesn't, and Randi's doesn't, of course, but perhaps it's a bit presumptuous to characterize the spirit of the age by reference only to our own worldviews. Maybe
we're the ones who are a bit out of step with many of our contemporaries.
