Bald’s Leechbook: The Doctor is In

I find as I do research on the so-called Dark Ages that time and time again, my preconceived notions about what life must have been like have been proven wrong. It’s hard to fight against the popular culture’s perception of the Early Middle Ages, that perception that people’s lives were “nasty, brutish, and short.” The Roman Empire had collapsed, the barbarian hordes had destroyed civilization as we know it, and the world was plunged into a cultural, scientific, and artistic darkness that would last until the Renaissance.

Some of that is true, up to a point. But the more I read about this time period, the more I find ways in which all of those assumptions are challenged.

Take medicine, for example. How did people treat the various diseases or injuries they suffered? I don’t know about you, but what springs to my mind is a muttering priest praying over a patient or a cackling crone stirring up a brew of some entirely unhelpful mix of ingredients, and administering it, along with a spell or two, to the sick.  Mainly, I imagine that people died of things that are easily cured today, and that people then had no idea of how the human body worked or how to fix anything that might go wrong with it.

Well, the truth is skirting around the edges of those ideas, to be sure, but perhaps, like me, you will be surprised to discover exactly how medicine was practiced in those days.

First of all, I have explained before about how the lack of written material from this era makes it hard for us to understand the customs and people of the day. But surprisingly, there are around five hundred leaves of connected medical texts in Old English that survive from this time period. So when you think about how little written material we have, to have this many medical texts surviving gives you a clue that there must have been a lot of medical texts available at the time.

The most important of these texts, called Bald’s Leechbook, presumably owned or named after a physician named Bald, comes to us from the ninth century, but is a copy of a work from about fifty years before. A leech was another name for a physician, because, yes, they did use leeches to treat some ailments (they are surprisingly effective in reducing swelling and bruising after an injury, because they are great at sucking blood out). It is a compilation of the best of medical knowledge stretching back to the Roman and Greek empires, and ultimately back to the celebrated Roman physician, Galen.

This gives us an important clue that the medical knowledge of the Greeks and Romans was not lost in Dark Ages Britain. From references in Bede’s histories, we see that both laymen and clerics were named physicians. And from looking at the remedies prescribed in the Leechbook and from other sources, we can see that a wide variety of cures and treatments for various maladies and injuries were available to the Anglo-Saxon physicians of the time. Most of these were plant-based herbal remedies, made up of both locally available plants and even some exotic ingredients such as cinnamon, pepper, or ginger, that would have been obtained from the far East through Arabic traders into the Continent, finally reaching Britain.

Some of these ingredients were helpful, some neutral, and some harmful. Others, containing ingredients such as garlic, onion, oxgall and copper salts, are very useful indeed against bacterial infection.

Just how useful was proven in 2015. Microbiology experts at the University of Nottingham recreated a recipe that was meant to be an eye salve, for eye infections. At the time, of course, physicians had no idea of bacteria or viruses, but found this recipe effective against eyes that were inflamed and sore. The university scientists recreated the recipe, consisting of crushed garlic and onion, 25 ml of English wine (which they obtained from a historic vineyard near Glastonbury) and bovine salts dissolved in distilled water. Bovine salts consist of dried bile from a cow’s intestine, in case you were wondering (I had to look it up, too!).

They thought it might have some positive effect, based on the ingredients, and made a large batch, which they tested on one of today’s antibiotic-resistant superbugs named MRSA. To their great astonishment, the mixture wiped out almost 90% of the MRSA bacteria. They cannot completely explain this, for the ingredients, separately, will not have the same effect. So it is the combination of the ingredients mixed together that prove effective, and they cannot, as of yet, explain why or how. Research is continuing.

There is evidence from studying skeletons found from this era, and from treatments prescribed in the Leechbook,  that surgery was also attempted at this time, and in some cases, successfully. Amputations for gangrenous limbs, using silk thread to suture abdominal wounds, and even plastic surgery in terms of suturing cleft palates was practiced.

Even brain surgery. Yes. Some skulls from this period (and even from pre-historic times, believe it or not) show evidence of trepanation. This is the drilling of a hole through the skull to expose the dura mater that covers the brain. This could be done after a head injury, to clean out the bits of bone and blood that collect under the skull and relieve pressure and pain that results. If you have ever drilled a hole in a fingernail to relieve that throbbing pain that results from an injury to a finger where blood is collecting under the nail, you get the idea.*

Even more astonishing than the fact they attempted this is the fact that the patient often survived, as shown by the trepanned holes in the skulls being edged with new bony growth, meaning the person lived for some time after.

There is, however, some “darkness” in Dark Ages medicine. There were certainly things that physicians could treat – mending broken bones, infections resulting from wounds, etc. However, there were maladies that they had no understanding of the causes and therefore had to resort to guessing how to fix it, or to charms. Things such as eczema or allergic reactions, or even the plague, would have been beyond their understanding as they didn’t know about the causes of these and so could not treat them.

Enter the Lacnunga (“Remedies”), a tenth century collection of medical and related materials. It is this collection that has given Dark Ages medicine it’s bad name, so to speak, for here we find the various remedies for ailments that involve charms, incantations, and other odd practices. Often they are a combination of ancient pagan practices with Christian prayers or symbolism. So we have, for example, this charm:

If cysts pain a man at the heart, let a virgin go to a spring which runs straight east, and draw forth one cup full, with [in the direction of?] the current, and sing thereon the Creed and Pater noster, and then pour it into another vessel; and let him/her draw again a second and sing again the Creed and the Pater noster; and do so that you have three [cupfuls]; do this nine days; soon he will be well.

 

Here we see sacred waters (the spring), running east (the direction of the coming Day of the Lord, when Christ will rise in the east), the virgin (note male or female), the number three, the number nine, the Creed (the Apostle’s Creed, the fundamental beliefs of every Christian), the Pater Noster (the Lord’s Prayer). This is a marvellous mixture of both pagan and Christian elements, and it shows in a very elemental way how the culture of the time was being tugged between these two belief systems, just as do Beowulf and the insular art of the Lindisfarne Gospels.

But as a medical treatment for “cysts of the heart” (whatever that may be), it is, of course, useless. Except in the giving of hope, which as we all know, is a powerful kind of medicine all in itself, so it’s not to say that these charms were always ineffective.

So were Dark Ages physicians simply ignorant hacks that killed more patients than they cured, using guesses and folklore to treat their patients?

I believe the evidence says no. As the Blackwell Encyclopedia of Anglo-Saxon England states, 

If we can trust the evidence of the surviving medical literature it appears that Anglo-Saxon medicine was no worse than any other of its day, and that at its best it was probably better than most.

And maybe even better than our own, in treating MRSA, at any rate!

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*I never, ever do this. My hubby has done this to himself. I can’t watch. I can’t even imagine doing this to treat a head injury. “Come here, Ecbert. Let me drill into your head with this big drill. It will make you feel better. Honest. “ Yikes. They were made of sterner stuff than I, to be sure.

 

Featured image: a facisimle page from Bald’s Leechbook, from Wikipedia