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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
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
smallpox
1868
716 deaths from typhus
artisans dwelling act
1875, rebuild houses to fit new gov. backed living standard,
1871-2
gov followed royal sanitary commission
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
four fluids
blood, phlegm, yellow bile, black bile
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
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
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
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
Ibn Zuhr
12 the century, described the parasitise that causes scabies and began to question the reliability of Galen
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
flagellants
whipped themselves in public to show god they were sorry for their past actions
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
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
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
monastery in canterbury catedral
had a complex water and sanitations system by 1250
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
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
1530s
Henry Viii closed the monasteries so few hospitals until the 18th century
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
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
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
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
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
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
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
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,
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
physicians
trained at uni for at least 7 years
used handbooks, vademecums and clinical observations
fewer than 100 in england in 1300, expensive
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
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