whose Hippocrates
Greek doctor who developed the theory of the four humours and clinical observation of the patient
what are the 4 humours and what happens if yours are out of balance
blood, phlegm, black bile and yellow bile. when they are out of balance, it causes illness
who was galen
a roman doctor who created theory of opposites and miasma
why did galens ideas stay around for so long
he belived in 1 god which means the church supported his ideas
since the church controlled all books and education , the texts about galen were the only ones widely taught
what is the theory of opposites
idea that humours could be rebalenced by giving something opposite from the symptoms e.g excess of blood (hot and wet) doctors prescribe something cold and dry
what were 3 medieval supernatural treatments
prayer
astrology
trepanning
whats were 3 medieval natural treatments
bloodletting
purging
herbal remedies
whats was trepanning
when a hole is drilled in the skull to let out spirits
whats bloodletting
the process of bleeding a patient by using leeches or cutting a vein and it was the go to method of treatment based on the 4 humours
whats purging
patients taking substances to make them vomit or empty their bowels to balance out the four humours
whats cauterisation
a process used to seal a wound. It involved heating a piece of iron in a fire and pressing it onto a wound. This would seal the blood vessels, but it also risked a severe burn and caused pain for the patient.
what are barber sugeons and what did they do to heal people in medieval times
barbers who had no formal univeristy training
performed minor surgeries such as bloodletting, pulling teeth and amputation
what are wise woman and what did they do to heal people in medieval times
healers who learnt cures and treatments of disease with charms
had knowledge from past generations
provided herbal remedies made out of things from their local landscape
What were travelling healers and what did they do to heal people in Medieval England?
They were 'healers' who travelled around the country 'curing' people in markets and fairs.
They extracted teeth, sold potions and mended dislocations or fractures.
how did monasteries provide healthcare in the medival time
they provided free healthcare and provided care for the sick and the local community
They used herbal treatments, bloodletting, prayer, rest in the infirmary, candles and confessions.
what healthcare could the rich access in medieval tines
a university trained doctor who had studied the ideas of Hippocrates and galen
what healthcare could the poor access in medieval times
barber surgeons
wise women
local monastery
why did the christian church set up so many medieval hospitals
they believed in following the example of Jesus who healed the sick
how did christians treat illnesses in the medieval times
prayers to god
used the ancient medical knowledge of Hippocrates and Galen
why didn’t medieval Christians believe in curing an illness
because they believed illnesses came from god so curing an illness would be a challenge to god who had sent it as a punishment
how much of an influence did the catholic church have on heathcare in the medeval times
had a large role in training doctors and providing health care in infirmaries within monasteries. the Church heavily influenced ideas about the causes of disease and treatments throughout the medieval period.
how did churches stop the development of medical progress
The Church controlled the teaching in universities. This meant Galen’s ideas continued to be followed and believed meaning no one questioned his ideas as would be seen as criticism of the church
They believed prayers and blessings were more important than physical treatments or drugs.
they forbade dissections meaning galens mistakes about anatomy couldnt be corrected
How did the Church help the progression of medicine?
The Church taught that it was part of a Christian's religious duty to care for the sick and it was the Church which provided hospital care.
after the fall of the roman empire, monks tried to copy and preserve medical texts
It also funded the universities, where doctors trained.
What were the main Islamic ideas about medicine?
Their faith also encouraged Muslim doctors to develop new ideas and treatments meaning Islamic medicine at this time is seen as having been more advanced than medicine in England.
The Qur’an tells Muslims they have a duty to care for people who are sick
muslim hospitals were made for treating patients and not just caring for them
who were 2 key individuals in islamic medicine
Al-Razi
Ibn Sina
Who was Al- Razi in islamic medicine
he stressed the need for patient observation
distinguishes measles from smallpox for the first time
although a follower of galen, he thought all student should improve the work of their teacher
wrote 150 books including ‘doubts of galen’
who was Ibn Sina in islamic medicine
He wrote many books, the most well-known of which was The Canon of Medicine
The Canon of Medicine explored ideas about anatomy and human development, and it encouraged natural treatments.
it also listed 760 medicines and their properties
became standard European medical textbook used to teach doctors in the west until the 17th century
He is known for being one of the first doctors to build on the works of Galen and not just copy them.
how did islam help preserve the writing of Hippocrates and galen
islamic empire ruled by Caliph
Caliphs library preserved hundreds of ancient greek medical books by Hippocrates and galen
Why was medieval surgery so risky?
Operated without effective painkillers.
Had no idea that dirt carried disease which lead to infection.
blood loss
who was abulcasis
Muslim surgeon
invented 26 surgical instruments
described many new procedures e.g. ligatures
made cauterisation popular
who was hugh of lucca
famous surgeon who worked in italy
wrote a book criticising common view that pus was needed for a wound to heal
used wine on wounds to reduce infection but disagreed with hippocrates so didnt become popular
who was john of arderne
most famous English medieval surgeon
used opium and henbane to dull pane
developed treatment for anal abscess
formed a work association called the guild of surgeons to separate surgeons from lower class barber surgeons
How was the patient being operated on be treated in medieval surgery?
They often had to be held or tied down from pain.
Natural anaesthetics like mandrake root, opium and hemlock were often used.
What is public health?
The health and well-being of the population as a whole.
how were toilets a problem to medieval public health
waste emptied onto streets
sewage from toilets with cesspits underneath to collect sewage seeped into the ground and got into wells and rivers
how were butchers a problem to medieval public health
allowed to butcher animals in towns/cities
butchers dumped waste they couldn’t sell on streets or in rivers
attracted rats - contributed to spread of the black death in 14th century
Why was it so difficult to keep Medieval town clean?
- Town populations grew and public health facilities couldn't cope.
- Rivers were used for drinking water, transport and to remove waste.
- People had no knowledge of germs and their link to disease and infection (they though that disease was spread by 'bad air' so were keen to remove unpleasant smells').
what are 2 things medieval town councils did to try and keep people healthy
1371 - London mayors prohibited the killing of large animals within city walls
1388- parliament passes law which fines people £20 for throwing ‘dung garbage and entrails’ into ditches, ponds and rivers
how did medieval monasteries ensure they were getting clean water
they redirected rivers to ensure a reliable supply
had systems of pipes to deliver water to wash basins and had filtering systems to remove impurities
how did monks use lavitoriums in medieval monasteries
had toilets which were emptied into a pit from which the waste could be dug out and taken away as manure.
the privies and cesspits would sometimes be flushed which helped stop spreading of disease
when was the Black Death?
1348-1350
what were the main symptoms of the black death
lumps/buboes found on neck, groin and armpits
high fever and vomiting
what were 4 believed causes of the black death?
1. imbalance of the 4 humours
2. bad air (miasma theory)
3. punishment from God
4. witchcraft
what were 2 actual causes of the black death?
1. bacteria from fleas, who fed on blood from rats which killed them and then fleas moved to humans and passed the disease on
2. malnourishment from food shortages meant people were more vulnerable to infection
why did the black death spread so fast
1. street cleaning was poor - encouraged rats to breed
2. animals dug up quickly-buried bodies
3. unhygienic habits from the general public (thriving rotten food on street)
4. laws about cleaning were hard to enforce as people were ignorant about germs and disease.
what did people do to prevent/cure the balck death
Flagellants whipped themselves, believing this would show God they were punishing themselves for their sins.
People would pray for others who were ill, hoping God would cure them.
Doctors would try to balance the four humours, so bloodletting was a common treatment.
Miasma theory led people to carry herbs or flower petals, so they could avoid the smell of the streets.
Physicians used a range of herbal remedies to try to treat people.
what was the consequence of the black death
up to half of Europe population was killed
trade suffered for a time and many labourers died meaning landowners/farmers struggled to work
food shortages created inflation making it harder for the poor
people could demand higher wages as their labour was more in demand
what was the renissance
A cultural movement in the late 1400's (the time period following the middle ages) which was a period of cultural, artistic, political and economic rebirth
What were the changes in the renaissance?
humanism - increased focus on human factors rather than supernatural things
People thought about how the human body worked based on direct observation and experimentation . This encouraged people to examine the body themselves, and to come to their own conclusions about the causes of disease.
people started to question the ideas of galen and other ancient doctors
How did the Renaissance spread?
before rennaisance books were rare and expensive as had to be copied by hand
because of the invention of the printing press in 1451 , knowledge became more accessible and widely available
Who was Versalius
He was a Belgian Professor of surgery at Padua University in Italy and was one of the first's to question Galen.
How did Versalius learn more about anatomy without relying on Galen?
A local judge let him dissect the bodies of executed criminals and he encouraged all of his medical students to do dissections and to learn from them.
What was Versalius' book and what was it about?
The Fabric of the Human Body.
Illustrated accurate textbook on the human body based on dissections and observation of the human body
Corrected Galen's mistakes.
What were the mistakes made by Galen that Versalius corrected in The Fabric of the Human Body?
- The breastbone of a human has three parts, not seven as an ape does.
- The lower jaw is made up of two bones not just one.
What was similar about all of Galen's mistakes corrected by versalius?
All of the mistakes he made were because he had based all of his knowledge on animals as he had only dissected them instead of humans.
What were peoples reactions to Versalius?
was critisised for saying galen was wrong and had to leave his job at the university
what was the impact Vesalius had in England
basis for better treatments in the future
showed others how to do dissections
what were Parés work on gunshot wounds in the renaissance
When treating gunshot wounds, the traditional method was to use hot oil to cauterise wounds.
instead when he ran out of hot oil he created a cream to put on them which was less painful and could heal them better
what was pares work on amputations in the renaissance
used to tie ligatures around blood vessels before the amputation instead or burning them as done previously
first person to use prostethic limbs on patients
what did harvey discover in the renaissance
discovered veins had valves and the blood was pumped around the body by the heart beating constantly
lead to discovery of blood transfutions later on
how was harveys discovery of the circulation of blood different to the ideas of galen
galen taught the liver produced blood and it was used as fuel
also taught blood passed from one side of the heart to the other through invisible holes
what opposition did harvey face
people didn’t believe him as they refused to accept the use of experiments in medicine
people were unable to see capillaries which linked the veins and arteries and it was only later on when microscopes were invented his theory was accepted
what were quacks
Quack doctors were unqualified and often claimed to be selling miracle cures.
whats an example of how superstition was still important in the renaissance period
People thought the King’s touch could cure scrofula (a skin disease).Thousands of people with scrofula are thought to have visited King Charles | (1600-1649) in the hope of being cured.
what was the great plague
another outbreak of the pneumonic and bubonic plagues from 1665 - 1666.
what were the similarities between how people treated the black death and the great plague
many treatments were still based on religion and superstition like praying and wearing lucky charms
bloodletting was still used
people thought miasma caused the disease so they carried herbs and flowers to improve the air
if you were rich enough, what was one of the simplest remedies to deal with the great plague
move to the countryside to avoid catching it
what were the differences with how the black death and the great plague were treated
people began to recognise the link between dirt and disease
towns and councils tried to stop the spread and plague victims were quarantined and their house was locked and a red cross was painted on the door
areas where people crowded together were closed e.g. theatres
bodies of victims were buried away from houses in mass graves
what was the miasma theory
Belief that bad air was harmful and cause illnesses
how was the 4 humours used to treat patients
they tried to get rid of the surplus of the humours through bloodletting, vomiting and purges
why was there an increasing number of hospital in the renaissance period
The monasteries had been closed down by Henry VIII in the 1530s, so towns needed to open hospitals to take their place.
how were hospitals funded during the renaissance period
through donations, legacies or private subscriptions
how did hospitals change during the renaissance period
started focusing on patient care and cure rather than religion
more hospitals were set up specifically for maternity and mentally ill
how did the training of doctors change during the renaissance period
doctors of the future often trained in new hospitals as many medical schools were attached to hospitals
why was john hunter significant
discovered sexually transmitted diseases
learnt how to treat an aneuyism by tying up the artery whihc saved their leg from being amputated
taught the importance of observation and experiment
He taught many young scientists to use scientific methods including edward jenner
what was john hunters approach to surgery
early promoter of careful observation and scientific methods in surgeries
even experimented on himself in 1767 when he injected himself to prove his belief that syphilis and gonorrhoea - infections caused by two different types of bacteria - were caused by the same disease.
To do this, Hunter infected a patient with pus from a gonorrhoea patient, but he ended up infecting them with syphilis as well.
how is an inoculation different to a vaccination
a vaccine is a substance you inject to provide antibodies for immunity
an inoculation is putting a mild version of the disease into you to build resistance towards the more deadly version
what were some of the problems with incocultion
religious objections - people argued god sent illness as a punishment so preventing illness with inoculation was wrong
risky as you had to experience the disease before you came immune which meant some people died
the poorest people couldn’t afford inoculation so weren’t protected
what did Edward Jenner do?
he discovered a vaccine for the biggest killer disease smallpox
how did Edward Jenner create the smallpox vaccine
observed that milkmaids who caught the mild disease cowpox did not go on to catch smallpox.
selected a healthy eight-year-old boy called James Phipps
took cowpox from a sore on a milkmaid’s hand and inserted it into Phipps’ body
observed that Phipps experienced uneasiness, a loss of appetite and a headache as a result of the mild disease but became well again
Phipps was then inoculated with smallpox, but no disease followed
name 4 reasons for why people opposed jenner's work
1. he couldn't explain how/why the vaccination worked because he didnt know about germs
2. many doctors were profiting from inoculating
3. attempts to repeat his experiment failed due to contaminated equipment which created doubt
when was Jenners smallpox vaccination made compulsory in the UK
1853, a law was introduced making it compulsory for all newborn babies to be vaccinated against smallpox.
when was smallpox eradicated
1980
what year did jenner develop the vaccine?
1796
what was the spontaneous generation theory?
the theory that living organisms (germs) could develop from non living matter
hat did louis pasteur discover
that the spontaneous generation theory was wrong and that germs where in the air all around us and that was what caused decay and disease
how did louis pasteur discover his germ theory
Pasteur placed liquid in a swan neck flask and a straight necked flask
claimed the straight spout would allow germs to get to the liquid easily
the liquid in the swan necked flask didnt turn bad as the germs all all settled at the lowest point of the curve so didn’t reach the liquid
this proved that the germs didn’t come alive on their own and only found in places they were able to reach
also proved germs infect things and turn them bad
what year did pasteur publish his work?
1861
why did people not believe germ theory?
people did not believe that germs could hurt something as large and advanced as humans
what did robert koch discover
found ways of using dyes to stain specific microbes undrer the microscope.
identified the germ which caused anthrax in 1876 before going on to find the microbes which cause tuberculosis (1882) and cholera (1883).
why was roberts kockh identifying the specific microbe anthrax so important
This was the first time the bacteria responsible for a specific disease had been identified. Identifying specific bacteria was crucial in being able to develop effective treatments and vaccines.
what are the six key factors that can affect medical breakthroughs?
- war
- government
- chance
- individual genius
- communication
- science and technology
- beliefs
what was salvarsan 606
the first magic bullet created by Paul Ehrlich (who had been part of kochs research team) which homes in and destroyed the harmful bacteria that caused syphyliss
whats a magic bullet
a drug or chemical that targets a specific germ or bacteria (a chemical cure) and does not affect any others
what nautral pain relief drugs were used in surgery and what was the probelm with them
alcohol, opium and mandrake but they could make the patient very ill as it was difficult to know the dose for each person
who discovered nitrous oxide? what year?
Humphrey Davy. 1795.
what were the side effects of nitrous oxide
it caused hysterical laughter, relaxation and caused no pain
who discovered ether? what year?
American dentist William Clark. 1842.
what were the disadvantages of using ether as an anasthetic in surgery?
difficult to inhale
flammable
caused vomiting
who discovered chloroform? what year?
Dr James Simpson. 1847.