Hello, and thank you for joining me for today's History lesson.

I'm Mr. Marchant, and it'll be my responsibility to help guide you through all of our resources today.

My top aim is to make sure that by the end of the lesson, you can meet our learning objective.

Welcome to today's lesson, which is part of our unit on mediaeval medicine and health, where we've been asking ourselves: how much was known about medicine and health? By the end of today's lesson, you'll be able to evaluate the extent of progress made in mediaeval surgery.

There are five keywords which will help us navigate our way through today's lesson.

Those are invasive, amputation, trepanning, anaesthetic, and cauterization.

Invasive in this context means medical treatments which involve cutting into the body.

An amputation is the cutting off of a part of the body.

Trepanning is a form of surgery which involved drilling a hole into the skull.

Anaesthetic is a substance that makes you unable to feel pain.

And cauterization is the action of burning body tissue using heat to stop an injury from bleeding or getting infected.

Today's lesson will be split into three parts, and we'll begin by focusing on mediaeval surgeons.

Surgeries are a form of medical treatment.

The surgeries involve removing, repairing, or readjusting organs or body tissues.

Surgeries are invasive as they involve the cutting of the body.

So thinking about what we've just heard, why are surgical procedures considered invasive? Is it because they are difficult to perform, because they can put a person at risk, or because they involve cutting the body? Pause the video here, and press play when you're ready to see the right answer.

Okay, well done to everybody who said the correct answer was C.

Surgical procedures are considered invasive because they involve cutting into the body.

Mediaeval surgeries were performed by barber-surgeons.

Barber-surgeons were not university trained to perform their jobs and therefore lacked formal qualifications.

Instead, many learned how to perform their jobs by observing other barber-surgeons and through practise, especially at times of war when there would be many wounded soldiers in need of surgery.

Mediaeval barber-surgeons not only lacked formal medical qualifications, but they also rarely devoted their full working time to medical procedures.

Instead, barber-surgeons frequently made a living by cutting hair as well as by performing basic surgeries, hence their name, barber-surgeons.

Therefore, barber-surgeon shops, which existed in many mediaeval towns and cities, were locations where both medical and non-medical work was carried out.

So, let's check our understanding of what we've just heard.

Other than performing surgical procedures, how else did many mediaeval barber-surgeons make a living? Pause the video here, and press play when you're ready to see the right answer.

Okay, well done to everybody who said the correct answer was by cutting hair.

Other than performing medical surgeries, many mediaeval barber-surgeons made a living by cutting hair, so they performed medical and non-medical work.

And let's try another question.

This time, we have a statement which reads, "Mediaeval barber-surgeons were university trained." Is that statement true or false? Pause the video here, and press play when you're ready to see the right answer.

Okay, well done to everybody who said that that statement was false.

But we need to be able to justify our response, so why was that original statement incorrect? Pause the video here, and press play when you're ready to check your answer.

Okay, well done to everybody who said mediaeval barber-surgeons did not have university qualifications and trained instead by observing others and through real-life practise.

So, we're now in a good position to put all of our knowledge of mediaeval surgeons into practise.

I want you to describe who was responsible for performing mediaeval surgeries.

You should try to include each of the following terms in your answer: university, barber, and practise.

Pause the video here, and press play when you're ready to reflect on your response.

Okay, well done for all of your hard work on that task.

So I asked you to describe who was responsible for performing mediaeval surgeries, and your answer may have included: Mediaeval surgeries were performed by a group known as barber-surgeons.

Barber-surgeons were not universally educated and trained instead by observing other barber-surgeons and through practise, especially at times of war.

As well as performing basic surgical procedures, many barber-surgeons made a living by cutting hair.

So really well done if your own response looks something similar to that model which we've just seen.

And now we can move on to the second part of our lesson, where we're going to focus on mediaeval surgeries.

People might turn to barber-surgeons to receive treatment for a variety of medical conditions.

Therefore, a range of different medical procedures were performed by mediaeval surgeons.

The most common medical procedure performed by mediaeval barber-surgeons was bloodletting.

This procedure involved cutting veins, such as those in the forearm, to drain the body of some blood.

In many circumstances, barber-surgeons continued the procedure until patients fainted.

Bloodletting was used to treat a wide range of conditions.

Widespread belief in the theory of the four humours meant that many people believed draining blood from their bodies could help to restore a balance between their humours and therefore allow them to recover from their illness.

Aside from bloodletting, mediaeval barber-surgeons also frequently removed growths from the outside of the body.

Barber-surgeons even provided dental care, which usually involved pulling teeth if they had begun to decay or were infected.

Okay, so let's check our understanding of everything we've just heard.

What was the most common procedure performed by mediaeval barber-surgeons? Was it bloodletting, removing growths, or teeth-pulling? Pause the video here, and press play when you're ready to see the right answer.

Okay, well done to everybody who said that the correct answer was A, the most common procedure performed by mediaeval barber-surgeons was bloodletting.

And let's try another question.

Veins in which part of the body were usually cut for bloodletting? Pause the video here, and press play when you're ready to check your answer.

Okay, well done to everybody who said the correct answer was forearm.

Veins in the forearm were usually cut for bloodletting by mediaeval barber-surgeons.

At times, barber-surgeons were requested to perform amputations, which involved cutting off parts or sometimes an entire limb, like a leg or an arm.

This type of work was particularly common at times of war when many men would be injured during fighting.

The purpose of amputation was often to prevent infections or diseases like gangrene from spreading from one area to the rest of a person's body.

Barber-surgeons also carried out trepanning at times.

This procedure involved drilling a hole into a person's skull.

Trepanning was encouraged by ideas such as the belief that epilepsy was caused by demons in a person's skull.

In these cases, it was believed that drilling a hole into the skull might allow any demons to escape and therefore cure a patient.

So, thinking about what we've just heard, we have a statement on the screen that reads, "Amputations had an important medical purpose." Is that statement true or false? Pause the video here, and press play when you're ready to see the right answer.

Okay, well done to everybody who said that that statement was true.

But we need to justify our answer, so why was that original statement correct? Pause the video here, and press play when you're ready to check your answer.

Okay, well done to everybody who said amputations were often carried out to try and prevent infections and diseases from spreading through a person's body.

And let's try another question.

Which part of the body did trepanning involve drilling a hole into? Was it the elbow, the ribs, or the skull? Pause the video here, and press play when you're ready to see the right answer.

Okay, well done to everybody who said that the correct answer was C, trepanning involved drilling a hole into the skull.

So, we're now in a good position to put all of our knowledge of mediaeval surgeries into practise.

I want you to study the procedures identified in the table.

Those procedures are amputation, bloodletting, dentistry, and trepanning.

For each one, I want you to provide a brief description of how the procedure worked in the mediaeval period.

One has been done for you.

So you can see next to dentistry, it says that barber-surgeons pulled out teeth, like those which were decaying or infected.

So, pause the video here and complete the rest of your table.

Press play when you're ready to reflect on your responses.

Okay, so, really well done for all of your effort on that task.

I asked you to provide a brief description of how each of the procedures in your table worked in the mediaeval period.

And your answers may have included, for amputation, that limbs like arms and legs were cut off, often to prevent infections gangrene from spreading.

For bloodletting, you may have said that barber-surgeons cut veins, often in the forearm, and allowed blood to run out in line with the theory of the four humours.

And for trepanning, you may have said that barber-surgeons drilled a hole into the skull, which was often used to try and cure epilepsy by letting the supposed demons in a person's skull out.

So well done if your own responses looked something like those model answers which we've just seen.

And so now we can think about the third and final part of our lesson for today, where we're going to discuss the problems of mediaeval surgery.

Despite a range of available procedures, most people preferred to avoid mediaeval surgery if possible.

Surgery at this time suffered from three major problems. The first was pain, but there was also blood loss and infection.

So, thinking about what we've just heard, I want you to identify the three major problems which affected mediaeval surgery.

Pause the video here, and press play when you're ready to check your answers.

Okay, well done to everybody who said that the major problems of mediaeval surgery were pain, blood loss, and infection.

Pain was a serious problem in mediaeval surgery as patients were usually conscious throughout any operation and therefore suffered terrible pain.

To ensure that barber-surgeons could still carry out their work, patients were often held or tied down.

But even then, they might still be able to move, which made the surgeon's work much harder.

At the same time, because surgery is invasive, it involves blood loss.

Mediaeval patients were at risk of losing too much blood during surgical procedures.

If this happened, then their organs would not receive enough oxygen and nutrients, which could lead them to fail.

This condition was known as shock, and it posed a serious threat to patients' lives.

Meanwhile, infection posed an even greater danger during mediaeval surgeries.

There was no knowledge of germs in the mediaeval period, nor of their role in spreading infections.

Consequently, barber-surgeons did not operate in germ-free environments, and patients' bodies could become very exposed to infection-causing germs during surgeries.

In fact, many people who underwent operations died afterwards due to infections.

Because of these problems, mediaeval surgeons were usually unwilling to attempt very invasive surgeries, such as removing cancerous tumours inside the body, whilst patients usually accepted surgery only as a last resort.

So, let's check our understanding of what we've just heard.

What condition would patients enter if they lost too much blood during surgery? Pause the video here, and press play when you're ready to check your answer.

Okay, well done to everybody who said that the correct answer was shock.

If patients lost too much blood during surgery, then their organs might not get the nutrients and oxygen which they needed, leading them to fail, and this condition is known as shock.

And let's try another question.

This time, I want you to write the missing word from the following statement.

There was no knowledge of blank in the mediaeval period, which made it harder to prevent infections.

So what's the missing word? Pause the video here, and press play when you're ready to see the right answer.

Okay, well done to everybody who said that the missing word was germs. There was no knowledge of germs in the mediaeval period, which made it harder to prevent infections.

There was some progress in reducing the impact of the three major problems of mediaeval surgery.

Many barber-surgeons understood that some natural substances, such as mandrake root or opium, could act as anaesthetics and dull patients to the pain of surgery.

However, these substances could also be lethal if patients were given too large a dose, which means amount, so they weren't always used.

Cauterization was mainly used as a method for combating blood loss.

This often involved heating metal tools which were then placed against the wound, burning it and stopping the flow of blood.

Cauterization saved some patients from shock, but it was immensely painful.

It was also incorrectly believed that cauterization could prevent infections.

In reality, the damage caused by burning body tissues could actually make infections more likely.

Some surgeons, although they did not understand the science, did make serious attempts to prevent infections too.

In 1267, Theodoric of Lucca, an Italian surgeon, began using wine on wounds, which achieved some success in fighting infection as the wine was able to kill some germs. However, despite some of Lucca's success, his ideas were disliked by the French surgeon Guy de Chauliac.

de Chauliac was one of the most famous surgeons in mediaeval Europe, and his criticisms of Lucca's work to prevent infection encouraged many other surgeons, including those in mediaeval Britain, to ignore Lucca's ideas too.

So, let's make sure we've understood everything that we just heard.

Natural anaesthetics like opium were able to help manage which problem of surgery? Was it blood loss, infection, or pain? Pause the video here, and press play when you're ready to see the right answer.

Okay, well done to everybody who said the correct answer was C, natural anaesthetics like opium were able to help manage the problem of pain in mediaeval surgery.

And let's try another question.

Cauterization was mainly used to help manage which problem of surgery? Was it blood loss, infection, or pain? Pause the video here, and press play when you're ready to see the right answer.

Okay, well done to everybody who said that the correct answer was A, cauterization was mainly used to help manage the problem of blood loss in mediaeval surgery.

And let's try one further question.

This time, we have a statement which reads, "The use of wine became widespread during surgeries to try and prevent infections." Is that statement true or false? Pause the video here, and press play when you're ready to see the right answer.

Okay, well done to everybody who said that that statement was false.

But we need to be able to justify our response, so why was that original statement incorrect? Pause the video here, and press play when you're ready to check your answer.

Okay, well done to everybody who said using wine was criticised by the famous surgeon Guy de Chauliac.

So whilst it could be effective, many surgeons did not use it.

So, we're now in a good position to put all of our knowledge of mediaeval surgery into practise.

We have two views, one from Jun and one from Sofia.

Jun says, "Developments during the mediaeval period allowed surgery to overcome its main problems." Sofia says that "there were improvements to mediaeval surgery, but its main problems remained a serious issue." For task C, I want to know, who do you agree with more about changes in surgery during the mediaeval period, Jun or Sofia? You need to explain your answer.

So pause the video here, and press play when you're ready to reflect on your response.

Okay, well done for all of your effort and hard work on that task.

So I asked, who did you agree with more about changes in surgery during the mediaeval period, Jun or Sofia? And I asked you to explain your answer.

So your response may have included: Jun is correct that there were some beneficial developments in surgery during the mediaeval period which helped with the major issues of surgery, which were pain, blood loss, and infection.

For instance, some surgeons used natural substances like opium and mandrake root as anaesthetics, which helped to dull the pain patients experienced during surgical procedures.

Similarly, there was some progress in managing the danger of infection during surgery as the Italian surgeon Theodoric of Lucca began using wine on wounds which were able to kill some germs and therefore reduce infections.

Nevertheless, overall, Sofia's view is more accurate than Jun's.

This is because whilst there were some developments, these were not able to effectively overcome the problems of mediaeval surgery.

For instance, natural anaesthetics like opium were often avoided because if they were given in too large a dose, it could kill the patient.

Likewise, whilst Lucca introduced helpful ideas for fighting infection, he was opposed by the influential surgeon Guy de Chauliac, meaning that most surgeons ignored Lucca's methods of using wine, and infection remained a common killer of patients who had undergone surgery in the mediaeval period.

So, really well done if your own response looks something like that model which we've just seen.

And that means we've reached the end of today's lesson, which puts us in a good position to summarise our learning about mediaeval surgery.

We've seen that barber-surgeons performed mediaeval surgery.

Bloodletting was the most common surgery performed in mediaeval Britain, but barber-surgeons performed other invasive procedures, including pulling teeth, trepanning, and amputations.

Pain, blood loss, and infection made mediaeval surgery severely unpleasant and potentially dangerous.

And some methods were available to manage mediaeval surgery's major problems, such as using wine to fight infections or opium as anaesthetic, but their overall impact was limited.

So, really well done for all of your effort during today's lesson.

It's been a pleasure to help guide you through our resources today, and I look forward to seeing you again in future as we think further about mediaeval medicine and health.