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1

1848

  • first public health act

  • board of health to encourage local areas to appointed a medical officer, provide sewers, inspect lodging, houses and check food safety

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2

progression of surgery

  • 1800, royal college of surgeons

  • 1811, had to take a course in anatomy and surgery

  • 1813, surgeons had to have a years worth of experience

  • 1856, of 10,200 on medical direction with qualifications, only 4% from English unis

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3

smallpox

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4

1868

716 deaths from typhus

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5

artisans dwelling act

1875, rebuild houses to fit new gov. backed living standard,

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6

1871-2

gov followed royal sanitary commission

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7

astrology

  • idea the movement of planets and stars could cause disease

  • new way of diagnosing disease, developed in Arabic medicine, brought to Europe between 1100-1300

  • owned a almanac, calendar, included information about where particular planets and stars were

  • doctors used this information to predict how patients’ health could be affected,

  • different star signs were thought to affect different parts of the body

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8

four fluids

blood, phlegm, yellow bile, black bile

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9

too cold

  • thought body created an excess of phlegm, which caused illness

  • cold, wet phlegm, could be given thicker, pepper or wine, considered hot and dry, to correct the imbalance

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10

alchemy

  • attempt to turn base metals into gold and discover the elixir of eternal life

  • trace its origins back to the Egyptians and it was preserved in the Islamic world

  • superstition was included, unsuccessful experiment likely blamed on the position of th stars, to spiritual putrid of the alchemist

  • but they invented useful techniques, distillation and sublimation, and prepared drugs such as landanum, benzoin and camphor

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11

Islamic medicine

  • lost of knowledge lost in west after the fall of the Roman Empire, ideas kept alive by Islamic scholars

  • 9th century, Hunain inn Ishaq, travelled from Baghdad to Byzantium to collect greek medical texts, translated into Arabic

  • this classical knowledge brought to Europe by IbnSina, Avicenna,

    • canon of medicine, translated into latin in Spain or italy,

    • crushes made europeans aware of the scientific knowledge of islam doctors

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12

Abu al-Qasim

  • wrote a wrote describing amputations, the remove of bladder stone and dental surgery, as well as methods for handling fractures, dislocations and the stitching of wounds

  • 10th century

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13

Ibn Zuhr

  • 12 the century, described the parasitise that causes scabies and began to question the reliability of Galen

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14

Ibn al-Nafis

  • 13th century

  • questioned Galen’s ideas

  • suggested that. blood flows from one side of the heart to the other via the lungs, and doesn’t cross the septum

  • wasn't recognised in the west until the 20th century

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15

flagellants

whipped themselves in public to show god they were sorry for their past actions

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16

bloodletting and purging

  • too much blood inside

  • small cut to remove blood, or use blood sucking leeches

  • some were killed, too much taken

  • purging, getting rid of other fluids by excreting, laxatives

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17

miasma cure

  • carried posies or organs when visiting patients, physicians, protect themselves from catching diseases

  • during black death, juniper, myrrh and incense were burned, so smoke or scent would fill the room and stop bad air bringing diseases inside

  • in the case of fainting, people burned feathers and made the patient breathe in their smoke

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18

remedies

  • herbs, spices, animal parts and minerals

  • books, explaining how to mix them together, ‘herbals’

  • others based on superstition, lucky charms containing powdered unicorn’s horn

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19

monastery in canterbury catedral

had a complex water and sanitations system by 1250

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20

John of adrene

  • surgeons tried to find ways to reduce pain during operations

  • created a recipe for an anaesthetic in 1376, included hemlock, opium and henbane,

  • in carefully controlled doses may have worked, but very likely to kill

  • henbane, a relatie of deadly nightshade

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21

John hunter

  • over 12 years in an anatomy school in London, presents t more than 200 dissections, developed an unrivalled knowledge of the human body

  • army surgeon in france and portal, popular surgeon and teacher in england

  • learned more about venereal diseases, a major cause of illness at the time, and introduce a new approach to the treatment of gunshot wounds

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22

1530s

  • Henry Viii closed the monasteries so few hospitals until the 18th century

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23

pasteur

  • proved there were germs in air, showed the sterilised water in a closed flask stayed sterile, where in open flask bread germs

  • 1867, Pasteur published evidence proving there was a link between germs and disease, demonstrating germs caused disease in silkworms

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24

germ theory impact

  • helped inspire Jospeh lister to develop antispetics

  • confirmed John snows finding about cholera

  • linked disease to poor livving conditions, put pressure on the government to pass the 1875 public health act

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25

jenner

  • injected James Phipps with the pus from the sores of Sarah Nelmes, and then infected him with smallpox

  • coined the term vaccinate using the latin word for cow, vac

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26

nightingale

  • set up school of nursing in st Thomas hospital, london

  • horror sties emerged about the barrack hospital in scutari

  • sidney hebert, asked for nightingale to go to sort out the nursing care

  • army o[posoed women nurses thought inferior, went anyway, taking 38 hand picked nures with her

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27

18th century hospitals

  • several charity hospitals opened, middlesex infirmary, the London hospital and guy’s hospital, funds by rich and offered largely free treatment to the poor

  • only those likely to recover were admitted, deserving poor

  • dispensaries provided free non residential care to poor people

  • cottage hospitals run by GP’S opened from the 1860s, provided care in rural areas

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28

John hunter 2

  • operation in 1785, introduced a new way too treat an aneurysm, hunter tied off the blood vessel to encourage the blood to flow through the other vessel in the leg, preventing it from having to be amputated

  • better approached to surgery, including good scientific habits, like,e learning a much about the body as possible to understand lines, expermintar and testing

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29

renaissance, continuity and change

  • superstition and religion still important

    • thought king’s touch could cure scrofula, skin disease known as the king’s evil, thousands with it visited King Charles I, in hope of being cured

  • from 1600 the college of physicians started to license doctors to stop quackery, set up 1518

  • 1700s, electricity started to be used in some medical treatments, although rarely effective

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30

living conditions in towns

  • 13th century, water channel called the great conduit built to bring clean water to London, as thames too toxic

  • 1388, government ordered town authorities to keep streets free of waste,

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31

Hugh of Lucca

  • and son Theodoric worked as surgeons in italy early 13th century, recognised importance of practical experience and observations, questioned some of Galens ideas

  • began dressing words with bandages soaked in wine as they noticed it helped to keep the wound clean and prevent infection, chance

  • realised pus wasn’t a healthy sign, unlike other doctors who would tr to case wounds to pus as they believed it would release toxins

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32

physicians

  • trained at uni for at least 7 years

  • used handbooks, vademecums and clinical observations

  • fewer than 100 in england in 1300, expensive

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33

koch

  • identified anthrax bacteria, 1876, ad bacteria that causes septicaemia 1878

  • dipyhrtis germs discovered Edwin Gelbs in 1883

  • Friedrich Loeffler cultured the diphtheria germ adn thought its effect on people was due to the toxin it produced

  • 1891, Emil von Behring proved Leoffler right, produced an antitoxin from the blood of animals that had just recovered from it, used to reduce the effect of the disease

  • Ronald ross, received Nobel prise in 1902, for discovery of how malaria is transmitted ross’ Nobel prize was disputed by Giovanni Battista Grassi, who Aldo discovers how malaria was transmitted, however koch support ross so he retained the prize

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34

Erhlich

  • discovered first dyes that could kill the malaria and sleeping sickness germs

  • 1905, the bacteria the causes the STD syphilis was identified

  • erhlich and team decide to search for an arsenic compounds that was a magic bullet for syphilis, hoped it would target the bacteria without poisoning the rest of the body

  • 600 tried

  • 1909, Sahachiro Hate joined team, recheck t rest and saw number 606 seemed to work, firs used on a human in 1911

  • second magic bullet discover in 1935

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