Medicine through time comment and analysis


Disease and supernatural

  • The Church's influence over medieval medicine meant that there was very little change in ideas about the cause of disease until the Renaissance - the Church and its messages were so influential that people were unable to question them
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Rational explanations

  • The Four humours and miasma were both incorrect theories. But they were rational - they assumed disease had a natural cause, rather than a supernatural one. This was important, as it suggested that people weren't powerless against disease - they could investigate and take action against it.
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Treating diseases

  • Bloodletting caused more deaths than it prevented, but it remained a popular treatment. This shows the strength of medieval people's beliefs in the face of observational evidence.
  • Barber-surgeons weren't doctors, so they had little medical training or insight. This meant they had neither the ability nor the desire to experiment with new treatments.
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Case study: Black Death

  • The high death toll of the Black Death was in large part because people didn't know what caused the disease. People tried to use existing ideas about the cause of disease to come up with ways to prevent or cure the plague. But because their ideas about the cause of disease were wrong, their attempts at prevention and treatment were mostly ineffective.
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Vesalius and Sydenham

  • The work of Vesalius didn't have an immediate impact on the diagnosis or treatment of disease. However, by producing a realistic description of the human anatomy and encouraging dissection, Vesalius provided an essential first step to improving them.
  • Sydenham's work on classifying diseases helped make diagnosis a more important part of the doctors' work. Before, the emphasis had been on prognosis - predicting what the disease would do next.
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Case study: William Harvey

  • A new type of water pump was invented at around the time of Harvey's birth. This new technology gave Harvey a comparison and inspiration for how the heart worked.
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Transmission of ideas

  • The printing press had a huge impact on the communication of ideas.
  • Huge progress was made in the Renaissance - and the printing press and the Royal society helped spread the new ideas. But because most people couldn't read or write, these things could only have an impact on a small part of society. Most people in the Renaissance were using the same cures and treatments as people in the Middle Ages.
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Medical treatment: Continuity

  • Hospital care was still in its early stages in the Renaissance. Many hospitals mainly focused on moral or spiritual education. But health and sickness were becoming more of a priority.
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Case study: The Great Plague

  • Living conditions were very poor in Renaissance England, so it isn't surprise that the plague came back. Death records show that the poorest, most crowded areas of London were worst hit.
  • The responses to the plague came from the local councils - they did more to try to combat the Great Plague than they had done for the Black Death 300 years previously. But there were no national government attempts at prevention.
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Case study: Vaccination

  • Jenner was important because he used an experiment to test his theory. Although experiments had been used during the Renaissance, it was still unusual for doctors to test their theories.
  • The government's attempts to get people vaccinated against smallpox were suprising given attitudes at the time. People believed in a laissez-faire style of government - they thought that government shouldn't get involved in people's lives. The vaccination policy went against this general attitude.
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Developments in nursing

  • The Germ Theory wasn't published until 1861, so initially Florence Nightingale didn't know what the cause of disease was - she believed in the miasma theory. But her teachings suggested that good hygiene could prevent the spread of disease.
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  • Anaesthetics helped solve the problem of pain, but patients were still dying from infection. This meant the attempts at more complicated surgery actually led to increased death rates amogst patients. The period between 1846 and 1870 is sometimes known as the 'Black Period' of surgery for this reason.
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  • Antiseptics (and later asepsis) solved the problem of infection. This, combined with the use of anaesthetics to stop pain, improved British surgery - many deaths were prevented as a result of antiseptics and anaesthetics.
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Case study: Cholera in London

  • Snow's findings took a while to make an impact - it was not until the Germ Theory was published that his theory became widely accepted. But eventually Snow's findings helped lead to a change in attitudes - people realised that waterborne diseases like cholera needed a government response in order to clean up the streets and waterways. This contributed to the 1875 Public Health Act. Like Jenner, Snow was also important for using observation and evidence to support his theory.
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The public health act 1875

  • Now that they had the vote, workers could put pressure on the government to listen to concerns about health. For the first time, polticians had to address workers' concerns in order to stay in power.
  • Just as the government used the work of Jenner to make vaccination compulsory, the 1875 Act built on the work of several individuals, including John Snow and Louis Pasteur. The scientific proof these individuals provided, combined with a change in attitudes towards the role of government, helped put pressure on the government to act.
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Modern ideas - causes of disease

  • The advances in science and technology since 1900 have shown that there is not just one cause of disease. In addition to bacteria, we now know that disease can be caused by viral infections, genetic mutations and our lifestyle choices. This makes their treatment and prevention even more complex - with so many different causes, treatment needs to be more targeted to the specific disease.
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Developments in diagnosis

  • Improvements in technology, like medical scans, have given doctors a much more detailed picture of what's going on inside their patient's body. This has enabled them to intervene much earlier, before the disease has become too advanced. Early treatment is generally more effective and has a higher chance of success.
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Case study: Penicillin

  • While individuals (like Florey, Chain and Fleming) were important in making the discovery of penecillin, it was large institutions like governments that funded its mass production.
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Modern treatments

  • The discovery of magic bullets showed that synthetic, targeted treatments for specific diseases were possible. Since Paul Ehrlich's first discovery, a huge pharmaceutical industry has grown, dedicated to the research and production of new treatments.
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The national health service

  • The founding if the NHS showed that government intervention could make a positive impact on people's health. However, it took a change in public attitudes (backed up by greater scientific knowledge) to make it happen.
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The government's role in healthcare

  • These campaigns mark a big shift in the government's approach from the foundation of the NHS, aand an even bigger shift from the laissez-faire attitudes of the 19th century, when people thought government shouldn't intervene at all in public health. Not only is the government trying to treat and vaccinate against known diseases, it is now intervening in people's lives in order to stop them getting particular illnesses in the first place.
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Case study: Lung cancer

  • Lung cancer prevention is a good example of an area of health where the government has been increasingly active - the large number of television campaigns and pieces of legislation show that the government is now taking health seriously, which is in contrast to its attitude before 1900.
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