Medicine Through Time

• Andreas Vesalius published the first atlas of anatomy in 1543. The book was called "The Fabric of the Human Body".
• He studied at the university of Padua and received a job as a lecturer of surgery
• His book was critical of the work of Galen. He showed that many of Galen's dissections were based on animal dissections instead of human dissections. 
• Vesalius used to steal fresh corpses from graveyards and dissect them in order to get a better undersatnding of the human anatomy. 
• Vesalius helped to promote dissections and showed how important it is that anatomists carry out their own dissection to understand the body instead of blindly accepting inoformation given to them. Hos work led to a change in attitudes.
• The discovery of the printing press c.1440 helped to spread Vesalus' work. The printing press allowed there to be more than one copy of book. This meant the information was easy to access. 
• The improvement in art meant that there were many more artists who were able to accurately draw the anatomy.
• Although his discovery didn't lead to new treatments, it did pave the way for revolutionary medical treatment in the future. Some people didn't wwant to accept that Galen was wrong.

• William Harvey studied medicine at Cambridge and Padua and wroked as a doctor in London
• Harvey built up a detailed knowledge of the heart and proved thta the body has a one way system for the blood . He also proved that the sae blood is pumped around the body by the heart by calculating the amount of blood going into arteries 
• He discovered the heart acted like a pump
• Previously, they believed that new blood was manufactured in the liver to replace the blood which had been burned by the body as this is what Galen said. He also said that the blood passed from one side of the heart to the otherthrough the invisible holes in the septum.
• Harvey's wprk laid the groundworks for uture investigation on blood
• He improved surgery and once again showed just how important dissection were.
• There were limitations to his work. For example, his discovery was only accepeted gradually and was only taught at universities 50 years after the initial discovery.
• His work didn't amke anyone better. 

• Worked at the Hotel Dieu in Paris and spemt 20 years as an army surgeon.
• He changed the treatment of gunshot wounds and he wrote many books on surgery. 
• Previously, gunshot wounds were teated by pouring hot oil onto the wound and binding it with an oil soaked rag. Pare created a mixture of egg yolks,oils of roses and turpentine to create a new way to treat the wounds. 
• He also created ligatures as an alternative to cauterising in order to stop bleeding. Ligature wew threads tied to each individual blood vessal. This was less painful but was time consuming. 
• He encouraged surgeons to try new methods
• There were limitations to his discoveries. For example, the ligatures could get infected.
• His discoveries were small scale 

• Thomas Sydenham stressed the importance of bedside practice and observation. He rejected anatomies and microscopic analysis to uncover the hidden cause of disease.
• He believed that you should daignose patients by examining them and treat the symptoms of the disease rather than looking for a cause. 
• He wrote the book "Observation Medicae"

• The royal society originated in 1600 and it was a group of people interested in science who met weekly. They had a laboratory with microscopes and King Charles II was it's patron
• The society's motto was "Nullius in verba" which means to not take anyone's word for it.
• This encouraged it's memebers to always research for new information and challenge what they read.
• The first Royal society meeting was held in 1645
• The Philosphical tractions were the world's firat ever science journal. It was published in 1665 after King Charles II granted a charter for the society to publish their findings. 
• It allowed people to know more about the latest discoveries  and ensures the information was readily availbale for those who wanted it. 

• In 1753, John Lind found a cure for scurvy. He made them drink lemon juice to prevent themselves from getting scurvy. 
• Sir John Flyer was the first person to identify the cause of the disease and offer clean air amd diet as a remedy. He did this in 1698 and published his findings in "A Treatise on Asthama". 
• Robert Burton published a study in mental illness. He claimed that a lack of exercise,idlenss and too much studying caused mental health problems. 
• George Cheyne published a report suggesting that obesity was hereditary and caused by a porr lifestyle. 
• in 1671, Jane Sharp published the midwives book which combined the medicals knowledge of the profession. 
• This suggest progress from the medieval time. 

• The Death Toll in London was 10,000
• The Great Fire of London in 1666 sterilised large part of Londodn, killing the bacteria which caused the plague. 
• People smoked pipes to clean the air around them as they still believd miasma caused the plague. 
• Infcected households were locked in and red crosses were painted on the doors with the words "Lord have mercy upon us"
• Carts collected corpses for mass burilas in plague pits, 
• Stray pigs, rabbits, cats and dogs were killed.
• Wandering beggars were not allowed on the streets to control the spread of disease. 
• Two watchmen were appointed to evry household to prevent people from going in and out of infected houses. 
• Examiners and searchers were appointed to check whether the household had contracted the plague. The inhabitants had to stay inside the house for a month. 

• When the plague hit, the royal court and even doctors fled the city to take shelter in the countryside.
• Those who stayed attacked Dutch merchants as they believed they brought the Plague to London.
• The Lord Mayor of London stayed in a glass case to prevnet himslef from catching the disease
• Those who left London had to have specila medical certificates to say they were safe to ravel. This was doen to control the spread of disease. 
• Metting places such as theatres were closed. 
• People in 1665 made the connection between dirt and disease.
• They still prayed to make God take the disease away.

• Physician - fully qualified healers. All men and studied work of Galen as well as work of Harvey and Vesalius
• Apothecary - sold and mixed medicines . They were not licenced to treat the sick but many still did. 
• Surgeon - trained by observing and copying work of ther surgeons. They were given licences by the local bishop.  Lokked down upon by the physicians, 
• Midwife - given licence by bishop to supervise the last week of preganacy and deliver baby. If there were complications, they had to call a physician.
• Wise woman - knew all the locals and had their trust. If they went wrong, they could be accused of witchcraft
• Housewife - girls were expected to learn how to treat common illnesses and injuries. 
• Travelling quack - people who made a living by selling miracle and magical potions which claim to treat any illness. 

• By the 1700s, women in surgery were decreasing sue to the lack of education available for women 
• The change in a attitudes also led to a decrease in women in medicine. It became fashionable to have a highly trained physician and people were worried what their friends would think if they were treated by an un-educated women.
• the dicovery of the obsteric foreceps 1620 - Anatomical knowledge was required to do this and as women did not have this, they were not allowed to use them. 
• More men were delivering babies by the 1700s

• Cholera - 2/3 people died from this disease
• Diptheria - 1/10 dies 
• Samllpox - 1/3 dies 
• TB - 1 in 2 people dies 
• Typhoid - 1/3 died

• They were less likely to blame illnesses on supernatural causes or unbalanced humours.
• Spontaneous generation was the latest theory. Scientists thought that germs were spontaneously generated by the decay and then then spread the disease further. 
• Bad air and miasma was also thought to be a cause of disease
• People believed that the rotting waste on the street caused the bad air. 

• Smallpox was a disease which casued many blisters with pus to appear every where on the body. People wpuld often die from this and if they did survive, they were likely to be blind or severly scarred. 
• Popele believed that it was spread by the miasma. The main way of preventing the disease was giving someone a weakned form of the disease in order to create immunity. 
• There were some problems with inoculation. for example, not everyone could afford it . You may also be given the stronger form of the disease by accident. Inoclated people could still pass the disease onto other people.
• Edward Jenner was country doctor from Gloucestershire who discovered the vaccine for smallpox in 1798
• He was inculated to prevent himself from getting smallpox when he was young. 
• Jenner had previously heard milkmaids say that they didn't get smallpox as they had previously had cowpox before. 
• To prove this theory, Jenener infected a young boy with some cowpox and later gave him some smallpox to see if it had an effect. 
• He saw the boy did not get smallpox as he was made immune to ot by the cowpox

• Many opposed Jenner's vaccine as they believed it was unnatural and radical. They thought it might make them bovine. 
• The Royal Society refused to publish his work as they were suspicious of it. However, jenner was not deterred as he went on to publish his work himself.
• An anti-vaccine league was formed in 1866
• Jenner could not explain the link between smallpox and cowpoxand vaccinatoin were not always successful. 
• In 1802 and 1807, the government gave Jenner £30,000 to develop his work on vaccines. 
• The vaccines were not popular at first but were made compulsory in 1852 but they were not enforced. Many did not want their children to be vaccinated and the government believed it wasn't their job to tell people what to do (laissez faire attitude)
• However, the vaccine laws were enforced in 1872 after a significant rise in the number of deaths as a result of smallpox. You could go to prison if you did't vaccinate your child. 
•  In 1887, the governmnet recognised that there were conscientious objector and allowed parents to refuse vaccintion. These children were still protecetd due to herd immunity.

The industrial revolution was the mass movement fo people from the countryside to the city due to the invention of machinery. 

• The people who worked in the factories in the city lived in back to back housing. Disease spread very easily here and cholera was common. The cesspits would often overflow and contaminate the water. 
• Chest infection due to damp housingw as also common. It alos makes you more succeptible of othere illnesses
• The landlords rented out the room for more than one family 
• Planning permission is needed to build the houses and the government granted them
• There were no government regulations and so many of the houses had no running water or toilets.
• 10-12 people lived in one room in the slum

• Edwin Chadwick wrote a report titled "Report on the sanitary conditions of the labouring popuation" in 1842
• He concluded that ill health was largely due to poor living conditions and it would cost less to look after the poor if their health was improved. 
• He believd that disease was caused by miasma and suggested that the streets should be cleaned
• He also suggested that the waste in the cesspit should be removed and that water supplies should be improved by adding a drainage system.
• He also put foward the idea of having a district medical officer who would treat only the patients in the district. He believd that making these improvements would save them money as the poor being healthier would make them work harder. 
• His sewers flushed 6000 cubic metres of waste into the River Thames. This allowed cholera to spread rapidly and many dies as resut of this. 

• The government had no control over what the rate payers did
• The rate payers wanted to decrease the cost of looking after the poor instead of increasing it. 
• Chadwick's report was published in 1842 but the government did nothing until 1848 when they created the Public Health Act.
• The act was permissive and allowed local authorities to make chnages only if they wanted to. 
• £11 million was lendto council between 1848 and 1872 in order to make these improvements. 
• The board of health fell in 1854 

• John Snow carried out the investigation on the Broad Street Pump in 1854
• He originally believ the miasma cause cholera
• John Snow made a map of the deaths shwing the geographical location of the water pump and created a voroni map by sectioning the map to show the proximity of deaths to he nearest water pump. 
• He interviewed peopel and checked government record to find out when the deaths occurred. 
• He also investigated contradictory evidence to explain anomalies. For example, the workhouse where they had their own pump and the brewery where they only drank beer
• 11 people died in the Broad Street Area and 35 died outside the Broad Street Area.

• Germ Theory -1861
• Pasteur published germ theory in 1861 and carried out experiments to prove it. He couldn't identify the specific bacteria which caused the disease and couldnt' prevent people from catching it. This made his theory seem useless.
• The belief that miasma cause illnesses continued even after his discovery as people couldn't see the bacteria which supposedly caused disease. 
• In 1876, Robert Koch discovered the the specific bacterium which caused anthrax. This information could then be used to create a vaccine to prevent people from getting the disease. 
• Pasteur work persuaded the government to enforce the compulsory vaccination laws against smallpox.
• Pasteur used Jenner's work to create vaccines to stop the spread of disease. He bagan with animal diseases and developed vaccines to prevent chicken cholera
• The first vaccine developed fro human was the vaccine for rabies in 1885