Did early medieval medicine ever work?

An unfortunate popular view of the “Dark Ages” is that life was nasty, brutish, and short. A scratch from a scythe was certain death, right? In a couple of earlier posts I looked at both disease and what might be called conventional medicine. While the saint’s lives are full of demonic possessions that look to us a lot like epilepsy, medical practitioners had a reasonable body of knowledge from which to draw. But what about medicine in the real world?

It doesn’t take too much effort to find a few examples of practical medicine which allow us a view into a side of daily life that is often obscured by popular imagination and overlooked by the sources. A few years ago Austrian archaeologists excavated a sixth century Merovingian grave that revealed a medical surprise. The occupant, a middle aged man, had lived for a least a couple of years after somehow losing his foot and ankle, and had gotten around on a prosthetic foot! The artificial foot was made of wood and leather, with a base made of an iron ring of some sort. No, I don’t know what that vicious looking spike coming out of the ring was for.

It probably wasn’t nailed into the remaining leg bones. As you can see in the second image, the ring was found about a foot (maybe I should say twelve inches…) from the remains of the leg. The bones show a darkening that might be the result of a leather pouch or other mechanism to further stabilize the prosthesis. The cause of the loss is, unsurprisingly, completely unknown. He was a high status individual, buried with grave goods, inside the churchyard, so it probably wasn’t a judicial punishment. Perhaps his foot was crushed somehow, and the docs (who until fairly recently, you may remember, were called sawbones) cut off the worthless remains cleanly, so that healing could begin. The amazing thing is that the man lived for at least a couple of years after he received medical attention.

If you really want the nitty-gritty, with more pictures, check out the article in the Journal of Paleopathology.

While I began this post with much tut-tutting about how crass and wrong people are to misjudge the early medieval period, we should also note that surviving an injury like this must have been extremely rare. With only rudimentary pain medication and no antibiotics, the initial injury and medical intervention must have been extraordinarily painful, and the subsequent recovery both painful and unusual. But it did happen.

If we allow ourselves to wander a century past our usual temporal haunts, and cross the Channel, we can turn to Bald’s Leechbook. This ninth century book of remedies includes a great many wonders, but one in particular made the news recently, in literally dozens of outlets. A team in England formulated the recipe for an eye salve. When the team ran some tests the salve turned out to be effective against MRSA, or methicillin-resistant Staphylococcus aureus. The sharp-eyed among you no doubt noticed the word “resistant” in there, which means that modern antibiotics have a tough time against that particular bug.

Fear no more! All you have to do is put together a mixture of garlic, onion or leeks, wine and cow bile, and let steep in a bronze or brass vessel for a week or so. Another victory for the history nerds, or so we all hope. I was wondering how it came to be that a scientific team came to select that particular recipe, and then to test it against that particular infection. In my search for answers I came across an opinion quite contrary to the mass hoopla. Helen King is a Professor of Classics with the UK’s Open University. She entitled her essay “Why I wasn’t excited about the medieval remedy that works against MRSA“, and she lays out some great points.

First she points out that this same remedy was tested in 1993 and 2005, with mixed results. Then she lists the problems that “apply to all such attempts to rediscover ancient remedies.” How to properly identify the ingredients? Names change all the time. Which ingredients should be tested, particularly if one of them is a puppy? You should read her thoughts and concerns to get a flavor for the nature of this debate.

In the comments for the essay the leader of the project, Freya Harrison, responded. She expresses astonishment that news of “an interesting side project that might result in some interdisciplinary conversation and possibly a short paper in a specialist journal” exploded in the cybersphere. She also notes that her team is also working on the linguistic issues, as well as reaching out to the 2005 team to find out what the two groups did differently. All in all the exchange is a fascinating example of how science, history, and the interwebs all come together, for good and ill.

Healed bone is one of the few ways we can detect practical medicine at work, as with the prosthetic foot above, because it is the only bodily material to survive. A find from Italy dating from between the seventh and eleventh centuries, provides another example of successful practical medicine. An article from the Journal of Paleopathology from 2000 presents the details.

The skull of a “vigorous male, between 40 and 50” was found in a cemetery in Cremona.^1.Cremona is not too far from Pavia, the Lombard capital. Is it too much to hope that we have stumbled onto a casualty of the Frankish-Lombard skirmishes? Probably, but hey… He had suffered a smashing blow to the face by “a blunt weapon with a narrow surface” which resulted in shattered bone around his left eye, forehead, and nose. The cause of this blow is impossible to determine, but, for fun, imagine a hammer between the eyes.^2.The authors of the article mention a mace or axe, but I don’t see how a mace is narrow, nor an axe blunt. This wound, as if it wasn’t bad enough, caused an “epidural abscess“, which is an infection and pus-filled swelling between the skull and the outer covering of the brain. To relieve and drain the infection someone went in and drilled or cut a hole through the skull near the wound site. A deliberate hole cut into the skull is called a trepanation, a procedure with a rich history, and well worth some additional reading.

But the important bit here is that “Macroscopic and X-ray examination of the edges of the fracture indicate a long survival of the subject after the wound.” Truly amazing. A guy takes a hammer to the face, hard enough to shatter the bones and cause swelling behind his skull. Without anesthesia or antibiotics^3.Well, probably no antibiotics – see above. someone cuts another hole through his skull to relieve the pressure of the infection. Our man goes on to live many more years, albeit probably with a pretty pronounced facial feature. And an excellent story.