The earliest noticeable changes were in the training of doctors. In the 11th century a medical school was established at Salerno, in southern Italy. This school taught that the careful observation of patients was essential, that cleanliness was linked to good health and that balances of fluids within the body was of paramount importance.

Such was the importance of this school that The Holy Roman Emperor of the time, Frederick, decreed that from 121 only doctors trained at the school could work in the royal court. This meant that medical training, whilst only being of benefit to the wealthy, was given a greater importance, which consequentially results in improved training methods and the spread of knowledge. Soon other medical schools, such as the one in Montpellier, were opened.

By 1300 there were a dozen or so medical schools in Europe and whilst change and improvements were slow, they did happen. Dissection for example was permitted and the teachings of Hippocrates and Galen were questioned with some degree of success. New ideas such as Urine charts also resulted from this upsurge in medical training and method.

These changes didn’t always spread throughout Europe and indeed most of them were only of real benefit to the rich. Ordinary people would have to rely upon traditional remedies passed on from generation to generation. Most couldn’t afford to pay Doctor’s as fees were high at the time. Medical care though did improve, and evidence exists of a growing number of surgeons and barber surgeons at the time. (Barber-Surgeons performed small operation such as the removal of teeth, they were mainly employed by the poor).