Extension Study
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- Created by: Elliemcgowanx
- Created on: 08-05-14 10:07
Before and After
Before
- Ancient Greeks had developed an explanation for ill health based on the idea it was an imbalance of the four humours
- treatment could be based on changes in diet, encouraging the patient to get rest, and exercise
- also based on bleeding or purging the patient due to excess humour
- many people continued to rely on prayers and charms to protect and cure them
- home made remedies were used from plants
After
- in 1347 the Black Death arrived in Europe and 1/3 of the population died
- the understanding of disease was limited
- treatment was based on the ideas of Galen
- in the 16th and 17th century more understanding of the body
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Roman society, and medicine and public health
- when the Romans conquered britain in 43ce they brought ideas about medicine and public health with them
- the Romans adopted many of their ideas about disease and illness from the Greeks and there were few developments by the Romans about theories of illness
- major improvements in public health
- they were more interested in what they could do to improve health and less interested in what actually caused the illness
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How did Roman Society affect medicine and public h
- Rome was crowded so they were aware of infectious disease
- had skilled engineers who planned to build aqueducts to bring clean water to the cities and sewers to remove human waste
- Romans were aware that hygiene linked to health but didnt know why
- the government organised large scale projects and raised taxes to pay for them
- Romans took on whatever attitudes and beliefs seemed to work
- the importance of the army controlling the empire meant there was an emphasis on keeping soldiers healthy
- many Greek doctors came to live and work in the Roman Empire bringing Greek ideas with them
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Public Health after the Romans
- When the Romans left in 410CE there were huge changes
- a number of local leaders took control
- many towns and cities fell into decay
- Britain was attacked by various invaders
As a result...
- doctors continued to be trained according to Galens ideas as they fitted with the Christian teachings
- Government became very weak
- knowledge was lost
- christianity dominated society
- the church controlled society and resisted new ideas
- christianity stressed the importance of caring for the sick rather than treating
- traditional cures and remedies continued to be very important
- no central organisation of armies or medical treatment for soldiers
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Hippocrates and Galen
Hippocrates
- believed illness had a physical rational basis and could therefore be treated
- he said a doctor should respect all life and not try a treatment if it was risky
- developed the theory of four humours as an explanation for illness
- developed clinical observation
Galen
- Greek doctor who worked in Rome
- developed a way of balancing the humours in the body through the theory of opposites
- had experience as a surgeon
- carried out dissections
- produced books which were studied for the next thousand years
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Roman ideas about disease
- supernatural
- miasma
- an imbalance in four humours
there were very few doctors in Roman Britain
- most illnesses were treated within the home by the father of the family using remedies
- used herbs and plants
- some treatments were purging or bloodletting
- the Romans would often mix these practical remedies with prayers and offerings made to Salus the God of Health
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Public Health in Roman Britain
- Roman Army hospitals were often well equippied and provided excellent training for surgeons and physicans
- very few hospitals open to the public so this treatment would have little impact on ordinary people
- Romans placed little emphasis on medical knowledge but did notice that disease increases if you live near marshes and swamps due to bad air (malaria)
- stressed the need to provide access to clean water and remove sewage
Public Baths in Bath
- the Roman Baths were part of a complex of facilities
- admission was not free but cheap enough to attend
- people would exercise before going in the baths
- there were public toilets with a sewage system
- there was also a steam room to remove dirt from the body
- they would then get in a cool pool to be clean and relaxed
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Medicine and Treatment- The Middle Ages
- The Romans left Britain in 410CE
- no one took responsibility for maintaining the structures built by the Romans
- Public Health Systems fell to ruins
- apart from Galens theory of opposites the Romans showed little interest in developing their understanding of disease further
- not a big change in medicine when Romans left Britain
- they worked out many cures through trial and error
- Honey was a common cure and it had antibiotic properties
- onions garlic and wine were also often used
Religion and Superstition
- the christian church became increasingly important
- most priests could read and write
- learning was preserved in the libraries of monastries and convents
- monastries and convents often had an infirmarian who cared for the sick
- people would say prayers and go on pilgrimage
- many people would carry a lucky charm
- astrologers would be consulted in order to choose the right time to carry out an operation
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influence of Galen in the Middle Ages
- in the towns richer people would consult a physican who was likely to use bloodletting or purging
- treatments were based on the four humours
- Galen was keen on bloodletting as a way of healing and preventing illness
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Medical Training from Roman Britain to 1350
- in the roman period doctors were not respected
- the romans felt that foreign doctors were trying to take advantage
- many doctors hated Galen when he publicised his ideas because he was arrogant and criticised old methods
- Alexandria in Egypt was the main centre of medical training because it allowed dissections
- no requirement for doctors to be formally trained
- most doctors trained by reading books such as the Hippocratic Collection
- no organisation to check doctors were knowledgeable
- anyone who wanted to be a doctor could
- by the 12th century a seperate course developed and medical training was based on a set of texts called Ars Medicinae including some works written by Muslim scholars
- by the 13th century most towns would not let a doctor set up a practise unless he could prove he had studied
- education and training were controlled by the church and ideas were slow to change
- the church approved of Galen and his ideas
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Public Health in the Middle Ages
- as towns grew bigger throughout the Middle Ages the problem with hygiene became more important
- animal and human excrement was common in the streets
- rubbish was not removed
- butchers slaughtered animals and left the remains in the street
- rats were common
- laws only had limited effect
- there were public toilets in London but people still used the streets
However
- rich people often had good standards of hygiene
- many had a toilet built
- monks and nuns lived simple lives but the standard of hygiene in monasteries and convents was high
- there was fresh water piped to the building and human waste was removed
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Hospitals
- over 1000 hospitals were established in England and Wales in the middle ages
- many of them were founded through charitable donations e.g St Bartholomews
- they were usually quite small and had 12 inmates in memory of Jesus' disciples
- there were some large scale hospitals like St Leonards which could admit over 200 patients
- hospitals were usually run by monks and nuns as part of their christian duties because Jesus said his followers should care for the sick
- there was thought to be a strong link between illness and religion because illness was seen as a punishment for sins
- it was felt that patients needed spiritual support more than medical treatment
- care for the soul combined with rest warmth food and care that patients recieved meant some patients did get better
- beds would be positioned so that the patients could see the altar, religious states, and stained windows to help them focus on religion to heal
Almshouses
- almshouses began to set up in the 14th century to care for the deserving poor and old
- the poor were expected to live according to strict rules about behaviour and prayer
- the almshouse was not intended to be a hospital providing medical treatment although it did provide care
Leprosy
- leper houses were set up
- leprosy sufferers were expected to keep themselves away from others as it was infectious
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Factors affecting developments in medicine and pub
Religion
- christianity was the main religion in Europe
- when the Roman Empire collapsed the church was left as the only international organisation that could preserve and transmit knowledge
- the church preserved the ideas of Galen
- it was believed that the Kings touch could cure TB
Government
- after the Roman Empire the rulers in Britain were more concerned with protecting their people and trade from attack than improving medicine
- medicine was not a priority
- this was because the church controlled so much of medicine and there was little that the government could do
- the government organised and funded the construction of a good system of public health but the standards of public health fell and local authorities faced problems trying to keep their towns clean
- people understood that cleanliness could help to prevent disease from spreading
- as towns grew and public health became more important the local authorities began to be more active
War
- war was responsible for the Romans settling in Britain
- war had a positive effect on medicine in Britain bringing knowledge from Europe
- when Romans left Britain because of war in Europe society became much more fragmented and public works decayed
- people were less likely to travel and exchange knowledge
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