Medicine Through Time

Lifestyle:

• They lived in tribes and were nomadic hunter gatherers
• They had a wide ranging healthy diet
• They didn't read or write
• Everything we know about their lifestyle was learnt from studying more recent tribes with similar lifestyles e.g. Aboriginies

Causes of Illness:

• Supernatural forces caused illness
• Evil spirits entered the body and caused illness

Treatments:

• Trephinning - putting a hole in the skull to release evil spirits (carried out by medicine men)
• People survived the procedure - skulls were found with slightly healed holes
• Women treated everyday illness like flu withherbs and potions
• Broken limbs treated with casts made of mud and leaves

• Rich society meant people could work as doctors and scholars
• They wrote on papyrun in heiroglyphics which helped spread ideas
• They traded accross the Mediteranian. They imported new herbs and ideas for medicine

Causes of Disease:

• Channel Theory
• They also believed Gods caused disease. This is shown in Priests' writing

Treating and Preventing Disease:

• Priests said spells and prescribed opium
• A healthy diet and good hygiene was encouraged
• They performed simple surgery. Temple carvings are evidence of this

Mummification:

• They prepared the body by removing soft organs however if the body was destroyed they couldn't enter the afterlife so they couldn't dissect, limiting anatomical knowlege

Factors Allowing Progress:

• Educated society. Medical library in Alexandria (human dissection also permitted there)
• There were many great thinkers
• Wars between states created injuries that required treating
• They traded around the world
• Improvements were made with brass and iron surgical instruments

Causes of Diseases:

• Four humours out of balance
• Supernatural

Treatments:

• Purging or blood letting
• Basic external surgery
• Reset bones
• Asclepions

The Four Humours:

• The body has four humours which must be kept balanced to remain healthy
• The four humours are blood, phlegm, black bile and yellow bile
• Illness is explained as the humours being out of balance
• Treatments included blood letting, purging
• Treatments included blood letting, purging
• The humours were associated with the seasons

The Hippocratic Oath:

• Always treat the patient with your best skill
• Keep confidential everything you learn about the patient
• Keep a professional relationship with the patient

Clinical procedure:

• Observe the patients symptoms, with that information give them a suitable diagnosis, prognosis and treatment

Factors Allowing Progress:

• Wealthy society - the righ had slaves - this gave people more time to study
• Taxes funded public health projects
• Massive empire meant they could add to medical knowlege
• Army needed doctors
• Learnt fron Greeks - they took over the medical library

Causes of Disease:

• Still believed in supernatural causes of disease
• Began to associate miasma with disease
• Still believed in four humours

Treatments:

• Herbal treatments
• Balancing humours
• Basic surgery and amputation

Public Health System Includes:

• Sewage systems to get rid of waste
• Aqueducts to supply water to towns
• Public toitets
• Water fountains
• Rules on where to bury the dead
• Kept areas clean and people healthy

• Galen was an army doctor who wrote 60 books
• He discoeverd that the brain, not the heart, controlled speach
• Believed in the Theory of the Four Humours
• Found arteries as well as veins carried blood
• Studied animals. This meant that he got some deatils wrong for example:
• He believed that the jaw bone was split in to
• He believed that blood passed from the right side of the heart to the left

After the Romans:

• Wars destroyed the Roman public health systems and medical libraries
• Wars made travelling dangerous, reducing communication
• Rulers of small kingdoms accross Europe built armies rather than improving healthcare
• Eventually the church began training doctors
• Town rulers orderd that they were cleared up
• Merchants began to travel again and spread ideas

The Church:

• The church was powerful; they controlled education, only Priests and Monks could read, and certain books were banned
• The church supported Galen's ideas as he referred to God as the 'creator'
• Hospitals were set up at monostaries
• Monostaires were some of the only places with sewers and running water

Causes of Illness:

• Still believed in the four humours
• Astrology; people blamed cretain allignments of the stars and planets for illness
• Christians believed illness was a punishment from God
• Some dissection was allowed in certain medical schools. LIttle anatomical knowlege was gained as they tried to link findings to the four humours

Treating Illness:

• Simple surgery was performed by barber surgeons. Surgers was not a respected profession
• Flagellation or pilgramiges to gain God's forgiveness
• Opposites theory
• Herbal remedies by housewives
• Wine was used as an antiseptic
• Diagnosis with urine samples

Not all Arabs were Muslim - some were Christian.

Factors Helping Progress:

• A wide-spread empire allowed Arabs to gain knowlege from Europe, India, China and Africa
• Libraries containing the works of Hippocrates and Galen
• Islam encouraged the care of the sick so hospitals were built
• They had a culture of reading and writing
• Ibn Sinna wrote a million word text book
• Made progress in treating eye problems

Factors Hindering Progress

• Islamic law forbade dissection
• Doctors thought theory was more important than practice so they didn't concentrate on surgery
• Many Muslims believed that the Koran already heald all important knowlege so there was no point in making no discoveries

• Swept accross Europe in the 1340's
• It hit Britain in 1348, killing a third of the population
• There were two forms - Bubonic (affecting the lymphatic system) and Pneumonic (affecting the lungs)
• It was carries on fleas on rats
• Symptoms included exhaustion, fever, swellings and breathing difficulties

Believed Causes:

• Punishment for sins
• Allignments of planets
• Poisoned water (Jews blamed)
• Miasma (this theory was hte closest to the truth but not completely accurate)
• Humours out of balance

Cures:

• Flagellation
• Prayer
• Sweet smelling herbs and spices
• Lighting fires
• Balancing four humours
• The germ theory not discovered yet so the plague returned

Factors Allowing Progress:

• Printing Press - Allowed ideas to spread more rapidly
• Weakening church - People began to question the church's teachings and looked for more natural causes of disease. Doctors could dissect
• Art - Medical drawings were done and shared amoung doctors. These were spread with the printing press
• Interest in anciennt learning - people challenged old ideas

Great Plague of 1665:

• The plague returned and killed 100,000 people in London
• Victims were quarrantined
• Dead were taken away
• People saw it was contagious but didn't know about germs
• Great Fire of LOndon 1666 steralised parts of London, killing the plague bacteria

Vesalius:

• Known for his anatomical charts
• He was allowed to dissect humans
• He drew accurate anatomical diagrams
• He showed where Galen was wrong (e.g. Galen said the jaw was made of two bones, Vesalius found that it was just one)

Pare:

• Before Pare, wounds were cauterised (sealed with hot irons or oil)
• One day, the hospital Pare was working in ran out of oil so Pare sealed them with ligatures and applied an improvised herb mixture. He saw that this was much more effective at treating the wound and the pain
• His ideas were accepted by the King of France

Edward Jenner:

• He observed that milkmaids didn't get smallpox
• After an investigation, he discovered that people who'd had cow pox didn't get smallpox
• In 1796 he injected a boy with puss from the sores of a milkmaid with cowpox. He later injected him with smallpox but he didn't become infected

Reasons for Opposition:

• He couldn't explain why
• People worried about the side effects (e.g. thought they might develop cow features)
• Doctors worried that it would reduce their work, reducing their earnings
• The church saw it as unnatural

Pasteur's Germ Theory:

• Scientists believed that microbes were caused by disease. This theory was called Spontaneous Generation. Miasma was blamed rather than microbes)
• Pasteur worked to explain the souring of sugar beet. He blamed grems in the air

Robert Koch:

• Koch built on Pasteur's germ theory
• In 1875 he injected 20 generations of mice with the bacteria that caused anthrax
• Bacteria in the end of the investigation was the same as it was at the start
• He also found the bacteria causing Cholera and Tuberculosis
• He identified them using powerful microscopes and dyes

Vaccinations:

• Because of the rivalry between France and Germany, Pasteur came out of retirement after hearing about Koch's work
• Both men worked with large teams of scientists
• Chamberland (Pasteur's team) forgot to inject chickens with chicken cholera and went on holiday, leaving the bacteria out. He they injected them after returning
• The chickens survived. He tried again and like the last time, they survived
• The Cholera was weakened. This error was a chance discovery

Pain:

• Surgical patients were given alcohol or opium
• in 1800 Humphry Davy discovered laughing gas. This discovery wasn't widely published
• In 1847 chloroform was discovered by James Simpson

Infection:

• Antiseptics such as carboic spray were introduced in surgery in the 1850's
• Aseptic surgery (the removal of all germs( was intorduced in the 1890's

Bleeding:

• Problem not overcome in 1800's
• There was no understanding of blood groups
• They couldn't prevent blood clotting

Florence Nightingale:

• Brought in professionalism to nursing
• Nursed English soldiers in teh Crimean war
• Improved hygiene

Mary Seacole:

• She volunteered to nurse but was rejected so she financed her own journey
• She nursed British soldiers on the battlefield and set up the British Hotel for soldiers to rest. It had a scandalous reputation
• She was bankrupt when she returned to England
• The press were interested in her story and she wrote an autobiography