Changes in Health and Medicine c.1340 to the present day

19th Century Advances in Surgery

Surgery was previously limited by pain, infection, and bleeding.
Two major advancements in the 19th century significantly improved surgery:
- Anaesthetics
- Antiseptics

James Simpson, a Professor of Midwifery at Edinburgh University, discovered that chloroform could relieve pain during childbirth through experimentation.
Simpson published articles about his discovery.
Early challenges with anaesthetics:
- Surgeons lacked knowledge about appropriate dosages.
- A patient died in 1848 due to a chloroform overdose.
Public opinion shifted after Queen Victoria used chloroform for pain relief during the birth of her eighth child in 1857.
Chloroform provided effective pain relief for patients.

Joseph Lister, a Professor of Surgery at multiple universities, applied Pasteur’s ‘germ theory’ to prevent post-operative blood poisoning (septicaemia).
Lister used carbolic acid:
- To wash his hands and surgical instruments before operations.
- To soak bandages before applying them to wounds.
- To soak silk threads before using them to tie up wounds.
Lister achieved a significant reduction in infection rates (from 46\% to 15\% within 3 years).
In 1871, Lister invented a spray machine to apply carbolic acid to a patient’s wound during surgery.
He published his findings in 1867.
Lister’s methods marked a turning point in surgery.
The discovery of the bacteria causing septicaemia (blood poisoning) in 1878 further supported the acceptance of Lister’s ideas.

Herbs were used to treat common illnesses via herbal drinks or ointments.
Books like the Leech Book of Bald (10th century Anglo-Saxon) provided remedies:
- Example: Lavender for headaches.
The printing press enabled the publication of herbals:
- Examples: Turner’s A New Herbal (1551) and Culpepper’s Complete Herbal (1652).

Barber surgeons performed various medical procedures:
- Bleeding patients.
- Extracting teeth.
- Performing minor surgery.
- Selling medicine.
- Cutting hair.
They worked in shops, indicated by a red and white pole (white for bandages, red for blood).
Barber surgeons had to work quickly and used hot irons to seal wounds and stop bleeding.

The prevailing belief was that imbalances in the Four Humours caused illnesses.
Treatment methods to restore balance:
- Blood-letting: Incisions to drain blood (venesection) or using leeches.
- Purging: Introducing herbs, honey, and water into the bowels through the rectum.

The Mediciner (physician or healer) in the laws of Hywel Dda used herbal remedies and treated broken bones.
Dynion Hysbys (wise men) were believed to break spells and undo evils to heal people and animals.
The Physicians of Myddfai, from Carmarthenshire, treated local lords and recorded cures in the Llyfr Coch Hergest (Red Book of Hergest), which included instructions on surgery, herbal medicines, or bloodletting.
Curative wells were associated with saints, leading to church construction nearby. St Winefride’s Well at Holywell was known for its healing properties and the water was used to treat rheumatism and skin disorders.

Herbals: Books listing the medical properties of plants.
Barber surgeons: Medieval doctors who performed surgery.
Four Humours: Belief that the body consisted of four body fluids, and illness occurred when these were imbalanced.

During the late 19th and early 20th centuries, Welsh bonesetters contributed to advances in orthopaedic injury treatment.
Thomas Rocyn Jones (1822–77) of Rhymney developed new bone-setting methods and wooden splints with a foot piece for fractures and muscle injuries.
Evan Thomas (1804–84) treated bone and joint diseases, while his son Hugh Owen Thomas (1834–91) designed and manufactured his own splints. The ‘Thomas Splint’ was developed to stabilize femur fractures and was widely used during World War I.
Sir Robert Jones (1857–1933), nephew of Hugh Owen Thomas, became a lecturer in orthopaedic surgery at Liverpool University and Inspector of Military Orthopaedics during WW!. He is known as the ‘father of orthopaedics’.

Anaesthetic: A substance or gas that produces unconsciousness before and during surgery.
Antiseptic: Chemicals used to destroy bacteria and prevent infection.

Marie Curie and her husband discovered that radioactive elements, such as radium and polonium, could destroy tissue, leading to cancer treatment.
Marie Curie's 1911 Nobel Prize was for discovering a means to measure radiation.

In 1928, Alexander Fleming discovered penicillin, a mould that killed bacteria.
In 1929, Fleming published a report on penicillin.
Howard Florey and Ernst Chain mass-produced penicillin, beginning human trials by 1941.
By 1944, enough penicillin was available to treat all Allied casualties.
In 1945, penicillin became available for civilians.
Fleming, Florey, and Chain received the Nobel Prize in Medicine for their research.
By the 21st century, some bacteria (e.g., MRSA) became antibiotic-resistant.

In December 1967, Christiaan Barnard performed the first human heart transplant on Louis Washkansky, who survived the operation but died after 18 days due to pneumonia.
Barnard performed ten heart transplants between 1967 and 1973, but organ rejection remained a problem.
Immunosuppressive drugs addressed the issue of transplant rejection.

Wales was the first part of the UK to adopt ‘presumed consent’ for organ donation.

Cancer treatments:
- Radiotherapy (attacking cancer cells with X-rays).
- Chemotherapy (using chemicals to attack cancer).
- Surgery (removing cancerous cells by operation).
Heart disease treatments:
- Diet and exercise.
- Drugs to stabilize pulse, lower blood pressure, or cholesterol.
- Surgery to install a pacemaker or perform by-pass surgery.
- Insertion of a stent to widen an artery.
Miniaturisation, fibre-optic cables, and computers facilitate keyhole surgery.
Microsurgery allows re-joining of nerves and small blood vessels, enabling limb re-attachment.

Hydrotherapy, aromatherapy, hypnotherapy, and acupuncture gained popularity.
These treatments are based on traditional practices designed to work in harmony with the body, rather than using chemicals against illness.