Medicine through time

Hippocrates theories

Theory of four humours
Hippocratic oath

Galen theories

Theory of opposites
- developed theory of 4 humours and said if they were imbalanced you'd fall ill

The key ideas of Hippocrates and galen
- prevention
- causes
- treatment

Prevention = exercise and good diet
Treatment = bleeding or purging
Causes = humours out of balance

What are the four humours

blood, phlegm, yellow bile, black bile

Who was head of the church in England

The arch bishop of Canterbury

The king and his governments role in Middle Ages

- Keeping streets clean
- taxes For war
- punishment
- defend country

What was the largest percentage job in the Middle Ages

90% of people worked in farming

Who controlled education in Middle Ages

The church

By the 1500s what percentage of population could read

50%

Where did the Black Death originate?

China

What percentage of population died due to Black Death

40%

When was the Black Death

1348-1349

Beliefs in causes of the Black Death

- Gods punishment
- bad air or miasma
- impact of the planets
- theory of the four humours

When did king Edward 111 order the streets to be cleaned to get rid of bad air

April 1349

How did people purify the bad air

- Carried sweet smelling herbs or lit fires to overpower bad air
- kept the air moving by ringing bells

How did people try to prevent plague with religious beliefs

- prayed
- fasted or lit candles in churches
- pilgrimages
- punished themselves in public

Treatments of Black Death

- Purging and bleeding
- cutting buboes
- avoid certain foods like garlic

Medieval healers were

- wise women, herbal remedies
- hospitals, run by monks - cared not cured
- Physicians, trained at unis for 7 years

How many physicians were there by 1300

fewer than 100

How many hospitals were there by 1400

over 500

Barber surgeons

- They didn't go to uni
- they did basic surgery such as bleeding, removing surface tumours, splints, seeing up wounds
- no anaesthetic

Apothecaries

- Home made medicines and remedies

What organism was used to bleeding a human

Leeches

Preventing disease

- Urine samples checked by physicians
- fitness and overall health
- cleaning towns and streets

Solution to to many animals in towns

= rakers cleaned the streets

Solution to dirty water in the middle ages in towns

fresh water was brought to public wells through lead pipes= aquaducts were built

Solution to waste and litter in towns

laws were passed to punish throwing waste + public latrine were built

Solutions to leaking latrines in towns

- Regulations were introduced about where to build private latrines
- cess pits lined with stone to reduce leaking

Why did the church prevent new medical ideas from publishing

- they believed gods punishment was the only cause as they were heavily religious
- the pope enforced that everything in the Bible should not be challenged and would go to hell if they did
- the churches ideologies lined up with Galens theories so no Christian challenged Galen

Education in the middle ages

- Controlled By the church
- dissections were not made as Christians believed if the body wasn't intact it would not go to heaven so no one discovered the structure of the human body

respect for tradition in the middle ages

- No one challenged the church and wanted no change in society

Individuals of the middle ages

- No break throughs due to lack of education or encouragement for change
- Galen and Hippocrates still followed
- Johannes Gutenberg discovered printing press in 1440

Government (Middle ages)

- no money was given to fund new research on medicine
- kings ordered towns to be cleaned (1349)

Great plague struck London when?

1665.

What treatments and prevention were used

- Similar to black death
- red cross on do for quarantine
- government ordered public prayer, fasting and confessions

How many dogs and cats were killed to try prevent the plague

40000dogs and 200000 cats

How did the plague end

- Cold weather
- the great fire of London in 1666
-

Thomas sydenham

- (English Hippocrates)He told physicians to observe patients to correctly diagnose them and treat them with appropriate remedies
- patient records of observed symptoms
- he created a description of Scarlett fever

When was the Royal Society founded?

1660, incorporated in 1662

What did William Harvey discover?

Circulation of blood

When did he publish his book an anatomical account of the motion of the heart and blood

1628

Who did Harvey prove wrong

Galen

How did apply his theories

- Dissecting live cold blooded animals
- dissecting human bodies to experiment on the heart
- proved that the body has a one way blood system
- proving veins carry blood and not air

How did Andreas Vesalius prove Galen wrong

- he discovered the human jaw bone is made from one bone, not two
- the breast bone has three parts, not seven
- blood does not flow into the heart through invisible holes in the septum

When was On the Fabric of the Human Body published?

1543

How did Andreas Vesalius make his discoveries?

Stealing and dissecting criminals bodies

Treatments - Renaissance

1) Purging and Bloodletting (4 Humours)
2) Praying, Fasting, Pilgrimage, Flagellation, 90000 people in 1660-1682 visited the kings court believing Charles 11 would cure them (Religious)
3) Herbal Remedies (New ones discovered), Pomander
4) Transference - Moving illness to something else

What did Edward Jenner discover and when ?

1798 - small pox vaccine

What did James Simpson discover and when

Chloroform anaesthetic 1847

What did John snow discover and when

Prevented cholera on the broad street pump in 1854,
Mapped 500 deaths around broad street pump as a result of infected water pump

What did Louis pasteur discover and when

1861 and germ theory suggesting bacteria caused human disease

When was the Public Health Act and what did it change

1875 improved sewers and drainage provided fresh clean water and appointed medical officers and sanitary inspectors to inspect public health

What did Joseph Lister do and when

1867 - Effective antiseptics against infection - catholic acid

What did Robert Koch do and when

1882 - identifying bacteria that cause diseases - tuberculosis, typhoid and anthrax

What did Florence Nightingale do and when

1850s and onwards - hospitals and nursing - during Crimean war she improved sanitation in hospitals and trained nurses

The public health act of 1848 stated

- a national board of health was set up
- in towns where death rate was very high the government could force the local government to make public health improvements to water supply and sewage and appoint medical officers
- local councils were encouraged to collect taxes to pay for public health improvements

How many nurses did nightingale take to crimea

38

Death rate in the hospitals fell from ??

40percent to 2 percent

When did nightingale set up her first school for nurses

1860

What did she improve in hospitals

- Sanitation in hospitals - clean water supplies good drains and sewers, toilet facilities, total cleanliness
- ventilation to make sure patients got fresh, clean air to breathe
- food supplies, clothing and washing facilities for patients

How many cottage hospitals were there by 1900

300

When did lister publish his results showing the value of carbolic acid and also insisted??

1867
- insisted that doctors and nurses wash their hands with carbolic acid before operations to avoid infection
- developed a carbolic spray to kill germs
- invented an Antiseptic ligature to tie up blood vessels and prevent blood loss

To ensure absolute cleanliness lister:

- Operating theatres and hospital were rigorously cleaned
- from 1887 all instruments were steam sterilised
- surgeons stopped operating in ordinary clothes and wore surgical gowns and face masks and rubber gloves

In 1802 how much did parliament give Jenner to develop his work on vaccines

30000

What was the life expectancy in 1900?

47 years old

In 1888 how many babies died per 1000 before their first birthday

163/1000

Why did the majority of families in 1900 not go to the doctor

Couldn't afford it

When was the National Insurance Act?

1911

When was the Beveridge Report?

1942

When did the NHS begin?

1948

What were the treatments discovered after 1900

- Chemical drugs- sulphonamide drugs
- antibiotics
- blood transfusions
- genetic medicine
- transplants, key hole and micro surgery

When was DNA discovered?

1953

When was Flemings discovery of penicillin

1928

When did Florey and chain do research and trials on penicillin

1938

How much funding did Florey and chain get from the government for penicillin

25 pound

When did they have enough penicillin to test one person

1941

When was penicillin used for the war

1941

When was penicillin mass produced?

1944

Who discovered the structure of DNA

James Watson and Francis Crick in 1953

What genetic diseases did they discover after discovering DNA

- Some cancers
- diabetes
- Alzheimer's
- Parkinson's disease
- Down syndrome

Why were pharmaceutical companies successful

- Investing in research and development to look for better remedies
- using improved scientific techniques and equipment to identify the precise chemicals that work as medicines
- using industrial tech to make huge quantities
- using experiments and experience to find dosages

When was the magic bullet discovered

1909 by Paul EHRLICH it was a sulphonamide drug

When was training for midwife's made compulsory

1902

When did all births need to notified by the local officer of health and nurses had to do medical checks in schools

1907

When was the Ministry of Health set up?

1919

When was the National Insurance Act?

1911

When was the nursing act set up

1919

In 1918 who could vote

All men and women over the age of 30

In 1928 who had the vote

Anyone over the age of 21

What was the Beveridge Report 1942?

identified the key problems that needed to be dealt with after the war (Giant Evils)

Who discovered the x ray and when

Wilhelm Roentgen in 1895

Who discovered radio therapy and chemotherapy

Marie curie, they discovered radium

Who discovered blood transfusions and when

Karl Landsteiner in 1901

Who discovered transplant surgery

First carried out in 1967 by dr Christiaan Barnard

During the war how many plastic surgery's were carried out

11000

What other discoveries were made during modern medicine

- Gene therapy
- customised drugs
- dialysis machines
- key hole and micro surgery's
- improved anaesthetics
- heart pacemakers

Figures for infectious diseases

25.9% - 1911
4.3% - 1951
0.7% - 2011

Figures for cancer

6% - cancer
16.2% - 1951
29% - 2011

Figures for heart disease

14.4% - 1911
45.1% - 1951
28% - 2011

The best ways to poor health and an early death (NHS)

- Being overweight
- poor diet
- lack of exercise
- drinking alcohol
- smoking
- stress
- poverty