Utilisateur
-rural communities
-majority of people worked in fields growing crops on land owned by lords-feudal system
-not many towns and cities and they had dirty crowded streets
-catholic church dominated all ideas including medicine
-limited scientific knowledge
-controlled learning (including uni's) so controlled ideas
-books produced and kept in monasteries-only monks and priests could read and write so the church controlled what was read
-supported Galens ideas because they fitted with Christian ideas i.e having a soul and being created by God
-discouraged dissection-only to show Galen's ideas
-encouraged care of the sick-hospitals in monasteries and nunneries
-disease was a punishment or test from God because of sin
-Theory of 4 humours-Hippocrates wrote the body had 4 liquids(blood, phlegm, black bile and yellow bile) and if they were out of balance illness was caused-humours had to be balanced to cure the illness-blood letting and purging
-miasma
-keep God happy-be a good christian with no sinning
-self-punishment-flagellants in the black death-if they punished themselves God wouldn't give them the plague so they walked through streets whipping themselves
-chanting incantations and prayers
-carrying lucky charms
-keep humours in balance- not overeating, exercising, blood letting and purging
-keeping streets clean to avoid miasma-laws passed to purify the air with sweet smells and streets cleaned
-regimen sanitatis-advice on how to maintain a healthy lifestyle-list of instructions from a physician on exercise, diet and bathing and keeping away from miasma
-went to universities that followed catholic churches ideas
-Galen's ideas taught with dissection only to prove Galen's work
-check balance of humours-checked the colour, taste and smell of urine in their handbook (vadememcum)
-check alignment of the planets for influence on humours and used zodiac charts on when to treat a patient
-pray,fasting, going on pilgrimage, paying for special mass to be said
-treatments based off specific ideas for specific illnesses
-belief in divine right of kings and link to God so thought to be able to cure illness
-made by Galen
-believed the humours could be balanced by giving the patient the opposite of their symptoms
-bleeding-cutting a vein or leeches, done by barber surgeons
-purging-using herbal remedies to evoke vomiting or diarrhoea
-herbel remedies to drink, sniff, bath or rub in
-physicians-trained at university and ideas based of Galen and Hippocrates-very expensive so they were rich
-Apothecaries-like chemists who mixed herbal remedies for everyone in society
-barber surgeons-did barbering work but also dealt with more physical problems like pulling teeth and surgery
-wise women-local women who knew many herbal remedies and often used by the poor
-monasteries offered hospitality to travellers but had infirmary connected to them
-1100/1500 with 30% church ran, the rest ran by charity from a rich person
-followed religious teachings so focused on caring not curing-only prayed to cure
-mainly places to rest and recover, kept clean with fresh food
-monks and nuns did the caring
-people with infectious disease were usually not admitted, and those with incurable conditions
-few specialised hospitals for lepers, insane and old
1348
-supernatural:
-God as punishment for sins
-astrology
-natural:
-miasma
-imbalance of the humours
-blaming outsiders like jews
-miasma:
-clear streets of rubbish
-carry herbs and spices
-light fires and ring bells to keep air moving
-imbalanced humours:
-bleeding, purging, diet and exercise
-herbal remedies
-supernatural-praying,holding lucky charms
-natural-rebalance humours and herbal remedies
-influence and power of the church in the middle ages
-attitudes in society-medical ideas had always been the same so people didn't think they needed a change
-lack of scientific understanding
-influence and power of the church
-treatments didn't change
-lack of training-monks and nuns were the only caregivers and only trained in biblical ideas
-rural communities dominate with towns still experiencing poor public health
-increases in population during this period in villages and towns
-Galen and Hippocrates ideas still followed with limited alternative ideas
-England became protestant not catholic
-church no longer dominated society and monasteries closwd
-weakening of the catholic church so now there could be challenges to the churches beliefs including medical ideas
-church no longer controlled learning
-key individuals begin to use scientific methods to investigate medical ideas as people were more curious about the world around them
-new ideas could be published more quickly and accurately
-work of important individuals could be spread to a wider audience
-catholic church couldn't control ideas
-British organisation set up in 1660 by scientists and physicians who wanted to share experiments and discuss new scientific ideas
-support from King Charles II gave it credibility
-published work in English not latin
-sponsored scientists to carry out research
-new ideas shared and discussed
-new medical ideas to be confirmed or dismissed
-new ideas spread more quickly
-God caused disease
-astrology
-Theory of 4 humours
-miasma
-move away from the supernatural
-more emphasis on natural ideas of cause like bad air, which became the most popular idea of cause by 1700's
-illness based on external factors
-getting rid of miasma
-living a good christian life
-keeping humours balanced
-regimen sanitatis
-more emphasis on removing miasma by temoving waste and dirt
-believe God would cure but not cause illness
-work of Sydenham encourages to look at surroundings eg weather and diseases in the area as well as external factors eg not humours
anatomical knowledge of the body
-dissected human bodies
-checked bodies with Galen's work
-human jaw bone in 1 part not 2
-human breast bone in 3 parts not 7
-men didn't have fewer ribs than women
-proved Galen wrong about anatomy
-encouraged experimentation, dissection, questioning
-not die to the nature of the patient but external factors
-could be organised into different groups
-observation of patient's symptoms important to diagnose
-moved Britain away from concentrating on Galen's ideas on diagnosis and encouraged observation of patients symptoms
-developed a new way of classifying and differenciating between diseases
-came up with alternative treatments eg cinchona bark from Peru to treat malaria
physiological knowledge about how the circulatory system worked
-heart was a pump
-heart pumped blood around the body in 1 direction
-arteries took blood away from the heart
-veins took blood back to the heart
-there was only so much blood in the body
-experimentation-dissection of animal and human hearts
-challenging old ideas-found out Galen was wrong about the body making blood and using it like a fuel
-credibility-physician to King Charles I
-technology-saw how water pumps worked and it gave him inspiration
-individual abilities-determined to find out for himself
-impact of others-influenced by work and teachings of others who supported investigation eg Fabricus in Padua
-short term:
-encouraged other scientists to dissect human bodies
-no practical use in medical treatments so treatments didn't change because of his work
-many doctors ignored his work and continued to use Galen's until 1651
-long term:
-proved Galen wrong and how the circulatory system worked
-helped doctors understand how the body worked and understand the importance of not bleeding
-Harvey's ideas appeared in universities in 1673
-ideas were the basis of future treatments like blood transfusions
-importance of blood linked to surgical developments in the 19th century
-still trained at universities
-many ideas about causes and treatments from Medieval period still taught like Galen's ideas
-trainee doctors could get more medical textbooks with new ideas eg books by Vesalius, Harvey and Sydenham
-by 1700 doctors studied anatomy and botany as well as traditional texts
-new ideas of diagnosis from Sydenham
-more observation and examination of patients from Sydenham
-didn't use urine to diagnose illness
-continuity-mixed herbal and chemical remedies and still cheaper than doctors
-change-more training with apprenticeships run by a guild and needing a licence to practise-use of iatrochemistry
-continuity-carried out surgical procedures and used by all of society
-change-needed a licence to practise
-very little
-no new ideas about cause of illness so no new treatments
-ordinary people continued to use the treatments used for years
-medical training at university continued for many years to teach Galen's work
-new herbal remedies using plants from the new world (the america's)
-iatrochemistry-new focus on chemical cures-alchemy was the study of metals to try and turn ordinary metals into gold-knowledge discovered about chemicals used in trying to develop new cures
-transference-the belief that an illness or disease could be transfered to something else eg rubbing a boil with an object or sleeping in the same room as an animal to transfer a fever
-still mainly provided by female relatives at home
-hospitals existed for care of sick
-changes to hospitals :
-fewer hospitals
-hospitals secular and not religious
-care was based more on medical treatment
-new types of hospitals :
-pest houses-hospitals that looked after people with 1 type of disease
-also known as plaguehouses or poxhouses depending on the disease of the patients
1665
-miasma-most popular belief
-God and astrology
-it could be passed between people
-increased efforts by local government to get rid of rubbish which was causing bad air eg removing rubbish off streets and killing stray animals
-prayer and lucky charms
-herbal remedies eg. mint and rosemary
-transference-the idea that illness could be transferred from one organism to another
-sweating-disease could be sweated out so sufferers wrapped in blankets in hot rooms
-continuity:
-cause-miasma
-preventation-getting rid of miasma with nice smells and fires
-treatment-praying to God and herbal remedies
-change:
-cause-more emphasis on miasma
-preventation-more scientific approach to getting rid of miasma
-treatment-more herbal remedies available (nutmeg) and the ideas of transference and sweating
-weakening of the power of the catholic church
-work of important individuals
-work of royal society
-discoveries weren't about what caused illness
-medical training at universities still concentrated on Galen's work
-attitudes in society remained the same about causes-ordinary people still believed in the 4 humours and that God would cure illness
-dramatic change in how people live
-increased urbanisation
-increased use of technology
-more organised workforce
-more government control over people's lives
-increased scientific investigation about the world
-poor public health-no clean water and lots of sewage
-easy spread of diseases-cholera, TB, typhus
-God-especially during epidemics
-humours-not too popular though
-miasma
-1800-little change from renaissance at the start
-new idea of spontaneous generation theory-microorganisms were caused by decay
-1900-major development-germ theory-microorganisms cause decay in food and disease-different germs cause different diseases
-germs are micro-organisms which cause disease
-in the air but not evenly distributed
-invisible to the naked eye
-killed by heating them
Louis Pasteur in 1861. In 1878 germ theory of infection was made
-asked by brewing company to explain why liquids were going bad
-observed microbes in liquids and theorised they could be the problem
-read Pasteur's work and began to study microbes
-proved a specific germ causes a specific disease so proving the theory
-what Pasteur and Koch based their work off and recorded the results
-French academy of science held competition to prove or disprove spontaneous generation theory
-Pasteur showed a series of experiments to prove Germ theory and disprove spontaneous generation
microscopes were powerful enough so that Pasteur and Koch could view micro organisms
-positives:
-lister developed antiseptics
-more evidence to support government action to keep cities clean
-limitations:
-most doctors still followed spontaneous generation and miasma theories, like Dr Henry Bastion
-British government believed in bad air-rejected idea germs were in wayer when there was a cholera outbreak in India in 1884
-Pasteur was a scientist working on food and drink not a doctor so people not willing to believe
-only with Koch's work to prove germ theory were people more convinced but this was 20 yrs after Pasteur's first publication
-germ theory explained why Jenner's vacinations worked
-new vaccines could be developed
-pasteur also discovered weakened micro-organism could be used as a protection from a stronger micro-organism
-easier to grow bacteria-in agar jelly
-easier ways to see bacteira under microscope-staining with dyes
getting rid of miasma
-vaccinations-Jenner developed the first ever vaccine to prevent smallpox
-work of pasteur-explained vaccinations and developed new ones
-change in government attitude- no longer attitude- public health act 1875
-more scientific approach-investigation and evidence which supported improvements
-cholera epidemics of 1831, 1848-49, 1854, 1858
-1858 great stink- the river thames smelled so bad in summer that parliament couldn't sit
-1867 working men got the vote- wanted MP's who would improve their living conditions realised only government could take necessary action-building sewers and checking water had to be done by government
-compulsary action by city authorities
-provide public health facilities-clean water, sewers, public toilets, street lighting and public parks
-appoint public health officer to moniter disease and health of citizens
-check new buildings- not damp, overcrowded and unsafe
-still trained at universities
-improvements in renaissance continue
-surgery was now included in the syllabus
-germ theory gaining more acceptance
-working with professional nurses when caring for the sick
-continuity:
-mixed herbal and chemical remedies and still available and sold to all in society by a variety of shops
-change:
-pharmacy developed as a profession
-pharmaceutical society of Great Britain established in 1841
-society wanted any practicing pharmacy to have training and be registered
-registration compulsary after 1868
-continuity:
-carried out surgical procedures
-change:
-by 1800 surgeons had separated from barbers
-Royal College of Surgeons establihsed in 1800
-college trained surgeons and exams increasingly rigorous with new developments in surgery
-increasingly respected by society
-progress:
-surgical developments as 2 problems solved
-no longer used idea of transference
-limited:
-concentratuon on preventation
-scientists hadn't discovered ways of destroying germs in the body
-ordinary people continued to use old treatments for years- eg herbal remedies
didn't know about blood groups until 1901
-alcohol-patient still moved about
-ether-was flammable and made patients sick and cough
-chloroform-an anaesthetic which made the patient unconscious
-sniffed different chemicals and realised what it could be used for
-dosage was hard to get right and some people died
-religious people thought pain was from God and had to be endured
-positive-surgery could be slower so less mistakes and more complex surgery possible
-negative-more complex surgery had higher risks so more deaths and still problems of infection and blood loss
Carbolic acid- an antiseptic
-negative-took a while for Lister's work to be accepted as more acceptance of germ theory
-positive-inspired others and development of aspetic surgery
-still mainly provided by female relatives
-hospitals existed for care of sick
dirty, disease spread fast, limited professionals, care by family and had a bad reputation
-not seen as a respectable profession
-nurses unskilled with bad reputation for laziness and drunkeness
-only trained staff- doctors employed by hospitals to provide care and treatment supported by trained nurses
-buildings clean with fresh air and good medical supplies
-government set up infirmaries-hospitals for the poorest in society
-specialist hospitals set up for mentally ill and infectious diseases
-in 1854 took over the military hospital in Scutari during the Crimean war and became a national hero
-credibility as heroine allowed her to influence government policy
-wrote books on nursing, how to train nurses- set up nursing school for educated and respectable women so improved reputation of nurses and making nursing a profession
-she influenced hospital design concentrated on making them easy to clean with separate wards to separate infectious patients- even though she didn't believe in germ theory
inoculation-exposure to a weakened form of the disease to protect against a more serious infection
-decided to investigate the idea if you had cowpox you didn't get smallpox (observations of milk maids)
- infected local people (such as James Phipps) with cowpox and tried to then infect them with smallpox but failed proving that catching cowpox prevented catching smallpox
-1798 wrote up his findings and published them privately as royal society wouldn't as they saw him as only a country doctor
-determination-decided to find out for himself if cowpox was actually a preventation
-experimentation-infected people with cowpox and then smallpox
-government support-given money to set up clinic and give vaccinations
-Jenner could prove it but not explain it
-Jenner was only a country doctor so had limited credibility
-people thought they shouldn't be given an animal disease
-inoculators and doctors lost money with the introduction of vaccination
-some doctors didn't vaccinate properly so it didn't work
-1802 parliament have £30000 grant to Jenner to open vaccination clinic to promote it
-1840 introduced free vaccination to children
-1852 vaccination made compulsary
-Jenner inventing an effective vaccination
-Government support
-Royal Jennerian Society-organisation of people who supported Jenner's ideas and spread the importance of being vaccinated-gave his development credibility as had important supporters such as the King's son
-1831, 1848-49, 1854, 1858
-nobody knew the real cause was germs in water so didn't know how to stop it spreading
-urbanisation conditions helped spread it- no clean water, no good sewage disposal, overcrowded conditions
-belief in spontaneous generation led to keeping homes clean and attempts to clear away rubbish
-limited impact as actions based off incorrect theories and government reluctant to deal with public health issues
Doctor and surgeon who lived in Soho, London
discovered the link between cholera and dirty water
-collected evidence using a spot map which showed the deaths from cholera were linked to a water pump on Broad St in Soho (Broad st pump)
-realised not as many deaths amongst people who drank from other water sources eg the brewery
-more evidence that helped government decide to pay for new London sewers and get rid of waste
-was somewhat limited as some people didn't believe him so no action to clean up water sources
-urban society
-government role-increasingly responsible for people's health-public health laws, funding of scientific medical research,influencing citizens lives
-scientific approach dominating medical ideas
-lifestyle-increased awareness of importance on health
-people live longer healthier lives
-more awareness of healthy living
God-not widely believed but in 1980's AIDS epidemic some people said it was judgement against certain groups in society (homosexuals) as they were first to be significantly affected
germ theory-firmly accepted by all and widely known different pathogens cause different diseases
-lifestyle factors-how people live affects their health
-genetics-information inherited can cause disease
-vaccinations-identification of more microbes resulted in development of more vaccines eg HPV vaccine and COVID 19 vaccine
-government involvement in public health-responsible for clean water, sewage disposal, safe housing and food standards
-lifestyle factors-doctors advise on lifestyle to keep healthy
-lots of government intervention :
-campaigns to make people aware of health risks of smoking, over consuming alcohol and having a poor diet eg Eat Them To Defeat Them
-compulsary vaccination programs eg 1942 diptheria
-NHS-guidance, vaccination, screenings
-public health laws eg reducing air and water pollution and health and safety policies in the workplace
-genetics:
-Human Genome Project identified and mapped every gene in the human DNA
-identification of gene could show if they would develop a disease and take action eg Angelina Jolie risk of breast cancer so had double mastectomy
-antibiotics-given to prevent infection eg after tooth extraction but by 21st century used less
-describe symptoms to nurse or doctor
-questions asked about symptoms
-examination of body
-questioned about lifestyle
-use of tests of bodily fluids eg blood or urine
-use of other tests eg blood pressure tests, biopsy
-use of tests requiring technology eg X-rays, CT scans
-use of genetic testing to find hereditary conditions
-improved accuracy of diagnosis
-more targeted treatment
a chemical compound that would kill microbes of a specific disease
-1909 Paul Ehrlich and Dr Hata- Salvarson 606 to treat syphilis
-1932 Gerhard Domagk-Prontosil to treat some types of blood poisoning
-after 1932-sulphonamides to cure pneumonia, scarlet fever and meningitis
-treatment that limits the growth of bacteria in the human body
-created by using micro-organisms not chemicals
improved treatment-equipment eg key hole surgery because of tiny cameras and surgical instruments avoiding major surgery
-improved diagnosis-labratory medicine-testing of bodily fluids eg blood or urine and biopsy
-improved preventatipn-genetic testing for some conditions
-work of scientists to disover new treatments eg magic bullets and penicillin the first antibiotic
-improved diagnosis-equipment like X-rays, MRI
-improved treatment-equipment-key hole surgery because of tiny cameras and surgical instruments
-mass production of drugs eg penicillin
1948
-medical personnel-advise on lifestyle choices
-organisation of vaccination programmes
-organisation of testing and screening programmes
-drug therapy
-surgery-key hole and robotic
-mental health services
-research and funding of new preventions, diagnostic techniques and treatments
-second most common cancer in the UK
-mostly affects people over 40 with 70-74 highest diagnoses
-main cause is smoking-85% of cases
-government forced to take action as increased deaths-1973 26,000
-symptoms-persistent cough, coughing up blood, tiredness, unexplained weight loss
-scans (technology)-PET-CT scanning and X rays
-biopsy (science)-laboratory medicine testing cells after bronchoscopy
-surgery-remove tumour or lung transplant
-radiotherapy-shrink or stop the growing of a tumour with radiation
-chemotherapy- shrink tumour or prevent cancer returning
-laws:
-2007 smoking banned in public workplaces and in 2015 banned in cars carrying children
-limited availability-2007 legal age to buy tobacco from 16 to 18
-awareness campaigns to show risks of smoking-prevent people starting to smoke and support quiting smoking
-advertising-tv tobacco advertisements banned-2016 no public display of tobacco products-packets have graphic warnings
-increased deaths especially in 1973 (26,000) and knew the cause
-easier diagnosis
-campaigns by high profile individuals- Roy Castle was an entertainer who developed lung cancer despite never smoking but worked in smoke filled venues
-work of Fleming (1920's)- investigating infections and saw penicillin germ destroying the staphylococci germ and decided to investigate
-Florey and Chain (1930's)- took Fleming's findings and developed an effective cure for infection in humans and took action to get government support to mass produce it
soldiers often died of infection rather than the original wound- D-day invasion of Europe in WW2 would result in many casualties and government wanted to protect soldiers
British government funded Florey and Chain's inital research then the US government funded chemical companies to mass produce it
Fleming, Florey and Chain used experimentation and observation to test penicillin to get their results and develop and effective treatment
new ways of mass producing and storing penicillin made it available in large quantities
penicillin spores floated onto Fleming's petri dishes with staphylococci germs on (Fleming working on it is not chance though)
-positive-led to development of other antibiotics to cure different infections
-negative-overuse of antibiotics in the modern period has led to antibiotic strains of germs so infections are rither taking longer to be cured or not cured at all affecting health of the patients