Medicine Through Time

• ‘Pre-History’ means before people wrote things down. Because they were not writing things down, it is very hard to find out about their lives and what they believed.
• Prehistoric people were nomadic (they moved around to hunt and gather). Their diet was mainly meat they could kill and fruit, this meant they were fairly healthy as they did not suffer from any of the diseases that come from living and unhealthy lifestyle (such as fast food, drinking alcohol and smoking).
• Women would treat illnesses as wives and mothers.
• Tribes also moved around which meant they did not get infected by their own waste. As they did not write, we have to look at other evidence to find out about medicine.

• Bones: From looking at the bones from Prehistoric people we can find out a few details of their lives and illnesses. Some bones showed diseases caused by lack of nutritional food (osteoarthritis) and some showed that they could catch diseases from animals (rabies).
• Bones also still have evidence of bad infections (gangrene), this tells us that they died when infections got into wounds. Some bones show signs of healed fractures – this shows us that they knew it was important to keep broken bones still. They could also have used plaster casts and splints.
• Skulls with holes in them have also been found. This is evidence of Trephining – a basic operation to cut open the skull. This was probably to release bad spirits – there is some evidence that people survived this operation as the bone has started to heal.

• Cave Paintings: These pictures can tell us about their beliefs about illness. Some cave paintings are done by drawing around the hand – they show that some people had fingers missing. This could be evidence that people may have suffered from leprosy or lost fingers in hunting accidents. From these paintings we can guess that they believed that spirits caused illness. There are also drawings of a man dressed up like a wild animal. This could be a ‘witch doctor’ or ‘medicine man’ – this man would drive away the spirits that caused disease.
• Significant individuals. 
  • Medicine Man – This was a man would provide charms and spells to frighten away the bad spirits that caused disease.
  • Factors affecting medicine:
  • Communication: This was very weak as they did not write and lived in small tribes

The Egyptian Empire was stable. This meant that they could settle in one place and develop farming. As the land was rich and fertile around the Nile, Egypt became wealthy. The farmers could afford jewellery, house builders and DOCTORS!

• Trade: The Egyptians traded with India, China & Africa. This meant that doctors could get new herbs to make medicine.
• Religion: Egyptian priests needed to be clean as part of their religion, they would shave their heads and wear clean cotton. People would try and be like the priests and keep themselves clean. This was very good for health.

• Nile: This flooded every year and left rich nutrients on the fields. The farmers would get water to their crops using channels and ditches – if these became blocked, the crops would die. They knew that this was similar to the human body – it also had channels that took blood, food and air around the body. If these became blocked – the person would become ill. This led Egyptian doctors to attempt to clear the blockages from the channels in the body.
• Writing: This meant that ideas and discoveries could be shared. This is very good for medicine as other doctors could understand new discoveries. It is also good for us as we have evidence about their beliefs.

• Doctors: They would use the Channel theory, magical charms and also common sense treatments. They would use many herbal remedies and common sense treatments such as straightening a broken nose.
• Significant individuals.

• Not many yet – but you should understand about priests and doctors.

Factors affecting medicine:

Communication: The Egyptian Empire was big. This meant that the Egyptian doctors could WRITE their discoveries down and share them throughout the Empire.

• Government: This was stable and this allowed the Egyptians to grow rich and develop medicine.

The Greek Empire was very powerful and very rich. This allowed them to concentrate on making new discoveries. They had many different gods. They were very interested in Science and explanations about how things worked. They made many discoveries that affect us today.

Religion: The Greeks believed that illness was a punishment sent by the gods and would pray for a cure. The God of Healing was called Asclepius and Greeks would travel to his healing temples called the Asclepeia. Asclepeia were very peaceful and clean, they also had a gymnasium and were away from the dirt of the cities. Greeks would make an animal sacrifice and stay in the temple overnight. Here Asclepius would visit and his snakes would heal the patient. Some people would get better – but this was probably due to the clean conditions and placebo effect

The Greek Empire was very powerful and very rich. This allowed them to concentrate on making new discoveries. They had many different gods. They were very interested in Science and explanations about how things worked. They made many discoveries that affect us today.

Religion: The Greeks believed that illness was a punishment sent by the gods and would pray for a cure. The God of Healing was called Asclepius and Greeks would travel to his healing temples called the Asclepeia. Asclepeia were very peaceful and clean, they also had a gymnasium and were away from the dirt of the cities. Greeks would make an animal sacrifice and stay in the temple overnight. Here Asclepius would visit and his snakes would heal the patient. Some people would get better – but this was probably due to the clean conditions and placebo effect

Significant individuals.

• Asclepius: God of Healing. 
• HIPPOCRATES! The ‘Father of Medicine’ – Was the first doctor to recommend observation, natural treatments and professional standards.

Factors affecting medicine:

• Communication: The Greek Empire was big and they wrote their discoveries down. This was good for the development of ideas.
• Individual Brilliance: Hippocrates and other doctors made significant progress – they invented the idea of clinical observation.
• Government: This was stable and this allowed the Greeks to grow rich and develop medicine.
• Science & Technology: The Greeks were very interested in developing science.

The Romans had a large Empire and were very interested in taking over other countries. They took a lot of their ideas from the Greeks (as well as most of their gods).

• Gods: The Romans would pray to the gods for healing. They believed in Asclepius and would visit the Asclepeia. Romans would carve shrines to the gods asking for healing – doctors were expensive.
• Doctors: Doctors would use common sense treatments for illness and could perform basic treatments such as removing a rotten tooth. Most would train by the great medical libraries in Alexandria (in Egypt but taken over by the Romans) and in Rome itself.

• Empire: The Empire covered about 60 of our modern countries and they could find many herbs and exchange information.
• Army: The Army was very important to the Romans as a healthy Army was essential to keep the Empire. They knew that they had to keep the Army away from boggy land and dirty water. They had some basic painkillers and army hospitals were hygienic. Amputations were common.
• Public Health: The Romans preferred to prevent illness rather than having to cure it.  They believed in that keeping the poor in cities clean would mean there was less illness for the rich to catch. The Romans were fantastic engineers (they were very good builders) and build aqueducts to bring fresh, clean water in from the mountains and have public toilets and sewers to wash away the waste. They also knew how important it was to be clean and built public baths. Today we know that most illness is caused by dirty conditions so we know how important these public health developments were!

• Public Health: The Romans preferred to prevent illness rather than having to cure it.  They believed in that keeping the poor in cities clean would mean there was less illness for the rich to catch. The Romans were fantastic engineers (they were very good builders) and build aqueducts to bring fresh, clean water in from the mountains and have public toilets and sewers to wash away the waste. They also knew how important it was to be clean and built public baths. Today we know that most illness is caused by dirty conditions so we know how important these public health developments were!
• Galen: Galen was a Greek doctor who travelled to Rome. He used the ideas from Hippocrates about observation and natural causes. He also believed in the Theory of the Four Humours but said doctors should treat according to OPPOSITES – this meant if the patient had too much phlegm, cold and wet, the doctors needed to use something hot and dry to clear it up. He could not dissect people so had to dissect pigs, apes and dogs. He made some discoveries about anatomy, such as the brain controlling the body, but made some mistakes (jaw bone having two bones etc.) He wrote over 350 books and no one really questioned his ideas for 1500 years! 

• Asclepius: God of Healing – taken from Greeks.
• Galen: Used the ideas of Hippocrates. Developed the Theory of the Four Humours by treating with OPPOSITIES. Wrote many books and spread his discoveries.

• Communication: The Roman Empire was big and they wrote their discoveries down. This was good for the development of ideas.
• Individual Brilliance:  Galen and other doctors made significant progress – they developed the idea of clinical observation.
• Government: This was stable and this allowed the Romans to grow rich and develop medicine. They took over other countries which allowed them to learn their medical knowledge. They promoted good public health.
• Science & Technology: The Romans were very good engineers and made very good structures to improve public health.

The Romans were in control of running Britain – they built roads, sewers, toilets and towns. They also kept law and order in the towns. When the Roman Empire ended – the people of Britain no longer had order and many tribes fought over the country. This led to government being ‘unstable’ – this meant that there was fighting and people could not make new discoveries. This lasted from about 400AD to 700AD and was called the ‘Dark Ages’. The Medieval period was after this and was mainly controlled by the Church.

• Galen: Galen wrote that the body fitted together so well that it must have had a ‘creator’. This supported what the Church thought about God. The Church would not let anybody question the work of Galen.
• Religion: This was the main influence on people’s lives.
• Hospitals: These were run by the Church and were not like modern hospitals. The word ‘hospital’ means ‘place for guests’ and were mainly for the poor and needy. It was very rare to get treatment at a hospital, the main treatments offered were praying and feeding.

• Wise Women: Poor people could not afford a doctor and would visit the local wise woman instead. These women would use herbal remedies.
• Barber Surgeons: These were surgeons who would cut hair and remove abscesses and bleed patients. Barber surgeons were trained on the job and were popular among the poor.
• Doctors: Some doctors trained at University and were available to the rich. They would perform some operations but their main task was to rebalance the humours. They would do this be bleeding and purging.
• Towns: Public health was very bad. Rotten meat, human waste and animal waste were common and people had little access to clean water.
• Black Death 1348: A very bad disease that killed about 30-50% of the population of Europe. It was spread by fleas on rats. Medieval people thought it was caused by – God, miasma (bad smell), dogs & cats and astrology. They used the following as cures – praying, killing dogs & cats, good smells and sticking a chicken’s bottom to the armpit.

Factors affecting medicine:

• Religion: The Church was the most important thing to most medieval people. This was probably because there was no strong ruler and the Church was powerful and stretched all over Europe. The Church banned dissection and this held medicine back. The Church also would not let anybody say Galen was wrong – this meant that people could not progress. This does not mean that religion held medicine back completely: the monks copied out Galen which would not have been available without religion. The Church also ran hospitals.
• Communication:  It was too dangerous to travel so not many discoveries were shared.
• Government: This was unstable there was poor public health.
• Science & Technology: The Medieval people did not make significant progress.

Renaissance means ‘re-birth’ and was a period of new invention that started in the 1400s. The printing press was invented which meant that more people could buy books. People became more educated and they started to look at the discoveries of the Greeks and the Romans. People across Europe realised that the current ideas were wrong and looked for new ways of carrying out experiments and questioning old ideas.

• Art: People began to draw realistic pictures of the body. These were so detailed and realistic that surgeons could use them to find out about atomy. The printing press allowed these pictures to be made widely available. Vesalius dissected corpses and created a book The Fabric of the Human Body that was an excellent representation of human anatomy. Some people did not accept his findings as they went against the teachings of Galen.

• Education: There was a new interest in learning and good universities were created in which people could study medicine.
• Religion: The Church became less powerful and more people were allowed to challenge its ideas.
• War: War was common in the 15th century and Paré was a battlefield surgeon. Wounds were cauterised (burned) closed. Paré ran out of oil and used cooling solution to wash the wounds. This worked and fewer patients died. He also decided that wounds should be sowed shut. However, many patients still died because he did not know about germs and patients would often die of infection.
• Heart: Harvey discovered that the heart pumped the same amount blood around the body. This disproved Galen who said that the body burned up blood as fuel. This would mean that the Theory of the Four Humours was wrong and doctors should stop bleeding patients. Harvey was very scientific and wrote books with his experiments so other doctors could prove his experiments. However, the microscope had not been invented and many doctors could not believe in the capillaries moving the blood through the body. 

Significant individuals.

• Paré: Discovered the importance of washing the wounds and sewing them shut. Still used today.
• Vesalius: Drew accurate pictures of human anatomy.
• Harvey: Proved Galen and the Theory of the Four Humours wrong by discovering that the heart pumped blood around the body.

Factors affecting medicine:

• Religion: The Church less important and people started to challenge its ideas.
• Communication:  The Printing Press made book widely available so more discoveries were shared.
• Government:  Was getting better but public health was still bad.
• Science & Technology: There was a big increase in interest of science and technology and this led to many new medical discoveries. However, most people were still superstitious.
• Individual Brilliance: Paré, Harvey and Vesalius made discoveries that would later become very important.

BUT! Despite all the advancements made in anatomy and surgery they still did not know about germs. This meant that the most people were still dying from the same old dirty conditions and diseases. People were also still superstitious. This can be seen in the treatment of Charles II – after Harvey made his discoveries the king was bleed and purged by the best doctors in the country, this probably led to his death. This should that his ideas had not been accepted. It can also be seen in the lack of progress between the Black Death and the Great Plague. This shows that although new discoveries were made – people still did not know what caused illness – 

1348 (Medieval Black Death)Medieval people thought it was caused by – God, miasma (bad smell), dogs & cats and astrology. They used the following as cures – praying, killing dogs & cats, good smells and sticking a chicken’s bottom to the armpit

1665 (Renaissance Great Plague)People still thought it was caused by – God, miasma (bad smell), dogs & cats and astrology. They used the following as cures – praying, killing dogs & cats, good smells and sticking a chicken’s bottom to the arm

• The main problems with health in this time were infectious disease and surgery. People still believed that God and miasmas caused disease and instead of cleaning the streets, they would pray and try to clean the air (in ways such as burning tar). In this period, Louis Pasteur discovered the germ theory and this was an exceptionally important step to better health. At the same time Lister and Simpson were making improvements in surgery. The Laissez Faire (leave well alone) attitude of the government meant that they did not act to clean up the streets and provide clean water. It wasn’t until the work of Snow and Chadwick that the government decided to make a significant effort to improve public health.

• Government: The government did not act to improve public health (the conditions in towns) so they were dirty, overcrowded and full of infectious disease. This did not end until John Snow proved that cholera was spread by dirty water and Edwin Chadwick wrote a report telling the government they had to improve public health. The
• Vaccination (1796): Jenner discovered that milkmaids who had cowpox did not catch smallpox. There was also inoculation which was putting a ‘weak’ strain of the live virus. This was expensive and dangerous. Jenner discovered ‘vaccination’, putting a similar disease into the system to create immunity. However, Jenner could not explain HOW it worked and there were many protests against it.

• Germ Theory: Pasteur was hired to find out why beer was going off. His theory was that bacteria were causing it to turn sour. By heating it, the bacteria were killed. This was the same for human disease – it proved the theory of ‘spontaneous generation’ (that the disease caused germs) was wrong and that germs caused disease. He proved this by experimenting with glass containers and sealing the end.
• Surgery: The three main problems in surgery at the beginning of the period were: PAIN, INFECTION & BLEEDING.  There was no knowledge of germs and operations were very painful and filthy. Eventually PAIN and INFECTION were solved, but BLEEDING was not solved until WWI. 

• Germ Theory: Pasteur was hired to find out why beer was going off. His theory was that bacteria were causing it to turn sour. By heating it, the bacteria were killed. This was the same for human disease – it proved the theory of ‘spontaneous generation’ (that the disease caused germs) was wrong and that germs caused disease. He proved this by experimenting with glass containers and sealing the end.
• Surgery: The three main problems in surgery at the beginning of the period were: PAIN, INFECTION & BLEEDING.  There was no knowledge of germs and operations were very painful and filthy. Eventually PAIN and INFECTION were solved, but BLEEDING was not solved until WWI. 

Significant individuals.

Jenner:Developed vaccinations BUT did not know how they worked. There was significant opposition but eventually they were made compulsory and this was very important in improving public health.

Pasteur: Discovered the germ theory (1861). He got stuck and Koch developed the theory. Pasteur was spurred on by this and eventually developed more vaccinations for animal diseases.

Koch: Used Pasteur’s germ theory and was able to identify which germs caused anthrax. He developed a way of dying germs to find out which diseases they were responsible for

Lister: Experimented with Carbolic Spray (1867). This was used in operations to kill the germs and solve the problem of infection. Some doctors and nurses did not like to use it as it stained hands and was difficult. It brought infections down and was the first step the aseptic surgery (making sure there are not germs).

Simpson: Discovered an effective anaesthetic (1847) and therefore overcoming the problem of PAIN. It was however criticised as some people thought that pain was sent by God, a punishment for women and manly. Some doctors also gave overdoses (Hannah Greener). The opposition was overcome by Queen Victoria using it. (1857) 

Chaddwick: Wrote a report (1842) saying that the government had to clean up the streets and improve public health. He did however still believe in the miasma theory.

Snow: Proved that cholera was spread through dirty water (1854) – he removed the handle of the Broad Street pump and the outbreak stopped.

Factors affecting medicine:

• Religion: The Church less important and people started to challenge its ideas.
• Communication:  Ideas were easily spread.
• Government:  Was getting better but public health was still bad until the Second Public Health Act 1875 which forced local councils to provide sewers and clean water.
• Science & Technology: There were developments in science including the germ theory and the development of microscopes.
• Individual Brilliance: Lister, Jenner, Pasteur, Koch, Snow, Chaddwick & Simpson made discoveries that were very important.

• The final surgery problem of BLEEDING was solved in this period. WWI and WWII helped to develop medicine and the National Health Service was set up. Alexander Fleming discovered the first antibiotic – a substance that kills infection internally and laves healthy cells undamaged.
• War: The conditions led doctors to try things they normally may not have done. The wars developed: Blood transfusion, plastic surgery, broken bones, curing infection, shellshock and X-rays.
• Magic Bullets: in 1909 Ehrlich found a chemical (Salverson 606) that killed the bacteria that caused syphilis. This was a magic bullet – a substance that was introduced into the body but did not harm healthy cells. Prontosil was also discovered; this killed the germs that caused blood poisoning. Alexander Fleming discovered that Penicillin was a very effective magic bullet but was unable to develop it for human use; this was left to Florey and Chain.
•  

NHS: After the wars, the public wanted more help from the government. They elected a Labour government that followed Beveridge’s ideas in setting up a National Health Service. This would provide free medical care for all and was paid for by tax. It is very controversial today.

Significant individuals.

• Fleming: Discovered that penicillin killed germs (1928) inside the body but could not develop it for use in human.
• Florey & Chain: Used Fleming’s discovery and developed penicillin for use in humans (1944). As this was during the wars they were funded by the US government who invested millions in the development.
• Beveridge: Recommended a series of actions to help poorer people, including the NHS, pensions and benefits.
• Bevan: The man appointed by the government to introduce the NHS.

• Factors affecting medicine:
• Religion: Had little influence.
• Communication:  Ideas were easily spread.
• Government:  Felt responsible for people after they had fought in the wars. Supported Florey and Chain in the development of penicillin. Introduced the NHS, health care for all.
• Science & Technology: There were developments in science including X-rays and bacteriology.
• Individual Brilliance: Fleming, Florey, Chain & Bevan made discoveries that were very important.
• War: Important developments were made due the amount of causalities in the wars. The government also felt the need to support people who had fought in the wars.