Marvellous medieval medicine: why their curious cures were better than you think

My urine has turned black!

What does your wee say about your health? Well, plenty – but perhaps not in quite the way medieval physicians understood it. Before the in-depth study of anatomy and physiology, establishing the causes of symptoms relied on theories that today seem primitive or foolish. However, they were often based on long-established ideas about the body and its function.

Medieval treatises on uroscopy – the study of urine – identified up to 20 colours, each indicating certain diseases. Many texts on this subject were accompanied by drawings of glass flasks filled with liquid coloured with an appropriate pigment. These might be arranged in a circular shape with descriptive labels, helping readers to memorise the key diagnostic details. Perhaps unsurprisingly, black was the worst possible colour, and was generally agreed to indicate imminent death.

Why was urine so significant? Because of prohibitions against opening the body (which extended to postmortem dissections), medieval doctors were reliant on external indicators. This included variations in a patient’s pulse but also the colour, texture, layers, smell and even taste of their urine.

The doctor’s role was to understand a patient’s nature: specifically, the four fluids or ‘humours’ inside the human body. In the treatise De Natura Hominis (‘On the Nature of Man’), by the ancient Greek physician Hippocrates (c460–c375 BC) or his pupil Polybus, it was determined that there were four such humours: blood, phlegm, black bile and yellow bile. Disease was caused by imbalances in these humours, or when they became ‘corrupted’ or concentrated in a part of the body.

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This theory was developed further by Galen of Pergamon (c129–c216), who likened digestion to the cooking process: food was converted into life-giving liquid, the humours were generated by the vital organs, and waste products – including urine – were expelled. Examining urine could therefore inform the physician about the state of a patient’s digestion and of any possible humoural imbalance and the disease that might result from it.

I’ve got an excruciating pain in my bottom

Medieval knights and noblemen could spend significant amounts of time on horseback. And who can blame them? This was, after all, the quickest way to get around. But it could also be extraordinarily painful.

Occupy the saddle for too long and you could start to suffer from an anal fistula – a condition that causes an abscess or an abnormal opening between the anal canal and the surrounding skin. This is as unpleasant as it sounds – which is why some sufferers called on the services of a medic called John Arderne.

Arderne was one of the most famous English surgeons of the 14th century. Among the novel developments he described in his writings, he came up with a procedure for treating anal fistulas that involved a surgical dilator called a tendiculum and a kind of flattened needle called an acus rostrata.

Arderne also illustrated the stages involved in the operation, and described medicines that could be injected into the rectum in a bid to promote healing. One of these – made up of rose oil and the single yolk of a raw egg – should be administered with the aid of a hollow wooden instrument called a nastare ligneum. This needed to be lubricated with rose oil and “gently inserted into the anus”.

“This,” Arderne promised, “effectively mitigates and mollifies any burning, stinging, itching and pain.” His patients would, no doubt, have prayed that he was good to his word.

I’m about to go into labour

Childbirth was perhaps the most perilous event in any medieval woman’s life. This was a primary focus of Gynaecia, a treatise perhaps written in the fifth or sixth century and ascribed to an author known as ‘Muscio’ (who was possibly from north Africa).

Gynaecia explained how normal and abnormal births should be managed, prioritised the role of midwives, and described different malpresentations of the foetus – and what should be done to ease the birth in such cases. In one manuscript from the Middle Ages, passages from the Gynaecia are accompanied by illustrations showing these various positions of foetuses in wombs.

Some women who “travaileth of child” might turn to magic for help. Recipe books and medical guides both contained instructions for preparing protective amulets that should be lain on a woman’s belly or thighs. Designed to be viewed, worn and read, these objects were believed to protect their wearers from harm by association with holy bodies and the pains they suffered.

One typical text from the late 14th or early 15th century invokes the names of holy mothers and their children: “Saint Mary bore Christ, Saint Anna bore Mary, Saint Elizabeth bore Saint John the Baptist.” Another example contains images of the instruments of Christ’s Passion and of his wounds and blood; a measurement of the length of the Virgin Mary’s body; and prayers to early fourth-century mother-and-son martyrs Saint Julitta and Saint Quiricus.

I can't stop farting

What did our medieval ancestors do when they were afflicted by stomach pains? And what remedies could they deploy if, worse still, that pain was accompanied by an attack of flatulence? One option was to take an electuary, a type of orally administered remedy sweetened, usually with honey, to make it more palatable.

A recipe for one such remedy contained a dizzying number of ingredients – some more familiar to the modern eye than others. These included sugar, chebulic myrobalan (fruits from an Asian tree), nuts, anise, caraway, fennel, cloves, the wood of aloes, mastic, French muscat and syrup. “You will,” so the recipe instructed, “give this in the form of a hazelnut [ie as a hazelnut-sized pill], at morning and night with warm water and wine or with wine alone.”

This recipe comes from a compilation of over a thousand remedies known as the Antidotarium Magnum, which was compiled in the 11th century by a monk of north African heritage known as Constantinus Africanus, who lived at the abbey of Monte Cassino in Italy. Innovatively, the text advised how much of each ingredient was required, using a system of symbols to denote measurements such as drams, scruples, pounds, sixths and halves.

The Antidotarium Magnum’s ingredients suggest that it was inspired by Islamic, Byzantine and classical sources. Yet that didn’t stop a copy reaching Durham Cathedral Priory, where – judging by the presence of a key to explain the meaning of these symbols – the monks tried to make some of the medicines that it describes.

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I’m feeling feverish

In the modern world, fevers are understood to be symptoms of the body’s immune response to infection. In the medieval period, however, a fever was thought to be a disease in its own right – an overheating of the body caused by malfunctioning digestive processes. And, in an attempt to turn down the heat, medieval medics often went on a charm offensive.

Today, science and magic tend to occupy separate spheres. In the Middle Ages, though, it was widely believed – even among learned medics – that words and rituals possessed healing potential, and many medieval manuscripts from the Middle Ages contain instructions for the recitation of magical charms.

One example instructed the reader to make three signs of the cross “on the right ear of the feverish, and with each cross, say in succession: ‘Christ conquers, Christ reigns, Christ commands.’” The reader was then advised to write a series of charms involving the Father, the Son and the Holy Spirit – not to mention a lamb, a sheep and a lion (all of which appear in a prophetic passage in Isaiah 11) – on the patient’s palms.

But perhaps the most extraordinary feature of this charm was that its healing power was only realised when the patient drank the ink with which it was written. This may not have been particularly pleasing to the palate but the patient could at least console themselves in the promise that, “without doubt, he will be cured”.

I’m suffering from menstrual cramps

Not everyone could afford to pay for the services of elite medics such as John Arderne. For the vast majority of people in the Middle Ages, finding a cure for illness meant relying on healers, their family or neighbours. These do-it-yourself doctors used everyday ingredients and common wild plants, which were crushed, chopped, boiled and strained with simple equipment found in the home. And, by the 14th and 15th centuries, this local medical knowledge bank was increasingly being collated and disseminated in hundreds of simple medicinal recipes written in vernacular languages.

The medicines contained within these recipes were often administered in draughts – liquid concoctions for patients to drink. Or they could be applied via sticky salves applied to the skin on pieces of fabric or leather. Some cures – such as one for “grinding and aching in the womb”, found in a 15th-century English recipe – employed both. “Take five-leaf and stamp it and temper it with stale ale,” it counselled, “and giveth the sick to drink thereof, five spoonfuls at once, and seethe and bind it to her navel as hot as she may suffer.”

I’ve lost my hearing

If you opened a medical manuscript in the Middle Ages, then you may have been confronted by the sight of ‘Vein Man’. No, ‘Vein Man’ wasn’t a medieval superhero but a visual aid, designed to help readers locate veins in the human body. He makes for an interesting figure – chiefly for what he tells us about medieval people’s attitudes to their health.

In order to cure many diseases, physicians might attempt to restore the correct humoural balance, often through purging the body of an excess or corrupted humour. A common method for this was phlebotomy, or bloodletting: the controlled release of blood from a patient’s veins. That’s where ‘Vein Man’ came into his own.

Accompanying labels described the ways in which bloodletting could alleviate a variety of ailments. For example: “Opening the vein next to the nostrils purges the head and aids and strengthens the hearing.”

However, timing such interventions carefully was crucial. It was believed that each part of the body was governed by a sign of the Zodiac: Aries was linked to the head, whereas Pisces was connected to the feet. If the moon was in conjunction with a particular constellation, it was considered perilous to operate on the area governed by that sign of the Zodiac.

This principle was summarised in a second kind of diagram, ‘Zodiac Man’. This comprised a human figure appended with the names (and sometimes miniature drawings) of the Zodiac signs. Again, accompanying labels provided advice – for example, when the moon was in Aries, you should “avoid incisions in the head or face and do not open the capital vein”.

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I can’t conceive

Have you ever procured a weasel testicle from your local pharmacy? Or burned half a handful of young mouse-ear in an earthenware pot? No, thought not. But if you’d lived 800 years ago – and been struggling to conceive – the answer may have been different.

Weasel testicle and mouse-ear (which, for those who don’t know, is a plant found all over Britain and Ireland) were two of the main ingredients in a medieval treatment for infertility. One remedy instructed users to grind and combine them into a “soft pill” which should be placed “so deeply in the private parts that they touch the uterus”. This was to be left for three days, during which the woman was advised to abstain entirely from sex. After this, the recipe continued, “she should have intercourse with a man and she should conceive without delay”.

Medieval people believed that their world was divinely created and organised, with plants, animals and even stones placed there for the benefit of humans. It was thus logical that parts of an animal’s body, or plants shaped like vital organs, might have curative properties for corresponding parts of a human body. Treatments for infertility often employed bits of animals known to be prolific breeders.

The remedy above was one of dozens compiled in the notebook of a Carmelite friar, Richard Tenet, in the early 15th century. Unlike monks, who were cloistered within their abbeys and priories, mendicant friars travelled between towns and cities; they relied on charitable alms, which they earned by preaching and hearing confessions. This brought them into contact with ordinary people, including women, from whom they appear to have learned common treatments.

James Freeman is a medieval manuscripts specialist at the University of Cambridge. He is curator of Curious Cures: Medicine in the Medieval World, which is running at Cambridge University Library until 6 December

This article was first published in the November 2025 issue of BBC History Magazine