MEDICINE THROUGH TIME

What did medical people believed cause disease?

• Punishment from God

• Astrology

• Miasma (bad smelling air)

• Theory of four humours (if they were unbalanced)

Who created the Theory of four humours?

Hippocrates

Who created the theory of opposites?

Galen

How were people treated for disease in medieval England?

• Religious treatment (Prayer, fasting, pilgrimages)

• Supernatural treatments

• Humoural treatments (purging, bloodletting, cupping)

• Theory of opposites (Add the opposite to the humour to heal it)

• Remedies by apothecaries (Theriaca)

• Hospitals run by monks (St Bartholomew’s)

• Home (women)

How were people trying to prevent disease in medical England?

• Religiously (Praying, offering tithes for priests to remove the disease)

• Lifestyle changes (Dietary book such as Regimen Sanitatis)

• Purifying air with sweet herbs

What did many people in medical England think caused the Black Death in 1348?

Miasma- Spread of bad fumes

What actually caused the Black Death in 1348?

Fleas on rats

How did people try to treat the Black Death in 1348?

• Praying to God

• Bloodletting, purging or lancing buboes

• Purify air with bonfires

How did people try to prevent the Black Death in 1348?

• Self-flagellation

• Purify air by carrying sweet herbs

• Quarantine laws were introduced but hard to enforce

What was the average life expectancy in 1350?

35 years old

What new ideas did people believe cause disease in renaissance England?

• Animalcules- Discovered by Antony Van Leeuwenhoek

• Thomas Sydenham (Believed that illness could be caused externally, not internally

What book did Thomas Sydenham write in 1676?

Observations Medicae

How did the new ideas of the cause of disease spread more easily in renaissance England?

• Printing Press (Made in 1440 by Johannes Gutenberg which enabled information to spread further)

• Royal Society (Founded in 1660 to discuss new ideas of medicine. A journal called Philosophical Transactions was written and the society was given a Royal Charter)

What new ideas were introduced to treat disease in renaissance England?

• Transference- disease could be transferred from a human to something else

• Alchemy (Medical chemistry- Remedies such as mercury was used)

• Herbal remedies- Chosen to treat disease because of colour and shape - Herbs appeared from the New World such as tobacco

• Hospitals employed physicians, but soon closed down due to the closure of monasteries

• Pest houses were made for plague and pox victims

How did the prevention of disease change in the renaissance period?

• Government took a more active role- People were fined for not cleaning streets

• Henry VIII closed down public bathhouses

How did the knowledge of the anatomy improve in the renaissance period?

• William Harvey (Discovered that blood circulated around the body and not by the liver)

• Andreas Vesalius (Found over 300 mistakes in Galen’s work by dissecting bodies of criminals)

When was the Great Plague?

1665

What did people have to do if they caught the plague?

Quarantine for 28 days and have a cross on the door which says ‘Lord have mercy upon us’

What did people believe caused the Great Plague in 1665?

• Punishment from God

• Miasma (Caused by sewages and rubbish in cities)

How did people try to treat the Great Plague in 1665?

• Physicians suggested wrapping up in thick clothing so disease could be ‘sweated out’

• Transference

• Quack doctors mixed herbal remedies

How did people try to prevent the Great Plague in 1665?

• Purify air using pomanders

• Government actions such as banning of large crowds, clean streets

• Plague doctors

What did people believe cause disease in industrial England?

• Spontaneous generation by Henry Bastian- Microbes made by decaying matter

• Germ theory by Louis Pasteur in 1861- believed that microbes could cause disease

• Miasma

Why was Louis Pasteur’s Germ Theory unpopular?

• Spontaneous generation was liked by doctors

• Pasteur wasn’t a doctor

• Pasteur had no evidence to show his theory

Who was Robert Koch and what did he discover?

Koch discovered bacteria which caused diseases such as cholera (1883) and tuberculosis (1882)

How did people treat diseases in industrial England?

• Hospitals worked on treating patients rather than just caring for them

• Surgery

• Florence Nightingale

Who was Florence Nightingale and what did she do during the Crimean War?

In 1854, she went to Scutari to treat British soldiers

• The death rate fell from 40% to 2%

• She made sure hospitals were clean and bedding and fresh clothes were provided

• She wrote books of her methods such as Notes on Nursing

What were three key problems with surgery?

Bleeding, pain and infection

Who founded the effective anaesthetic chloroform in 1847?

James Simpson

• However, during the black period of surgery (1850-1870) many people died from receiving too much chloroform

Who found the antiseptic, carbolic acid in 1865?

Joseph Lister

• Help to disinfect the air and keep wounds clean

• Aseptic surgery was put in place- Clean operating theatres and sterilised equipment

How did people try to prevent disease in industrial England?

• Inoculation (Spreading pus onto healthy skin for body to build up resistance to it)

• Vaccination

• Public health acts/role of government

Who developed the smallpox vaccine and how?

Edward Jenner

• Saw that dairy maids with cowpox didn’t catch smallpox and experimented with a local farm boy

• He believed that vaccination was softer than inoculation as you can control the dosage

• By 1852, the vaccine was made compulsory

What attitude did the government have towards public health?

‘Laissez-faire’ (Leave alone)

Who published a report on public health in 1842 and what was it called?

Edwin Chadwick

• ‘Report on the sanitary conditions of labouring classes’ - Showed that poor classes had a low life expectancy compared to higher classes

When was the first public health act introduced and why didn’t it work?

1848

• Didn’t work as it wasn’t compulsory

When was the second public health act and what were some of the city authorities?

1875

• Provide clean water

• Build public toilets

• Check food quality

When did cholera come to London?

1854

Who believed cholera was caused by drinking dirty water?

John Snow

What did John Snow do to prevent cholera?

• He removed the water pump handle from Broad Street which stopped the outbreak

• A new sewage system was out into place

• Although many people rejected the idea, he was a well respected doctor

What do people believe caused disease in modern England?

• Genetics

• lifestyle factors

What does hereditary disease mean?

A disease passed on from parents

Who and how was DNA identified in 1953?

• James Watson and Francis Crick found the shape of DNA (double helix)

• They looked at photos which were produced by Rosalind Franklin and Maurice Williams

Why was the structure of DNA important for finding out diseases?

Scientists could identify which parts caused hereditary diseases

• James Watson launched the Human Genome Project in 1990 which helped to find the blueprint of DNA of people with and without hereditary diseases

What lifestyle factors affect health?

• Smoking could cause cancer

• Diet with high amounts of sugar and fat

• Alcohol cause damage the liver

• Drug taking

• Unprotected sex

• Tanning

What changes were there to improve diagnostic procedures?

• Blood pressure monitors (1880)

• X-rays (1890)

• Endoscopes (Tube which enters throat to see digestive system)

• Blood tests

• CT scans

What were the key ideas about the treatment of disease in modern England?

• Magic bullets

• Antibiotics and penicillin

• Surgery

• NHS

Who discovered the first magic bullet in 1909?

Paul Ehrlich

• Tested arsenic compounds and found one which cured syphilis

• This is known as Salvarson 606 and could kill the patient as arsenic is poisonous

Who found the second magic bulletin in 1932?

Gerhard Domangk

• Discovered prontosil cured blood poisoning

Who found penicillin by accident in 1928?

Alexander Fleming

• Noticed that penicillin mould killed harmful bacteria in Petri dish

Who continued to work with penicillin in 1940?

Howard Florey and Ernst Chain

• They grew penicillin to treat a human and tested it on a police man

• British companies didn’t mass produce as they were focused on WW2, but American companies agreed to start the production

• Fleming, Florey and Chain shared a Nobel prize in 1945 for their work

How was the problem of bleeding solved in modern England?

Blood transfusions

• Karl Landsteiner identified the blood groups in 1900

What types of surgery was performed in modern England to improve successful organ transplantation?

Keyhole and robotic surgery

When was the NHS founded?

1948

Why was the NHS founded?

William Beveridges report which had 5 evils in society

• Squalor (dirtiness)

• Ignorance (lack of education)

• Want (Poverty)

• Idleness (unemployment)

• Disease

How was lung cancer diagnosed in modern England?

Using CT scans which gave a detailed image of inside the body

How is lung cancer treated in modern England?

• Lung transplant

• Radiotherapy

• Chemotherapy

How was lung cancer prevented in modern England?

• Cigarette advertising was banned in 2005

• Legal age to buy tobacco was raised from 16 to 18 in 2007

• Anti-smoking campaigns were produced

What are the key preventions of disease in modern England?

• Mass vaccinations ( Funded by government)

• Government legislation (Clean air acts on 1958 and 1968 to prevent smog. Health act of 2006 made smoking illegal indoors

• Government lifestyle campaigns (Warn people of dangers of smoking, drugs, alcohol and unprotected sex)

What were some medical breakthroughs in the years before WW1?

• Aseptic surgery

• X-rays (Discovered in 1895 but there were risks rush as burns on body or fragility of machine)

• Blood transfusions (Karl Landsteiner discovered the first 3 blood groups)

What were the trenches like in WW1

• Zig-zag pattern

• Space between two lines of trenches was called the no-man’s land.

• Frontline trench is where soldiers was shoot from

• Reserve trench is where back up soldiers would be

• Communication trench made it so messages and supplies were passed easier

What was the main consequence of the First Battle of Ypres in 1914?

- British lost over 50,000 troops

What was the main thing that happened in the Second Battle of Ypres in 1915?

First time Germans used chlorine gas

What was the main consequence in the Battle of Somme in 1916?

British lost over 400,000 lives

What happened in the Battle of Arras in 1917?

British made a safe underground network and had a hospital with electricity and water

What happened in the Battle of Cambrai in 1917?

Large use of tanks (500)

What was trench foot?

• Caused by standing in cold water or mud

• Symptoms were pain swelling of feet which lead to gangrene

• Treatments were to rub whale oil or even amputate leg

What was trench fever?

• Body lice

• Symptoms were flu-like

• Treatments included delousing stations

What was gas gangrene?

• Open wounds infected by bacteria

• Symptoms included dead skin

• Treatment was to amputate infected area

What was shell shock?

• Psychological damage

• Symptoms included tiredness, mental breakdowns

• Condition wasn’t well understood, and many were call cowards for suffering with this

What was shrapnel injuries?

• Caused by being hit by bullets or bits of metal

• Solution was to wear Steal Brodie Helmets (Introduced in 1915) to protect the head

What was gas attacks?

• Chlorine, phosgene or mustard gas

• Symptoms included burned skin, blisters or death by suffocation

• Solution was to wear a gas mask

What were the four main stages in the chain of evacuation in WW1?

• Regimental Aid Posts (Gave immediate aid)

• Dressing stations (Dealt with more serious injuries

• Casualty clearing stations (Had a triage system so men were divided into three groups based on condition)

• Base hospital (Located at coast so men could be sent back to England

What is the FANY and how did they help on the Western Front?

First Aid Nursing Yeomanry

• Founded in 1907

• Women’s organisation which sent volunteers to help in WW1

• They drive ambulances and gave emergency first aid

How were the wounded transported on the Western Front?

• Horse drawn wagons

• Motorised ambulances

• Stretcher-bearers (men who carried injured soldiers)

What were problems with treatment in the trenches?

• Contaminated conditions

• Shrapnel or dirt in wounds would cause infections

• Sheer number of casualties meant the system struggled

What were some methods to dealing with infections on the Western front?

• Plastic surgery (Rebuilding destroyed facial features)

• Brain surgery- Using a magnet to get shrapnel out (Developed by Harvey Cushing)

• Blood banks (Blood was carried in a case during battles and can treat injured soldiers)

• Blood transfusions (Portable kit)

• The Thomas Splint- Held leg still during surgery (Improved survival rate for leg injuries from 20% to 82%)

Why was access to medical care and treatment improved in the Modern Period?

• Infirmaries set up by charities can councils for people who could not see a doctor

• NHS (After 1948, free health care wad provided to all, which made others attend)

• Mass vaccination programmes (ensured most diseases would be prevented. Polio-1950 or Covid-2020)

• Government lifestyle campaigns (Prevent diseases through advertisements against smoking, unprotected sex. E.G- Stoptober, or Change4life)