Combating Disease in the Medieval Period (GCSE Example Answer)

Here is an example answer to the following 16-mark question on approaches to combating disease in the medieval period.

‘Approaches to combating disease in the medieval period were a failure’. How far do you agree?

Marks: 16 marks + 4 marks SPAG

Stimulus = The Black Death, 1348-49 / Hospital care

[Examiner commentary following each paragraph and at the end is provided in italics]

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I agree with this statement to a large extent and this is because knowledge about causes of disease were often inaccurate, which meant ways of preventing or treating disease were ineffective too. If there were successes, these would be more through luck than judgement.

[Clear judgement established from the outset, however this could benefit from development as to why one has arrived at this judgement.]

In terms of outright treatment, a lot relied on superstition and religion, which may have given the patient peace of mind but did nothing to rid them of the specific disease affecting them. Because people believed that disease was often a punishment from God or sent by the devil to test their faith, common ways of combating disease included praying, fasting, touching holy relics and lighting a candle proportionately as tall as you (or as long as the body part you wanted to heal). For those with means (and relative health) pilgrimages to holy sites known for healing powers were popular too. In more extreme cases, unrelated to religion, some superstitious treatments included boiling a fox in water and then bathing in it to treat paralysis as it was believed that the quick and nimble properties of a fox would transfer into the patient. It was also widely believed that the King had the power to heal certain illnesses, especially scrofula (a type of tuberculosis). During his coronation, his hands would be rubbed with special holy oil and this, it was believed, would give him supernatural powers. Edward I, for example, aimed to touch 2000 people a year. Importantly, as the desperation of the Black Death took hold in England between 1348 and 1351 one preventative measure even included flagellation (where one would whip themselves publicly to show God they were sorry for the sins of man), or to rub a shaved chicken on the buboes in the hope there would be some transference of the illness. Here then, such a variety of examples to treat and prevent disease were clearly based on a lack of scientific knowledge and understanding of the causes involved. This is also proven by (much to the disapproval of the Church at the time) the adoption by some of spells, chanting and the use of charms to ward off evil spirits.

[Accurate and relevant information precisely selected here. Clear link back to the question, with reference to a major theme like causes of disease, helps to support the original judgement.]

In some cases, the medieval era either had the wrong solutions, or the right solutions to the wrong problems. Either way, combating disease was ineffective. The dominance of the four humours in medieval life (where illness was often attributed to the imbalance of one of the humours) meant that many common, recommended treatments were in fact detrimental to the patient and made them weaker. For example, bloodletting was often used as it was believed that ‘bad blood’ would leave the body. This could take place in three ways: either cutting a vein, using leeches or cupping (a heated cup would be placed over a small wound which drew blood out). Bloodletting was even believed to be a way of treating depression. Conversely though, emphasis on purging the body meant that some beneficial treatments to minor problems could work. Purging, where patients were given an emetic to make them vomit or a laxative to help them excrete other waste, did sometimes benefit patients. Elsewhere, because bad air and bad smells were believed to cause illness (known as miasma theory) people carried flowers around or threw sweet smelling flowers (like lavender) around to purify or ‘clean’ the air. Whilst this was ineffective, it did lead to efforts to ensure no rotting animals were left around in the streets or that particularly dirty toilets were cleaned. Even though the medieval era was incorrect in believing bad smell caused disease, there was clearly a flawed logic in linking smell back to the importance of cleanliness. However, by the time of the plague, cleanliness as a way of combating disease was rejected. Instead, it was believed the foul smells of the rubbish and rotting bodies would in fact overpower the smell causing the plague. Here then, the lack of understanding of the causes of disease once more highlighted how quickly ways of combating disease could change and thus be ineffective.

[Wide-ranging knowledge with supporting examples adds persuasiveness to the argument. Counter-argument embraced (which all 16-mark answers need. The ‘how far’ / ‘to what extent’ nature of the question means there are always limitations to the view outlined).]

However, in other ways, especially with prevention and care, the medieval period was quite successful. For example, the medieval era was aware of contagion, which meant that plague victims were quarantined. People new to an area had to remain isolated for 40 days to ensure they had not been infected by the plague before they arrived. Even the Pope’s physician, Guy de Chauliac, recommended people to ‘go quickly, go far and return slowly’. Lepers too were placed in leper houses and in extreme cases, island communities. They were even banned from going down narrow alleys to avoid contact with others, as it was believed disease could be passed by breathing on others. There was some instruction with public health too in a document known as the Regimen Sanitatis which was logical and offered good advice (largely however due to the incorrect emphasis on balancing the four humours). For instance, the Regimen Sanitatis recommended a healthy diet and exercise, bathing and avoiding stress. It also stressed public safety by recommending people to avoid drunks and barking dogs. Lastly, herbs were used for different illnesses, with various ingredients including aloe vera, mint, chamomile, rose oils, saffron and almonds. Such natural ingredients are still commonly used today in the promotion of wellbeing. However, not all herbal remedies were effective and the apothecaries responsible for remedies were not bound necessarily to do the best by their patients. They sometimes prescribed poison as a way of ridding a patient of illness too. It should also be noted that hospital care was a feature of medieval life, with around 1100 hospitals by the year 1500. However, the emphasis lay in caring for the sick rather than treating the disease, which meant that patients shared beds, with rest and prayer the priority.

[Specialist knowledge and historical terms evident, with support of specific examples. This not only gives the writing more impact, but helps guarantee the 3-4/4 for SPAG which forms 20% of the final mark. Where possible, statistics are useful in the analysis. They help showcase the scale/importance/relevance/popularity of something and are superior to generalised statements.]

Overall, whilst the medieval era had awareness of contagion and issues of healthy dieting and promoted at different times the importance of cleanliness and herbal remedies, the overpowering influence of the Church, the dominance of the four humours and its links to bloodletting, as well as the myriad, desperate responses to the Black Death, revealed how little was known about the causes of disease in the medieval era. This meant that combating disease during this time can largely be seen as a failure.

Overall Examiner Comments:

Level 4, 13-16 (+3-4 marks SPAG)

A thoroughly analytical answer that goes beyond the stimulus points and demonstrates wide-ranging knowledge of relevant information throughout. The answer is filled with specialist historical terms, regularly goes beyond the stimulus points, frequently links back to the question, embraces counter-arguments and reasserts the criteria for an overall judgement in the conclusion.