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First teaching 2016

Last exams 2025

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Perceived Causes of Disease in the Middle Ages (Edexcel GCSE History)

Revision Note

Zoe Wade

Written by: Zoe Wade

Reviewed by: Bridgette Barrett

Diseases During the Medieval Period - Timeline & Summary

Timeline highlighting key historical events in medicine: 5th Century BCE - Hippocrates' Theory of Four Humours; 2nd Century CE - Galen's Theory of Opposites; 1348 - Black Death in Britain.

Examiner Tips and Tricks

Nowadays, historians do not use the terms BC and AD to measure time. This is because they are associated with Christianity. Instead, they use the non-religious terms of BCE (Before Common Era) and CE (Common Era) which you should try to use in your exams. There is no year difference in dates between BC/AD and BCE/CE

During the Medieval period, there was a lack of understanding about why people became ill. This was because scientific explanations did not exist. People looked to natural or supernatural reasons to explain the unexplainable. They followed the ideas from philosophers like Galen and Hippocrates who had lived in Ancient Greek and Roman times. They seemed to have more answers about why people became ill.

The Church’s power was enormous in 1250. Priests were one of the very few individuals that could read and write. In Church, they taught people how disobedience would result in going to hell in the afterlife. The Church stated that it was God’s will about who was healthy or not. Ordinary people did not question the authority or wisdom of the church. The Church and people did support the ideas of Galen and Hippocrates as their ideas matched Christian teachings. This meant they were not challenging the Church’s power. It took the emergence of the Black Death in 1348 for some people to begin to question the Church and existing theories

Natural Causes of Disease in the Middle Ages

Miasma

  • Miasma is bad air and was understood to be found near swamps, corpses and rotting objects

  • If you breathed in miasma, people believed that you would become ill

  • Many people believed in using pleasant smells to protect against miasma-causing illness

Urine

  • Physicians believed in examining the urine of their patients 

  • They believed the urine indicated which humour was unbalanced

  • Physicians would check the colour, consistency and smell of the urine and compared it to a urine chart

Hippocrates and the Theory of the Four Humours

What are the Four Humours?

  • Hippocrates was an Ancient Greek physician

  • He theorised that four humours made up the human body:

    • Blood

    • Phlegm: A water-like substance coughed out or contained in a sneeze

    • Black Bile: Blood that had clotted, seen in vomit or poo

    • Yellow Bile (Choler): A substance contained in vomit or pus

  • People believed that for a person to be healthy, the four humours should be in balance

  • Hippocrates’ theory stated that if someone had more or less of one of these humours, the body would become unbalanced. The person would then become ill

  • The humours also linked to seasons, elements and star signs

Diagram of the Four Humours showing Blood for spring/hot, Yellow Bile for summer/dry, Black Bile for autumn/cold, and Phlegm for winter/wet.
A diagram of the Four Humours showing their links with seasons, elements and star signs

The importance of Hippocrates to medicine

  • Hippocrates was one of the first people to state the importance of observing a patient’s symptoms before diagnosis

  • Doctors today still take the Hippocratic Oath which promises that they will not harm patients in their care

  • Hippocrates is known as the ‘Father of Modern Medicine

Worked Example

Describe one feature of the Theory of the Four Humours

2 marks

Answers:

The humours had to be balanced to be healthy (1); Having too much or too little of a humour would cause somebody to become ill (1)

Examiner Tips and Tricks

When answering ‘Describe one feature of…’ questions, two marks are given to you for:

  • Identify - write a relevant point based on the question topic

  • Describe - add some specific own knowledge about the point you have made

This question previously asked students to describe two features of a given event. This question was out of four marks. However, as of 2025, Edexcel will split this question into two subsections, asking you to describe a feature of two different events. Each subsection is worth two marks

Galen and the Theory of Opposites

  • Galen was an Ancient Roman physician who expanded on the Theory of the Four Humours

  • Galen's Theory of Opposites argued that the cure for an excess of one humour is treatment with the opposite humour

    • For example, people believed that the cure for too much phlegm (cold) was eating a hot pepper (hot)

The importance of Galen to medicine

  • Galen had a keen interest in anatomy

    • He publicly dissected animals, particularly pigs

      • This provided Galen with evidence for his theories on the functions of organs, nerves and the skeletal structure of the human body

  • The use of pigs meant that his ideas were mostly incorrect when applied to human anatomy

    • Despite this, Galen's ideas dominated medical thinking for 1,400 years

Examiner Tips and Tricks

Do not confuse the Theory of Opposites with the Theory of the Four Humours. Both theories focus on the humours but the way Galen used the opposite humour as treatment was entirely different to Hippocrates’ approach. Therefore the Theory of Opposites built upon the ideas of the Theory of the Four Humours to give it more practical use for treatments

Hippocrates & Galen's Popularity

  • The theories of Hippocrates and Galen did not require human dissection which allowed the Church to support them

    • The Church did not believe in cutting the body as, for a person's soul to go to heaven, the body needed to be intact

  • Many people in Medieval England could not read

  • Physicians who had read Hippocrates and Galen were regarded as better-educated

    • This meant that Medieval people did not question the physicians

  • Due to a lack of scientific knowledge, there were no better explanations for illness than those suggested by Hippocrates and Galen 

  • Hippocrates encouraged physicians to observe a patient’s symptoms

    • The Four Humours theory matched with what Ancient and Medieval physicians saw in their patients

Supernatural Causes of Disease in the Middle Ages

Religion

  • The belief in God played an incredibly important role in Medieval people’s day-to-day lives

  • The Church dictated people’s lives from ‘cradle to grave’ 

    • People went to Church every Sunday

    • As a baby, they would be christened in the Church

    • They would be married at Church

    • They would go into confession and pay for indulgences to clear their soul of sin

    • When they died, they would have a funeral at Church

  • If you sinned, it was believed that God had the power to make you ill

  • People believed that certain diseases were a result of God’s punishment, for example, leprosy

Astrology

  • Astrology is the study of the position of the planets and stars

  • The Church did not like the use of astrology but it did have links to Hippocrates’ Theory of the Four Humours 

  • Physicians would consult star charts and look at when the patient was born to help diagnose their illness 

    • e.g. Capricorn, Aquarius and Pisces were linked to excess phlegm

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Zoe Wade

Author: Zoe Wade

Expertise: History

Zoe has worked in education for 10 years as a teaching assistant and a teacher. This has given her an in-depth perspective on how to support all learners to achieve to the best of their ability. She has been the Lead of Key Stage 4 History, showing her expertise in the Edexcel GCSE syllabus and how best to revise. Ever since she was a child, Zoe has been passionate about history. She believes now, more than ever, the study of history is vital to explaining the ever-changing world around us. Zoe’s focus is to create accessible content that breaks down key historical concepts and themes to achieve GCSE success.

Bridgette Barrett

Author: Bridgette Barrett

Expertise: Geography Lead

After graduating with a degree in Geography, Bridgette completed a PGCE over 25 years ago. She later gained an MA Learning, Technology and Education from the University of Nottingham focussing on online learning. At a time when the study of geography has never been more important, Bridgette is passionate about creating content which supports students in achieving their potential in geography and builds their confidence.