Medicine in Britain GCSE History 9-1

Supernatural - Astrology, if the alignments of planets and stars were out of place, it could determine why you were ill.

Religious explanations - Were sent by God as punishment for your sins. To get better you'd have to pray.

Theory of the Four Humours - Developed by Hippocrates in ancient Greece and continued to influence ideas on Medieval times. It suggested if one of your four humours (BLood, Phlegm, Yellow Bile and Black Bile) were imbalanced, that is why you have a disease. Galen supported this

Miasma Theory (Bad air) - Believed to be harmful. Believed it contained poisonous fumes and that rotting matter transmitted disease.

Theory of Opposites - Galen believed that if you had a cold, you should treat it with something hot, like a pepper.

Galen believed in the soul, so the church supported what he said and promoted his ideas.

Supernatural and Religious - Prayers, fasting, pilgrimages.

Rational - Balance for the four humours:

• Cutting the Vein - Blood
• Placing leeches on skin - Blood
• Purging, vomit to clear the body

Herbal remedies used.

To prevent:

• Take care of bodies by exercising, sleeping, keeping clean, breathing clean air.
• Purified air by spreading sweet herbs.

Physician - 7 years at university. Diagnosed illness. Rarely treated patients

Apothecary - Herbal Remedies. Gained knowledge from experience. Less expensive than a doctor.

Barber Surgeon - Performed simple surgery, such as bloodletting and pulling teeth

Hospitals - Owned by the church and care given by monks. Infectious, insane patients rejected. Provided rest and care

Home - Sick people cared at home. Women would care for them. Women weren't allowed to become physicians.

Beliefs about causes: 

• God sent as punishment
• Unusual alignment of planets
• Imbalance of four humours.
• Bad air

Treatment:

• Prayer asked for God's forgiveness
• Holy charms
• Bleeding, purging, theory of opposites
• Strong herbs

Prevention:

• Pilgrimages and prayer
• Fines for throwing litter were increased
• Quarantine for people

Lots of Continuity: Miasma, church, supernatural

Changes in Explanations of the causes of disease:

• Most now believed God didn't send down disease
• by end of 17th century, most physicians didn't believe in Four Humours

Thomas Sydenham:

He believed in closely observing the symptoms of patients, noting down descriptions and looking for remedies to treat the disease.

Printing Press:

the 15th century it was invented. Enabled medical information to be spread further and more quickly. Contributed to the decline of the church

Royal Society

Founded in London 1660 to discuss new ideas. Sponsered scientists and assisted them 

Continuity: Bloodletting, herbal remedies, bad air, women cared for sick

Changes: 

• People began to look for chemical cures for diseases rather than relying on herbs and bloodletting
• Renaissance hospitals began to treat people with wounds and curable diseases

DEALING WITH THE GREAT PLAGUE 1665

Causes: Astrology, Punishment to cleanse, imbalance, Miasma, Touching

Prevention: Prayers, Quarantined for 28 days and door painted with a cross, Fasting, plague doctors treated patients wearing a birdlike mask and sweet-smelling herbs, Smoke tobacco.

Also: Banned public meetings, sweeping streets, killing cats and dogs and burning barrels of tar.

Vesalius

1543: Fabric of the human body.

He found mistakes in Galen's work which included:

• Jawbone had 1 bone, not two
• human breastbone has three parts not seven.

He corrected these mistakes and encourages doctors to base their works on dissection of humans.

Impact of Vesalius: Anatomy became central to study of medicine. His work was heavily copied due to the printing press. Challenged the ideas of Galen and inspired others too.

Havery

Discovery of the circulation of blood:

Proved veins and arteries were linked together in one system. Corrected Galen and showed that only veins carried blood. 

Encouraged other doctors to experiment. Had little impact though as little change in medicine.

Still continuity, but was fading out

Louis Pasteur's Germ Theory:

1861: Published discovery of germ theory. Showed that it may cause disease in the human body.

• Little immediate impact because doctors and surgeons couldn't see Pasteur's microbes
• Impact of Lister's work as it linked to germ theory of infection
• In long-term, Pasteur's discovery led to changes in preventing disease with vaccinations and introduction of antiseptic and aseptic surgery.

Koch's work on microbes:

Postive: Koch made it easier to see microbes by developing a dye. His new method of growing microbes enabled other scientists to study specific diseases. 

Negative: Didn't have an impact on medical treatment. Took time for cures and vaccines to be developed. Initially, the government rejected the idea of the Germ theory.

More people were treated in a hospital, but this led to less sanitary conditions.

Surgery was dangerous. People faced problems of pain, infection, and bleeding.

James Simpson: Discovered chloroform as an anesthetic.

Joseph Lister:  1865, used the carbolic spray to clear bacteria from wounds of patients - ANTISEPTIC surgery.

Wasn't very nice, and from 1890, ASEPTIC surgery was performed.

Edward Jenner observed milkmaids who had previously suffered from cowpox didn't suffer from smallpox.

in 1796 he gave a boy a dose of cowpox and 6 weeks later infected him with smallpox, but he did not catch it.

It took some time before vaccination was accepted:

• People opposed it as Jenner couldn't show how it worked. 
• The idea of infecting someone with an animal disease was considered strange and unacceptable.
• The Royal Society refused to publish his findings.

1852 - The government made it compulsory and smallpox was then eradicated.

1854 - John Snow started to investigate the outbreak of Cholera:

• Snow created a spot map to show deaths from Cholera that occurred around Broad street.
• Led to Snow noticing a pattern; all deaths connected to a water pump
• Snow removed handle of water pump and refused people from using it
• there was then no more deaths
• Snow looked at the water pump and saw cesspit leaking.

He was able to prove that Cholera was spread by dirty water.

The First Public Health acts 1848:

• Cities encouraged to provide clean water supplies. It wasn't compulsory.

The Second Public Health act 1875:

• Forced to provide clean water
• dispose of sewage
• building public toilets

1953 - Watson and Crick discovered the structure of DNA. Once this was found, scientists created the Human Genome project which was completed in 2000. It found the genetic codes of DNA.

Influence of Lifestyle factors:

Smoking linked to diseases - Cancers, heart disease

Diet - too much sugar, for example, could lead to type 2 diabetes

Skin cancer - Too much sun exposure

Improvements in diagnosis:

Technology - Xray, CT and MRI, Ultrasound, Endoscope, Blood testing

Medicine:

• Magic Bullet - used to describe a chemical cure that attacks microbes which cause a particular disease, without side effects

Antibiotics: Fleming, Florey, and Chain:  Fleming discovered it in 1928 when he noticed moldgrowing in a dirty petri dish.

1940 - Florey and Chain tested penicillin on infected mice. It cured the infection

1941 - Florey and Chain tested it on a human patient, even though they had little Penicillin. He became better.

Penicillin was difficult was difficult to make in large quantities.

Florey and Chain needed a factory so it could mass produce penicillin and went to the USA for help. Us government funded for it and 1944 had enough to treat allied casualties.

High-tech medical and surgical treatment:

• Radiotherpy and Chemotherpy to target and shrink tumours
• Prosetic limps for soldiers
• Transplant surgery
• Keyhole surgery to prevent cutting in the body

Change in Care and Treatment:

Introduced the NHS in 1948 and it gave hosptials, GPs, dentists, ambulances and health visitors.

Diagnosis: use PET scans to identify cancerous cells.

Treatment: Transplants, Radiotherapy - waves of radiation to shrink, Chemotherapy - injected with drugs to shrink tumor

Prevention: Banned smoking in all public places in 2007, raised the legal age to 18 in 2007, banned tobacco ads, introduced stop smoking campaigns.