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Before and After

Before

  • ancient greeks developed an explanation for ill health based on natural causes rather than supernatural
  • romans introduced good standards of public health throughout their empire
  • when the Romans left Britain in the 5th century their civilisation collapsed and England was invaded

After

  • no significant advances in the understanding of causes of ill health, and uses of science and tech until the 18th and 19th centuries
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Life Expectancy

  • in the 1350s it was around 30 years
  • the rich lived longer
  • infant mortality was high
  • 1 in 5 children born would die before their first birthday 
  • causes of death- illness, injury, poor living conditions, malnutrition
  • many women did in childbirth
  • focused on dealing with infectious diseases and daily aches and pains
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Hippocrates and the Theory of the Four Humours

  • the ancient Greeks identified four different humours in the body: blood, phlegm, yellow bile, black bile
  • the Greeks thought every person had their own individual mix of the four humours, and if this mix became unbalanced you become ill
  • examples- temperature, skin goes red and hot because you had too much blood
  • thought the four humours were linked to the four seasons and the elements
  • blood- spring, air, warm and moist
  • yellow bile- summer, fire, warm and dry
  • black bile- autumn, earth, cold and dry
  • phlegm- winter, water, cold and moist
  • Hippocrates had a hollistic approach and believed treatment should be based on rest and diet
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Galen and the Theory of Opposites

  • Galen, a doctor working in Rome in the 2nd century, developed the theory further
  • believed strongly in blood letting as a treatment
  • also suggested the balance of a persons four humours could be restored by his theory of opposites
  • example- too much phlegm= eat hot peppers, if you had a temperature= eat cucumber
  • Galen produced over 350 texts about medicine and surgery which summarised medical knowledge at the time
  • he claimed he had now perfected ancient Greek ideas
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Galen in the Middle Ages

  • Galens ideas continued to be the basis of medical training 
  • teaching was based on his ideas and texts rather than students having any practical experience
  • treatment usually based on bloodletting, purging, and the theory of opposites
  • there was a great deal of interest in stars and astrology
  • these ideas were then linked to Galens ideas on medicine, e.g. when to operate
  • physicans used urine charts for diagnosis, or a zodiac chart to know when to avoid certain treatments
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The Black Death

  • in 1348 the Black Death spread
  • a third of the population died 

Religion

  • most people were christian and followed the catholic church
  • religion was a very important part of peoples lives because it provided explanations for so much that happened
  • they believed bad things happened because God was angry with them or testing their faithfulness
  • flagellants walked in procession to churches whipping themselves to ask God for mercy

Other ideas

  • an unusual positioning of the planets
  • poisonous fumes from volcanoes and earthquakes
  • miasma from decaying refuse
  • imbalance in the four humours
  • jews poisoning the wells

Treatments

  • holding bread against the buboes and burying it
  • fasting and praying
  • eating cool things
  • smelling herbs and spices
  • flagellation
  • tidying the streets
  • lighting a fire in the room
  • keep the air moving by ringing bells or letting birds fly round the room
  • not allowing people into the town or out of the town
  • some people sold herbal remedies
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Galens ideas and medical teaching

  • Medical schools were set up in universities during the 12th century, most of the physicans training was based on Galens ideas
  • only a few dissections were carried out to demonstrate Galens teachings
  • nobody was expected to question whether Galen was right or not
  • Galen believed in a soul and said parts of the body had been created to work together 
  • these ideas fitted well with Christian beliefs and so the church approved of his teachings
  • it was very difficult to challenge Galens ideas
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Who to go to

Trained Physican

  • had training at medical school and passed exams
  • diagnoses using urine and astrological information
  • administers treatment based on Galen
  • expensive
  • would be male

Apothecary

  • trained but no medical qualifications
  • cheaper than a doctor
  • mixes ingredients to produce medicines
  • probably male

Barber- surgeon

  • does lots of bloodletting
  • does some basic surgery
  • no anaesthetics
  • not trained or respected by trained physicans
  • also cuts hair

Hospital

  • usually part of a monastery or convent
  • looked after those who were old or had specific illnesses such as leprosy

Housewife-Physican

  • knew traditional remedies for every day aches
  • could also deal with broken bones and childbirth
  • used some herbal remedies or charms and spells
  • could be lady of the manor who treated their servants or family

Prayer and Pilgrimage

  • people would go on a pilgrimage to a holy shrine in the hope they could be cured of an illness

Women and illness

  • there were few female physicans such as Trotula, who taught at Salerno medical school in the early 12th century
  • women were not allowed to attend universities
  • midwives were expected to have a licence from their bishop to show they were of good character and wouldnt encourage illegal abortion
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The Medical Renaissance

  • Renaissance= a period in Eurpoean history when Ancient Greek and Roman ideas became fashionable
  • changes in religion known as the reformation led to decline in the Churchs authority even though many people remained strongly religious
  • a new attitude began to spread, instead of relying on views of an accepted authority, educated people wanted to check the knowledge for themselves
  • a group meeting in London formed themselves into the Royal Society in 1660, they published regular accounts of their discussions on a wide range of scientific theories. the group included Christopher Wren, Robert Boyle, Isaac Newton, and Robert Hooke
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Vesalius and Harvey

  • in 1543 Vesalius the professor of surgery at Padua university in Italy published a book called the fabric of the human body
  • William Harvery published an explanation of his ideas in a book in 1628 called an anatomical account of the motion of the heart and blood in animals
  • they both proved that some of Galens ideas were wrong
  • Galen said the heard is divided by a septum which has holes in, Vesalius showed the septum does not have holes
  • Galen said the liver had five parts or lobes, Vesalius showed the liver does not have any lobes
  • Galen said the lower jaw was made up of two bones, Vesalius showed this was only true for monkeys and pigs
  • Galen said the Sternum had 7 parts, Vesalius showed it only had 3
  • Galen said veins carry a mixture of blood and air, Harvey showed Veins only carry blood
  • Galen said blood is constantly manufactured by the liver and is used as it travels around the body, Harvey showed the blood circulates repeatedly around the body with the heart acting as a pump

The Importance of Printing

  • the invention of the printing press in Germany in the mid 15th century meant printed copies of books could be produced quickly and cheaply
  • people could still learn a great deal of anatomy from Vesalius illustrations and could copy Harveys experiments
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Impact of Renaissance Discoveries

  • mechanisms in pumps and clocks helped people to accept the idea of the body functioning as a machine
  • scientist Antonie Van Leeuwenhoek developed better lenses for a microscope and discovered bacteria
  • Harvey was correct when he said that Blood had to go through tiny blood vessels in order to move from arteries to veins but the lenses in the microscope were not powerful enough to show this
  • took 40 years for Harveys ideas to be accepted and taught in medical schools, because people were reluctant to change
  • Harveys work was on physiology rather than the cause of illness so his work did not seem relevent
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Renaissance Developments

  • significant changes in peoples knowledge and understanding of the human body during the renaissance period but very little improvement in the understanding and treatment of illness
  • ordinary medical treatment continued to be based on the four humours
  • people also believed a kings touch could cure them of TB 

events and factors affecting the development of medicine during this period:

  • the church controlled education and training
  • church discouraged dissection
  • some herbal remedies worked
  • mechanical pump invented
  • printing press invented
  • some felt better after being bled or purged
  • few people could afford a trained physican
  • herbal remedies passed down generations
  • new plants discovered when lands were explored
  • authority of catholic church decreased
  • microscope invented
  • many people were reluctant to change
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The role of women

  • evidence is limited
  • most people could not read and write
  • the education for girls was based around running a home
  • we have very few sources provided by women
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