HEALTH AND THE PEOPLE

• What was the renaissance?

  Rebirth. A period of change from 15th to 18th centuries beginning in Italy, where there was a surge in interests in art, literature, history and learning and a rediscovery of a love of all things classical.
• 1What was the relationship like between the renaissance and Galen?

  A scientific method of learning began which involved observation, hypothesis and experimentation so people began to question Galen’s theories. There was also a desire to show the human form in more detail in art so corpses were studies so Galen’s theorised anatomy was proven wrong.
• What did Vesalius do to challenge Galen?

  He carried out dissections which showed human anatomy to be different than Galen thought. People didn’t like that Galen was wrong so said anatomy must have changed overtime or that the body dissected was abnormal.
• Why was Vesalius’ work significant?

  The Fabric of the Human Body 1543 was an illustrated textbook which showed how different body parts (e.g. skeleton, muscles, nerves and veins) worked. It was sold to barber-surgeons and was the basis for better treatments and taught people how to do dissections more safely.
• How did Pare improve surgery? (2 ways needed)

  1510 – 1590. For gunshot wounds, he used just creams (instead of the usual boiling oil, cream, egg whites and turpentine – agonising) to sooth patients so they slept well, allowing their wounds to heal. He believed ligatures were better than cauterisation but they could infect the wound and took longer so Pare moved onto making artificial limbs.
• What did William Harvey discover?

  Blood was pumped around the body in a circular motion. His book was called ‘On the Motion of the Heart’ and published in 1628 and challenged bleeding as a cure.
• How did Harvey challenge Galen?

  He showed the heart was the centre of the human body, not the liver.
• What was the reaction to Harvey’s discoveries?

  People opposed his ideas as capillaries are too small to be seen to the naked eye so they didn’t exist.
• How did John Hunter develop better approaches to Surgery?

  In his time working with the army, Hunter disproved the idea that a gunshot injury poisoned the area around the wound which had led to unnecessary treatments - for example, cutting out the area around a wound. Hunter’s army work and observations also led him to argue that amputation should only be carried out as a last resort. He experimented with various ways to try to save wounded limbs.
• How did hospitals develop in the 1700s?

  They were funded by the charitable gifts of private people, e.g. banks and merchants, and sometimes local people came together for the construction and running of these new hospitals. Most treatments were still based of the 4 humours theory in terms of purging and bleeding. The poor were given medicine for free. People began to abandon the idea that disease was a punishment for sin and a more evidence-based, scientific point of view towards illness was needed.
• New discoveries made in 17th/18th centuries

  Robert Burton's study of mental illness, 1621 blamed lack of exercise, idleness, and excessive pleasure for ‘melancholy’. Recommended fresh air, exercise, music and laughter as a remedy.

  1671: Jane Sharp's ‘The Midwives Book’ and argued midwifery was for women when it was becoming increasingly male-dominated.

  1698:  Sir John Foyer’s ‘A treatise on Asthma’ identified its causes & recommended clean air and diet.

  1724: George Cheyne - a poor lifestyle --> obesity.

  1753, James Lind scurvy cure = eating lemons and limes.
• How deadly was smallpox?

  Very. 30-60% of people who caught it died and survivors were covered in scars, and some were left blind. Major epidemics killed at least 35 000 in 1796 and 42 000 between 1837 and 1840.
• What was inoculation?

  Early form of vaccination where the skin is scratched rather than injected with the pathogen.
• How did Edward Jenner discover a vaccination for smallpox?

  He found out the milkmaids who caught cow pox never caught smallpox, so reasoned that cowpox gave people immunity to smallpox and experimented on a 9 year old boy called James, who had had neither cowpox nor smallpox and injected him with pus from the sores of a milkmaid with cowpox. When he had recovered from cowpox, Jenner gave him a dose of smallpox but James was immune, proving his hypothesis.
• What impact did vaccination have on smallpox?

  In 1853,it was made compulsory, even though the government had a Laissez-faire attitude. In 1871, parents were fined if they didn’t vaccinate their children and the death rate decreased dramatically so in 1887 the government allowed parents to refuse to vaccinate their children. Smallpox was eradicated in 1977.
• How did people react to Jenner’s discovery of vaccinations for smallpox?

  People felt it was wrong to inject cowpox into someone. Others argued that smallpox was God’s punishment for leading a sinful life so they shouldn’t try to interfere with it or stop it from spreading.
• What did people think caused the plague in the 17th century (page 47)

  Some people made the connection with plague victims and poorer, dirtier parts of London so linked dirt and disease. Other causes were miasma, evil spirits, animals.
• Plague 1665 government protective measures

  The King of England & the Mayor of London's measures: all public entertainment was stopped; pigs and other animals were kept out of the city; dogs and cats were caught and killed; rubbish was cleared from streets, fires were lit to drive away bad air, houses with plague victims were sealed for 40 days; no one could enter the city without a certificate of health; bodies were burnt after dark but not in churches of churchyards; public prayers were said on Wednesdays and Fridays; and weekly fasts had to be held.
• How deadly was the plague of 1665?

  This was the worst outbreak of plague in England since the black death of 1348. London lost roughly 15% of its population. While 68,596 deaths were recorded in the city, the true number was probably over 100,000.
• What did most people in early 19th century think caused disease?

  Most people still believed ill-health was caused by bad air, ‘spontaneous generation’ or an imbalance of the 4 Humours. 
• What did most people in early 19th century think caused germs/infection?

  Spontaneous generation – microbes can appear as if by magic when something rotted.
• What discovery did Pasteur make that challenged spontaneous generation?

  Germ theory -the idea that disease is spread by tiny organisms called germs.
• How did people react to Pasteur’s discovery?

  People didn’t believe him as he didn’t have proof that microbes were the cause of disease, he didn’t support the theory of spontaneous generation, and he wasn’t a doctor -he was a chemist.
• What impact did Pasteur’s discovery have on diseases and surgery?

  He is responsible for hospital cleanliness and for us washing our hands before eating to get rid of germs. He came up with the rabies vaccine and learnt how to ‘grow’ vaccines in a laboratory, building on Jenner’s work.
• How did Islam help medical progress up to 1500?

  Muslim writers like Avi Senna saved l almost lost in the dark ages, translating the works of Ancient Greece and Rome into Arabic, which eventually passed on to Western Europe. He wrote books like 'Canon of Medicine,' which became the standard European medical textbook used to teach doctors in the West until the 1500s. Hospitals in the Islamic Empire treated patients & didn't just care for them. Cleanliness was encouraged. Islamic hospitals often contained lecture rooms, pharmacies, libraries - they were places for medical education.
• How did Medieval hospitals help medicine in the Medieval Period?

  They provided for people who were old and unable to work, monks and sisters who often ran the hospitals had some knowledge of herbal medicine, and there is evidence of monks knowing how to amputate limbs, make surgical instruments and induce birth.
• How did Medieval hospitals not help medicine in the Medieval Period?

  Not everybody could be admitted to hospital, the main treatment was prayer which was ineffective, there were very few physicians or surgeons, and often the most needy were not admitted into hospital.
• Medieval 'doctors'.

  The local 'wise woman' used various herbs to produce homemade medicines and potions. Barber-surgeons were less respected than university-trained doctors but were more common. They travelled around the country and combined hair cutting with small surgical operations such as bloodletting and tooth extraction.

  Ordinary people depended on the apothecary, who would sell medicines, herbs and spices from his shop in town.

  If you could afford it, you could visit a university-trained doctor. but there were very few of them and they were expensive.
• Who made progress in surgery in the medieval period?

  John Bradmore (used honey and wine as an antiseptic and nvented a medical instrument to safely remove the arrowhead)

  Hugh and Theodoric of Lucca (Italian surgeons who questioned the idea of Galen that pus in a wound was a sign that it was healing. To clean wounds, they used wine, which has antiseptic properties.)
• Give 2 pieces of evidence for good public health in the Medieval Period.

  Bathhouses were built in medieval towns, some towns had aqueducts which helped transfer water.
• Give 2 pieces of evidence for poor public health in the Medieval Period.

  There were animals everywhere, as they were used for transport, so there was often dung everywhere. There were open drains which often overflowed for waste and water.
• How did town councils help public health in the Medieval Period?

  The London local council made householders who used the stream pay a fee to have it cleaned each year (1374). Worcester council said that the blood and guts of butchered animals had to be carried away the same night (1466).
• Why was public health better in monasteries than in towns during the Medieval Period?

  It was better because of the wealth of the monasteries, the environment as they were often located far from cities, the facilities with advanced water systems, and the monks who had a religious routine of cleanliness and who were educated and disciplined.
• ⁠What was the Black Death?

  A disease which began in Asia and travelled rapidly along trade routes to western Europe. It killed nearly half of Europe's population, arriving in England in 1348. It killed roughly 1.5 million people in Britain and in some cases entire villages were wiped out.
• What different things did people think caused the Black Death?

  The planets, God, bad smells, the Jews, the four humours, and natural disasters.
• What cures/treatments did people use against the Black Death?

  Bathing in urine 3 times a day, or drinking it once a day, avoiding plague victims, attending church and praying for your soul, and carrying evil smells and spices to keep away bad smells.
• What were the different impacts of the Black Death on Medieval England?

  By the end of 1350 the impacts of the Black Death had subsided. However, there were further outbreaks in England between 1361- 93. It also returned in the early 1400s and throughout the next 200 years. In 1603 it killed 38000 in London and in 1665 it killed around 200000, 1/4 of London's population.