History -Medicine : Entire Topic

Medieval: The Church: Attitudes

-Conservative mindset -Respect for tradition creating resistance to change

Medieval: The Church: Communication

-Printing press wasn’t made until 1440 -Most people illiterate (50% large towns 15th century) -Monks copied books- religious teachings

Medieval: The Church: Individuals

-Supported Hippocrates and Galen (teachings over 1000yrs old)

Medieval: The Church: Education

-Funded universities -Doctors predominantly learnt from books -Banned dissection -Limited Experiments

Medieval: The Church: Government

-King had no duty to improve health -Local government had little power to take action

Medieval: Cause of Disease: God

-Disease is a punishment from god/test of faith -Lack of alternate scientific knowledge

Medieval: Treatment of Disease: God

-Prayer -Catholic Mass -Pilgrimage -Kings touch (e.g cures scrofula)

Medieval: Prevention of Disease: God

-Prayers -Avoiding sin -Good Hygiene (good hygiene\= god’s favour)

Medieval: Cause of Disease: Astrology

-Health is affected by the position of planets/stars, especially at birth -Church only accepted after 1348 Black Plague (fortune-telling) -Fit with Hippocrates teachings (planets/starts affects humors)

Medieval: Diagnosis of Disease: Astrology

-Physicians checked star charts at patients birth before diagnosis

Medieval: Galen and Hippocrates

-Theory of 4 Humors/Theory of Opposites (Galen) -Work so detailed it was hard to challenge

Medieval: The Four Humors

-Phlegm -Black bile -Yellow bile -Blood

Medieval: Treatment of Disease: Humors

-Bring patients humors back into balance -Purging (laxative/emetics) -Bloodletting (leeches, cups) -Bathing (unblocks humors) -Opposites (Galen) e.g too much phlegm (wet+cold) - chilli (hot) -Herbal remedies -Warm, moist dishes

Medieval: Prevention of Disease: Humors

-Moderate diet -Purging to clear digestive system

Medieval: Miasma

-Bad air and smells caused disease

Medieval: Origin: Miasma

-Came from Galen + Hippocrates “bad smelling swamp” -Religion- bad smells associated with sin

Medieval: Prevention of Disease: Miasma

-Bathing (private/public bath, rivers) -Clean homes, hanging sweet herbs -Carrying posies

Medieval: Physicians

-University educated -Expnesive -Diagnosing disease for the rich (star charts, urine charts, humors) -Matched remedies to individual symptoms -Did not treat/do surgery/ meet their patients in person

Medieval: Apothecaries

-Cheap -Mixed remedies -Gave medicines/ herbal remedies

Medieval: Barber surgeons

-Cheap, lacked training -Basic procedures e.g tooth pulling

Medieval: Hospitals

-Run by church, funded by charity -Clean +hygienic places -Prayer, rest, food,herbal remedies (not medical) -most did not admit infectious/pregnant people

Medieval: Women

-Grew herbs and mixed remedies -Most common medical carer

Medieval: Black Death: Key Points

-1348-9 -Bubonic (40% death rate) fleas on rats -Pneumonic (100% death rate) coughs and sneezes

Medieval: Black Death: Ideas of Origin

-Miasma (most popular) -Unbalanced humors -Planets misaligned -Punishment for sin -Contact with sick

Medieval: Black Death: Treatment

-Prayer -Bleeding/purging -Herbal Remedies -Bursting buboes

Medieval: Black Death: Prevention

-Prayer, pilgrimage, flagellation -Holding posies -Quarantines (local government lacked power to enforce) -Stopping cleaning streets (smell will drive of miasma)

Hippocrates: Dates

470-360 BCE

Galen: Dates

129-216 AD

Renaissance: Definition

Rebirth

Renaissance: Key Points

-Some ideas began to change -Way doctors treated/prevented disease hardly changed

Renaissance: Humanism: Key Points

-Rejected religious ideas -Encouraged science and experiments

Renaissance: Education: Key Points

-Became more affordable -New universities opened (Cambridge) -Experiments encouraged -Church had now lost control over education

Renaissance: Technology: Key Points

-New things invented (microscopes, thermometers) -Made experiments easier

Renaissance: Communication: Key Points

-Printing press (1440) -Books were now cheaper -Ended the churches control over ideas -The Royal Society’s journal

Renaissance: The Royal Society: Date

Set up in 1660

Renaissance: The Royal Society: How was it so powerful?

-\`Had a royal charter (gave it credibility raised it’s profile) Charles II -Meant more people would send in their work or donate money to support

Renaissance: The Royal Society: Facilities

-Contained its own laboratory -Members could do their own experiments or confirm the work of others (e.g leeuwenhoek’s animalcules 1683 confirmed by a royal society microscope)

Renaissance: The Royal Society: Journal

-The Journal of Philosophical Transactions (1665) -Contained letters, book reviews + experiments -Scientists could easily share their work which spread medical ideas -English so it was accessible

Renaissance: The Royal Society: Reference Library

-It was required for people to make a copy of their submissions so anybody could study them

Renaissance: God: Cause for Disease

-By end of the period most people recognised god did not cause disease -Due to panic this theory came back in epidemics (e.g the plague)

Renaissance: God: Treatment for Disease

-Prayer -Fasting -Some people still believed in the King’s touch (e.g scrofula) -No catholic traditions (e.g pilgrimage)

Renaissance: God: Prevention for Disease

-Prayer -Avoiding sin -Repentance -No Catholic traditions (e.g flaggulence)

Renaissance: Four Humors: Background

-Physicians stopped believing this after it was disproved by 1700 -Ordinary people still believed and expected their physicians to use this theory

Renaissance: Four Humors: Treatments

-Purging (antimony, sweat/vomiting) -Bloodletting (Cups/leeches) -Herbal remedies

Renaissance: Four Humors: Preventions

-Balanced lifestyle (avoiding strong alcohol and rich/fatty foods)

Renaissance: Miasma: Background

-Most widely believed theory about disease -Belief spiked during epidemics (plague)

Renaissance: Miasma: Preventions

-Good Hygiene (public bathing stopped because it became associated with syphilis) -Rubbing themselves with linen and frequently changing clothes -Clean homes -Clean streets -Moving away from dirty areas

Renaissance: New Treatments: Example

-Herbal remedies, matching colors to disease (e.g saffron cures jaundice)

Renaissance: Thomas Sydenham: Quote

“you must go to the bedside, it is there alone you can learn about disease'“

Renaissance: Thomas Sydenham: Key Points

-1624-89 -Nicknamed “English Hippocrates’ -Was known for treating diseases as a whole -Noticed diseases could be grouped -First person to make detailed description of Scarlet Fever

Renaissance: Vesalius: Discoveries

-Jaw (1 bone not 2) (dogs) -Breastbone- (3 parts not 7) (monkey)

Renaissance: Vesalius: Book

-Fabric of the human body (1543)

Renaissance: Fabric of the human body: Significance

Doctors learnt for themselves rather than being brainwashed by the previous mistakes laid down by gaken and perpetuated by the church

Renaissance: Harvey: Discoveries

-Blood circulates around the body -The heart (not liver) is the centre of the body (challenged bleeding) -Body is a one way system

Renaissance: Harvey: Book

-On the motion of the hart and blood (1628)

Renaissance: Physicians

-University educated -Mainly trained from books -Completed dissections

Renaissance: Apothecaries

-Mixed remedies -Cheaper than physicians -Had new chemical ingredients -Licensed

Renaissance: Barber Surgeons

-Simple operations -Cheaper than physicians -New techniques due to war -Liscenced

Renaissance: Hostpitals

-Funded by charity -Began admitting infectious patients -Provided medicine and physicians

Renaissance: Home

-Women -Grew herbs/mixed remedies -Most common form of carer

Renaissance: Plague: Death Rate

100k Londoners dead/ 20%population

Renaissance: Plague: Causes

-Miasma (most popular) -Punishment for sin -Contagation (seeds in air)

Renaissance: Plague: Treatments

-Transference -Herbal Remedies

Renaissance: Plague: Preventions

-Prayer -Holding Posies -Smoking Tobacco -Quarantines/banning public gatherings

Western Front: Four Key places

-Ypes -Somme -Arras -Cambrai

Western Front: Ypres General Info

-Germans had the high ground -British trenches were in low, waterlogged ground -Salient (enemy surrounding on 3 sides)

Western Front: 1st Battle of Ypres

-October-November 1914

Western Front: 2nd Battle of Ypres

-April-May 1915 -Chlorine gas first used by Germans

Western Front: 3rd Battle of Ypres

-July-November 1917 -Ground was waterlogged, many men fell and drowned -245k British Deaths

Western Front: Battle of the Somme

-July-November 1916 -60k Brits Dead (20k first day) -400k total dead -Deadliest battle of WW1

Western Front: Arras

-Chalky terrain _Soldiers could build networks of tunnels -Underground rooms with running water -700 bed underground hospital was built

Western Front: Battle of Arras

-April 1917 -160k British deaths

Western Front: Cambrai

-Robertson set up a blood bank before battle

Western Front: Battle of Cambrai

-October 1917 -First major use of tanks -The land won was lost because there was not enough infantry to support tanks

Western Front: Evacuation Route

-Stretcher Bearers -Regimental Aid Post (RAP) -Field Ambulance + Dressing Stations -Casualty Clearing Station -Base hospital

Western Front: Stretcher Bearers

-Fetched wounded from Trenches and No Man’s Land -Carried Basic Medical Supplies (bandages +morphine)

Western Front: Stretcher Bearers: Problems

-Limited basic supplies -Only 16 bearers per 1000 men -In muddy conditions it took 6-8 men to carry a stretcher -Injured had to wait hours/days to be rescued

Western Front: Regimental Aid Post

-In front line/close behind -In a dug out/behind a wall -Run by battalion medical officer -Bandaging minor wounds +send back out -Pain relief for severe rounds and send through

Western Front: Regimental Aid Post: Problems

-Poorly lit/dirty -Often under fire -One officer per 1000 men

Western Front: Field ambulance and Dressing Stations

-Mobile team of doctors , assistants and nurses (ao 1915) -Set up dressing stations -Sent severe cases to casualty clearing

Western Front: Field ambulance and Dressing Stations: Problems

-Not enough ambulances

Western Front: Casualty Clearing Stations

-10 Miles from front line -7 docs plus nurses -Often did operations (amputations) -Good facilities (mobile x-rays, wards, operating theatres) -Triage system (minor, critical, hopeless cases)

Western Front: Casualty Clearing Stations: Problems

-Could deal with 1k patients -Became overwhelmed

Western Front: Base Hospitals

-Near railway lines, far from front line -Serious cases arrived by train or motor ambulance -Teams of doctors/surgeons (more advanced operations) -Up to 2500 patients -Had labs, x-ray departments, specialist centres (e.g gas injuries)

Western Front: Base Hospitals: Problems

-Transport from CCS was slow and painful -Caused time delays

Western Front: War Wounds: Cause

-Artillery shells -Rifles -Machine Guns -Shrapnel

Western Front: War Wounds: Prevention

-Steel Helmets

War Wounds: Treatment

-Amputation of limbs

Western Front: Infection: Cause

-Increased risk because bad weather conditions at time of wounding

Western Front: Gas Gangrene: Cause

-Bacteria from soil getting into sounds Gas Gangrene

Western Front: Gas Gangrene: Symptoms

-Injured area turned white then green

Western Front: Gas Gangrene: Prevention

-Antiseptic dressings (ineffective)

Western Front: Gas Gangrene: Treatment

-Debridement and amputation

Western Front: Gas Casualties: Cause

-Poison gas -Chlorine/phosphene (1915) -Mustard gas (1917)

Western Front: Gas Casualties: Prevention

-Gas masks (ao 1915)

Western Front: Gas Casualties: Treatment

-Oxygen -Washing gas off skin

Western Front: Gas Casualties: Symptoms

-Temporary blindness -Skin irritation -Cough

Western Front: Trench Fever: Cause

-Body lice in clothing/shared blankets

Western Front: Trench Fever: Symptoms

-Flu-like _Headache -Joint paint (5 days)

Western Front: Trench Fever: Treatment

-Drugs (salvasan) ineffective -Passing electrical currents through body