History of medicine

Course overview. Brown - Key dates, Yellow - Time periods, Bluey green - Public Health, Green - Statistics.

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  • Medicine Through Time
    • The Middle Ages 1350 - 1500
      • Key People
        • Galen 120AD
          • Wrote books which were the first examples of Greek thought. Dismissed magic. Created Theory of four humours.
          • Anatomical. Dissected animals and therefore made mistakes however was very advanced at the time and influenced training and many of the training for a long time.
          • Continued on Hippocrates (400BC) Theory of Opposites
      • Beliefs about causes of disease
        • Supernatural
          • Astrology and Astronomy
        • Religious
          • Punishment from God
        • Ancient
          • Four Humours and Theory of Opposites
        • Natural
          • Miasma
      • Key Events
        • Black Death 1348
      • Medical Treatments
        • Padua Univeristy
          • For the rich:
            • Surgeons who had studied at Padua. They had studied Galen.
          • For the poorer:
            • Barber Surgeons
              • No formal training, sometimes had an apprenticeship
              • Performed some surgery, blood letting, pulled teeth, sold medicine and cut hair
            • Apothecaries
              • Prepared and sold medicines to surgeons and directly to patients
              • Often diagnosed illness and were sometimes accused of practising witchcraft
            • Wise Women, House Wives and Midwives
              • Delivered babies and, occasionally, carried out abortions
              • Administered herbal remedies
              • Founded branches of alternative medicine
              • Belittled by more professional branches of medicine, and often by men
      • Impact of Church
        • Help
          • Invested in training institutions
          • Monasteries provided care and some medical help
          • Medical books were copied by monks
        • Hinder
          • Catholic Church was unchallenged
          • Church's teaching was accepted as being the truth
          • Church taught that God punished people for wrongdoing
          • The clergy accepted the works of Hippocrates and Galen therefore medicine was not encouraged to continue
      • Since Roman period -
        • Change
          • Lack of public health due to no strong government
          • Wars that led to the fall of Rome meant books were lost
        • Continuity
          • Continued to study Hippocrates and Galen
      • Public Health Through Time
        • 1350- 1750 (Middle Ages & Renaissance)
          • Key Events
            • 1348 Black Death
              • Standards Improved after as population had fallen.
                • People struggled to deal both epidemics. Most methods of prevention were ineffective.
                • Only short term improvements to medicine.
            • 1665 Great Plague
              • Standards Improved after as population had fallen.
                • People struggled to deal both epidemics. Most methods of prevention were ineffective.
                • Only short term improvements to medicine.
          • Stagnation
            • Problem of sewage and rubbish disposal.
              • Contamination of water.
                • Only monasteries had fresh water.
                • Middle Ages - water carriers. Renaissance - some piped.
          • Role of Government
            • Laws passed to try and keep   cities cleaner i.e. 1372 Fine for throwing waste out of houses.
            • Ordered days of fasting and praying
          • Disposal of waste
            • No flushing toilets
            • Rakers attempted to keep streets clean
          • Problem of population explosion - over 100,000 during Renaissance
        • 20th Century
          • Key People
            • Aneurin Bavin 1945
              • Minister for health - wanted to set up NHS but faced opposition. Set up in 1948. Resigned in 1951 because prescription charges were introduced.
          • Liberal Welfare Reforms
            • 1948 Welfare State
          • NHS 1948
            • Minister for health - wanted to set up NHS but faced opposition. Set up in 1948. Resigned in 1951 because prescription charges were introduced.
          • Role of Government, Technology and Wealth
            • 1911 National Insurance
            • 1956 Clean Air Act
            • NHS 1948
            • By 1931 life expectancy was 60yrs
            • Industrialisation - 1900 Boer War 1/3 medically unfit
          • 1750 - 1900 (Industrial Revolution)
            • Key People
              • John Snow 1854
                • Investigated deaths due to Cholera.
              • Edwin Chadwick 1842
                • Wrote  report on "The Sanitary Conditions of the Labouring Population". Nothing done until 1848 Cholera epidemic.
            • 1848 and 1875 Public Health Acts
              • Wrote  report on "The Sanitary Conditions of the Labouring Population". Nothing done until 1848 Cholera epidemic.
            • Impact of Industrialisation
              • Population explosion
                • Manchester grew from 70,000 to 303,000 from 1801-51
              • Poor quality housing
              • High death rate due to infectious disease
                • TB
                • Typhoid
                • Cholera
                  • Outbreaks in 1848, 1854 and 1866
            • Government Involvement
              • End of Laissez Faire
              • Public Health Acts
      • Renaissance 1500 - 1750
        • Key Discoveries
          • Printing Press
            • Discovered around 1450, meant that medical ideas could be written down and spread further more quickly.
          • Work in obstetrics and created forceps.
          • Water pump gave Harvey inspiration
          • Microscopes, first in 1590
        • Key Individuals
          • Vesalius 1543
            • Studied at Padua. Conducted his own dissections. Found faults in Galen's work. Helped with blood-letting. Created anatomical drawings. Moved people on from studying Galen.
          • Harvey 1628
            • Studied medicine at Cambridge. Was a Doctor and Lecturer. Discovered the heart was a pump and that humans come from eggs.
          • Pare 1575
            • French Barber Surgeon. Found alternatives to cauterising. Introduced ligatures. Experienced through war. Ligatures were less painful but increased infections so not popular. Also involved in obstetrics.
          • Hunter brothers
            • Work in obstetrics and created forceps.
        • Changes in training
          • Physicians
            • No longer used urine or astronomy charts.
          • Surgeons
            • Work of Hunter brothers improved training.
              • Hunter brothers
            • Midwives
              • Discovery of forceps meant men began to dominate midwifery.
            • Impact of Church
              • Reduced influence as people started to question Galen and criticise Church.
              • Dissections carried out, especially at Padua even though against Church.
                • Reduced influence as people started to question Galen and criticise Church.
            • The Royal Society 1660
              • Scientists shared ideas. experimentation encouraged.
            • Medicine and healthcare in home and hospitals
              • Still usually run by  monasteries.
                • Impact of Church
                  • Dissections carried out, especially at Padua even though against Church.
                  • Until reformation when new hospitals created, helped by Royal Society
            • Industrial Revolution 1750 - 1900
              • Key Individuals
                • Edward Jenner 1798
                  • First breakthrough of fight against infectious disease. Studied inoculations and produced vaccination for cowpox. Got idea from Turkey.
                • Louis Pasteur  1861
                  • French Scientist, not a Doctor. Worked with beer - realised it went off due to "germs in the air". Unusual because people thought germs were the product of decay.
                    • Produced a vaccine for Anthrax, Cholera and Rabies.
                • Robert Koch 1880s
                  • German Scientist. Used Pasteur's findings to begin own study for cause of disease. Identified specific microbe that caused Anthrax which caused Jenner's work to be understood. Industrialisation helped Koch produce a die that stained and showed septicaemia microbe.
                • Elizabeth Garrett Anderson 1866
                  • First female Doctor to qualify in England. Opened a school of medicine for women. Went to France to study.
                • Florence Nightingale 1856
                  • Nursed in the Crimean War and caused death toll to fall significantly. Set up a school of nursing.
                • Rontgen 1895
                  • Discovered X-Rays
                • Simpson 1847
                  • Anaesthetics. Discovered chloroform when experimenting with friends. Very successful but dangerous. Extended length of operations and improved complexity.
                • Snow 1848
                  • Worked in  anaesthetics (Ether). First to monitor prescription of  chloroform with inhaler.
                • Lister 1867
                  • Antiseptics. Carbolic Acid spray. Cleanliness already studied by Semmelweis (who caused deaths to fall from 12% to 1%). Others not as systematic and  kept changing ideas.
                • Paul Ehrlich 1890s
              • Beliefs about causes of disease
                • Miasma (bad air causing illness)
                  • Both disproved by germ theory (Pasteur), which showed that disease was caused by microorganisms.
                • Spontaneous Generation (decay caused germs)
                  • Both disproved by germ theory (Pasteur), which showed that disease was caused by microorganisms.
              • Influence of Industrial Revolution on medicine
                • Development of pharmacies and patent medicine
                  • Produced branded products available to sell to the public.
                • Discovery of microbes and 'magic bullet'.
                  • Specific compounds that target  and kill specific disease: Salvarsan (for Syphilis), Methylene Blue (for Malaria) and Trypan Red (for Sleeping Sickness).
                    • Paul Ehrlich 1890s
                • Improvements in communication and technology
                  • 1895 Discovery of X-Rays
              • Improvements in hospitals and training
                • 1815 Apothecaries Act - introduced compulsory apprenticeship and formal exams.
                • 1858 General Medical Act
                • Voluntary Hospitals and sick clubs
              • End of Laissez Faire
            • 20th and 21st Century 1900 - 2013
              • Development of Magic Bullets
                • Specific compounds that target  and kill specific disease: Salvarsan (for Syphilis), Methylene Blue (for Malaria) and Trypan Red (for Sleeping Sickness).
                • Key Individuals
                  • Crick and Watson 1953
                    • Discovered double helix structure of DNA. Studied at the same time as Wilkins and Franklin, whose Crystallography helped.
                  • Alexander Fleming 1928
                    • Scientist working on Staphylococci. Noticed that culture dish mould killed germs without side effects. Developed penicillin.
                  • Florey and Chain 1930s & 40s
                    • Developed Penicillin after Fleming
                • Beliefs about cause of disease
                  • Understanding microbes
                    • Scientist working on Staphylococci. Noticed that culture dish mould killed germs without side effects. Developed penicillin.
                    • Increase in use of vaccinations - many diseases wiped out.
                  • Genetic Conditions
                    • Discovered double helix structure of DNA. Studied at the same time as Wilkins and Franklin, whose Crystallography helped.
                    • 2000 Human Genome mapped
                • Treatments
                  • Development of pharmaceutical industry
                  • NHS 1948
                  • Changes in the training of doctors, nurses and midwives.
                  • Alternative medicine
                    • Acupuncture
                    • Hypnosis
                    • Homeopathy
                • Science and Technology
                  • Transplants, first in 1952.
                  • Key hole surgery
                • Blood
                  • 1902 Landsteiner
                    • Blood groups
                  • 1915 Lewison
                    • Blood Storage
                  • 1967 Bernard
                    • Heart Transplant

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