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5+ Outdated Medical Practices From the Middle Ages

I've spent half a century writing for radio and print (mostly print). I hope to still be tapping the keys as I take my last breath.

"Healing the sick" dates from 1442.

"Healing the sick" dates from 1442.

Medicine in the Middle Ages

For folk in the Middle Ages, it was best not to get sick; the primitive medical knowledge of the era meant the treatment (they didn’t have much in the way of cures) might be worse than the disease.


It seems that for almost every ailment that could fall on people there was one therapy―bleeding.

The practice of phlebotomy (the medical term for bloodletting) had been going on for a couple of thousand years by the Middle Ages. It’s curious then that nobody seems to have noticed it didn’t do much good.

The weapon of choice for the physician was either a sharpened piece of wood or metal. With this instrument, a vein in the arm or neck would be opened and blood allowed to flow into a bowl. When the blood drawer judged enough had been spilled to cure the unhappy spleen, gouty big toe, or whatever, the incision would be closed by compression.

The victim, sorry, patient, looks surprisingly cheerful given the circumstances.

The victim, sorry, patient, looks surprisingly cheerful given the circumstances.

The Use of Leeches

A slightly less agonizing treatment was the use of leeches. The little bloodsuckers can siphon off almost 10 times their own body weights.

Eventually, bloodletting surrendered its supremacy to science, although it is used today in dealing with hemochromatosis, a condition when there is too much iron in the blood, and a couple of other rare illnesses.

Letting the leeches have a feed.

Letting the leeches have a feed.

Urine Tells All

Archimatthaeus was a twelfth-century Italian physician. According to him, everything that needed to be known about a patient’s health could be found in the bladder. “While you look at the urine for a long time,” he wrote, “you [should] pay attention to its colour, substance and quantity, and to its contents.”

In 1506, Ulrich Pinder published his medical text, Epiphanie medicorum. The book contained a colour chart advising physicians on what to look for in a flask of urine.

The so-called Urine Wheel “was used for diagnosing diseases based on the color, smell, and taste of the patient’s urine” (Scientific American). Of course, those medieval pee analysts were not as far off the mark as the bloodletters. Many illnesses can cause changes in urine and it’s still a major diagnostic tool used by doctors today, although family physicians no longer do the taste test.

However, once the nature of an ailment had been discovered, the hapless patient was likely to be tossed back into the clutches of the bleeders.

What Was Trepanation?

This is not for the squeamish. There’s evidence that people have been knocking therapeutic holes in the heads of other people for at least 7,000 years.

Trepanation is described by the BBC as “a crude surgical procedure that involves forming a hole in the skull of a living person by either drilling, cutting, or scraping away layers of bone with a sharp implement.” It’s not clear why the procedure was carried out in pre-historic times but, by the medieval era, it was used to treat a variety of maladies.

A 2011 study in Spain came up with several explanations for trepanation:

  • “Magic/religious reasons such as to free people from demons that could be torturing them;
  • “Initiations as a way of giving right of passage to adulthood or to turn someone into a warrior;
  • “Therapeutic reasons to treat tumours, convulsions, epilepsy, migraine, loss of consciousness, and behavioural changes; and,
  • “The treatment of traumatisms like skull fractures.”

Thank goodness we’ve left such brutal procedures behind us. But, we haven’t.

Trepanation is one of those things that can become a fad from time to time.

In the late 1990s, an organization called the International Trepanation Advocacy Group rose from the ashes of discredited medicine. Its founder, Peter Halvorson, advised people on how to do self-trepanations, and there were those who thought it was a good idea.

Hieronymus Bosch, in about 1494, painted a surgeon performing a trepanation.

Hieronymus Bosch, in about 1494, painted a surgeon performing a trepanation.

Astrological Therapy

Would anybody today base a course of treatment for sciatica based on when Jupiter is in a state of perfect harmony with Orion? Okay, silly question, because there are people around who might do just that.

In the Middle Ages, there would have been many more takers of medical advice based on the alignment of planets and stars. The Zodiac Man appeared in many medical texts noting that particular body parts were supposed to be associated with certain signs.

  • Leo―heart, spinal column, upper back
  • Sagittarius―thighs, hips, and legs
  • Aquarius―circulatory system, ankles, and calves

A tiny bit of doubt is shed about the efficacy of astrological medicine by the fact that practitioners believed in a geocentric Universe, in which planets, moons, and stars rotated around Earth. So assumptions made about celestial influences on health were completely upside down.

Never mind, Encyclopedia explains that “Even in the twenty-first century medical astrology practitioners continue to claim that they can predict potential illnesses and select the best time for surgery.”

A Royal Pain

The medieval period is generally said to have ended with the Renaissance of the fourteenth century, however, primitive remedies were still being used at the end of the seventeenth century.

In early February 1685, King Charles II of England suffered a seizure. His medical staff rushed to his side and determined the monarch needed to lose some blood. They drained 16 ounces (half a litre) from him.

This was deemed to be insufficient to cure the ailing king, so they took another eight ounces (250 ml). This was followed by a drug to induce vomiting and a couple of enemas. Then, they plastered his feet with pigeon droppings and put cowslip flowers on his stomach, as you would. Although how you would procure cowslip flowers in the dead of winter is not explained.

The following day, Charles appeared to have perked up so, of course, another 10 ounces (third of a litre) of blood was withdrawn from the royal body. Various potions were administered and the monarch slept peacefully.

On day three of the treatment, the king had another seizure. describes how the medical team sprang into action: “His doctors bled him again, after feeding him first sienna pods in spring water, and white wine with nutmeg; next a force-fed drink made of 40 drops of extract of human skull, taken from a man who met a very violent demise, as well as a gallstone (the Bezoar Stone) from an East Indian goat. The physicians proudly announced that the king was going to survive.”

So, of course, he lapsed into an irreversible decline punctuated only by more bleedings, enemas, and force-feeding of potions that became more exotic by the day.

After, six days of being subjected to the excruciating care of his physicians, Charles II told those attending him “I have suffered much more than you can imagine. You must pardon me, gentlemen, for being a most unconscionable time a-dying.”

Shortly after 11 am on February 6, 1685, the king died at the age of 54.

Charles II

Charles II

Bonus Factoids

  • Heather Perry, 29, of Gloucestershire, England, travelled to the United States in 2000 for a trepanation. Under the supervision of a couple of self-described experts who did not possess medical qualifications, she used an electric drill to bore a two-centimetre hole in her head. She claimed it relieved her of the curse of depression and chronic fatigue syndrome but she continued to quieten her demons with street drugs. She died in 2012 from an overdose of diazepam and morphine.
  • Those with cataracts underwent a procedure known as couching. Using a thorn or needle, the practitioner pierced the clouded lens and pushed it downwards. Sometimes, the patient got limited vision back, sometimes they went completely blind.
  • Life expectancy in the medieval era was 30 to 35 years; the average being dragged down by a very high mortality rate among children, with about one third dying before the age of five.


  • “The History of Bloodletting.” Dr. Jerry Greenstone, British Columbia Medical Journal, January/February, 2010.
  • “Medicine in the Middle Ages.” Dr. Alixe Bovey, British Library, April 30, 2015.
  • “The Urine Wheel. Christina Agapakis, Scientific American, October 18, 2012.
  • “Medieval Medicine: Killer or Cure?” Elma Brenner, BBC History Extra, August 9, 2018.
  • What a Chart of Urine Tells Us About the History of Color Printing.” Sarah Laskow, Atlas Obscura, February 27, 2018.
  • Why Our Ancestors Drilled Holes in Each Other’s Skulls.” Robin Wylie, BBC Earth, August 26, 2016.
  • “Evidence of Trepanations in a Medieval Population (13th-14th Century) of Northern Spain.” Belén López, et al., Anthropological Science, 2011 Volume 119 Issue 3 Pages 247-257.
  • “Curiosities of Medical History: Trepanation.” Medical News Today, undated.
  • “Britain’s Charles II’s Medical Treatment Led to His Suffering and Death.”, March 12, 2018.

This content is accurate and true to the best of the author’s knowledge and is not meant to substitute for formal and individualized advice from a qualified professional.

© 2020 Rupert Taylor


Miebakagh Fiberesima from Port Harcourt, Rivers State, NIGERIA. on April 15, 2020:

Hi Rupeqt, what an interesting read. Pockets of such practice can exist today in any primitive tribe. Some voodoo church did these things nowadays. Thanks for digging down into medical history and sharing.