History

Hippocrates

Romans

Galen

?

Hippocrates

He was a teacher who travelled treating patients

Born 460BC

Died 370BC

Born in Cos, Greece

He believed theory of the 4 humour caused dieseas & natural causes

His natural remidies were blood letting & vomiting ( he believed doctors shouldn't interfere- let nature take its course)

Observation: ask patients about their past> ask about their symptoms> ignore nothing!

Books: he wrote hundreds of books about surgery & how to live healthy lives

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Romans

Keypoints:

The romans believed in many different Gods

The roman empire was wealthy> they could afford slaves & doctors

They built roads> could travel easier

Romans took over Alexandria & all its' universities

The romans were not interested in theories like the Greeks> they preferred practical solutions to problems such as illness

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Public Health

The government kept the public clean and healthy:

they Romans knew keeping clean kept disease away (even though they didn't know about germs)

The Romans had an empire to defend>couldn't spend as much time developing medicine> spent money on weapons not medicine

It was vitally important to keep people fit and healthy

Romans were able to build facilities e.g. baths & toilets

They liked to concerntrate on practical things> like the construction of sewers.

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Galen

Galen argued that first-hand observvation was vital. He did this in 2 ways:

Diagnosing patients> he could diagnose just by talking to them> he examined them carefully to find out the state of the 4 humours> he also examined their blood, nasal passages & faces

Carrying out experiments> he insisted doctors knew about the structure of the human body> unlike Hippocrates he dissected on Apes, pigs and elephants heart> he felt the need to repeat dissections> he was a showman> he liked doing public demonstrations to show how the nervous system worked.

He stopped the heart beating bu cutting the nerves from the heart to the brain> proving the idea that nerves come from the heart was wrong

cut the nerves in the neck> showed how the shoulder was paralysed

cut the nerves in the throat> show the loss of voice

to show kidneys produce urine> he tied the ducts into which urine passes from the bladder> showed kidney swelling

His ideas were based on studies of human skeleton,his work with gladiators and experiements on animals> he realised how important bones were

Most of his dessections were done on animals> he got things wrong

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Galen- showmanship

Born  in 129AD> Greek empire

He studied in Alexandria for 12 years

He went to Rome and took care of gladiators> he learned about the anatomy of the human body

He wrote stories & books about his findings & own experiements

He rejected other influential doctors ideas> to gain reputation for his skills

he became the Emporors doctor

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Galen- treatments

he believed in the 4 humours> after they were discarded

he accepted that in the stomach food turned into the 4 humours

he added the idea about 'opposites' being used to keep them in balance>Used a cucumber for a fever and pepper for a cold

Famous from encouraging blood-letting

He was important because he relived Hippocrates methods

wrote over 350 books>clever about what he wrote

his version of Hippocrates work was passed on> people believed he had perfected it

He gave the impression he was right about everything he wrote> when he died no one researched anything

the church banned disection> no one could check his ideas> he got the wrong ideas as he didn't dissect ( he agreed with the church- so they agreed with his ideas)

He told people doctors were greedy for money> his books praised himself

by CHANCE christianity became the official religion> the church was powerful> Galen was not christian but believed in 1 God> he believed the body was ruled by the soul> this made his ideas acceptable

People were using his ideas for 1500 years> but they were WRONG!

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Galen- Findings

Right:            brain= important                       knew the heart needed regular flow

              knew the veins & arteries were important for transporting blood  

                            knew nerves didn't come from the heart     

Wrong:         thought the human jaw had two bones (like pigs and apes) 

 thought blood was from the liver            though blood used up- liver made more

thought blood passed through the heart- one side to the other

-dissected animals

-knowledge on the nervous system

-failed to realise blood continually circulated the body

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Medeival medicine- Doctors

By late middle ages, every doctor had to be trained in medical school

They did not question Galens ideas or books as the church supported them> they fitted with the christian idea of creation

Dissection was used to show students what Galen had said about the body> not to question his ideas> why little progress was made in the middle ages

A doctor would would be trained in both astrology and had a table of the positions of the planets to treat and diagnose patients S.N

A doctor would be trained to base his treatment on the theory of four humours.

Little change in the Middle ages to the cause of illness than in the Roman era> doctors continued the theories of Galen rather than discover new ideas.

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M.M- Surgery & Midwifes

Was not usually taught in universities

You became a surgeon by being an aprentice to another

The work they could do was limited> there was a lack of effective anesthetics> alcohol and opium were sometiumes used to deaden the pain> they were not effective

3 types of surgeons: Surgeons, Barbers, Military surgeons

Midwives: the church was against women doctors.

women were not permitted at university so could not become doctors.

Doctors didn't get involved with the childbirth.

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Treatment & prevention

Praying: people believed praying could cure patients bcause they thought they had the power of God.

believed God sent the illness so can take it away again.

when someone died people would pray/religious prayers to get them to heaven.

Supernatural: peopel believed there was a strong link between the zodiac and parts of the body.

Natural: Illnesses were sometimes treated with herbal remedies and plants.

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Medieval hospitals

lepers hospitals: provided food and lodging outside the city to isolate the lepers

 No medical care

Hospitals: towns had big hospitals. Countryide had small.

Seriously ill people> not accepted.

some stayed for years, other briefly.

Sheltered the hungry overnight.

Some specialist hospitals e.g. meternity.

Run by Monks/nuns- church!

treatment was mostly herbal and prayer.

Almshouses: For children, preganant women, widows, elderly, single mothers

 Shelter for pilgrims

Some stayed long-term, some brief stay

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Medeival hospitals

Did hospitals help the sick:

People were in the same bed> weren't very hygienic>disease spread and led to new disease ( little knowledge of hygiene)

There were elements of supernatural treatments- religious buildings and religious statues ( they believed in christianity)

They were very busy so there was little place avaliable.

The bags of the dead bodies was in the same place as the place where the patients were- spreading disease.

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Black Death

Pneumonic:

Caugh up blood

Caused breathing problems

Died more reapidly

Bubonic:

high fever and severe headaces

swelling in armpits

blisters all over body

swelling in groin

lingured unconcious several days before death

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Monastries

why were they important:

They preserved the writings of Hippocrates & Galen> during the dark ages, monastries preserved, copied & studied the medical writhings of the Greeks & Romans> people kept the same idea ( as G & R)> kept the books so they could be studied in the future.

they built hospitals> monastries encouraged the care of the sick> monastries became key medical centres> most had infermary for sick monks & seperate for the public> at least 1 monk specialised in caring for the sick> he would keep a herb garden.

They developed public health system> many monastried were wealthy> had the money to stay healthy> they could build pipes, drains & wash houses.

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Black Death- causes

What people believed caused the Black death:

the smell from filth lying in the street (N)

god caused it as punishment for their sins (S.N)

bad smells spread disease ( spread by the wind) (N)

Jews were deliberatly spreading plague (S.N)

the position of the stars (S.N)

bad air if the seasons were not clear (N)

bad humours within those who died (N)

over indulgence of food (N)

sex (N)

baths (N)

not keeping warm(N)

not smelling nice scents(N)

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Rennaissance- Vesalius

Vesalius:

1514-1564

Studied medicine in Paris & Italy> met artists who studied skeletons and dissecting bodies for more realistic paintings.

Became professor of surgery

Wrote books> in which had detailed illustrations of the human anatomy.

Realised the mistakes made by Galen e.g. human jaw bone.

he dissected on human bodies.

vesalius showed blood must travel a different way than to what Galen said.

Vesalius questioned the ideas of Galen.

People started to believe Galen didn't have all the answers> Vesalius thought it was because he dissected animals instead of humans> people questioned Galen and dissected more on human bodies.

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Rennaissance- Harvey

Harvey:

1578-1637

Studied medicine at Cambridge

published a booka bout the heart & blood in animals.

Discovered the circulation of the blood> the idea that the heart was a pump was already a theory made by Erasistratus but had not been proved- Harvey proved it

he dissected live cold blooded animals> dissected on human bodies to build up a detailed knowledge on the human heart> tried pumping liquids in the veins but couldn't> proved blood flowed in a one way system around the body

whenever he disagreed with Galen he proved why.

he showed blood flowed around the body and is carried away from the heart by arteries.

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Rennaissance- Pare

Pare:

1510-1590

aprentice to his brother ( a barber surgeon) then became a surgeon & treated 3 kings

he wrote a book on surgery & spent 20 years on campaign treating wounds such as sword & gunshot

used oil for cauterisation> after a while the oil ran out (chance)> wanted to help the wounded so made an own mixture of egg yolk rose oil & turpentine> it worked

he spent 20 years as an army doctor> learnt about treating wounds> found a method of stopping bleeding after amputation> usual treatment was red hot irons (pressing it onto the stump)> it sealed the vessels but was very painful.

he thought to use ligatures> a silk thread tied around each vessel> when Pare became famous people started to notice the idea of ligatures> the thread stopped bleeding but carried infection.

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Rennaissance- Jenna

Jenna:

inoculation> started in China> spread over 100's of years

a small amount of puss from a smallpox scab was put into an open wound of a healthy person>  led to s mild dose of smallpox which protects against full attack>

seen as a way of making money in britain

there was mass inoculation during epidemics

it was difficult to judge the dose so it often caused full smallpox & death> caused people to carry the disease and spread it> some people refused it> poor couldn't afford it

did reduce the risk of smallpox!

he developed vaccination by thinking he could use cowpox as a method of preventing smallpox.

his work was important> there was now a prevention for smallpox> not as many people died

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