Medicine in Britain

• Medieval 1250-1500 causes of diseases


  god, astrology, miasma, four humours
• God as a cause of disease (1250-1500)

  The church taught that God made people ill because he was displeased with them or he was testing their faith

  
  

  So people believe there was no need to search for other explanations for disease so medical research was held back
• Astrology as a cause of disease (1250-1500)


  Alignment of planets and stars were thought to cause some diseases

  
  

  Also used to help diagnose a patient
• Miasma as a cause of disease (1250-1500)


  Disease was spread by bad air

  
  

  Related to god because as bad smells indicated sin

  
  

  This theory originated in the ancient world
• The Four Humors as a cause of disease (1250-1500)

  Ancient Greeks thought everyone had a mix of 4 humours in their body

  
  

  Hippocrates and Galen's ideas were respected - still used 1000 years later

  
  

  Black bile, phlegm, blood and yellow bile were the 4 humours

  
  

  People became ill because this mix was unbalanced

  
  

  The theory of opposites was further developed by Galen and inspired many treatments (balance the humours by giving the patient the opposite of their symptoms)
• Methods of prevention - religious and supernatural (1250-1500)


  Living a Christian life, praying, going to church, carrying lucky charms, self-punishment such as flagellation (punishing yourself so God wouldn't)
• Methods of prevention - rational (1250-1500)

  Bathing, purifying the air, bleeding and purging, exercising, not overeating, physicians were sent urine of the wealthy, keeping towns clean
• Treatments (1250-1500)

  Herbal remedies, bleeding and purging, praying, fasting, going on a pilgrimage, surgery
• Women caring for the sick (1250-1500)


  Treated at home by women

  The 'wise woman' would also tend to people in their homes for free

  Used herbal remedies
• Barber surgeons (1250-1500)


  Trained as apprentices through observing others

  Basic surgery such as bleeding, sewing up wounds and making splints

  No effective anesthetiser but still amputated limbs

  Cost less than a physician
• Apothecaries (1250-1500)


  Received training but no qualifications

  Mixed medicines and ointments based on knowledge or physicians orders

  Herbal remedies used
• Physicians (1250-1500)

  Medically trained at university

  Diagnosed illnesses and gave treatments or more likely sent patients to barber surgeons or apothecaries

  Expensive

  Very few of them

  Observed symptoms like pulse, skin colour and urine

  Consulted urine charts

  Consulted zodiac charts
• Hospitals (1250-1500)


  Nuns and monks ran them so emphasis was on God and healing souls

  One of the most famous early hospitals was St Bartholomew's in London

  By 1400 over 500 hospitals

  Travellers and pilgrims stayed their on journeys

  Kept very clean

  Patients given fresh food and rest
• The Black Death date?

  1348-9
• How many did the Black Death kill?

  One third of Britian's population
• Black Death symptoms

  Large lumps filled with pus, fever and chills, headache, vomiting, diarrhoea and abdominal pain
• Treatments for the Black Death

  Praying, lucky charms, cutting open buboes to drain pus, holding bread against the buboes then burying it, eating cool things and taking cold baths
• Causes of the Black Death (believed)

  Religion - god sent the plague as a punishment for sins

  
  

  Astrology - positions of Mars, Jupiter and Saturn was unusual

  
  

  Four humours - disease was caused by imbalance

  
  

  Outsiders - strangers or witches had caused the disease

  
  

  Miasma - bad air or smells
• Prevention of the Black Death


  No one could stop or cure it - only God (services were held, people prayed for forgiveness, fasting)

  
  

  Clearing up rubbish in streets

  
  

  Smelling bad smells because this would overcome the plague

  
  

  Lighting a fire or having birds flying around the room to keep air moving

  
  

  Carrying herbs and spices to avoid bad air

  
  

  Not letting unknown people enter towns or villages
• Cause of disease (1500-1700) CONTINUITY

  Miasma continued to be believed to be a cause of disease especially in epidemics

  4 humours theory continues to be accepted although by 1700 very few physicians still believed in it
• Cause of disease (1500-1700) CHANGE

  Fewer people began to believe in religious or supernatural causes - various new explanations for disease were suggested (seeds in air spreading disease)

  
  

  Fewer people believed astrology caused disease

  
  

  Due to improved knowledge of digestion, physicians realised urine was not a good indicator of disease and stopped using it

  
  

  Physicians carried out more direct observations and examinations of patients
• Other changes (1500-1700)

  Religious ideas (reformation) challenged authority of the Catholic Church making it hard for the Catholic Church to promote ideas about science

  
  

  Still very religious but began to look for more logical explanations of disease
• Development of printing press and it's impact on medicine (1500-1700)


  Invented around 1440 so by 1500 there were hundreds of printing presses in Europe

  
  

  Meant exact copies of texts could be copied quickly

  
  

  Helped reduce church control as it could no longer prevent the spread of ideas that it disapproved of

  
  

  Ideas could be spread more effectively and across a much wider area
• Royal society (1500-1700)


  Aimed to further scientific understanding by carrying out and recording results of experiments

  
  

  Sharing scientific knowledge and encouraging new theories and ideas

  
  

  Sponsored scientists to enable them to carry out research

  
  

  1665 philosophical transactions was published > meant scientists could share work and ideas
• How did hospitals changed from 1250-1500 to 1500-1700

  more sick people were treated

  many hospitals closed because of the dissolution of the monasteries

  when hospitals reappeared they were run by physicians and less focused on religion

  More pest houses began to appear where people suffering from particular contagious diseases could go for care
• What did women do for the sick in 1500-1700

  Still cared for people at home as physicians were still expensive
• How did treatments and prevention change from the medieval period?

  Miasma was removed through draining swamps, removing sewage and rubbish

  Clothes were regularly changed

  New herbal remedies appeared and some were effective

  People rubbed objects on themselves to transfer disease to the object
• Apothecaries and surgeons role between 1500-1700


  no university training and still inferior to physicians

  better trained though and a licence was now needed to have these jobs which was issues after completing training
• Continuity in the role of physicians 1500-1700


  still university training

  still based on textbook learning rather than practical experience
• Change in the role of physicians 1500-1700


  better access to wider variety of books and drawings

  new ideas led some to become more practical and experimental

  dissection was legalised
• why in general was there a lack of change in 1500-1700?

  ideas too slow to be accepted

  they did not have any direct improvement of treatments or prevention of disease

  did not improve understanding of the cause of disease
• Andreas Vesalius discovery


  dissected bodies and proved that Galen was wrong about the anatomy

  proved that the jaw bone is made from one bone not two (Galen said this)

  The breastbone has 3 parts not 7( Galen said this)

  Blood does not flow into the heart through invisible holes (Galen said this)
• Importance of Andreas Vesalius work

  Improved understanding of the body

  Made study of the anatomy fashionable

  Proved some of Galen's work was incorrect - encouraged others to question Galen's theories

  Inspired doctors to carry out dissections

  Work was widely published throughout Europe
• How did Andreas Vesalius do it?


  Science and technology - printing press (fast, flawless)

  Individuals - inventive and determined (stole the body of a criminal so he could dissect it)

  Seeking improvement - vital to ask questions and challenge Galen's ideas
• William Harvey and his discovery

  Discovered blood circulation

  Researched Vesalius' theory that blood flowed to the heart and proved it through dissection

  Proved veins carry blood not air (Galen said this)

  Discovered arteries and veins were one system and that blood pumped around the body by the heart
• Importance of Harvey

  Proved some of Galen's ideas were wrong so people questioned his other ideas

  Improved knowledge about how the body worked and passed this on

  As a royal doctor, his work gained publicity and credibility

  Scientific methods were copied by others

  Left unanswered questions which encouraged further experiments
• How did Harvey do it?

  Individuals - thorough - spent hours repeating experiments

  Seeking improvement - not satisfied to believe Galen was correct

  Science and tech - influenced by water pumps

  Communications - read previous work of scientists
• The great plague date

  1665
• Great plague causes

  Miasma

  Less people thought 4 humours

  Knew disease could be spread person to person
• Treatments of Great plague

  Herbal remedies

  tried to transfer disease to to other objects

  sweat the disease out