History

Pre - historic = look at bones, remenants, brakeages, size and strength to predict lenght of life, age of death. Evil spirits, medicine man, used charms, herbs. could only treat what they could see - had no technology to look inside. Trappaning - drilling into peoples skulls, bones show people survived this operation.

Ancient Egypt = channels flowed blood air water, rotting food in these made you ill this lead to The Theory of the Channels based on the river Nile, irrigation channels - got blocked, caused illness. Also had Supernatural beliefs like the god SEKHMT who had the power to cause illness and cure it. IMHOTEP great doctor. Advances- rich, had money for medicine, places for treating sick, doctors, skilled craftsmen- fine bone instruments for doctors, trade links more medicine and new methords form china, africa and india, preparing the body allow them to see insodes though could not cut organs due to beliefs, paper to record their findings and ideas, paintings

Hippcrates and the Greeks = Asclepion, place of healing, make offerings stay overnight gods whold heal you. Ideas accepted- Hippocratic oath, Hippocratic collection, direct observation. He regected ideas of gods wanted to look for natural causes. The Four Humors, hot and moist, spring, air, blood/ hot and dry, summer, fine ,yellowbile/ cold and dry, autum, earth, black bile/ cold and moist, winter, water, phlegm. too much of one meant you were ill and excess humor had to be drained off.

The Romans = war injuries burns, stabbing, broken bones, arrow cuts, severd limbs, infections, trampled, crushed. Had hospitals for soldiers, doctors were skillful but their operations were painful. still some supernatural beliefs, learnt form Hippoctatic collection, herbs were still used, excersise and diet were recommended. Galen- greatest doctor, he balenced out the four humors to treat the sick, experimented with pigs to descover the nervous system, learn't at gladiator school, he became doctor to the emperor, wrote 434 books on anatomy - made mistakes with pig jaw and human and how it was made up. Public health- pumped fresh water with aqueducts, created toilets, baths and sewage systems, claning means getting rid of bad smells that cause disease MIASMA. They made advances because they were rich, strong centralised givernment, good communication- conqured most of europe, had past work from greeks, technology advances, army.

Middle Ages = Saxons **** living conditions, short life expectancy, bone and joint desease alot of climate change, houses were small, dark , danky and smokey with one room, water was from streams or wells, waste was put in cesspits outside houses. Vikings- animals roamed free, waste was on the streets water was from the rivers and streets were infested and dieased. things got worse because no one could challenge Galen, the church controlled most things after the romans trade and the empire was in chaos.

1348- the black death, bubonic, sceptaemic, pneumonic, spread by fleas on rats due to trade, if you were bitten you died. causes of this plage was beliefed to be at the time miasma, punishment from gods, eye contact with plagued person, humors out of balance, astrology, bad digestion, earthquakes releasing smells and the jews.

The church helped by;

schools reading Galens books,disections once a year, universities for training doctors, armies had doctors, 1300's measure put in for cleaning up towns, ideas were being spreas around europe, part of religoud duty to care for the sick.

they hindered medicine by;

not letting students do the disection, having religous reasons for healing and the sick, dissection was banned until the 14th C, armies and defense were more important than medicine, churches everyone dictating what you should belief, nothing was to challenge the bible, they controlled education and what was read, not everone was treated.

Renaissance = New inventions like the water pump, artist drawings for text books, they were accurate, printing in 1450, more books could be read, war- new wepons new injuries, challenging the church.

Versalius- anatomy "fabric of the human body" 1543, illistrated books, proved Galen wrong about the jaw, was professor of surgery at the university of padue

Pare- war surgeon, book in 1575, used herbs abd bandages instead of quarterising with oil.

Harvey- the circulation of the blood, showed blood flows around body and is pumped by the heart, book "an anatomical account of the heart and blood in animals" in 1628, proved his ideas with man whos heart stcuk out after accident.

the great plague 0f 1665= thought causes were, astrology, outerspace, supernatural, human contact, Miasma, insects ,microscopic creatures.

C19th = 1750+ Edward Jenner descovers vaccinations from cowpox, people thought it was odd, they were sceptical cause he couldnt give an explanation, doctors lost money, dangerous cuase of mix ups and infected needles. Cholera was thought be be cased by toads, severe weather, dirty streets, sins/punishments, uncleanliness, supernatural,

Edwin Chadwick- reported on living conditions and wanted public health reforms, but was not accepted. 1848- first public health act, volentary for governments to spent money on public health. Lassiaz Faire- belief government shouldnt interfere with peoples lives.

John Snow- epidemiology he proved the link with cholera without knowing the actual cause. proved cholera eas water born in 1854, government was more prepared to pay for public health.

1847- Ignaz Semmlwiss- purple fever, was thought due to air, this was proved wrong was people sitting next to each other one could have purple fever and the other did not, he found real cause was doctors not washing their hands however his ideas were not spread because he could not write in another language but his own and was embarrased.

1858- The Great Stink- the Thames was full of sewage, the smell was unbareable, this affected the houses of parliment and encourage public spending.

1861- Louis Pasture and germ theory, did this through leaving beer to go bad, the result was specific micro- organisms cause human disease.

Robert Koch- while researching the cause of anthrax, infected mice and left others, he managed to identify the caused of things like TB, cholera,and typhoid. he also invented the stain medium for experimenting with micro-organisms, allow you to see them and observe them.

Florence Nightengale - Crimean war 1854- soliders affected by frost bite, gangerine, wounded, no toilets, living in muddy tents, hospitals were crowded and dirty they had rats, men were in corridors along with operations, no anti-biotics, men were left in their own waste, nightengale had amputations done in privacy, everything was cleaned,better food, wards were re-built, begain a nursing school in 1860, after the war she wrote a book. got an award at the end of ther life for her efforts.

Nineteenth century surgery=

could not stop bleeding, did not know of blood types, could not stop infection when sewing up the artieries - ligitures, could not store the blood did not know where for how long or in what condition.

infection- they didnt know about germs, could only cut off limbs, nothing inside the body could be solved,

Pain- nothing to ease the pain of amputations and operations, they only had alcohol which thins the blood, made people reluctant to have operation,

James Simpson and Chloroform- made the descovery with friends when experimenting with chemicals, inhaleing the fumes knocked them out. doctors refude it because they thought god wanted pain and caused higher death rates when not used properly, but they could now operated deeper inside which cause more infections and loss of blood.

was accepted when queen victoria had it during child birth to her 8th .- anesthetic.

1867- working class men given the vote, pressure to improve health

1875- the second public health act it was now complusery.

WWI- sped up findings- good thing for medicine.

X-rays- surgeons can see bones and war shrapnel- accurate operations. Wilhelm Rontegen found these in 1895- used in hospitals.

saline solution(salty water) stopped the becteria in the trenches and on their clothes.

Blood transfusion- descovered the liquid part plasma could be seperated from the corpusdes. the cells were bottled and packed in ice, to be stored when needed.

1901- descovery of different blood groups.

penicillin- egyptians though moldy bread helped illness,

1928- flemmnig descovers penicillin in petridish but does nothing more.

Florey and Chain- 1937- 1939early WWII "heath robinson productions"1941 experiment with injured police officer shows penicillin wirks but only produce a limited amont and though extract it from his pee they run out. june 1941 they travel to America, America fund mass producing and they start in 1943, penicillin then saves thousands of lives in 1944 aka D-day .

Joseph Lister and Anti- septic

experimented with carbolic spray,experimented on a 11yr old boy and his wound had healed, his ideas were accepted as surgery was now clean surgeons sterillised and used rubber gloves. still used today. opposition said carbolic spray cracked hands and smelt, it was also more expensive and less pleasent for surgeons. it slowed it down.

Before the NHS

1911 insurance scheme- of covered the employed, did not cover women, children, elderly or the sick. employees made weekly contrinutions, was introduced by the liberal party.

Great Depression

harder to get good medicine, 3 million unemployed and couldnt pay insurance. after 1930 death rates of infants grew,national government only payed 5% of health costs in 38/39.

Available care

no money meant relying on family remidies, relied of family and neighbours when ill, doctors had debt collectors for those who couldnt pay,

NHS

teaching hospitals, medical research, hosptials, specialists, blood transfusions, dentists, medicines and appliances, family doctors, ambulance, vaccination,health centers, visitors ans carers, materity and childcare.

people opposed the NHS because of the cost, doctors feared it would be a reduction in wage, hospitals would be nationalised.

it was first opposed by 54% of BMA's menbers this then rose to 90% in 1948.

Bevan managed to get the doctors on course by promoting salaries and allowing them to treate privately as well, he was a forceful and persuassive person.