medicine through time 2

The Renaissance- rebirth of knowledge 1300-1600

Ambroise pare

• proved many of Galens ideas were incorrect

• Became an army surgeon in 1536 

• He discovered that wounds healed more quickly if boiling oil was not used.

• He Came up with a way to stop patients from bleeding after apmputations , but did not realise that this caused infection on patients.

• He published a book in 1575

William Harvey ( 1578)

• Discovered that Galens ideas about blood was wron.

• was the first to describe how blood was pumped around the body by the veins but pumped through the body y the heart. He did this by the dissection of animals 

• He was the first to suggest that animals and mammals sexually reproduced via the fertilisation of an egg cell and sperm cell.

Versullias ( 1514)

• first man to do human dissection 

• He studied at wars and helped treat injured soldiers.

• He corrected Galen because Galen only dissected monkeys so he got a few teachings wrong Versailles was there to correct him.

• He discovered...
• The muscular tissue 
• The skeleton system 

Factors causing discoveries in the Renaissance:

• Exepriements- people were willing to challenge old ideas in order to prove theories were correct 

• Challenges- many old ideas were challenged Copernicus said that Earth travelled around the sun not the other way around so people questioned this 

• Wars: there were many wars in 16th- and 17th century Europe.

• Education: literacy was increasing and there were many more schools in the 16th and 17th centuries 

• Printing: from the late 1400s printed books meant that new idea spread much more rapidly/ more knowledge 

• Ancient learning: there was renewed interest in the writings of Roman and Greek thinkers.

• Art: skilful artists found work and people to buy their sculptures and paintings/ drawings in books 

• Machinery: improved clocks watches pumps and more 

• Wealth: since the Black Death 1300s many people had grown wealthier they had money to spend on luxuries and money to spend on Medicare.

How did medical training for doctors improve in the Renaissance?

John hunter ( 1728- 1793)

• emphasised importance of observation and experiment 

• expert in dissection and provided very clear and detailed illustrations of human anatomy

• observed and documented changes in the body eg. pregnancy, progressive diseases.

• Taught Edward Jenner 

• They ahieved a lot of good work and published several important hypothesis. They even set up their own medical school in London, which benefitted others.

What he achieved

• His lectures on autonomy helped develop a more professional approach to medical training
• He taught the importance of observation and experiment

Did the church help or hinder the medical progress? - the middle ages 1500s

Hinderd because of the following reasons: 

• Dissection and studying was only available for the church this did not benefit people as a whole.

• They left behind key teachings of Galen 

• They put people in prison for their ideas 

• Dissection of corpse once a year and students did not do it themselves they had to stand across the room and watch.

• They build water supplies but only provided for church. 

• Fish ponds and kitchens and other places were created but only available for the church 

• They recycled waste which was not pure and healthy .

Hospitals in 1350

• run by monks or nuns who believed god had sent the ilness in the first place. Therefore medical care was mainly focused on praying for the souls of the patients 

• There were no medical proffesions to look after the ill, so hospitals did not admit infectious or incurable disease

• They were almost exclusiilvly run as care homes for the elderly 

Hospitals between 1350 and 1750  

• The dissolation of the Monasteries by henry VII in the middle of this time period ( 1500s) had a huge impact on the way hospitals were run because the monastries had provided hospital care, instead local people , charities and town councils paid for hospitals to be opened .

• By 1750 there had been major changes .

Hospitals by 1750

• They were run by trained physicians and by nurses who did not have medical training.

• some hospitals, paticularly in the biggest cities now admitted infectious patients.

• Herbal remedies and minor surgery were common although prayers still featured heavily.

roman ideas about causes of ilness:

• disease were sent by gods or the result of a curse put on u by someone else. 
• Bad air which was bad smells in places like swamps.
• an imbalance in a persons humours.

• The Roman armies affect on the progress of anatomy:  
  
• The Roman Army forts usually had hospitals that treated injured soldiers. The hospitals provided training for surgeons and physicians but a few were open publicly.

common treatments of diesis in Roman Britain:

• Remedies were used throughout the empire and some were written down. Purging and blood-letting for humours.
• Prayers and offerings were made to God
• Celtic and druid knowledge of herbs and plants were used in Britain to make medicines.

Name some examples of public healh in Roman Britain:

• hey built their towns in areas away from swamps and marshes
• Public baths
• Aqueducts and pipes were built which brought clean water into towns
• Sewers were built to take away human waste from homes.

The romans invaded Britain in 49 AD.

what impact did the Romans leaving Britain have on the public health of Britain:

• public health systems were destroyed. 
• Libraries full of books were dismantled
• The invading tribes coudnt read so they were not interested about education or public health
• War was the most important priority and money was mostly spent on the army.

Religion was the only powerfut thing that survived the collapse of the roman Empire.

Hippocrates: 

• A greek doctor. He managed to dismiss the idea that God caused disease and believed there was a physical reason for ilness.

treatments and discoveries of hippocrates:

• The four humours (blood, black bile, yellow bile, phlegm) hippocrates believed that when these humours were unbalanced people became ill, so to make people feel better they tried to put this balance right. Most treatments were based on diet, exercise.

2 treatments 

• He also used bleeding and purging to balance the humours
• Hippocratic Oath ( doctors must respect life) 
• clininical observation (symptoms)

Galen :

Galen carried out dissections on dead bodies, then drew anatomy diagrams. Galen was roman and operated on wounded gladiators.

treatments and discoveries 

• 2nd Ad theory of opposites was aimed to balance the humours by giving patient opposite of their symptoms eg. to much phlegm (cold)= hot peppers
• Galen discovered that Arteries carry blood.
• discoverd that speech was controlled by the brain and not the heart

What the people in the middle ages believed caused diesis:

• the four humours 
• ilness was a punishment from God
• Miasma (bad air)

treatments in the middle ages:

• Doctors studied urine charts and astrology to diagnose and treat ilness. 
• honey was used to treat sore throats and cuts. We know that honey had antibiotic poroperties therefore using it as a drink or ointment would help to prevent infection.
• onions, garlic, wine and lichen were also used as treatment and all have antibiotic properties. 
• They had access to leechbooks which contained a mixture of greek and Roman ideas about medicine including herbal remedies. The most famous leech book was the leech book of Bald.
• village healers but mostly not doctors because they were expensive.
• Midwives
• Wise women provided herbal remedies and advice on curing diesis.
• Hospitals were places of rest and recuperation

how  the christian church influenced medicine:

• the church taught that ilness was a punishment from God.
• The church supported Galen and Hippocrates ideas because they fit with chistian ideas.
• The monasteries and conventshad the best libaries and some of them provided training for doctors.
• Many people would say prayers and make offerings to God to cure them. 
• Many people would carry lucky charms or carry out a superstitious ritual such as rubbing snail juice on their eyes to cure blindness.

Doctors in the middle ages were not encouraged to prove Galen wrong.

public health in the middle ages:

• Animal and Human excretment was common in the streets
• rubbish was not removed
• butchers slaughtered animals and left remains in the street. 
• Laws were regularly passed, especially in times of diesis, but only limited effect.
• the biggest public health problems in towns were caused by..
• lack of clean water.
• no means of removing sewage
• the remains of butchered animals being left on the streets.

rich people would often had good standards of hygiene and would bathe in a wooden tub. Many had a privy ( A private latirine). Monks in Monstaries lived simple lives but had good standards of hygiene. 

ideas about treatments of the black death:

• looking at urine and using astrology. 
• Most common treatment was bleeding.
• herbal remedies were popular treatments.
• Praying and fassting
• Clearing up rubbish in the streets.
• Lighting a fire in the room or ringing bells to keep air moving.

people though the black death was caused by...

• Religion
• astrology
• Miasma (bad air)
• volcanoes
•  four humours
• people who came into town.

who treated the ill in the middle ages?

• physicans ( trained at university) 
• Apothecaries (recieved training but no medical qualification)
• Housewife physicians (wise women usually cheapest option and dealt with child birth)
• Monks and nuns ( Ran hospitals using church donations)
• barber surgeons.

Public health ( 1350-1750) problems and solutions 

1) Problem= largely populated twins and cities were not beneficial because if there was a epidemic a lot of people would be wiped out in a small amount of time.

Solution: they made the towns clan so that if there was a epidemic it would be much less significant and and so that others would no catch the diesis. Local authorities paid for piped water supplies. Public baths were built

2) Problem= the great plaque was bubonic this killed about a quarter of its population. This was spread fast so many people died. 

Solution= they attempted to stop the diesis from spreading by closing theatres to prevent crowds they banned large funeral and carts came through daily to collect the dead bodies.

The idustrual revolution ( 1750-1900)

• The houses were cramped closely together. This was unhygienic because infectious diesis could spread easily.

• There was a lot of air pollution which affected the well being of people.

• little fresh food

• drinking water often polluted by sewers

• long working hours

• many accidents in factories

• poor working conditions

Vaccinations

• In 1721 Mary wortely montague hade children with inoculation.

• Large groups of people began inoculation parties 

• The the 19th century Edward Jenner developed the idea of vaccinations.

• In 1796, he carried out his now famous experiment on eight-year-old James Phipps. Jenner inserted pus taken from a cowpox pustule and inserted it into an incision on the boy's arm.

• He was testing his theory, drawn from the folklore of the countryside, that milkmaids who suffered the mild disease of cowpox never contracted smallpox, one of the greatest killers of the period, particularly among children.

• Jenner subsequently proved that having been inoculated with cowpox Phipps was immune to smallpox. He submitted a paper to the Royal Society in 1797 describing his experiment

• Edward Jenner tried to publicise his work but was rejected

• In the 1802 the government accepted his idea and was payed

• After this people started using vaccination.

• What is inoculation? 
• It is similar to how vaccinations are made but more old fashioned 

• What does the reinasance mean?
• Rebirth of knowledge 

germ theory 

Louis Pasteur (France: 1860s)

• he discovered (by using a swan-necked flask) that germs cause disease. Before he made this discovery, doctors had noticed bacteria, but they believed it was the disease that caused the bacteria (the so-called theory of 'spontaneous generation') rather than the other way round.

• One of the spin-offs of Pasteur's discovery was the pasteurisation of milk, which prevented it from going sour by killing the germs and sealing it from the air.

Other scientists also made crucial discoveries, among them

eg.Robert Koch (Germany: 1878)

• discovered how to stain and grow bacteria in a Petri dish (named after his assistant Julius Petri). He was thus able to find which bacteria caused which diseases:

• septicaemia (1878)
• TB (1882)
• cholera (1883).

• In the same period other bacteria were discovered, including those that caused:

• typhoid (1880s)
• pneumonia (1880s)
• plague (1894)

Factors that cause discoveries :

• Technology example: microscopes used to find out the germ theory and dissection equipment for first time Versailles did dissection 

• Rivalry: example: Pasteur studying the work of Jenner carefully and Koch studying the work of Pasteur. Pasteur was from france and Koch was from Germany and in 1871 france had lost a war to Germany and there was a bitter rivalry that surred both men to work harder in finding cures. 
• The rivalry also meant that the governenment were willing to give pasteur and koch grants to research teams

• Research teams: pasteur and koch

• Economics: money needed to make discoveries

How far was public health improved in the 19tj century?
Edwin Chadwick:

• He wrote a report saying to do public health and 10,000 copies were given and 20,000 copies sold.

• People did not agree with Edwin Chadwick as he firmly stated that he believed that everyone should be housed but they did not believe this as they thought that it was poor people's fault for being poor.

john snow:

Who was John snow? What did he achieve.

• He wanted to find out why mass numbers of people were dieng so he compared an area where lots of people were dieng to and area where not as many people died.

• He then saw what was different about them both inorder to understand what caused it. He explored many deaths  of broad water road

• He realised that in broadwater road people drank from the water pump.. However people in a brewer hardly ever drank water and they didn't die so he figured it was the water -cholera.

• After her work in the Crimean War, Florence Nightingale became a highly influential figure in the management of hospital care in the UK. In the second half of the nineteenth century and well into the twentieth, not only were the best nurses trained in the Nightingale School at St Thomas's Hospital (known as 'Nightingale Nurses' - trained in her methods and ingrained with her values) but she even had a ward-type - the 'Nightingale Ward' - named after her.

• For a very long time these wards became ubiquitous in any new hospital design. Even today, they are still discernible serving as integral parts of existing health-care facilities of long-standing hospitals still in use under the National Health Service, visible from maps or in satellite views. But although these wards came to carry her name, Florence Nightingale was promoting an idea already in evolution.
• Here we feature a small clutch of items held in the Foyle Special Collections at King's, all of which are associated with the Victorian debate about the best design for British hospitals.

• The mid-Victorian debatewas rooted in public knowledge about hospitals as foci of disease. Richer people were still largely cared for at home. Most better-off households had at least one servant - many had more - and could afford private nurses and medical staff to visit. One has only to look at the casebooks of Dr John Snow, who worked as a free-lance anaesthetist in London, to see that even surgical operations were done in a

• domestic setting for those that could afford to hire the necessary staff.

• Hospitals were for those who could not afford such care, and conditions in them were largely below the radar of general public discussion until the 1850s. There was however, constant fund-raising for the 'voluntary' charitable hospitals which accepted poorer patients with acute and curable conditions; the lying-in hospitals for maternity, and the fever hospitals which endeavoured to contain and limit the spread of infectious diseases in the community.

• Then, too, there were institutions funded by compulsory local Poor Rates: the Poor Law workhouses which housed the infirm elderly, chronically sick, mentally ill, incapacitated, disabled, unmarried mothers, and the orphaned and dying poor. Dying in the workhouse was an occupational hazard of growing old among the working population, as there were no pensions, and even large families were often so depleted by early deaths and emigration that for many old people there was literally nowhere else to go. Amongst the working population, the fear of dying ‘on the parish’ was endemic.