GCSE History- Health and medicine

Key factors that influenced diseases

• beliefs (religions and superstitions)

• role of individuals

• communication

• chance

• war

• government

• science and development

medieval period

1000 AD to 1500

Medieval ideas about diseases

• very limited medical knowledge- no knowledge of germs

• blood poisoning common

• death by wars

• no idea about sanitation and causes of illness

Hippocrates

father of modern medicine- was an ancient greek philosopher who thought he needed to know how the body works in order to treat diseases

Hippocrates’ theories on diseases

the ‘four humours’- 4 substances that make up the body

The four humours

black bile, yellow bile, blood and phlegm- 4 substances that made up the human body

hippocratic oath

pledge to not do harm to a patient

Hippocrates’ belief on healing patients

bleeding or purging

Claudius Galen

made major breakthroughs in anatomy, lived in Rome and found may useful information by dissections

Church’s belief on medicine in medieval period

sickness was the divine punishment of sin

Year of the black death

1348

percentage of British population killed from black death

40%

Medieval beliefs for the causes of diseases

Punishment from God, Miasma, Astrology, unbalanced humors

Methods of preventing disease by punishment of God

Praying regularly, attending church

Methods of treating diseases by punishment from God

Herbal remedies

Methods of preventing diseases by miasma

taking a bath, using rushes and herbs like lavender, carrying sweet smelling flowers

Method of treating diseases by miasma

Removing filth of the streets (ordered by King Edward III to Lord Mayor)

Methods of preventing diseases by astrology

no method of prevention

Method of treating diseases by astrology

movements of sun, moon, stars and planets affected people’s bodies, zodiac charts used to show when to treat each part of body

Method of preventing diseases by unbalanced humors

healthy diet: eating too much frowned upon, purging and laxatives

Regimen sanitatis- instructions provided by a physician to live a healthy life

Method of treating diseases by unbalanced humors

bleeding, blood letting through leeches

Middle ages

medieval times

phlegm

water in the body

Yellow bile

Puss (WBC), vomit

black bile

blood clots, excrement

Galen’s theory of opposites

Galen’s theory where each humor needed to be in complete balance to be healthy

Hippocrates’ ideas

the universe made of 4 basic elements which was also in the body

Reasons for popularity of theory of opposites and theory of four humors

supported by the church as it didn’t contradict ideas of God

Galen’s incorrect beliefs

heart controlling speech

Impact of Galen’s work

ideas lasted more than 1400 years, his books supported by the church, doctors used his theories for next 1000 years, dissections still used today

Women training (medieval)

knowledge passed down generations, ‘wise women’, midwives

Use of women treating diseases (medieval)

Most treated at home by female member of family

treatments women gave (medieval)

mainly herbal remedies (eg. honey to fight infections)

Physicians training (medieval)

trained at university, watching dissections while listening to lecturer reading from Galen’s books

Use of Physicians (medieval)

highest ranking doctors, afforded only by the wealthy, only diagnosed, did not treat

Amount of Physicians in 1300s England

less than 100 (<100)

Physicians treatments (medieval)

treatments based on four humors. eg. bleeding, purging, advising to life a ‘healthy life’

Surgeons training (medieval)

trained by watching others, apprenticeship (women), guilds of master surgeons

Use of surgeons (medieval)

people with a bit of money

Surgeon treatments (medieval)

most surgery performed by ‘barber surgeons’, simple operations, offered: blood letting, tooth extractions, amputations

John Bradmore (medieval)

developed forceps to remove arrowheads following the prince of Wales being wounded on a battlefield

Henri de Mondville (medieval)

a french army surgeon who taught his students to bathe and cleanse wounds then closing them up quickly- disagreeing with Galen’s theory of letting wounds form pus.

Problems with surgeries (medieval)

• infections

• only simple operations (lack of knowledge)

• no anaesthesia (pain)

• blood loss

Blood letting

patient bleeding on purpose to balance the four humors and cure them

problems with blood letting

often patients bled too long and died from blood loss

Examples of issues with blood letting

US President George Washington died of blood letting

Amount of children who died before age 7 (medieval)

30%- due to poor medical care and malnourishment

Amount of England’s population killed through dysentery, typhoid, smallpox and measles (medieval)

10% of English population killed

Towns in medieval times

more dangerous, due to higher density of people, causing more disease to spread

Barber Surgeons

unqualified surgeons who carried out minor operations for most people

Women’s role in medieval times

family members and midwives

Physician’s work (medieval)

looked at sample of urine, blood and faeces, consulted star charts

Use of Medieval hospitals

used as a place to rest and recover- mostly located in monasteries

cause of diseases at home (medieval)

homes heated using open fires, caused smoky air (miasma)

treatment of disease for illiterates

went to physicians and looked to God

Reason for black death because of astronomy

star charts in 13448 showed ‘bad alignment’ of stars, blamed for black death

fever reasons (medieval)

too much blood, cold, too much phlegm, depression, lack of black bile

Use of baths (medieval)

prevent blockages of humors

Boiling foxes in water and bathing with it (medieval)

foxes’ water making them more aware and back to healthy

Christianity helping medical knowledge

• copies of ancient books made (incl. Galen) after collapse of Roman empire- used to teach barber surgeons

• hospitals founded in middle ages as part of monasteries (similar to modern care homes)

• Nuns cared for patients in hospitals- food and herbal remedies given

• Saints linked to different illnesses, people prayed to particular saints for help

• mass said 7 times a day

Hospitals in England by 1400

500 hospitals (most were very small with only space for 10 patients)

Lord Mayor Richard Wittington hospitals

paid for an 8 bed hospital in London for unmarried pregnant women

Leper houses

built outside towns to separate people with Leprosy from rest of society

Christianity hindering medical knowledge

• church controlled universities were Physicians trained, teaching only Galen’s ideas

• held back scientific knowledge

• did not like physicians challenging traditional ideas

• people told to pray as ‘most important treatment was prayer’

al-razi

A doctor who helped plan the building of the first documented general hospital in the world in Baghdad (modern day Iraq) which opened in 805 AD, wrote over 200 books and were translated into Latin and used to teach in many universities, first to work out difference between smallpox and measles, believed in observation and seeking natural causes

Ibn Sina

astronomer and doctor who wrote many books including ‘canon of medicine’ in 1025 which was the most well known, first doctors to build on works of Galen

Islamic medicine compared to English medicine (medieval)

considered to be more advanced with new discoveries and developments in Islamic kingdoms

Communication in Islamic medicine

doctors travelled frequently to the Holy land with crusaders and learned new ideas from Islamic kingdoms (war helping progess)

Black death mortality rate

40% of english population died from disease

Black death year

1348

Black death international impact

spread across europe

First instance of black death

23rd June 1348

transmission of black death disease

carried by sailors with flea bites

Symptoms of black death

Swelling with pneumonic plague or bubonic plague and ended with death

pneumonic plague

caused respiration and breathing issues and fevers

Bubonic plague

buboes- caused tennis ball sized swellings, lung restrictions and swollen arms

effect of black death after 18 months

half of population infected and dead

Plague carts

carts used to carry dead bodies which were later piled up

Black death blame

miasma, astrology, God punishing humans, four humors out of balance, anti-semitism, earthquake in China

Most common victims of the black death

priests due to being on patients bedside- causing infections

Places with most severe impact due to black death

Norwich- second largest city at the time- overcrowding caused more infections

Effect of black death on Norwich

5000 of 7000 population died

Time taken for population recovery

200 years to return population to pre-black death population levels in England

Flagellants (medieval)

people who whipped themselves and each other while walking around to prove to God their confessions

Treatments of black death

• praying to God and going to church

• making human sized candles and burning it

• avoid eating too much

• avoid baths

• avoid sex

• avoid plague victims

• clean filth from streets

• bathe in urine

• drink mixture of vinegar and mercury

year that black death completely goes away

1350- entirely goes away

buboles

red humps that was a symptom of the black death

problems with public health in medieval times

• overcrowded streets

• no sewers, dirty streets- some homes had toilets overhanging streams

• miasma in the air

• lack of medical knowledge- based on ancient ideas of Galen and Hippocrates and arab doctors (Al-Razi, Ibn Sina)

Roman public health facilities causing black death (medieval)

built in the 11th century, such as public baths, toilets, fountains and sewers were left in disrepair and destroyed by those who wanted to remove remains of romans

Toilets built on bridges causing black death (medieval)

built over thames river causing waste to be washed into the city

Gong farmers causing black death

emptied waste from a pit that wealthy individuals could afford to build, they would sometimes empty it into a river or another part of town

Butchers causing black death (medieval)

butchers allowed to slaughter animals in towns and cities, dumping waste into streets or rivers, if the waste on the street was not washed away, it would rot and attract rats, spreading diseases

solutions to waste on streets (medieval)

40p fine introduced in 1309- equivalent to £400 in 2021 for anyone who dumped rubbish in the street

Solutions to butcher’s waste

butchers banned from slaughtering animals in the street

muck rakers

employed to remove waste on the streets and latrines

gong farmers

emptied out cesspits and would dig sewage out and take it out of the city but most would dump the waste elsewhere in the city

surveyors of the pavement

employed to remove rubbish and waste from pavements

cesspits

individual toilets built for wealthier individuals

Bath houses (medieval)

improved public health by having 18 in London

understanding of personal hygiene (medieval)

some knowledge- King John travelled with a bath tub