What happened when the Roman Empire Collapsed?

After the fall of the Roman Empire in the west during the fifth century, much of the medical knowledge of the Greeks and Romans was lost to people living in Western Europe. The collapse of the Roman Empire led to a breakdown in law and order, with no effective central government and a return to pagan tribal societies. This was the time of the so called Dark Ages in Europe. Roman style government and society continued in the Byzantine Empire based around the city of Constantinople but this empire was cut off from the rest of Europe. Had it not been for the emergence of the Arab Empire in the seventh century then the knowledge of the Greeks and Romans might have been lost permanently to Western society.

The Arab Empire was at its height between the eigth and the

sixteenth century when it controlled what is now Spain, North Africa and the whole of the Middle East as far as India. Followers of Muhammad were taught that there is always a cause and a cure for every disease. This belief encouraged medical research and the importance of recording and transmitting this knowledge. Works by Hippocrates and Galen were translated into Arabic along with translations of both Indian and Chinese writers. These translations were then combined into large encyclopaedias and summaries into which Arab writers added their own comments based on research they had undertaken.

Europe gradually emerged from the Dark Ages as the Christian church became more powerful. St Benedict founded the first monastery at Monte Cassino in Italy in 529 AD and these quickly grew in number and influence. Monks played an important role in spreading Christianity within Europe and in 595 AD, Benedictine monks arrived in England led by Augustine who later became the first Archbishop of Canterbury. As monasteries were built throughout Europe, they became not only religious centres but also centres of learning. As well as translating and copying religious works, monks also copied books by writers such as Hippocrates and Galen. Constantine the African was a Benedictine monk who by his work helped to reintroduce Greek medicine to Christian Europe.

The Rule of St Benedict states that "before and above all things, care must be taken of the sick”. Virtually every monastery had an infirmary for the monks or nuns, and this led to care being made for other patients. Almost a half of the hospitals in medieval Europe were directly linked with monasteries or other religious institutions.

What happened to medicine when the Roman Empire collapsed?

Monks weighing ingredients and mixing potions for patients

Phase 1: ChaosTribes overrun Rome and turn on each otherPublic health systems and libraries destroyedMoney spent on defence rather than medicineTrade disrupted so countries are poorerTravel is dangerous so communication stopsWar disrupts education and technological developmentSoldiers rather than doctors are trained

Phase 2: the ChurchMissionaries sent to warring tribesThousands of churches and monasteries appearThe Church is the only strong centralised organisation left – powerPope tells people what to believe and how to behavePriests and monks are the only people who read. The Church controls education.The Church teaches supernatural explanations for everything: God/the Devil

Phase 3: StabilityWars cease and societies regain stabilityTrade and money increasePeople begin to travelChurch sets up universities for doctor trainingArmies begin to take doctors with them to planned battlesRulers began to try and clean up townsCommunications open up again

Constantine the African was an eleventh-century translator of Greek medical texts.

He was a native of Carthage, then under Arab rule. As a Christian he had a good knowledge of Latin, enabling him to translate medical works from Arabic. He was invited to join the Schola Medica Salernitana by Alfano I, Archbishop of Salerno c.1065 in order to help with the translation of various Arabic manuscripts. In this way he helped reintroduced Greek medicine to Christian Europe. His translations of Hippocrates and Galen first gave the West a view of Greek medicine as a whole.

Life

Constantine the African (born c. 1020, Carthage or Sicily, died 1087, monastery of Monte Cassino). Constantine possessed much knowledge in many different languages, such as Greek, Latin, Arabic, and several Oriental languages. He had acquired these different languages during his extensive travels in Syria, India, Ethiopia, Egypt, and Persia. He studied at the University of Salerno, which was Europe's first organized medical school. Later, he entered the Monte Cassino, the monastery founded by St. Benedict in 529.

Translations

The first translation from Arabic to Latin from the works of Constantine the African was the Complete Book of the Medical Art (the Kitab) in 1087. This text was the first comprehensive Arabic medical text. The significance of this text was that it was an important resource for the student of the transmission of scientific ideas. The Complete Book of the Medical Art contains a collaboration of 128 known manuscripts. This text also contains a survey of the 108 known Latin manuscripts of Constantine the African. This text rapidly became part of the standard medical curriculum for students.

His 37 translated books from Arabic to Latin, which, introduced Islam's extensive knowledge of Greek medicine to the West. His translations of Hippocrates and Galen first gave the West a view of Greek medicine as a whole.

How did Galen’s works survive into the Middle Ages?

Constantine examining patients’ urine

ORDER EVENT

A

The Empire splits into an eastern half and a western half. The eastern half contains Greece

B

In 410 AD the Roman Empire Collapses when Rome is sacked

C

The eastern half is temporarily taken over by Arabs. They find Galen’s works and translate them from Greek into Arabic. The originals are lost

D

Whilst travelling in Italy, Constantine hears that there is no knowledge of Galen’s works in Western Europe

E

Constantine the African, a Muslim merchant with some medical knowledge, can read Arabic. He reads Galen’s works

F

He gets some of Galen’s works and brings them to Monte Cassino in Italy. He learns Latin and becomes a monk. Between 1070 and 1087 he translates

some of Galen’s works into Latin

G

In total, half of Galen’s writings survive to the Middle Ages. They form the basis of medical thought until the Renaissance

H

In the twelfth century more of Galen’s works are translated. The Christian Church agrees with Galen’s ideas because they reflect Christian beliefs about

the body being the best possible design, made in God’s image.

Medicine Through Time The Middle Ages:

Disease & its Treatment

What was religion’s role in medicine during the Middle Ages?

During the Middle Ages religion came to dominate all aspects of life throughout much of Europe. The Christian church established monasteries, which served as hospitals, and later began to provide training for doctors. At the same time, medical schools based on Islamic practice were gaining a high reputation at centres like Salerno in Italy and Montpellier in France.

I

Infirmary for the sick in 13th Century Europe

The Christian Church saw it as the duty of all Christians to help the sick and needy, but they had no particular method for treating disease beyond faith and prayer. The population relied on local healers, who were often women. By 1200, the training of doctors had become established, in universities in Western Europe which were controlled by the Church. The work of Galen was translated from Greek into Arabic and then into Latin. His ideas about medicine fitted well with Christian beliefs by abiding by a set of pre-determined natural laws. By and large, the Christian church during this period resisted any change. Dissection, for example, was forbidden until the 14th century, and even then it was strictly controlled and only took place in medical schools within universities. Students watched dissections carried out by the teacher’s assistant.

The Islamic religious influence was more positive in the Middle Ages. Islam reached the peak of its civilisation in AD 1000, with Baghdad as its capital. Based on the Qu’ran, the religion gave clear instructions on social responsibilities, such as the rich providing for the poor, and the healthy caring for the sick. On this principle, many hospitals were founded.

At the same time, Arab medical scholars greatly admired the works of the Greek doctors Galen and Hippocrates. They applied the Greek methods of observation to their treatments of disease. Rhazes was a Persian doctor who worked in the hospitals of Baghdad around 900AD. His methods of observation led him to discover the difference between measles and smallpox. This was one of the earliest recorded examples of a doctor being able to identify a specific disease.

Alchemists found new ways of purifying chemicals in their attempts to create gold. In Islamic cultures at least, religion furthered some aspects of the treatment of disease.

Think about this: How the early Christian church, despite its charity, hindered an understanding of disease

and its treatment How the instructions of the Quran encouraged charity and subsequent development of

public health care Why both Islamic and Christian religions supported the work of Galen.

Punishment from God

What’s the idea? This idea was particularly popular during the Middle Ages when the church was a very

powerful organisation. People had many superstitious beliefs in the Middle Ages; among them was the belief that

God and the Devil influenced health.

Tell me more Frightening epidemics like the plague were seen as God’s punishment for people’s sins. Even more personal disasters like the death of a child or sickness were seen as the result of

sin. Sometimes disease was believed to be a trial sent by God to cure people of their pride.

What next? This idea remained influential as long as the church remained powerful. As science

progressed and specific causes of disease were identified, the belief in punishment from God declined.

However, as recently as the early 1980s, many people saw the outbreak of AIDS as God’s judgement on homosexuals.

Portrait of

The role of monasteries

The factsThe best chance of living a healthy life in the Middle Ages would have been in a monastery. Why was this?

Although individual monks took a vow of poverty, monasteries were usually very wealthy because rich barons gave them land and endowments. Many monasteries were able to set up profitable businesses; the Cistercians for exam very successful sheep farmers. They used their resources to help the sick and the poor. Some monasteries had hospitals Monastery Hospital, Montserrat, Spainand all had sick bays for monks who fell ill.

Monasteries were also usually built in remote country areas, not in the centres of towns. Monks had plenty of time on their hands, and often experimented with herbs and plants which they made into medicines. Their treatments were based on these herbs and plants but also in their belief in the power of God. Patients were also kept clean and allowed plenty of rest.

Memory time… During the Middle Ages monasteries were very wealthy and some ran profitable businesses Some monasteries had hospitals attached; treatments would combine natural remedies with

religious faith Monks had the time and opportunity to experiment with creating medicines.

Did the Christian Church help or hinder medical progress?

What was the Church’s role in:

What does the Source show?

Explain how this helped or hindered the development of medicine

Developing new medical ideas

P76 Source 1

Knowledge of anatomy P68 Source 1P77 Source 6

Public health P77 Source 3P60 Source 7

Training doctors P57 & 68

Did the Christian Church help or hinder medical progress?

What was the Church’s role in:

What does the Source show?

Explain how this helped or hindered the development of medicine

Spreading medical knowledge

P57

Care of the sick P72-73

The search for effective treatments

P76-77 Sources 2 3 4

Licensing healers P69

Explaining disease P64-65