For over eight hundred years, the Western institution of the medical doctor has represented the pinnacle of understanding in the domain of healing. After universities were established in 12th century Europe to study theology, some students began getting basic medical instruction with the humble libraries available. Since the general theory of disease revolved around the punishment of God, it made sense that people would turn to someone schooled in the Bible rather than gross anatomical study. Surgery was seen as an inferior and unrelated specialty practiced by illiterates, something an educated doctor would prudently avoid, since cutting people open meant infections and death, ruining the reputation of the doctor.
All the lessons at university were in Latin, a dead language reserved for the privileged which made it impossible for commoners to weigh in on anything that would be considered important. This old Medieval barrier still continues to this day through the use of complicated medical terms which, when missing from a vocabulary, immediately ruins credibility. One wonders just how impressive medicine would seem if terms were translated (e.g. almond & seahorse versus amygdala & hippocampus), but I’ve found that when I do educate myself and learn these words, I’ll get amused looks along with the suggestion to stop consulting “Doctor Google”.
Medieval medical programs lasted a full decade, followed by an internship and a final exam by peers. This was a really tough process and meant that there weren’t a lot of doctors to go around, especially since the powerful and wealthy would hire them as personal consultants, which generally remained the case up until the French Revolution. Since students entered university when they were 14, I wonder if part of the length wasn’t just to keep unruly teenagers busy with something, although the sacrifice of one’s youthful prime was very real and remains an important element in today’s education. When anyone’s going through a tough professional challenge, their friends might say “hey, at least you’re not in medical school”.
There were strong criminal penalties & fines for people who tried to practice medicine without the necessary stamp of approval, a group of people lumped together as empirics, fools, & women. So-called empirics were folk healers, closer to scientists than the clerical doctors, since they relied on trial-and-error rather than the sanctioned literature of the university, which was mostly based on rough versions of Galen’s 2nd century observations. Most people’s experience with medicine would have been with an empiric since trained doctors were scarce and expensive.
My great-great-grandmother Katinka, who lived to be in her nineties, was a famed folk healer of a small Romanian village in the 19th century. Incidentally, I’ve often wondered how it is that people could live to such old age without modern advances in medicine, but it turns out that as long as people made it through their childhood & adolescence, they were likely to live for a quite a while after; both popes & artists lived into their seventies in the 13th century.
Katinka was highly sought after and had a wide variety of remedies, here’s a small sample:
Colds
Give the patient a vigorous massage and administer leeches.
Headaches & Fevers
Take a cloth and soak it with vinegar and cold water. Wrap it around the patient’s head with some slices of fresh potato.
Colicky Baby
Take some cannabis buds and wrap it in a cloth with sugar. Give to the baby to suck on before bedtime.
Stomach pain
Well-cooked meat with celery & carrot soup. Sour pounes for desert, along with mint and chamomile tea.
Uncertain Future
Take some tin and heat it up, then pour it into a bucket of cold water. Inspect the shapes created to determine patient’s future.
Eye Infection
Take some breast milk and wrap it in thick cloth, administer slowly in drops to the affected eye.
This last one made me laugh when I heard it, but to my surprise, not only is it still commonly done in Eastern Europe, but there is some evidence to back it up as an effective technique, although the interplay of bacteria is still relatively new subject. What’s especially ironic is that modern doctors see it as quackery, even though it was specifically recommended by Galen in the canonical literature originally required to become a doctor. Katinka was seriously OG.
The Medieval suspicion of so-called empirics is particularly interesting, since the lack of respect for evidence-based practice seems to still run through contemporary medicine, although this might be owing to the way people are wired in general. I once tried showing a doctor an excerpt from the American Journal of Roentgenology that contradicted her position regarding MRIs for appendicitis, to which she responded with immediate hostility and condescension rather than curiosity or engagement. It was by no means an isolated incident.
Again, for MDs, it seems the villain is “Doctor Google”, an unreliable, confusing mess of data that tells you both everything and nothing. Although everyone rightly pokes fun at useless resources like WebMD which suggests that just every ache and pain might be cancer, it’s not easy to draw the line between where the internet ends and legit medical information begins.
I think some people might be surprised at just how hard some organizations fight to keep scientific information being behind thick paywalls, going so far as to bully and harass someone until they kill themselves, as in the case of Aaron Swartz. After Swartz’s death, JSTOR finally allowed their public domain content to be viewed for free, a pitiful concession which makes it clear that it will take activists like Alexandra Elbakyan to revolutionize access.
Through Library Genesis and SciHub, plenty of ridiculously expensive medical papers and textbooks are available for free online, and anyone can see how a medical specialist does their differential diagnoses, without forking over hundreds of dollars. Seeing behind the Wizard of MD’s curtain like this would have been absolutely, completely, utterly unthinkable to the original doctorate professors in the 12th century.
The distinction between prescription & over-the-counter medicine is also a Medieval legacy which, in the face of easily accessible online documents, makes it seems like there’s something else going on. In fact, if none of the original medications are still in use, none of the original teachings are relevant, and none of the original barriers to medical knowledge exist, it makes me wonder:
What’s a doctor?
