A crowded field
There was no single medieval medical profession. People who treated the sick ranged from university graduates to village women with inherited knowledge, and the categories overlapped. Which one a patient called on depended on money, location, the type of problem and personal trust. Titles also varied by region and century, so the descriptions below are typical patterns, not strict rules.
Physicians
A physician was a learned practitioner, usually trained in a university or a similar school, who read texts and worked mainly by judgment and advice. The training for a physician, discussed under medical education, involved years of study of authorities such as Hippocrates, Galen and Ibn Sina, preceded by the arts curriculum.
The physician’s work was largely diagnostic and advisory. He (nearly all were men) would take a history, feel the pulse, and examine urine, a method called uroscopy that was a hallmark of the profession. He might consult astrological tables to choose a time for treatment. His treatment was typically a regimen: changes in diet, exercise, sleep, bathing and emotions, with medicines prepared by an apothecary and, in some cases, bloodletting ordered but performed by someone else. A university-trained physician generally avoided manual work, considered beneath his status, and rarely cut the body.
Physicians were expensive and were found mostly in cities and at courts. Kings, nobles, bishops and wealthy merchants might retain one. Many people never saw one in their lives.
Surgeons
Surgeons dealt with the outside of the body: wounds, fractures, dislocations, abscesses, hernias, bladder stones and ulcers. They learned mostly through apprenticeship, though some wrote learned treatises. In the fourteenth century, the French surgeon Guy de Chauliac wrote a major surgical work, the Chirurgia magna, that was widely copied.
Surgery was a practical skill, and battlefield and tournament injuries gave experience in treating wounds. Surgeons used cautery, sutures, bandages, splints, salves and, with care, surgical instruments. Pain relief was limited, though some texts mention sponges soaked in mixtures believed to induce sleep, and how well these worked is uncertain. Infection was a serious risk, and surgeons argued about whether pus was a good sign.
In many towns, surgeons organized themselves in guilds or companies, which shaped training and discipline. Exact titles varied from “master surgeon” to “wound-man,” and status could be high in some cities and low in others.
Barbers and barber-surgeons
Barbers shaved and cut hair, but they also commonly performed minor procedures such as bloodletting, tooth drawing and lancing boils. The tie to bloodletting grew in part because monks were forbidden at some point from performing it, as church rules discouraged clerics from shedding blood. In the later Middle Ages, barber-surgeons became a recognized group in many towns, and the relationship between them and the surgeons’ guilds was often contested over who was allowed to do what.
Apothecaries
Apothecaries prepared and sold medicines, spices and sugar-based preparations. They worked from written recipe collections, called antidotaries, and carefully weighed ingredients. Medicines were often compounds with many ingredients. The apothecary’s trade depended on imported goods, particularly through the spice trade, which brought pepper, cinnamon, ginger and other aromatic substances to Europe.
In some cities, apothecaries were organized into guilds and subject to inspection, because mistakes could be dangerous and adulteration was a worry. Apothecaries could also give simple advice, which sometimes brought them into rivalry with physicians.
Midwives
Childbirth was largely a female domain. Midwives were experienced women, often chosen by neighbors or approved by parish clergy, who assisted at births, handled complications as best they could, and sometimes performed an emergency baptism if the infant seemed unlikely to survive. Some towns formalized the role by swearing in midwives. Their knowledge was passed on by experience. Male physicians and surgeons were typically called only in unusual emergencies. Medieval midwives and the broader questions of women’s roles are treated elsewhere on this site.
A body of texts on women’s health, often associated with the name Trota or Trotula and linked to the school of Salerno, circulated in later centuries, though historians debate their authorship and how they were used.
Household and community healers
Most care took place at home. Mothers, wives and neighbors treated minor illnesses with familiar herbs, hot baths, rest, food and prayer. Lords’ wives and monastic cellarers often kept stores of remedies. Local healers, sometimes called leeches, cunning men and women, or wise women, offered treatments that mixed plants, charms and prayers. Clergy also prayed over the sick and offered the sacraments, and medical advice sometimes came from a priest or a monk who owned a medical book.
Licensing and regulation
From the thirteenth century, rulers and towns began to regulate practice. Examinations, oaths and guild rules appeared in some places, and fines or bans punished unlicensed practice. These rules were uneven and did not stop informal healing. Jewish and Muslim practitioners also worked in parts of Europe, particularly Iberia and southern Italy, and some were highly respected.
How effective were they?
Results varied, and records rarely tell us whom patients thought helped them. Bone setting, wound care and the regimen’s emphasis on rest and nutrition probably did some good. Bloodletting, purges and many compound drugs probably did not, and some did harm. What medieval healers could offer was explanation, care and hope, which were valued in a world where outcomes were uncertain.