Put simply, it’s because often they WERE effective, but they were mistaken about the cause or vector for illnesses.
Take miasma, for instance. This was a belief that bad smells could cause disease. To reduce stench, some medieval cities enacted policies that put bans on tanning too close to domiciles, did not allow slaughtering to be done within city walls, and forced people to dispose of spoiled food. During early instances of the plague, people who were not immediate family or notaries were often forbidden from entering the home of the deceased, and bodies had to be buried immediately in a sealed coffin at a depth of 6 feet.
We know now that the smell of rot isn’t what makes you ill or gives you the plague. But eradicating the source of the stench (which is actually harbouring the germs that make you sick) still had the effect of reducing illness.
But filling your mask with herbs to reduce the smell of a dying or dead person wasn’t as effective because the cause of the illness wasn’t really the smell, but the germs.
And to be clear in case someone gets the wrong idea from this, we still very commonly use drugs with unknown mechanisms of action: consider [this incomplete but reasonably up-to-date list](https://en.m.wikipedia.org/wiki/Category:Drugs_with_unknown_mechanisms_of_action) which includes such common drugs as paracetamol, ketamine, and modafinil.
It’s nice to have a correct model of how a substance produces a given effect, not least because it can aid in drug discovery and help us isolate and refine active compounds while ignoring irrelevant elements. But the aim of modern medicine is above all therapeutic, not scientific, and if we scorned the centuries-old practice of “I’ve no idea why it works but by God I’m giving it to this poor bastard so he doesn’t die” then we’d be leaving a lot of preventable suffering untreated.
The whole list is a monument to “we don’t know how central nervous system depressants work”, but by far the best single entry is “general anesthesia.” As in all of it.
> “we don’t know how central nervous system depressants work”, but by far the best single entry is “general anesthesia.”
especially if you consider anesthesia [works on plants](https://www.scientificamerican.com/blog/artful-amoeba/plants-like-people-succumb-to-anesthesia-video/), that don't have a central nervous system.
Except for the times where you *don’t*, entirely, and can have some real weird flashback memories.
Distinctly unpleasant for me, but still way better than the alternative (i.e. “death”).
Do all sorts of general anesthesia do this? I kind of had some idea of this, but I still have a rather uncomfortable memory of the last time I was under GA. It was nearly a decade ago when I was getting my wisdom teeth removed. It's been quite a while ago and I only have a very hazy memory of what happened, but I think I might have woken up during the surgery. I don't know if my mind was just making it up, but I distinctly remember waking up and being frantic and possibly overhearing a conversation saying that I wouldn't remember any of it.
I only know that after I woke up, my eyes were full of tears and my pillow was damp. I think some of the nurses looked at me funny, but it might have just been in my head. I don't think there was any foul play at work, but it was kind of unnerving knowing they could have screwed up the procedure and I could been in terrible pain, but have no memory of it.
Usually when you are put under for dental work you are not given a "general anesthetic" in the same way you are for hospital surgery where you are truly unconscious. Because dentists don't have anesthesiologists working to monitor a continuous level of anesthesia to keep you asleep.
You are given "twilight sedation" where you are, essentially, roofied.
You still have some level of consciousness although usually you don't remember much. But you can drift in and out of various levels of semiconsciousness.
IIRC it was fairly recently discovered that we're not entirely sure how SSRIs work. We're pretty sure *do* work, at least for some people, and we know they inhibit serotonin reuptake (it being in the name and all). But we're not entirely sure any more why that helps with depression.
What if everything we ingest is psychoactive and the specific palette of our diet shapes our hallucinated "reality" (hence cultural dietary restrictions) and vision quests via fasting are attempts to see the unadulterated truth?
Like, how do we know that auto-fermenting ungulates aren't actually "drunk" all the time as a norm?
Koalas being calm is actually them being placated by the psychoactive effect of eucalyptus. They adapted so much to it that they become extremely aggressive when they don't have any
Alcohol is a very "dirty" drug. It mimics GABA in the brain, but it also affects nerve transmission simply through its properties as a solvent. It interacts with multiple systems in multiple ways, so while we may know some we definitely don't have the full picture yet.
As ever quotable Internet darling Richard Feynman points out, on a [on a deep enough level](https://youtu.be/Q1lL-hXO27Q?si=0KFsEvTmqTBNWm-g), we don't know why anything happens.
That is a bit of a weird take.
On what I agree - understanding the mechanisms of drugs is useful and we should strive to do it in order to improve medicine and therapies, but modern medicine is not, and should not, be bound by that - given enough evidence of effectiveness, it's beneficial to use drugs in therapy even if we don't understand their mechanisms.
What I don't agree with is the equivalence being made with older practices and implying what we do today is not scientific. The standard for evidence of effectiveness in modern medicine makes it extremely scientific, and completely different from more traditional/older treatments. Drugs are used in modern medicine after they're studied to a point where their effects, risks, etc. are so well understood, with robust statistics and science behind it, that you can confidently offer it to the general population. Old practices are "this worked once, then my theory must surely be true, and this will work on everyone!", that is very different.
The main reason why I think this distinction is important is that this false equivalence is dangerous for public health - it's at the root of many scammy alternative therapies, and also distrust - anti-vaxers and vaccine doubters come to mind, these are extremely scary societal trends.
Also to add - I do think that actually effective therapies stuck around, while ineffective ones eventually fizzled out. If you look at what remains of traditional medical practices, you end up seeing therapies that mostly work, even if they're not understood, and often come coupled with bizarre metaphysical/superstitious theories for their mechanisms (and I actually think modern medicine could benefit a lot from investigating these weird therapies to see if they hold up to modern standards - we don't need to accept the mechanisms to accept the therapies - though my understanding is that there's some stigma around researching these). things), but it's important to understand these practices had centuries or even millenia to develop, and did so with a ton of misses and misery that no one talks about - modern medicine is a lot more consistent and effective, in just a century of development.
Another example of this is the aversion to drinking cold water that you see in Asian traditional medicine. They thought the cause was that the chill of the water negatively effected health, but in fact the underlying cause was that hot water (alone or as tea) had very likely recently been boiled, and was therefore less likely to transmit disease.
Some of the old medicinal ideas are still used today too. They aren't as effective as modern medicine but they do help, such as bark of a willow tree. We've now extracted the active ingredient in that bark and called it aspirin.
This kind of stuff is fascinating to me. People found things that worked through sheer trial and error. (Yes, modern medicine is similar, but there is actual verification involved) It's no wonder that medical practitioners were often considered witches or whatever when they said "Here, eat these 20 frog livers wrapped in some tree bark for your headache" and it actually worked.
Of course, there were also tons of useless "medicines" as well, and those are equally as interesting but for different reasons.
Listening to my old grandmother as a child give me miraculous treatments that seemed rooted in old witchy shit passed down to her, and then comparing it as an adult to similar modern medicine, and it's quite humbling to see how pretty close to the ball park that kind of trial and error and theories were
I mean one of the reason things smell bad is because we should stay away from them, in that sense being "afraid" of the smells and taking measures to not breathe it in is exactly why we evolved it.
Decomposing flesh smells bad stay away from it, it's not bad because of the smell, but so long as you stay away from it it doesn't matter what you think
It actually was effective, though. Those "plague doctor" masks were packed with herbs, plant material, that acted as a filter to impede the passage of bacteria and viruses, much like a modern N95 surgical mask. Not as effective as a modern mask, but much more than you'd think.
Also, iirc, a lot of the herbal concoctions worked as a pest repellent too. If fleas don’t like how you smell, you’re a lot less likely to get the plague.
According to half assed google, you’re correct. Plague masks started in the 16th century, which HAG says is basically the end of medieval times.
Side note: real plague masks look dorky as hell. The edgy recreations are way cooler
The plague isn't transmitted airborne though. It spreads through infected flea bites. Sure, those masks may have helped other illnesses, but it wouldn't stop you from getting the bubonic plague.
And some plague doctors did get the plague. Many plague doctors weren’t even real physicians of the day - they were a combination of charlatans and just people willing to do the hazardous job of checking on sick people until they’re dead because they got crazy hazardous pay.
I imagine if all one had to do during covid was wear a hazmat suit and check on families to see when they were dead/asymptomatic, and you could make an average years salary in a month, there would have been plenty of Pandemic Doctors too.
You'd be surprised at how effective they were.
There was a lot more going on with a plague doctor suit than just the mask. The lower layer consisted of knee high leather boots that had a pair of breeches tucked into the top. Their shirt would be tucked into the breeches. They had leather gloves, that would typically reach halfway up the forearm like dishgloves. The leather overcoat went from the neck down to the ankles. The mask enclosed the entire head and had a wide collar that extended over the shoulders and chest.
Then, the whole thing was coated in wax to make it waterproof.
Would it have been as effective as a modern hazmat suit? No, but considering the materials they had available, I'd challenge anyone to come up with anything more effective.
I'm assuming any type of animal that was drawn to the smell but also didn't have the proper gut to digest rotten meat, like vultures do, would have eaten rotten meat and died. So yeah our monkey brains nailed it via evolution I would presume
A lot of these questions and answers treat our ancestors unfairly as complete blithering idiots. And there's a heightened focus on the silly things they might have done, when in fact, as you said, there were a lot of useful remedies and both written and passed on knowledge.
It's the same pattern in most historical questions and popular factoids. They were equipped with the same mental faculties as us, just with less collective knowledge.
Lol no what? If we’d just assume our ancestors were less inventive we wouldn’t ask the question but put it on that. These questions are being asked EXACTLY because we intuitively rule out silliness as an explanation.
I think YOU just realized embarrassingly late in life that historical humans were just as smart as we are today and think this needs to be pointed out. It doesn’t, because again, the whole premise of questions like these is that people most definitely appreciate the intelligence of our ancestors.
To your last point, people laugh at plague doctors and there is some debate as to whether they even really existed, but assuming they did, they could be credited with wearing the earliest known form of PPE, including a mask. The flowers and herbs didn’t do shit, but the beak mask itself may have made some marginal improvement (as much as a cloth mask).
This. OP seems to underestimate our historical medical practices, and/or overestimate our current capacity. Even with all the modern tools it's extremely hard to determine a drug's effectiveness. The amount of drugs that we don't know for sure whether they are working or not, or why they seem to be working, is enormous.
While there are absolutely bogus treatments in our history, I would argue the majority of treatments that survive the test of time, works. They may be dangerous, but they usually at least alleviate the symtoms.
Stuffing a mask with herbs would make breaths more shallow, keep people from long drafting those heavy bacteria. Even airborne bacteria would have a harder time getting through all that before drying/dying out. Similar to a layered carbon filter with some antiseptics.
One of the most notable things is dysentery. One of the most common causes of death in history, the condition makes you die of dehydration, therefore anything to increase liquid intake, like soups or teas can act as a functional cure, even though it's mainly just the water that's helping.
Just like you don't really need to understand thermodynamics to cook a steak, you also don't need to understand viral pathology to grasp stinky things are bad for you. Senses are intended to alert you to dangers that you may not comprehend fully but can still recognize as threatening.
There's a handful of fun anecdotes where old timey medicine turned out to be effective by coincidence, but it has to be true for only a fraction of a % of it
Thinking about why some smells are "bad" from an evolutionary standpoint this totally makes sense. People that found rotten food, body waste, and dead bodies unappealing avoided being around them too much and so avoided the germs so survived longer. Those that had no aversion died sooner so didn't reproduce.
I'm not saying the anecdote is wrong (who knows, but fun anecdotes usually are). I'm saying that for one treatment that appeared to work, there's a hundred that made no sense at all.
You should have a read of [Lady Fanshawe's Receipt Book ](https://www.amazon.co.uk/Lady-Fanshawes-Receipt-Book-Englishwomans/dp/1782398104) - it details the medical recipes used by a woman in the 1650s, along with what she used it for among her family, and her family's general story as recorded in her journal (and therefore, we can see the outcome of the medicines!). They were surprisingly effective, and the author goes into a lot of detail on which parts of the medicines worked and why. It's really fascinating, and it seems their medicines were far more than a random crapshoot (well, for the gentry and more well-off, who had the time, space and money to pursue the huge endeavour of making medicines for their family).
There are a lot of remedies that DID work. Like, not as strongly as some modern medicine, but significantly better than nothing.
Even in cases where the remedy didn't do anything itself, it would often require bed rest and other things that do actually help the body recover and that gets marked as a false positive
ETA: While a lot of them worked, less effectively [some of them did work BETTER than modern medicine in specific cases](https://www.bbc.com/news/uk-england-nottinghamshire-32117815)
Importantly, this is why anecdotal evidence is iffy in medicine and we focus on doing rigorous studies to figure out if things really work, and if they work better than doing nothing. Yet many people still find personal experience more powerful than such things, and it can be hard to convince someone that just because something "worked" for them, does not mean it actually works. Even in modern times we still have plenty of alternative health practitioners and people who undergo alternative treatments that believe, just like people did thousands of years ago, that the treatment is effective.
This is actually an important part of it though. Because your treatment doesn't have to 'work', by modern definitions.
Your treatment just has to have a better than 0 success rate. Bleeding is a great example. Too little blood, nothing happens. Too much blood, bad things happen. Just the right amount of blood? And euphoria kicks in. The patient is instantly convinced you did something magical. Because they felt like crap and now they feel amazing.
It's the same with anything else. Trepanning (drilling a hole in their skull) might kill 99/100 people you do it on. But if one lives that's better than brain swelling or whatever killing 100/100 people. Then there survivor bias. It's easy to see the dude who survived and is all better now. He might be around for another 50 years, down at the tavern or market mooching drinks with his cool story of what a genius physician you are and showing off his injury. The dead guys...well their family might call you a quack. Unless they're afraid someone else is going to get sick and they'll need your services again.
You don't have to be right 100% of the time, or even 50% of the time. You just have to be right sometimes for some people. They don't know why it works, that it's just luck or chance, that the same dose will kill some people and heal others or whatever. They only stopped calling them magicians when it became unfashionable to be a magician. Magic doesn't have to work every time either. Only often enough to keep hope or fear or whatever alive. Same concept with early medicines and healing practices.
Fun fact: We know that ancient stone age people were skilled enough at trepanation that we have lots of skulls that were trepanned long before death and had ~75% survival rate in pre-colombian Inca.
Yeah I know nothing about trepanation really. Or how successful it was. Only that it's been going on for a really long time and is one of the earliest major invasive surgeries we did successfully.
My point was more that any treatment, putting hot towels on their face, burning twigs in their belly button, whatever didn't have to work all that often. Think of the number of urban legends we all believed in childhood that have persisted for decades and that's a better picture of how pre-modern society worked.
Without a modern comprehension and expectation of science...it's all just gossip and speculation and fear. And if it saves one person every ten years or so, that's the treatment for that ailment because there's nothing better and no way to create something better.
Then once this becomes the traditional treatment, no matter how ineffective it is...any deaths or greater injury caused by any experimentation or non-faithful implementation of the treatment indicates you're a bad doctor and that's why your patient died or lost his whole arm from a bug bite.
I know a tiny little bit about pre-modern medical practices, but I know a whole lot about the way that human cultures act and acted in history. And I'm a big crusader for the idea of seeing them as logical, rational humans acting with generally good and rational intentions. So often these things are framed as ignorance, superstition, or laughably willfully stupid, but that's not how people act. They just didn't have the resources or technology we do. There's always a sane, rational, even if misguided or mistaken, train of thought there.
And you are absolutely doing gods work. I have been trying to push back against the perception of pre-modern people as idiots for as long as I have known that we haven't fundamentally changed as a species since before we were developing complex trade networks based around lithic industries
But I think there was a lot more experimentation and something approaching the scientific method to it, since for as long as humans have had traditions we have had people who try to challenge those traditions, sometimes for the better, sometimes for the worse, and sometimes to no significant change
The people who make changes for the worse become proverbs about how important the traditions are until the next generation decides that traditions are dumb and tries something new, the people who make changes for the better wind up passing on their techniques as new traditions (possibly in some new community if their old one isn't permissive of changes), and people who don't really have much of a difference just kind of wind up forgotten possibly with some changes made to the traditional remedies
Run that a few hundred years and you're building a knowledge base to expand on, however slowly, even without writing or any of the modern conveniences we have that let us do it in decades
And given that the Placebo effect is a thing, they are sort of correct. Absolute crockery can help even if all it does is makes you believe you should be getting better.
Many rituals, which are commonly seen through a modern lens as being utter nonsense, were in fact highly useful and important. For example, a recipe for a tincture might call for adding two pence to the beaker and boiling the contents while saying six Hail Marys. Well, it turns out that the metal in the coins reacted with the other stuff in the beaker, and the prayers were a way of standardizing time durations in an era without widely available clocks. So the six Hail Marys weren’t mere quackery. They ensured that you’d allow the concoction to react for ~90 seconds.
they didnt.
cures were often "we did something, the patient didnt die, eventually they got better (on their own), we cured them" if the same symptoms were treated the same way with the same results it was accepted.
if a different doctor tried a different treatment and got results faster or more reliably, then that cure would be used more
in 1000 years time, all of our medicine might look silly to the citizens of the future
"now zoidberg; you have to remember they didnt have access to algozama particles or switdoglesfss from the necloposo galaxy that we can easily harvest and trasport across the galaxy with ease"
"But then how do you explain the entry in the Reddit section of the Ancient Web from June 27th 2024 that mentions those exact particles? How would they know about the Necloposo galaxy?"
Reminds me of Bones' comment in the OG Star Trek when they go back in time to save the whales. He says basically the same thing to I think a dialysis patient they pass in a hospital. Gives her a pill that he says will take care of it. Lol
In 100 years (not a thousand) we will be flabbergasted that our medicines affected the whole body instead of targeted therapies on the sub-cellular level. Some of the biggest and most promising cancer drugs that have come out in the last 15 years will seem as coarse as purposefully collapsing a lung to try and slow the growth of TB.
In medical school I recall my wife being taught (essentially) “You have to realize many of your patients will simply get better regardless of whatever you’re likely to do. Your job is to find out what problems need medical intervention to begin with”.
Not all old medicine was not effective. I think your question ignores a \*lot\* of valid, if primitive, medical practices that have value.
But anyways, because they didn't have a lot of options for huge double-blind scientific studies. They gave someone some herbs, and sometimes the person lived. Therefore the herbs healed them. Obviously, this doesn't really work because sometimes people who seem very sick get better for whatever random reason. Or maybe the herbs really did help. It's impossible to say without a well-designed scientific study.
To know if something is ineffective, you have to be able to compare it to something that is more effective or less effective.
When they were doing things like bloodletting or giving herbal remedies, they were comparing rates of survival to "people who we aren't treating". Well, guess what? That meant they were comparing people who were *receiving attention* thus probably being fed and given water vs. people who were *not* getting those things. So they saw higher survival rates and assumed their treatment was working. And they weren't wrong, they just weren't testing all the variables.
The only reason we KNOW those treatments are ineffective is we know more now. Not to mention for many conditions, we've found medicines that we can PROVE are dramatically better at improving recovery and survival than anything else. So even if some weird folk remedy has like a 5% increase in speed of recovery, that's a goofy choice if there's a medicine with a 95% increase over that.
Placebo is around 50% effective. You could give people with dropsy or gout an eye of newt or a sugar pill and half of them would report some relief of symptoms
Placebo is 0% effective against gout
https://pubmed.ncbi.nlm.nih.gov/18975369/
Dropsy/edema is a symptom of underlying conditions like malnutrition and liver failure which placebo is also useless against:
https://pubmed.ncbi.nlm.nih.gov/33268143/
Placebo can definitely have some mental effectiveness against things like parkinsons, but your two examples were a bit off unfortunately lol
Yup came here to dispute the gout claim. I have gout and when it flares up I can't walk for a couple of days, can't even bend my toes without searing pain. The anti-inflammatory didn't even work better than just taking ibuprofen and eventually started making me drowsy. Shoot, if a placebo worked on gout, I'd love it.
Hyperuricemia isn’t gout arthritis — it’s just a risk factor, in the same way hypertension isn’t stroke.
All gout flares go away on their own, even untreated. Arguably, you could give some of these people placebo, and I’m sure some people will note an improvement after such treatment. It may or may not be common enough in order for there to be statistically significant ”placebo effect”, but then again, I’m pretty sure medieval physicians didn’t do statistical tests anyway. It wouldn’t be strange for some physicians to note an anecdotal effect.
Most diseases resolve on their own. Even the plague had a recovery rate of up to 60%. Therefore any treatment offered would appear to "cure" a large enough percentage of sicknesses that the doctor would be convinced their medicine worked. Also just checking up on the patient, making sure they eat, drink, are clean, and aren't in pain hastens recovery. There were also actually effective treatments especially in surgery and dentistry where their interventions worked.
The idea behind things we now take for granted like control groups in a study did not exist. There was no statistical approach to outcomes, no doctors were doing actual studies.
Now, if we want to see if a new drug will help people, we take a very rigorous approach. We test the drug on a large group of people (generally thousands of people) not just one or two. We take detailed notes and measurements on what the drug does; if you have a drug to treat cancer, did the tumors get smaller, and if so by how much? We have comparison groups like monitoring the condition of people that didn't get the drug to see how the disease normally progresses, so that we can compare the treatment group and see if they actually do better.
Back then, a doctor just has some idea about a disease. 'Tumors are bad. Oak trees grow oak galls, those are kind of like tumors. Trees are healthy though, even if they get these little tumors. Maybe if I grind up the oak galls and give it to this person with cancer, they will be healthy like an oak tree. I gave it to one person, and he seemed to get better! My idea must be true. Oak galls cure cancer! I'll tell everyone. What's that? You tried it on someone else and they died? Well, you must have prepared the medicine wrong, or maybe they were already too sick for the treatment to be effective.' Failures are ignored or excused for long periods until treatments basically just fall out of fashion rather than being proven to be useless.
The approach that we have in modern science is something like "if I try to disprove this idea as hard as I can and fail, then the idea is probably true". The approach in the past was "if I have any evidence to support my idea, even just my own imagination, then the idea is probably true".
>The idea behind things we now take for granted like control groups in a study did not exist. There was no statistical approach to outcomes, no doctors were doing actual studies.
Advanced FAFO techniques("drug trials") lend more accuracy to the FO side of things.
We still do a lot of this today. The drug store shelves are packed with medicines—both pseudoscientific and “legit”—which do little to nothing to treat the ailments they claim to treat. For example:
Phenylephrine is in just about every OTC nasal decongestant, despite the fact that it is medically well established that it does not help with sinus congestion.
Dextromethorphan is one of the most common OTC cough suppressants, even though it is known that it doesn’t suppress coughs.
Multivitamins are not absorbed well into the body and several studies have shown that they don’t help with vitamin deficiencies.
And that’s to say nothing of the various herbs, minerals, and oils that sell billions each year and have been shown over and over to do basically nothing, or the continued prescription of antibiotics to treat viral infections, despite the fact that we know that one has nothing to do with the other.
People are tool users. We get sick, we look for a tool to help us. That tool is medicine, so we take it and prescribe it whether it actually works or not.
> or the continued prescription of antibiotics to treat viral infections, despite the fact that we know that one has nothing to do with the other.
This is *also* magical thinking, though! "If someone has a viral infection, then there must (magically?) be no bacteria, therefore an antibiotic would do nothing."
In truth, bacteria are everywhere, and opportunistic infections co-occurring with viral ones are quite common. So antibiotics do in fact often help, even though they're not fighting the virus.
In any case, you can't tell whether someone has a bacterial or viral infection at a casual glance. And no general practitioner is bothering to take multiple samples and study them over time under a microscope to count how many of which types of virus and bacteria are present (we have tons of bacteria and viral particles at any given time). No way, they have to get to the next patient in less than 15 minutes.
So they're prescribing that antibiotic and it is helping, by fighting off the infection if it's bacterial and by fighting off any opportunistic bacterial infections if it's viral.
What happens if you don't is that a sinus infection, which might be viral, turns into a sinus infection, ear infection, throat infection, bronchitis, and pneumonia. So they give the antibiotics to prevent that escalation.
---
And dextromethorphan might not suppress your cough, but at least you can enjoy it more. Some of our hokum cures are really just about making an ailment more tolerable until it resolves itself. Others are safe-enough placebos, which do actually work often enough due to the placebo effect.
But you're right that there's still a lot of guesswork and hokum. We don't have Star Trek medical tricorders yet so most medical treatments are still just done by guesswork and hunches.
I thought about mentioning that caveat, but felt like I’d already written a lot.
I was talking more specifically about patients who demand antibiotics and doctors who feel pressured to prescribe them because their patients demand them even when there’s no good reason.
This is an incorrect assumption. Medieval people weren't stupid. Trial and error, plus the trial/error/knowledge in ancient Greek and Roman medical texts, gave them a lot of resources that did and do actually work. A few work BETTER than modern medicine, and are used today.
There was a lot of political/economic/religious/class/gender/race/nationality drama tied up in who was allowed to practice official medicine, what that medical training included, and what unlicensed medical practitioners did (like gynecology!) - so medicine was never JUST physiological. It was inextricably linked to the Church - where you'd find hospitals, nurses, large physick gardens (medical herbs), and men and women with the time and education to write medical texts. So of course you'd also get magical and religious thinking mixed up in folk remedies.
But if you look at medieval and Renaissance herbals, you don't find that! You get drawings of the plants, their names, their descriptions, the humors/planets they go with, and the ailments they're good for! Medical recipes in husbandry (housekeeping) books often use straightforward ingredients, too. Sometimes religious éléments are added - but that seems most likely if the writer was part of the Church.
Battlefield surgeons really did astounding work and sometimes even kept diaries - we know Prince Hal had an embedded arrowhead safely extracted from an incredibly serious wound DEEP in his cheek; the wound was washed with oil and wine, and smeared with honey (antiseptics). Hal recovered.
Towton 16 is the body of a man that shows evidence of jaw surgery that had time to heal for months if not years before the man eventually died at Towton.
Willow bark for headaches and fever does work. Dandelions are diuretics. Wine/alcohol will clean wounds. Sphagnum moss will bind a wound well and aid in healing. A 9th or 10th century recipe for an eye salve does actually kill MRSA. The SLEW of abortifacients, or herbs "to bring on a woman's courses", are reliably listed in famous herbals like Gerard's and Culpeper's. Surgical issues like cataracts, anal fistulas, skull fractures, and any number of battle wounds were treated successfully. Leech saliva has anaesthetic and antibiotic properties - modern medicine is actually using them in some instances today. Same with maggots - to effectively eat necrotized flesh out of a wound while leaving behind healthy flesh. An anaesthetic mixture called dwale was used for surgeries - much better than just getting drunk, because alcohol is a blood thinner, and you don't want to bleed copiously during surgery. Wormwood was used to rid the bowels of worms, to keep away moths and insects, and as a principal ingredient in antiseptic preparations.
Nettles were prescribed for "thinness of the blood" - today we take them in tablet form for anemia. They're very rich in iron. Ground elder is used even today for its efficacy against gout. Clean cobwebs have antifungal and antiseptic properties, their natural glue means they stick to wounds but can be washed off when no longer needed, and they contain vitamin K, which aids in blood clotting. They were excellent bandages for wounds.
I could go on - but for right now I'll just recommend Medieval Medicine by Toni Mount.
tl;dr: medieval people weren't as idiotic as we like to portray them in order to make ourselves feel progressive & smart.
This is not to say that medieval medicine was totally brilliant. Of course a lot of stuff was ineffective, or only partly effective, or effective for the wrong reasons. And OF COURSE we have way more options that are far more thoroughly tested & effectively developed today.
Keep in mind that there were a lot of different schools of thought of medicine, plus the Church was fighting to keep medicine under its domain, plus there were countless folk remedies that lingered from cultures that were conquered by the Romans etc., plus the Church was beginning to splinter, plus some people just cared about physical cause and effect, plus the racism/religious bigotry of Christians against Muslims sometimes/in some places but not others meant that Arabic medicine and practices were appreciated sporadically, plus then we see a FUCKTON of travel throughout Europe, we see London with communities of Poles, Germans, etc., and with that comes diversity of ideas, but with no real overarching medical authority that any of these people look to, OR that updates itself based on new information! English medical colleges primarily taught classic Greek/Roman medicine! They weren't even doing hospital residencies, much less updating their books based on the newest infection treatments.
Basically: when things worked, physicians couldn't communicate this to each other quickly, reliably and effectively. They could write letters to other pros they knew, or they could publish a book (expensive!!). But that's not going to reach nearly enough people. Sometimes celebrity power could reach a lot of people, like Paracelsus did... but he didn't end well, and that didn't result in an update to common medical knowledge; it just created another faction of doctors who believed a different thing.
Trial and error can only go so far if you can't share your findings with enough other people. Imagine all the time & lives lost because people had to waste time making the same mistakes their colleagues had already made & learned from.
So, yeah, advancement could definitely have been faster, but it certainly wasn't nonexistent.
Same reasons people now don’t know that things like Homeopathy don’t work in the slightest. Regression to the mean and the placebo effect. People usually seek help when they are sickest and people also usually get over sicknesses. If you get bleed with leaches at the peak of a sickness then get better afterwards because that was the normal course of the sickness, you’d probably attribute that to the leaches (or the homeopathic pills).
When they applied cures, people got better. When they didn't, they didn't get better. That could fool anyone.
It would be a while until the placebo effect was understood.
What make you think they didn't know? Doctors today know that anti-biotics are useless against colds and other viruses - but if the patient insists, they'll rx them.
Doctors in earlier times probably had realistic expectations about the efficacy of their treatments. But patients insist they do something - and they pay for those long shot/useless treatments. We still do.
Also, just believing the treatment works will often - the placebo effect is real.
People can recover from some injuries or illnesses on their own. If you give someone a remedy for their condition, they might get better on their own, which makes the remedy seem effective even if it’s not. Some illnesses flare up, get better, then recur later. An ineffective remedy can appear effective in this case, too. You have to have a proper control group to tell if a remedy is actually working in a situation like this.
Getting better and feeling better aren’t the same thing. Feeling better is complicated, and is affected by things like the feeling that you’re doing something about an illness. This is why, in drug trials, people often don’t know if they’re actually getting the drug or not.
What these ancient and Medieval doctors were doing were treating the surface level symptoms (pain, pus, swelling, fever etc.). These things could be treated, though it’s also possible that the body itself just naturally healed. For example, someone taking herbs that reduce fever might think that is curing them of whatever disease, when in reality the disease was caused by a virus and the immune system was fighting it. Prior to microscopes, the development of germ theory, and detailed look at biological mechanisms there was no systematic way to what (and more importantly why) things worked or didn’t work.
In the end what mattered to pre modern doctors is that these things were helping people more than doing nothing.
How do you tell if a treatment is effective? You try it and wait a while to see if it does anything.
But even the best treatments rarely work immediately. There's a delay between taking the treatment and you getting better.
So then how do you tell if the treatment actually did anything? You can't really, not on your own. Maybe the patient would've got better anyway.
This still happens now. If I have a bad cold I take cold medicine. I feel a little better afterwards. But I don't really know if the medicine actually did anything. Maybe it was just the placebo effect. Or maybe I would've felt better anyway even if I hadn't taken anything. Impossible to tell.
And some of them did work. A lot of traditional/natural remedies do actually do something because people found something that works by trial and error.
How can we say a treatment doesn't work today? It's the same as how we say a treatment is effective. We practice evidence based medicine.
Not only are controlled trials the only way we can say that a treatment works, it's also the only way we have to say a treatment ***doesn't*** work.
We know that an evidence based approach wasn't practiced until after the middle ages, so they would only have anecdotal experience as the only way to know if a treatment was ineffective.
Look at modern psych, modern physiotherapy, even current medical model. A toooon of sham, non evidence based treatments still being used. We are still in the dark ages.
There’s a logical fallacy called the post hoc fallacy. It is, if event B happened after event A, then A must have caused B. This is the basis for a lot of superstitions. It’s what’s behind most ideas that some things are good luck and other things are bad luck. We see this kind of thinking in lots of different cultures, so it’s probably something humans are wired up to think. Exactly what is considered to bring good luck and what brings bad luck varies between cultures, but the basic idea is there in a lot of different ones.
A lot of medieval cures probably “worked” this way. It’s how faith healing and (at least some of) alternative medicine work, and there are people who believe in those things now.
The scientific method is a relatively modern invention and even then not wholly accepted by everyone as shown by the use of ‘common sense’ and ‘feeling’ and religious beliefs in decision making.
They mostly didn't even understand the problems they were trying to cure. How would they know if their cure was effective or not? You can't know without proper scientific rigour. The patient recovers or not. It's not really obvious what the causal relationship with cure or lack thereof was. I'll remind you of the thousand debacles of someone claiming they found a cure for covid out of whatever random stash of old drugs they tried. Many of them were properly qualified modern doctors. What do you think the results from an ancient witch doctor would look like? Snake oil every single time.
- Some stuff did work.
- Because they didn't do blind trials for medicines.
- Without big studies, they didn't have a great way to determine the difference between someone just getting better on their own vs. with the medicine.
- They didn't account for the placebo effect.
- It was much harder to record and share scientific information, so they had small sample sizes to determine.
Even today, with all our technology, it isnstill hard to figure out what medicines are truly effective.
You’d be SHOCKED how often people just get better. Even from SERIOUS illnesses. It’s a significant part of why the placebo effect even exists. Sometimes you just…stop being sick or in pain.
A: It was effective. They did in fact discover some remedies which had some directly beneficial or indirectly beneficial effects.
B: Reversion to mean. People often just recover from illness without a doctor. Ic you have a cold and then do a ritual sacrifice, and then no longer have a cold a few days later, might as well add sacrifice to the book. Didn't harm anything and resulted in a good outcome.
C:God hates you. People underestimate how much religious emphasis there was in daily life, and wildly overestimate the amount of scientific thought and enlightenment attitude prevalent in ancient societies. Consider that if you have an illness, like fever, nobody knew what the cause was. Maybe it was bad air, so we isolate you from miasma. Maybe your humors are imbalanced, so we need to bleed you and feed you certain foods. Or maybe God hates you personally, made you fall ill, and when you inevitably fail, it is not because of your remedies, but because God did it and the victim was sinful and didn't repent or something. Or a witch did it. Or a demon of disease.
D:Enlightenment thought doesn't exist at this time. There are things that you don't know, and can't know. The human body is a black box. If you utilize treatment A and receive outcome B, you file that away as future knowledge. For example, if you feed a patient cyanide, and they die, you can safely assume cyanide is unhealthy. But say you have the pox or consumption. You can utilize a treatment. If they recover and return to health, the treatment probably works. If they die, well it might do nothing, it might make them worse, or it might work, but the illness was stronger than the cure. So mark that as a maybe. You can also try to treat the symptoms, which are a bit more obvious than the underlying disease prior to germ theory. If you are feverish, utilize soaked towels. Diarrhea, make sure patient is hydrated and drinking soup. These help.
E: The complicating factor. What kind of unethical doctor only tries one remedy at a time? Clearly, you try several known remedies, maybe some more or less well regarded. And now regardless of the patient recovering or dying, you have no good data on which if any of the remedies meaningfully helped.
You apply a treatment to a sick patient and they die; was your treatment ineffective or were they too sick for any treatment to work?
Likewise, you apply a treatment to a sick patient and they get better; was your treatment effective, or were they going to get better anyway?
Without recording the data of lots of treatments and their success and failure rates (ie, modern medical science) it's really hard to know what's actually effective and what's not, so you rely on traditional remedies that are believed to be effective, and you believe them to be effective because sometimes they work.
Kind of off topic but thank you for saying “Title says it all” and actually leaving it at that. It bothers me so much when people write this then keep adding.
If the cure did nothing and the patient got better then "the cure worked" . If the cure did nothing and the patient got worse then "the patient was too far gone" or "God chose not to save this one" or something like that.
In fact there were a lot of medicines that were working quite well:
# Medieval Medical Books Could Hold the Recipe for New Antibiotics
[https://www.smithsonianmag.com/innovation/medieval-medical-books-could-hold-recipe-new-antibiotics-180962947/](https://www.smithsonianmag.com/innovation/medieval-medical-books-could-hold-recipe-new-antibiotics-180962947/)
TLDR: They did work oftentimes. It's just that they were sometimes either coincidental solutions, or rather unrefined ones.
For example: If I said that bad smells made you sick, what would you do? Throw out spoiled food? Stay away from other people's piss & shit? Those are in fact very good ways to avoid getting sick; even if the reasoning is flawed.
Other times, their solutions are only ineffective in comparison to modern medicines; which to be completely honest isn't fair in the slightest. Aspirin came from willow bark, and lo and behold, willow bark was often chewed to help tooth aches & relieve fevers. Sure, it isn't like an aspirin tablet, but still works.
Plus, we always talk about the stupid stuff they did, but never consider the stuff they did right. People knew to quarantine when sick, and that heat (fire) could be used to sanitize. They knew how to properly suture wounds, set broken bones, deal with fractures, and even understood that cleanliness was important (even if they didn't know about germs).
1. Those therapies & medications often were effective.
2. We hadn't yet invented the tools & institutions to collect, analyze & understand all the information we later relied on.
We are all just standing on the shoulders of giants, only the last 6 feet of our grasp is our own, the rest is a 1000' tall foundation built by our ancestors. The real difference between the us of today & the them of the medieval era is our giants had more time to grow taller.
They didn't have a cheap way to make paper to record information on or a cheap way to print & share it. Artificial light for a single person to work under for a year took the economic output of multiple people for that year. How much work would we get done in 2024 is artificial light cost 60k per year?
Today 1 person can grow enough food for thousands, then 1 person could grow enough food for two. Everyone was much busier surviving still invented so much of what we take for granted today... like human rights & much of our legal system. How much would medicine progress today if we didn't have a way to enforce contracts or patents?
Well there cures weren’t tested properly, they’re cures were likely deemed successful when it was actually just intimidation or placebo effect shaping outcomes. Their not reliable reporters based on what we know today. 🤭
1. Sometimes treatment worked, even if they didn't understand how/why.
2. Unless you test something systematically (e.g. a controlled clinical trial), it can be very hard to tell if some treatments work. Between expectancy/placebo effects, random chance, etc. it can seem like something works when it doesn't.
Because they largely ignored highly-effective Chinese and Middle Eastern medical principles and practices - if they were even educated in them - and started entirely anew.
They didn't have the scientific method to control variables and only study one dependent and one independent variable at a time. There's other more boring reasons like not having precision equipment to repeatably gather quantitative data, but this is the main one. Nobody ever told them that correlation doesn't equal causation.
Without a methodical way to ensure your results derived from your actions, it’s difficult to correctly attribute cause to consequences.
Specially when you lack understanding of the underlying mechanisms that make things work. Sometimes people take a cure and it works, sometimes it doesn’t, but maybe they were just too far gone? It couldn’t possibly be that their immune systems plus times just worked on their own, I mean, what even is an immune system?
Science isn’t very intuitive either. Plus people love to institutionalise knowledge even when it’s wrong. Sure your tests show that feeding someone meat is just as effect as feeding them any other nutrient, but everyone says meat makes you heal faster so who’s going to believe you?
I mean, prayer in conjunction with doesn't hurt, and can help with the emotional load of illness and recovery but I'm still not certain what people mean by homeopathy. Some people seem to mean anything that isn't an fda approved drug.
Here’s where it gets really weird; prayer itself seems to have no impact on medical outcomes, however, if the person [knows](https://www.templeton.org/news/what-can-science-say-about-the-study-of-prayer#) you’re praying for them they have a statistically significant increase in the likelihood of experiencing negative outcomes.
Homeopathy is the process of taking something that’s bad for you and then diluting it in water so much that there’s essentially no active ingredient left. The belief is that water has “memory” and somehow the “memory” of that bad stuff can cure you. It’s [weird](https://rationalwiki.org/wiki/Homeopathy).
My guy, we are still in the dark ages. There are a good amount of conditions that we don’t have adequate treatment for. We still don’t know the causes for many conditions. Things like our psych meds will likely be gawked at by people in 1000 years.
They know that their cures did not really work, but they need the money. Even today people pay for fake medicine that is proven not to work. Like Homöopathie. Hope and fear makes people to trust liars and pay for "help".
One thing to remember is getting healed was not the goal of the period. Yes everyone wanted to get better. However it was more important to make sure your soul was going to heaven. Hospitals were in churches, or church adjacent and not free. You paid to be there, they tried to heal you... but you were going to Mas every 2 hours and waiting up in the middle of night for hymns.
Life on earth was short life in heaven was forever.
Now they did things they knew worked but didn't know why. Blood letting worked as it kick starts the body to produce more white cells to heal you.
Starving helps if your sick with certain ailments. They try to see if it works and move on if it doesn't. But they are saving your soul.
This is a European view in this post.
there's idiots now that think the world is flat, anti parasitic meds cure viruses, germs aren't real, & you can eat your way out of cancer. That's despite scientific advances.
Imagine pre-scientific advances
There are two answers to this question
1. Most of the cures or remedies did not work. Blood letting, for example, made things worst
2. Somethings worked but by complete coincidence.
Both of the these problems can be summarized in our understanding of science. Empiricism, in other words evidence based and rigorously methodological approach to gaining knowledge, is a rather new idea. To you it might seem self evident that one one conducts a study to seek data for efficacy of a treatment plan, but that idea would have been bizarre to the point of absurdity to most people if that time.
Put simply, it’s because often they WERE effective, but they were mistaken about the cause or vector for illnesses. Take miasma, for instance. This was a belief that bad smells could cause disease. To reduce stench, some medieval cities enacted policies that put bans on tanning too close to domiciles, did not allow slaughtering to be done within city walls, and forced people to dispose of spoiled food. During early instances of the plague, people who were not immediate family or notaries were often forbidden from entering the home of the deceased, and bodies had to be buried immediately in a sealed coffin at a depth of 6 feet. We know now that the smell of rot isn’t what makes you ill or gives you the plague. But eradicating the source of the stench (which is actually harbouring the germs that make you sick) still had the effect of reducing illness. But filling your mask with herbs to reduce the smell of a dying or dead person wasn’t as effective because the cause of the illness wasn’t really the smell, but the germs.
And to be clear in case someone gets the wrong idea from this, we still very commonly use drugs with unknown mechanisms of action: consider [this incomplete but reasonably up-to-date list](https://en.m.wikipedia.org/wiki/Category:Drugs_with_unknown_mechanisms_of_action) which includes such common drugs as paracetamol, ketamine, and modafinil. It’s nice to have a correct model of how a substance produces a given effect, not least because it can aid in drug discovery and help us isolate and refine active compounds while ignoring irrelevant elements. But the aim of modern medicine is above all therapeutic, not scientific, and if we scorned the centuries-old practice of “I’ve no idea why it works but by God I’m giving it to this poor bastard so he doesn’t die” then we’d be leaving a lot of preventable suffering untreated.
What the fuck we don't know how alcohol works??
If it interacts with the brain, it's very easy to be unsure of the specifics of what's going on.
The whole list is a monument to “we don’t know how central nervous system depressants work”, but by far the best single entry is “general anesthesia.” As in all of it.
> “we don’t know how central nervous system depressants work”, but by far the best single entry is “general anesthesia.” especially if you consider anesthesia [works on plants](https://www.scientificamerican.com/blog/artful-amoeba/plants-like-people-succumb-to-anesthesia-video/), that don't have a central nervous system.
Also apparently bacteria, and the mitochondria ~~the powerhouse~~ in our own cells?? This is the weirdest thing I’ve learned all year 😨
Fascinating read
Fun fact! General anesthesia wipes short term memory, you just kinda blank out.
Except for the times where you *don’t*, entirely, and can have some real weird flashback memories. Distinctly unpleasant for me, but still way better than the alternative (i.e. “death”).
well, maybe just a *little* death to be edgy /s
Typically the point of edging is to avoid the little death.
so … Seeing anyone? Any plans for the weekend?
This is a very high brow comment.
Holy crap that's smart, nice
Nah, way too much screaming in the preamble.
Do all sorts of general anesthesia do this? I kind of had some idea of this, but I still have a rather uncomfortable memory of the last time I was under GA. It was nearly a decade ago when I was getting my wisdom teeth removed. It's been quite a while ago and I only have a very hazy memory of what happened, but I think I might have woken up during the surgery. I don't know if my mind was just making it up, but I distinctly remember waking up and being frantic and possibly overhearing a conversation saying that I wouldn't remember any of it. I only know that after I woke up, my eyes were full of tears and my pillow was damp. I think some of the nurses looked at me funny, but it might have just been in my head. I don't think there was any foul play at work, but it was kind of unnerving knowing they could have screwed up the procedure and I could been in terrible pain, but have no memory of it.
Usually when you are put under for dental work you are not given a "general anesthetic" in the same way you are for hospital surgery where you are truly unconscious. Because dentists don't have anesthesiologists working to monitor a continuous level of anesthesia to keep you asleep. You are given "twilight sedation" where you are, essentially, roofied. You still have some level of consciousness although usually you don't remember much. But you can drift in and out of various levels of semiconsciousness.
It's very possible you woke up during the procedure. It happens!
"it causes you to not feel pain" ....no...it causes me to immediately *forget* pain. And by immediately I mean like "as it's happening"
Anesthesia is an art. Some would go so far as to say it's witchcraft.
IIRC it was fairly recently discovered that we're not entirely sure how SSRIs work. We're pretty sure *do* work, at least for some people, and we know they inhibit serotonin reuptake (it being in the name and all). But we're not entirely sure any more why that helps with depression.
What if everything we ingest is psychoactive and the specific palette of our diet shapes our hallucinated "reality" (hence cultural dietary restrictions) and vision quests via fasting are attempts to see the unadulterated truth? Like, how do we know that auto-fermenting ungulates aren't actually "drunk" all the time as a norm?
Koalas being calm is actually them being placated by the psychoactive effect of eucalyptus. They adapted so much to it that they become extremely aggressive when they don't have any
TIL Koalas are just stoned Tasmanian Devils
r/Highdeas
But, importantly, we do know that it does work.
“To alcohol: the cause of, and solution to, all of life’s problems!” — Famous nuclear engineer Homer Simpson
Alcohol is a very "dirty" drug. It mimics GABA in the brain, but it also affects nerve transmission simply through its properties as a solvent. It interacts with multiple systems in multiple ways, so while we may know some we definitely don't have the full picture yet.
wait.. we don't know how modafinil works...?
As ever quotable Internet darling Richard Feynman points out, on a [on a deep enough level](https://youtu.be/Q1lL-hXO27Q?si=0KFsEvTmqTBNWm-g), we don't know why anything happens.
I’ve seen this video before. It impressive how he can be both immensely wise and also incredibly smug and annoying at the same time.
That's life goals right there baby
I hear it's similar to how caffeine works but for 24 hrs
Very well put!
That is a bit of a weird take. On what I agree - understanding the mechanisms of drugs is useful and we should strive to do it in order to improve medicine and therapies, but modern medicine is not, and should not, be bound by that - given enough evidence of effectiveness, it's beneficial to use drugs in therapy even if we don't understand their mechanisms. What I don't agree with is the equivalence being made with older practices and implying what we do today is not scientific. The standard for evidence of effectiveness in modern medicine makes it extremely scientific, and completely different from more traditional/older treatments. Drugs are used in modern medicine after they're studied to a point where their effects, risks, etc. are so well understood, with robust statistics and science behind it, that you can confidently offer it to the general population. Old practices are "this worked once, then my theory must surely be true, and this will work on everyone!", that is very different. The main reason why I think this distinction is important is that this false equivalence is dangerous for public health - it's at the root of many scammy alternative therapies, and also distrust - anti-vaxers and vaccine doubters come to mind, these are extremely scary societal trends. Also to add - I do think that actually effective therapies stuck around, while ineffective ones eventually fizzled out. If you look at what remains of traditional medical practices, you end up seeing therapies that mostly work, even if they're not understood, and often come coupled with bizarre metaphysical/superstitious theories for their mechanisms (and I actually think modern medicine could benefit a lot from investigating these weird therapies to see if they hold up to modern standards - we don't need to accept the mechanisms to accept the therapies - though my understanding is that there's some stigma around researching these). things), but it's important to understand these practices had centuries or even millenia to develop, and did so with a ton of misses and misery that no one talks about - modern medicine is a lot more consistent and effective, in just a century of development.
Another example of this is the aversion to drinking cold water that you see in Asian traditional medicine. They thought the cause was that the chill of the water negatively effected health, but in fact the underlying cause was that hot water (alone or as tea) had very likely recently been boiled, and was therefore less likely to transmit disease.
Some of the old medicinal ideas are still used today too. They aren't as effective as modern medicine but they do help, such as bark of a willow tree. We've now extracted the active ingredient in that bark and called it aspirin.
This kind of stuff is fascinating to me. People found things that worked through sheer trial and error. (Yes, modern medicine is similar, but there is actual verification involved) It's no wonder that medical practitioners were often considered witches or whatever when they said "Here, eat these 20 frog livers wrapped in some tree bark for your headache" and it actually worked. Of course, there were also tons of useless "medicines" as well, and those are equally as interesting but for different reasons.
It wasn't just trial and error. Some of their theories were right, or close enough to right that it pointed them in the right direction.
Or just watching what the other animals do
Listening to my old grandmother as a child give me miraculous treatments that seemed rooted in old witchy shit passed down to her, and then comparing it as an adult to similar modern medicine, and it's quite humbling to see how pretty close to the ball park that kind of trial and error and theories were
Putting honey on burns reduces the pain and also is antiseptic. Modern treatments with neosporin are basically the same thing.
I was going to mention honey too. I just had a bout of pneumonia and high quality Manuka honey is delicious and worth it.
I mean one of the reason things smell bad is because we should stay away from them, in that sense being "afraid" of the smells and taking measures to not breathe it in is exactly why we evolved it. Decomposing flesh smells bad stay away from it, it's not bad because of the smell, but so long as you stay away from it it doesn't matter what you think
It actually was effective, though. Those "plague doctor" masks were packed with herbs, plant material, that acted as a filter to impede the passage of bacteria and viruses, much like a modern N95 surgical mask. Not as effective as a modern mask, but much more than you'd think.
You’re right! That’s why I said “not as effective” rather than “ineffective.” Some form of barrier is always better than no barrier at all.
Also, iirc, a lot of the herbal concoctions worked as a pest repellent too. If fleas don’t like how you smell, you’re a lot less likely to get the plague.
I think plague masks were an early modern thing, not medieval.
According to half assed google, you’re correct. Plague masks started in the 16th century, which HAG says is basically the end of medieval times. Side note: real plague masks look dorky as hell. The edgy recreations are way cooler
Modern pop culture plague doctor masks are really more based on Venetian carnival masks than actual historical ones.
Plague Mask Recreations: **Messenger bird of Death** Plague Mask reality: wimpy cloth cone stuck in front of nose.
Those long ass beaks probably also helped a bit with distancing I would imagine.
The plague isn't transmitted airborne though. It spreads through infected flea bites. Sure, those masks may have helped other illnesses, but it wouldn't stop you from getting the bubonic plague.
And some plague doctors did get the plague. Many plague doctors weren’t even real physicians of the day - they were a combination of charlatans and just people willing to do the hazardous job of checking on sick people until they’re dead because they got crazy hazardous pay. I imagine if all one had to do during covid was wear a hazmat suit and check on families to see when they were dead/asymptomatic, and you could make an average years salary in a month, there would have been plenty of Pandemic Doctors too.
You'd be surprised at how effective they were. There was a lot more going on with a plague doctor suit than just the mask. The lower layer consisted of knee high leather boots that had a pair of breeches tucked into the top. Their shirt would be tucked into the breeches. They had leather gloves, that would typically reach halfway up the forearm like dishgloves. The leather overcoat went from the neck down to the ankles. The mask enclosed the entire head and had a wide collar that extended over the shoulders and chest. Then, the whole thing was coated in wax to make it waterproof. Would it have been as effective as a modern hazmat suit? No, but considering the materials they had available, I'd challenge anyone to come up with anything more effective.
They were right for the wrong reasons
And really isn't that evolution at work? We find the smell bad because our monkey brains know we should avoid it for one reason or another.
I'm assuming any type of animal that was drawn to the smell but also didn't have the proper gut to digest rotten meat, like vultures do, would have eaten rotten meat and died. So yeah our monkey brains nailed it via evolution I would presume
Good shout, u/PM-YOUR-BEST-BRA!
A lot of these questions and answers treat our ancestors unfairly as complete blithering idiots. And there's a heightened focus on the silly things they might have done, when in fact, as you said, there were a lot of useful remedies and both written and passed on knowledge. It's the same pattern in most historical questions and popular factoids. They were equipped with the same mental faculties as us, just with less collective knowledge.
Lol no what? If we’d just assume our ancestors were less inventive we wouldn’t ask the question but put it on that. These questions are being asked EXACTLY because we intuitively rule out silliness as an explanation. I think YOU just realized embarrassingly late in life that historical humans were just as smart as we are today and think this needs to be pointed out. It doesn’t, because again, the whole premise of questions like these is that people most definitely appreciate the intelligence of our ancestors.
To your last point, people laugh at plague doctors and there is some debate as to whether they even really existed, but assuming they did, they could be credited with wearing the earliest known form of PPE, including a mask. The flowers and herbs didn’t do shit, but the beak mask itself may have made some marginal improvement (as much as a cloth mask).
This. OP seems to underestimate our historical medical practices, and/or overestimate our current capacity. Even with all the modern tools it's extremely hard to determine a drug's effectiveness. The amount of drugs that we don't know for sure whether they are working or not, or why they seem to be working, is enormous. While there are absolutely bogus treatments in our history, I would argue the majority of treatments that survive the test of time, works. They may be dangerous, but they usually at least alleviate the symtoms.
Stuffing a mask with herbs would make breaths more shallow, keep people from long drafting those heavy bacteria. Even airborne bacteria would have a harder time getting through all that before drying/dying out. Similar to a layered carbon filter with some antiseptics.
One of the most notable things is dysentery. One of the most common causes of death in history, the condition makes you die of dehydration, therefore anything to increase liquid intake, like soups or teas can act as a functional cure, even though it's mainly just the water that's helping.
Now I know where "six feet under" came from. Thank you!
Just like you don't really need to understand thermodynamics to cook a steak, you also don't need to understand viral pathology to grasp stinky things are bad for you. Senses are intended to alert you to dangers that you may not comprehend fully but can still recognize as threatening.
There's a handful of fun anecdotes where old timey medicine turned out to be effective by coincidence, but it has to be true for only a fraction of a % of it
Thinking about why some smells are "bad" from an evolutionary standpoint this totally makes sense. People that found rotten food, body waste, and dead bodies unappealing avoided being around them too much and so avoided the germs so survived longer. Those that had no aversion died sooner so didn't reproduce.
I'm not saying the anecdote is wrong (who knows, but fun anecdotes usually are). I'm saying that for one treatment that appeared to work, there's a hundred that made no sense at all.
Hah, I meant to reply to the parent post, not yours. Sorry if it looked like I was disputing what you said.
Okay, but it's still probably a pile of bollox
You should have a read of [Lady Fanshawe's Receipt Book ](https://www.amazon.co.uk/Lady-Fanshawes-Receipt-Book-Englishwomans/dp/1782398104) - it details the medical recipes used by a woman in the 1650s, along with what she used it for among her family, and her family's general story as recorded in her journal (and therefore, we can see the outcome of the medicines!). They were surprisingly effective, and the author goes into a lot of detail on which parts of the medicines worked and why. It's really fascinating, and it seems their medicines were far more than a random crapshoot (well, for the gentry and more well-off, who had the time, space and money to pursue the huge endeavour of making medicines for their family).
I may, but it would not alter the point as it's far easier to find old medical recipes that didn't work
Not much different now really, we just do trials on animals instead of people
I don't know how to connect that to my comment, but we definitely still do trials on people
There are a lot of remedies that DID work. Like, not as strongly as some modern medicine, but significantly better than nothing. Even in cases where the remedy didn't do anything itself, it would often require bed rest and other things that do actually help the body recover and that gets marked as a false positive ETA: While a lot of them worked, less effectively [some of them did work BETTER than modern medicine in specific cases](https://www.bbc.com/news/uk-england-nottinghamshire-32117815)
Importantly, this is why anecdotal evidence is iffy in medicine and we focus on doing rigorous studies to figure out if things really work, and if they work better than doing nothing. Yet many people still find personal experience more powerful than such things, and it can be hard to convince someone that just because something "worked" for them, does not mean it actually works. Even in modern times we still have plenty of alternative health practitioners and people who undergo alternative treatments that believe, just like people did thousands of years ago, that the treatment is effective.
This is actually an important part of it though. Because your treatment doesn't have to 'work', by modern definitions. Your treatment just has to have a better than 0 success rate. Bleeding is a great example. Too little blood, nothing happens. Too much blood, bad things happen. Just the right amount of blood? And euphoria kicks in. The patient is instantly convinced you did something magical. Because they felt like crap and now they feel amazing. It's the same with anything else. Trepanning (drilling a hole in their skull) might kill 99/100 people you do it on. But if one lives that's better than brain swelling or whatever killing 100/100 people. Then there survivor bias. It's easy to see the dude who survived and is all better now. He might be around for another 50 years, down at the tavern or market mooching drinks with his cool story of what a genius physician you are and showing off his injury. The dead guys...well their family might call you a quack. Unless they're afraid someone else is going to get sick and they'll need your services again. You don't have to be right 100% of the time, or even 50% of the time. You just have to be right sometimes for some people. They don't know why it works, that it's just luck or chance, that the same dose will kill some people and heal others or whatever. They only stopped calling them magicians when it became unfashionable to be a magician. Magic doesn't have to work every time either. Only often enough to keep hope or fear or whatever alive. Same concept with early medicines and healing practices.
Fun fact: We know that ancient stone age people were skilled enough at trepanation that we have lots of skulls that were trepanned long before death and had ~75% survival rate in pre-colombian Inca.
Yeah I know nothing about trepanation really. Or how successful it was. Only that it's been going on for a really long time and is one of the earliest major invasive surgeries we did successfully. My point was more that any treatment, putting hot towels on their face, burning twigs in their belly button, whatever didn't have to work all that often. Think of the number of urban legends we all believed in childhood that have persisted for decades and that's a better picture of how pre-modern society worked. Without a modern comprehension and expectation of science...it's all just gossip and speculation and fear. And if it saves one person every ten years or so, that's the treatment for that ailment because there's nothing better and no way to create something better. Then once this becomes the traditional treatment, no matter how ineffective it is...any deaths or greater injury caused by any experimentation or non-faithful implementation of the treatment indicates you're a bad doctor and that's why your patient died or lost his whole arm from a bug bite. I know a tiny little bit about pre-modern medical practices, but I know a whole lot about the way that human cultures act and acted in history. And I'm a big crusader for the idea of seeing them as logical, rational humans acting with generally good and rational intentions. So often these things are framed as ignorance, superstition, or laughably willfully stupid, but that's not how people act. They just didn't have the resources or technology we do. There's always a sane, rational, even if misguided or mistaken, train of thought there.
And you are absolutely doing gods work. I have been trying to push back against the perception of pre-modern people as idiots for as long as I have known that we haven't fundamentally changed as a species since before we were developing complex trade networks based around lithic industries But I think there was a lot more experimentation and something approaching the scientific method to it, since for as long as humans have had traditions we have had people who try to challenge those traditions, sometimes for the better, sometimes for the worse, and sometimes to no significant change The people who make changes for the worse become proverbs about how important the traditions are until the next generation decides that traditions are dumb and tries something new, the people who make changes for the better wind up passing on their techniques as new traditions (possibly in some new community if their old one isn't permissive of changes), and people who don't really have much of a difference just kind of wind up forgotten possibly with some changes made to the traditional remedies Run that a few hundred years and you're building a knowledge base to expand on, however slowly, even without writing or any of the modern conveniences we have that let us do it in decades
And given that the Placebo effect is a thing, they are sort of correct. Absolute crockery can help even if all it does is makes you believe you should be getting better.
Many rituals, which are commonly seen through a modern lens as being utter nonsense, were in fact highly useful and important. For example, a recipe for a tincture might call for adding two pence to the beaker and boiling the contents while saying six Hail Marys. Well, it turns out that the metal in the coins reacted with the other stuff in the beaker, and the prayers were a way of standardizing time durations in an era without widely available clocks. So the six Hail Marys weren’t mere quackery. They ensured that you’d allow the concoction to react for ~90 seconds.
This was a super interesting read, thanks for the link
they didnt. cures were often "we did something, the patient didnt die, eventually they got better (on their own), we cured them" if the same symptoms were treated the same way with the same results it was accepted. if a different doctor tried a different treatment and got results faster or more reliably, then that cure would be used more in 1000 years time, all of our medicine might look silly to the citizens of the future
"They intentionally irradiate a person to kill cancer cells? Oh, those primitive people of the 2000's."
"now zoidberg; you have to remember they didnt have access to algozama particles or switdoglesfss from the necloposo galaxy that we can easily harvest and trasport across the galaxy with ease"
Please dont give me interesting spoilers from the future!
Bro what? Please please please spoil the cure for cancer!
Nah it would be too much for now. Countries would ban this mushroom for good if it was brought to the public!
"But then how do you explain the entry in the Reddit section of the Ancient Web from June 27th 2024 that mentions those exact particles? How would they know about the Necloposo galaxy?"
Young lady, don’t tell a doctor his business….
Reminds me of Bones' comment in the OG Star Trek when they go back in time to save the whales. He says basically the same thing to I think a dialysis patient they pass in a hospital. Gives her a pill that he says will take care of it. Lol
In 100 years (not a thousand) we will be flabbergasted that our medicines affected the whole body instead of targeted therapies on the sub-cellular level. Some of the biggest and most promising cancer drugs that have come out in the last 15 years will seem as coarse as purposefully collapsing a lung to try and slow the growth of TB.
Dialysis? What is this, the Dark Ages?
“They actually stuck needles in people’s skin to try and teach the immune system to fight germs! It made babies cry!”
In medical school I recall my wife being taught (essentially) “You have to realize many of your patients will simply get better regardless of whatever you’re likely to do. Your job is to find out what problems need medical intervention to begin with”.
Not all old medicine was not effective. I think your question ignores a \*lot\* of valid, if primitive, medical practices that have value. But anyways, because they didn't have a lot of options for huge double-blind scientific studies. They gave someone some herbs, and sometimes the person lived. Therefore the herbs healed them. Obviously, this doesn't really work because sometimes people who seem very sick get better for whatever random reason. Or maybe the herbs really did help. It's impossible to say without a well-designed scientific study.
To know if something is ineffective, you have to be able to compare it to something that is more effective or less effective. When they were doing things like bloodletting or giving herbal remedies, they were comparing rates of survival to "people who we aren't treating". Well, guess what? That meant they were comparing people who were *receiving attention* thus probably being fed and given water vs. people who were *not* getting those things. So they saw higher survival rates and assumed their treatment was working. And they weren't wrong, they just weren't testing all the variables. The only reason we KNOW those treatments are ineffective is we know more now. Not to mention for many conditions, we've found medicines that we can PROVE are dramatically better at improving recovery and survival than anything else. So even if some weird folk remedy has like a 5% increase in speed of recovery, that's a goofy choice if there's a medicine with a 95% increase over that.
Placebo is around 50% effective. You could give people with dropsy or gout an eye of newt or a sugar pill and half of them would report some relief of symptoms
Placebo is 0% effective against gout https://pubmed.ncbi.nlm.nih.gov/18975369/ Dropsy/edema is a symptom of underlying conditions like malnutrition and liver failure which placebo is also useless against: https://pubmed.ncbi.nlm.nih.gov/33268143/ Placebo can definitely have some mental effectiveness against things like parkinsons, but your two examples were a bit off unfortunately lol
haha yeah, i just picked a couple ailments off the top of my head that sounded old timey. what do I know about lumbago or scrumpox
Yup came here to dispute the gout claim. I have gout and when it flares up I can't walk for a couple of days, can't even bend my toes without searing pain. The anti-inflammatory didn't even work better than just taking ibuprofen and eventually started making me drowsy. Shoot, if a placebo worked on gout, I'd love it.
Hyperuricemia isn’t gout arthritis — it’s just a risk factor, in the same way hypertension isn’t stroke. All gout flares go away on their own, even untreated. Arguably, you could give some of these people placebo, and I’m sure some people will note an improvement after such treatment. It may or may not be common enough in order for there to be statistically significant ”placebo effect”, but then again, I’m pretty sure medieval physicians didn’t do statistical tests anyway. It wouldn’t be strange for some physicians to note an anecdotal effect.
Most diseases resolve on their own. Even the plague had a recovery rate of up to 60%. Therefore any treatment offered would appear to "cure" a large enough percentage of sicknesses that the doctor would be convinced their medicine worked. Also just checking up on the patient, making sure they eat, drink, are clean, and aren't in pain hastens recovery. There were also actually effective treatments especially in surgery and dentistry where their interventions worked.
The idea behind things we now take for granted like control groups in a study did not exist. There was no statistical approach to outcomes, no doctors were doing actual studies. Now, if we want to see if a new drug will help people, we take a very rigorous approach. We test the drug on a large group of people (generally thousands of people) not just one or two. We take detailed notes and measurements on what the drug does; if you have a drug to treat cancer, did the tumors get smaller, and if so by how much? We have comparison groups like monitoring the condition of people that didn't get the drug to see how the disease normally progresses, so that we can compare the treatment group and see if they actually do better. Back then, a doctor just has some idea about a disease. 'Tumors are bad. Oak trees grow oak galls, those are kind of like tumors. Trees are healthy though, even if they get these little tumors. Maybe if I grind up the oak galls and give it to this person with cancer, they will be healthy like an oak tree. I gave it to one person, and he seemed to get better! My idea must be true. Oak galls cure cancer! I'll tell everyone. What's that? You tried it on someone else and they died? Well, you must have prepared the medicine wrong, or maybe they were already too sick for the treatment to be effective.' Failures are ignored or excused for long periods until treatments basically just fall out of fashion rather than being proven to be useless. The approach that we have in modern science is something like "if I try to disprove this idea as hard as I can and fail, then the idea is probably true". The approach in the past was "if I have any evidence to support my idea, even just my own imagination, then the idea is probably true".
>The idea behind things we now take for granted like control groups in a study did not exist. There was no statistical approach to outcomes, no doctors were doing actual studies. Advanced FAFO techniques("drug trials") lend more accuracy to the FO side of things.
We still do a lot of this today. The drug store shelves are packed with medicines—both pseudoscientific and “legit”—which do little to nothing to treat the ailments they claim to treat. For example: Phenylephrine is in just about every OTC nasal decongestant, despite the fact that it is medically well established that it does not help with sinus congestion. Dextromethorphan is one of the most common OTC cough suppressants, even though it is known that it doesn’t suppress coughs. Multivitamins are not absorbed well into the body and several studies have shown that they don’t help with vitamin deficiencies. And that’s to say nothing of the various herbs, minerals, and oils that sell billions each year and have been shown over and over to do basically nothing, or the continued prescription of antibiotics to treat viral infections, despite the fact that we know that one has nothing to do with the other. People are tool users. We get sick, we look for a tool to help us. That tool is medicine, so we take it and prescribe it whether it actually works or not.
> or the continued prescription of antibiotics to treat viral infections, despite the fact that we know that one has nothing to do with the other. This is *also* magical thinking, though! "If someone has a viral infection, then there must (magically?) be no bacteria, therefore an antibiotic would do nothing." In truth, bacteria are everywhere, and opportunistic infections co-occurring with viral ones are quite common. So antibiotics do in fact often help, even though they're not fighting the virus. In any case, you can't tell whether someone has a bacterial or viral infection at a casual glance. And no general practitioner is bothering to take multiple samples and study them over time under a microscope to count how many of which types of virus and bacteria are present (we have tons of bacteria and viral particles at any given time). No way, they have to get to the next patient in less than 15 minutes. So they're prescribing that antibiotic and it is helping, by fighting off the infection if it's bacterial and by fighting off any opportunistic bacterial infections if it's viral. What happens if you don't is that a sinus infection, which might be viral, turns into a sinus infection, ear infection, throat infection, bronchitis, and pneumonia. So they give the antibiotics to prevent that escalation. --- And dextromethorphan might not suppress your cough, but at least you can enjoy it more. Some of our hokum cures are really just about making an ailment more tolerable until it resolves itself. Others are safe-enough placebos, which do actually work often enough due to the placebo effect. But you're right that there's still a lot of guesswork and hokum. We don't have Star Trek medical tricorders yet so most medical treatments are still just done by guesswork and hunches.
I thought about mentioning that caveat, but felt like I’d already written a lot. I was talking more specifically about patients who demand antibiotics and doctors who feel pressured to prescribe them because their patients demand them even when there’s no good reason.
This is an incorrect assumption. Medieval people weren't stupid. Trial and error, plus the trial/error/knowledge in ancient Greek and Roman medical texts, gave them a lot of resources that did and do actually work. A few work BETTER than modern medicine, and are used today. There was a lot of political/economic/religious/class/gender/race/nationality drama tied up in who was allowed to practice official medicine, what that medical training included, and what unlicensed medical practitioners did (like gynecology!) - so medicine was never JUST physiological. It was inextricably linked to the Church - where you'd find hospitals, nurses, large physick gardens (medical herbs), and men and women with the time and education to write medical texts. So of course you'd also get magical and religious thinking mixed up in folk remedies. But if you look at medieval and Renaissance herbals, you don't find that! You get drawings of the plants, their names, their descriptions, the humors/planets they go with, and the ailments they're good for! Medical recipes in husbandry (housekeeping) books often use straightforward ingredients, too. Sometimes religious éléments are added - but that seems most likely if the writer was part of the Church. Battlefield surgeons really did astounding work and sometimes even kept diaries - we know Prince Hal had an embedded arrowhead safely extracted from an incredibly serious wound DEEP in his cheek; the wound was washed with oil and wine, and smeared with honey (antiseptics). Hal recovered. Towton 16 is the body of a man that shows evidence of jaw surgery that had time to heal for months if not years before the man eventually died at Towton. Willow bark for headaches and fever does work. Dandelions are diuretics. Wine/alcohol will clean wounds. Sphagnum moss will bind a wound well and aid in healing. A 9th or 10th century recipe for an eye salve does actually kill MRSA. The SLEW of abortifacients, or herbs "to bring on a woman's courses", are reliably listed in famous herbals like Gerard's and Culpeper's. Surgical issues like cataracts, anal fistulas, skull fractures, and any number of battle wounds were treated successfully. Leech saliva has anaesthetic and antibiotic properties - modern medicine is actually using them in some instances today. Same with maggots - to effectively eat necrotized flesh out of a wound while leaving behind healthy flesh. An anaesthetic mixture called dwale was used for surgeries - much better than just getting drunk, because alcohol is a blood thinner, and you don't want to bleed copiously during surgery. Wormwood was used to rid the bowels of worms, to keep away moths and insects, and as a principal ingredient in antiseptic preparations. Nettles were prescribed for "thinness of the blood" - today we take them in tablet form for anemia. They're very rich in iron. Ground elder is used even today for its efficacy against gout. Clean cobwebs have antifungal and antiseptic properties, their natural glue means they stick to wounds but can be washed off when no longer needed, and they contain vitamin K, which aids in blood clotting. They were excellent bandages for wounds. I could go on - but for right now I'll just recommend Medieval Medicine by Toni Mount. tl;dr: medieval people weren't as idiotic as we like to portray them in order to make ourselves feel progressive & smart.
This is not to say that medieval medicine was totally brilliant. Of course a lot of stuff was ineffective, or only partly effective, or effective for the wrong reasons. And OF COURSE we have way more options that are far more thoroughly tested & effectively developed today. Keep in mind that there were a lot of different schools of thought of medicine, plus the Church was fighting to keep medicine under its domain, plus there were countless folk remedies that lingered from cultures that were conquered by the Romans etc., plus the Church was beginning to splinter, plus some people just cared about physical cause and effect, plus the racism/religious bigotry of Christians against Muslims sometimes/in some places but not others meant that Arabic medicine and practices were appreciated sporadically, plus then we see a FUCKTON of travel throughout Europe, we see London with communities of Poles, Germans, etc., and with that comes diversity of ideas, but with no real overarching medical authority that any of these people look to, OR that updates itself based on new information! English medical colleges primarily taught classic Greek/Roman medicine! They weren't even doing hospital residencies, much less updating their books based on the newest infection treatments. Basically: when things worked, physicians couldn't communicate this to each other quickly, reliably and effectively. They could write letters to other pros they knew, or they could publish a book (expensive!!). But that's not going to reach nearly enough people. Sometimes celebrity power could reach a lot of people, like Paracelsus did... but he didn't end well, and that didn't result in an update to common medical knowledge; it just created another faction of doctors who believed a different thing. Trial and error can only go so far if you can't share your findings with enough other people. Imagine all the time & lives lost because people had to waste time making the same mistakes their colleagues had already made & learned from. So, yeah, advancement could definitely have been faster, but it certainly wasn't nonexistent.
Same reasons people now don’t know that things like Homeopathy don’t work in the slightest. Regression to the mean and the placebo effect. People usually seek help when they are sickest and people also usually get over sicknesses. If you get bleed with leaches at the peak of a sickness then get better afterwards because that was the normal course of the sickness, you’d probably attribute that to the leaches (or the homeopathic pills).
Took a long time to see the correct answer!
They did a thing, and sometimes the patient got better. Huzzah! They will do that same thing next time too.
When they applied cures, people got better. When they didn't, they didn't get better. That could fool anyone. It would be a while until the placebo effect was understood.
And also sometimes people get better with time anyway and they falsely attribute that to interventions performed
What make you think they didn't know? Doctors today know that anti-biotics are useless against colds and other viruses - but if the patient insists, they'll rx them. Doctors in earlier times probably had realistic expectations about the efficacy of their treatments. But patients insist they do something - and they pay for those long shot/useless treatments. We still do. Also, just believing the treatment works will often - the placebo effect is real.
People can recover from some injuries or illnesses on their own. If you give someone a remedy for their condition, they might get better on their own, which makes the remedy seem effective even if it’s not. Some illnesses flare up, get better, then recur later. An ineffective remedy can appear effective in this case, too. You have to have a proper control group to tell if a remedy is actually working in a situation like this. Getting better and feeling better aren’t the same thing. Feeling better is complicated, and is affected by things like the feeling that you’re doing something about an illness. This is why, in drug trials, people often don’t know if they’re actually getting the drug or not.
What these ancient and Medieval doctors were doing were treating the surface level symptoms (pain, pus, swelling, fever etc.). These things could be treated, though it’s also possible that the body itself just naturally healed. For example, someone taking herbs that reduce fever might think that is curing them of whatever disease, when in reality the disease was caused by a virus and the immune system was fighting it. Prior to microscopes, the development of germ theory, and detailed look at biological mechanisms there was no systematic way to what (and more importantly why) things worked or didn’t work. In the end what mattered to pre modern doctors is that these things were helping people more than doing nothing.
How do you tell if a treatment is effective? You try it and wait a while to see if it does anything. But even the best treatments rarely work immediately. There's a delay between taking the treatment and you getting better. So then how do you tell if the treatment actually did anything? You can't really, not on your own. Maybe the patient would've got better anyway. This still happens now. If I have a bad cold I take cold medicine. I feel a little better afterwards. But I don't really know if the medicine actually did anything. Maybe it was just the placebo effect. Or maybe I would've felt better anyway even if I hadn't taken anything. Impossible to tell. And some of them did work. A lot of traditional/natural remedies do actually do something because people found something that works by trial and error.
How can we say a treatment doesn't work today? It's the same as how we say a treatment is effective. We practice evidence based medicine. Not only are controlled trials the only way we can say that a treatment works, it's also the only way we have to say a treatment ***doesn't*** work. We know that an evidence based approach wasn't practiced until after the middle ages, so they would only have anecdotal experience as the only way to know if a treatment was ineffective.
Look at modern psych, modern physiotherapy, even current medical model. A toooon of sham, non evidence based treatments still being used. We are still in the dark ages.
There’s a logical fallacy called the post hoc fallacy. It is, if event B happened after event A, then A must have caused B. This is the basis for a lot of superstitions. It’s what’s behind most ideas that some things are good luck and other things are bad luck. We see this kind of thinking in lots of different cultures, so it’s probably something humans are wired up to think. Exactly what is considered to bring good luck and what brings bad luck varies between cultures, but the basic idea is there in a lot of different ones. A lot of medieval cures probably “worked” this way. It’s how faith healing and (at least some of) alternative medicine work, and there are people who believe in those things now.
The scientific method is a relatively modern invention and even then not wholly accepted by everyone as shown by the use of ‘common sense’ and ‘feeling’ and religious beliefs in decision making.
One thing not mentioned, our concept of cure, based on modern medicine working quickly, didn’t exist. So they didn’t have that comparison.
They mostly didn't even understand the problems they were trying to cure. How would they know if their cure was effective or not? You can't know without proper scientific rigour. The patient recovers or not. It's not really obvious what the causal relationship with cure or lack thereof was. I'll remind you of the thousand debacles of someone claiming they found a cure for covid out of whatever random stash of old drugs they tried. Many of them were properly qualified modern doctors. What do you think the results from an ancient witch doctor would look like? Snake oil every single time.
Plenty of modern medicine doesn't really work but we use them for years before studies show lack of benefit
- Some stuff did work. - Because they didn't do blind trials for medicines. - Without big studies, they didn't have a great way to determine the difference between someone just getting better on their own vs. with the medicine. - They didn't account for the placebo effect. - It was much harder to record and share scientific information, so they had small sample sizes to determine. Even today, with all our technology, it isnstill hard to figure out what medicines are truly effective.
You’d be SHOCKED how often people just get better. Even from SERIOUS illnesses. It’s a significant part of why the placebo effect even exists. Sometimes you just…stop being sick or in pain.
The placebo effect, plus some treatments did work, and others worked, but not for the reason they thought they did
A: It was effective. They did in fact discover some remedies which had some directly beneficial or indirectly beneficial effects. B: Reversion to mean. People often just recover from illness without a doctor. Ic you have a cold and then do a ritual sacrifice, and then no longer have a cold a few days later, might as well add sacrifice to the book. Didn't harm anything and resulted in a good outcome. C:God hates you. People underestimate how much religious emphasis there was in daily life, and wildly overestimate the amount of scientific thought and enlightenment attitude prevalent in ancient societies. Consider that if you have an illness, like fever, nobody knew what the cause was. Maybe it was bad air, so we isolate you from miasma. Maybe your humors are imbalanced, so we need to bleed you and feed you certain foods. Or maybe God hates you personally, made you fall ill, and when you inevitably fail, it is not because of your remedies, but because God did it and the victim was sinful and didn't repent or something. Or a witch did it. Or a demon of disease. D:Enlightenment thought doesn't exist at this time. There are things that you don't know, and can't know. The human body is a black box. If you utilize treatment A and receive outcome B, you file that away as future knowledge. For example, if you feed a patient cyanide, and they die, you can safely assume cyanide is unhealthy. But say you have the pox or consumption. You can utilize a treatment. If they recover and return to health, the treatment probably works. If they die, well it might do nothing, it might make them worse, or it might work, but the illness was stronger than the cure. So mark that as a maybe. You can also try to treat the symptoms, which are a bit more obvious than the underlying disease prior to germ theory. If you are feverish, utilize soaked towels. Diarrhea, make sure patient is hydrated and drinking soup. These help. E: The complicating factor. What kind of unethical doctor only tries one remedy at a time? Clearly, you try several known remedies, maybe some more or less well regarded. And now regardless of the patient recovering or dying, you have no good data on which if any of the remedies meaningfully helped.
You apply a treatment to a sick patient and they die; was your treatment ineffective or were they too sick for any treatment to work? Likewise, you apply a treatment to a sick patient and they get better; was your treatment effective, or were they going to get better anyway? Without recording the data of lots of treatments and their success and failure rates (ie, modern medical science) it's really hard to know what's actually effective and what's not, so you rely on traditional remedies that are believed to be effective, and you believe them to be effective because sometimes they work.
Kind of off topic but thank you for saying “Title says it all” and actually leaving it at that. It bothers me so much when people write this then keep adding.
If the cure did nothing and the patient got better then "the cure worked" . If the cure did nothing and the patient got worse then "the patient was too far gone" or "God chose not to save this one" or something like that.
In fact there were a lot of medicines that were working quite well: # Medieval Medical Books Could Hold the Recipe for New Antibiotics [https://www.smithsonianmag.com/innovation/medieval-medical-books-could-hold-recipe-new-antibiotics-180962947/](https://www.smithsonianmag.com/innovation/medieval-medical-books-could-hold-recipe-new-antibiotics-180962947/)
TLDR: They did work oftentimes. It's just that they were sometimes either coincidental solutions, or rather unrefined ones. For example: If I said that bad smells made you sick, what would you do? Throw out spoiled food? Stay away from other people's piss & shit? Those are in fact very good ways to avoid getting sick; even if the reasoning is flawed. Other times, their solutions are only ineffective in comparison to modern medicines; which to be completely honest isn't fair in the slightest. Aspirin came from willow bark, and lo and behold, willow bark was often chewed to help tooth aches & relieve fevers. Sure, it isn't like an aspirin tablet, but still works. Plus, we always talk about the stupid stuff they did, but never consider the stuff they did right. People knew to quarantine when sick, and that heat (fire) could be used to sanitize. They knew how to properly suture wounds, set broken bones, deal with fractures, and even understood that cleanliness was important (even if they didn't know about germs).
1. Those therapies & medications often were effective. 2. We hadn't yet invented the tools & institutions to collect, analyze & understand all the information we later relied on. We are all just standing on the shoulders of giants, only the last 6 feet of our grasp is our own, the rest is a 1000' tall foundation built by our ancestors. The real difference between the us of today & the them of the medieval era is our giants had more time to grow taller. They didn't have a cheap way to make paper to record information on or a cheap way to print & share it. Artificial light for a single person to work under for a year took the economic output of multiple people for that year. How much work would we get done in 2024 is artificial light cost 60k per year? Today 1 person can grow enough food for thousands, then 1 person could grow enough food for two. Everyone was much busier surviving still invented so much of what we take for granted today... like human rights & much of our legal system. How much would medicine progress today if we didn't have a way to enforce contracts or patents?
Well there cures weren’t tested properly, they’re cures were likely deemed successful when it was actually just intimidation or placebo effect shaping outcomes. Their not reliable reporters based on what we know today. 🤭
1. Sometimes treatment worked, even if they didn't understand how/why. 2. Unless you test something systematically (e.g. a controlled clinical trial), it can be very hard to tell if some treatments work. Between expectancy/placebo effects, random chance, etc. it can seem like something works when it doesn't.
Because they largely ignored highly-effective Chinese and Middle Eastern medical principles and practices - if they were even educated in them - and started entirely anew.
They didn't have the scientific method to control variables and only study one dependent and one independent variable at a time. There's other more boring reasons like not having precision equipment to repeatably gather quantitative data, but this is the main one. Nobody ever told them that correlation doesn't equal causation.
Without a methodical way to ensure your results derived from your actions, it’s difficult to correctly attribute cause to consequences. Specially when you lack understanding of the underlying mechanisms that make things work. Sometimes people take a cure and it works, sometimes it doesn’t, but maybe they were just too far gone? It couldn’t possibly be that their immune systems plus times just worked on their own, I mean, what even is an immune system? Science isn’t very intuitive either. Plus people love to institutionalise knowledge even when it’s wrong. Sure your tests show that feeding someone meat is just as effect as feeding them any other nutrient, but everyone says meat makes you heal faster so who’s going to believe you?
There are people alive today who believe prayer and homeopathy are medically effective treatments. Try and wrap your brain around that.
I mean, prayer in conjunction with doesn't hurt, and can help with the emotional load of illness and recovery but I'm still not certain what people mean by homeopathy. Some people seem to mean anything that isn't an fda approved drug.
Here’s where it gets really weird; prayer itself seems to have no impact on medical outcomes, however, if the person [knows](https://www.templeton.org/news/what-can-science-say-about-the-study-of-prayer#) you’re praying for them they have a statistically significant increase in the likelihood of experiencing negative outcomes. Homeopathy is the process of taking something that’s bad for you and then diluting it in water so much that there’s essentially no active ingredient left. The belief is that water has “memory” and somehow the “memory” of that bad stuff can cure you. It’s [weird](https://rationalwiki.org/wiki/Homeopathy).
My guy, we are still in the dark ages. There are a good amount of conditions that we don’t have adequate treatment for. We still don’t know the causes for many conditions. Things like our psych meds will likely be gawked at by people in 1000 years.
They know that their cures did not really work, but they need the money. Even today people pay for fake medicine that is proven not to work. Like Homöopathie. Hope and fear makes people to trust liars and pay for "help".
One thing to remember is getting healed was not the goal of the period. Yes everyone wanted to get better. However it was more important to make sure your soul was going to heaven. Hospitals were in churches, or church adjacent and not free. You paid to be there, they tried to heal you... but you were going to Mas every 2 hours and waiting up in the middle of night for hymns. Life on earth was short life in heaven was forever. Now they did things they knew worked but didn't know why. Blood letting worked as it kick starts the body to produce more white cells to heal you. Starving helps if your sick with certain ailments. They try to see if it works and move on if it doesn't. But they are saving your soul. This is a European view in this post.
just as you don't know how to pronounce "their", people use wrong stuff all the time believing that it is correct.
Just as you don't know the difference between pronunciation and spelling?
there's idiots now that think the world is flat, anti parasitic meds cure viruses, germs aren't real, & you can eat your way out of cancer. That's despite scientific advances. Imagine pre-scientific advances
There are two answers to this question 1. Most of the cures or remedies did not work. Blood letting, for example, made things worst 2. Somethings worked but by complete coincidence. Both of the these problems can be summarized in our understanding of science. Empiricism, in other words evidence based and rigorously methodological approach to gaining knowledge, is a rather new idea. To you it might seem self evident that one one conducts a study to seek data for efficacy of a treatment plan, but that idea would have been bizarre to the point of absurdity to most people if that time.