GCSE History · Topic guide

Medicine in Britain, c1250-c1500: Ideas About the Cause and Treatment of Disease

Medieval English people explained illness in three overlapping ways: supernatural causes (God punishing sin, or the position of the planets and stars, read from astrology charts), miasma (poisonous 'bad air' rising from rotting matter, sewage or corpses), and the Theory of the Four Humours. The Greek physician Galen, who lived c.129-c.216 AD, developed this theory from the earlier work of Hippocrates: the body contained four humours, blood, phlegm, black bile and yellow bile, and illness resulted from these falling out of balance. Because the medieval Church protected Galen's authority and discouraged human dissection, and few people outside the Church could read the Latin and Greek texts that held this knowledge, treatment followed logically from these beliefs, but the underlying explanations of disease barely changed for well over a thousand years, which is why historians often call this period 'medicine stands still.'

Grades 4-7 (GCSE)Medicine in Britain, c1250-presentAQAWJECEduqas

Before you start

No specific prerequisites - this is a good place to start.

Method

  1. Sort your knowledge into two separate boxes before you write: ideas about what CAUSED disease (supernatural, miasma, the Four Humours) and approaches to TREATING or PREVENTING it (bloodletting, purging, prayer, herbal remedies) - exam questions often ask about only one of these, and mixing them up loses marks.
  2. Learn the Theory of the Four Humours precisely: name all four humours (blood, phlegm, black bile, yellow bile) and explain why a diagnosed imbalance logically led to a treatment such as bloodletting or purging.
  3. Learn who provided medical care and what made each role different: the physician (trained, expensive, diagnosed using urine charts and astrology), the apothecary (mixed and sold remedies), the barber-surgeon (bloodletting and minor surgery), and unlicensed wise women and quack doctors.
  4. Learn the Church's double-sided role: it preserved classical medical texts and trained physicians through monasteries and universities, but its insistence on Galen's authority and its restrictions on dissecting human bodies also discouraged new discoveries.
  5. For a 4-mark 'explain one way X was similar to/different from Y' question, choose ONE precise point of similarity or difference, then support it with one specific, named detail from each period rather than describing both periods in general terms.
  6. For a 12-mark 'explain why' question about this period, build your answer around named factors (e.g. the Church, lack of a scientific method, low literacy) rather than retelling the story of medieval medicine; explain HOW each factor slowed or shaped change.
  7. Keep a bank of specific supporting detail ready to use: Galen's dates, the four humours by name, at least one named practitioner type, and one concrete example of a treatment matched to its believed cause.

Worked example

Explain one way in which ideas about the cause of disease in medieval Britain, c1250-c1500, were different from ideas about the cause of disease in Britain today.

  1. Identify one precise difference rather than a vague one: medieval people explained illness mainly through supernatural causes and the Theory of the Four Humours, while modern medicine explains illness through germ theory and genetics.
  2. Support the medieval side with a specific detail: physicians believed illness came from an imbalance of the four humours (blood, phlegm, black bile, yellow bile), sometimes worsened by God's punishment for sin or an unfavourable position of the planets.
  3. Support the modern side with a specific detail: today, illness is explained by identified causes such as bacteria, viruses or inherited genetic conditions, diagnosed using evidence such as blood tests or scans rather than urine charts or astrology.
  4. Make the contrast explicit in a single sentence so the examiner can see the comparison clearly: unlike today's evidence-based, scientifically tested explanations, medieval explanations rested on inherited classical authority and religious belief that were rarely tested or challenged.

Practice questions

Try each question, then tap to reveal the answer.

Q1Name the four humours in Galen's theory.Show answer

Answer: Blood, phlegm, black bile and yellow bile.

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Q2Roughly when did Galen, whose ideas dominated medieval medicine, live?Show answer

Answer: c.129 to c.216 AD - his ideas were followed in England for well over 1,000 years after his death.

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Q3Give one supernatural explanation medieval people gave for illness.Show answer

Answer: That it was sent by God as punishment for sin (or that it was caused by an unfavourable position of the planets and stars, read through astrology).

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Q4What was miasma believed to be?Show answer

Answer: Poisonous 'bad air' given off by rotting rubbish, sewage or decaying corpses, thought to spread disease.

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Q5Name one type of medical practitioner, other than a physician, that a sick person in medieval Britain might visit.Show answer

Answer: An apothecary, who mixed and sold herbal remedies (or a barber-surgeon, who carried out bloodletting and minor surgery).

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Q6Why did physicians commonly recommend bloodletting?Show answer

Answer: Because illness was believed to result from an imbalance of the four humours, so removing blood was thought to restore the balance.

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Q7Give one reason why medical ideas about the cause of disease changed so little in this period.Show answer

Answer: The Church protected Galen's authority and discouraged challenges to it, and it restricted the dissection of human bodies, so there was little opportunity to test or correct old ideas.

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Exam-style questions

Written in the style of a GCSE History exam paper, with a full mark scheme.

Q1[4 marks]

Explain one way in which ideas about the cause of disease in medieval Britain, c1250-c1500, were similar to ideas about the cause of disease in Britain during the sixteenth and seventeenth centuries, c1500-c1700.

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Q2[12 marks]

Explain why ideas about the cause of disease changed so little in Britain during the period c1250-c1500.

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See real GCSE History past-paper questions, with official mark schemes

Free printable worksheet

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