Medicine through time 1000-present day

• Medieval 1000-1485 - Medicine

  • Zodiac charts used for diagnoses and when to operate
  • Avicenna - Islamic doctor - wrote "The book of healing" & "Canon of Medicine"
  • "Canon of Medicine" was used until the 1700s

  IMPROVEMENT

  • War/Religion - Crusades; Arabian medicine more advanced
  • War - Pain killers & antiseptics
  • Communication - Arabs wrote down things lost in Britain during dark ages
  • Religion - established university schools of medicine
• Medieval 1000-1485 - Public Health

  IMPROVEMENTS: (Government)

  • Gongfermers - paid 3x average skilled wage / tonne
  • Muck rakers - street cleaners
  • Surveyors of the pavement - remove waste/rubbish
  • Butchers banned from slaughtering in the city and from selling meat at night

  Religion:

  • Monasteries took water from upstream
  • Physic gardens for herbs
• Renaissance 1485-1799 - Medicine

  Small pox:

  30% death rate. Variolation (inoculation) lowers to 3%. Vaccination lowers to almost nothing
• Renaissance 1485-1799 - Medicine

  People:

  • Edward Jenner - Small pox vaccine
  • William Harvey - "on the motion of the heart" 1628
  • Thomas Sydenham - 'The English Hippocrates' - small pox cool therapy & clinical observation
  • Lady Johanna St John - book of cures and remedies
  • Nicholas Culpepper - "complete herbal", talked to patients
• Renaissance 1485-1799 - Surgery

  People:

  • John Hunter - Wrote down surgical methods; opened a museum in 1783 changing opinions on surgeons; conducted first transplant on a chicken
  • Ambrose Paré - egg yolk, turpentine & roses oil instead of cauterisation oil
  • Andreas Versailius - Gibbet man - "the construction of the human body" 1543 finds over 200 errors in Galen's work on anatomy
• Renaissance 1485-1799 - Public Health

  Edward Jenner small pox - 1796 tests first vaccine on 8 year old James Philips

  100000 die of The Great Plague in London alone
• Smallpox and vaccine dates

  1796 - Jenner tests smallpox vaccine on 8-year old James Philips

  1802 - Jenner given £10000 to open vaccination clinic

  1840 - Vaccination is made free for all infants

  1853 until 1887 - Vaccination made compulsory for all children

  1871 until 1887 - Parents can be fined for not vaccinating their child

  1979 - Smallpox irradiated worldwide
• 1800s - Medicine

  • 1850 - 36 specialist hospitals in London alone
  • 1850s - Pasteur asked to see why beer going off
  • 1861 - Pasteur publishes germ theory
  • Pasteur creates vaccines for chicken cholera and rabies
  • 1878 - Koch isolates septicaemia causing bacteria
  • 1882 - Koch isolates TB causing bacteria
  • 1883 - Koch isolates cholera causing bacteria
  • 1889 - Infant mortality at 142 per 1000
  • 1894 - Erlich creates anti-diptheria serum
  • 1910 - Erlich creates Salvarsen-606 "magic bullet" for syphilis
• 1800s - Surgery


  • 1847 - Simpson and friends test chloroform
  • 1853 - Queen Victoria uses chloroform for birth of Leopold. Goes against church who are saying anaesthesia shouldn't be used for childbirth
  • Pre discoveries, Lister has 50% death rate. After discoveries, infection rate went down 90%
  • 1858 - All surgeons regulated by General Medical Council
• 1800s - Public Health

  Cholera timeline

  • 1830 - first case
  • 1832 - outbreak - 52000 dead
  • 1848 - outbreak - 53000 dead
  • 1854 - Broad Street water pump
  • 1854 - Grand Experiment
  • 1866 - Less severe outbreak
  • 1883 - Koch isolates the bacteria which causes cholora
• 1800s - Public Health


  • 1842 - Sir Edwin Chadwick publishes "An inquiry into the sanitary condition of the labouring population of Great Britain"
  • 1848 - Public Health Act - REQUESTED all councils to provide clean water
  • 1850s Crimean War - Florence Nightingale reduces death rate by 40%
  • 1858 - Great Stink
  • 1859 until 1868 - Bazelgette's sewers built
  • 1875 - Public Health Act - All councils forced to provide clean water and sewers [bit late as this is 20 years after John Snow]
• Modern - 1900-present day - Medicine

  Penicillin

  • 1880s - Lister uses it but doesn't record it or keep using it
  • 1928 - Alexander Fleming rediscovers penicillin by chance
  • 1929 - Fleming publishes his findings but doesn't have funding for further research
  • 1937 - Howard Florey & Ernest Chain start researching penicillin
  • 1940 - tested on mice
  • 1941 - Tested on a human - bad rose bush scratch, survives 5 days until stocks run out
  • 1943 - used on troops in WWII
  • Britain and USA jointly produce
• Modern - 1900 - present day - Medicine

  1944 until 1956: many other antibiotics and drugs for almost everything produced
• Modern - 1900-present day - Medicine

  • 1950s - Thalidomide drug produced
  • 1962 - Problems are found and the drug is recalled
  • 10000 babies are born deformed with over half dying within the first few months of life
  • Led to medicines act of 1968
  • Led to distrust in chemical medicines with "alternative medicine" eg acupuncture, hydrotherapy, hypnotherapy
  • Led to distrust: Andrew Wakefield 1998 claims MMR vaccine causes autism
• Modern - 1900-present day - Surgery

  Blood Transfusions

  • 1901 Karl Landsteiner discovers different blood types
  • WWI blood stored in paraffinised glass bottles to delay clotting
  • WWI first blood banks
  • 1921 - First voluntary blood donor scheme
  • 1938 - First blood depot opens in Bristol
  • 1940 - Blood stored and transported dehydrated as plasma
• Modern - 1900-present day - Surgery

  WWI surgery developments

  Thomas leg splint

  • 1914 - 80% die from a broken femur
  • 1916 - 80% survive

  Harold Gillies - plastic surgery

  • Government give him money post-WWI
  • 50000 people treated
• Modern - 1900-present day - Surgery

  WWII affects on surgery

  • Sir Archibald McIndoe improved Gillies' skin grafting technique for burns
  • Sir Harold Ridley found plastic splinters were not always rejected by the eye. Leads to cataract surgery
• Modern 1900-present day - Surgery

  Developments

  • 1952 - First kidney transplant
  • 1961 - First pacemaker
  • 1967 - First heart transplant (lived for 18 days)
  • 1977 - First hip replacement
  • 1978 - First IVF baby
  • Keyhole surgery
  • Robotic Surgeons
• Modern - 1900-Present Day - Public Health

  NHS:

  • William Beveridge publishes the Beveridge report in 1942
  • reports of 5 big problems: Squalor, want, disease, idleness and ignorance
  • This, plus impacts of WWII, plus a labour government led to the NHS being established in 1948
• Modern 1900-present day - Public Health

  Problems:

  • 1889 - Charles Booth finds 35% of Londoners live in poverty
  • 1899 - 90% of volunteers for Boer war are unfit to fight
  • 1901 - Seebohm Rowntree finds over half of York's working class lived in poverty
• Modern 1900-present day - Public Health

  Legislative changes in response to Booth & Rowntree findings:

  • 1906 - Education (provisions of meals) act - Free school meals
  • 1908 - Children and Young Persons Act - illegal to sell alcohol, tobacco or fireworks to children
  • 1908 - Old Age Pensions Act - over 70s paid 5s / week, married couples paid 7s 6d / week
  • 1909 - Housing and Town Planning Act - no back-to-back houses
  • 1911 - National Insurance Act - contribution scheme for sick and unemployment pay
• Modern 1900-present day - Public Health

  Great smog of 1953 leads to clean air act of 1956

  1960s rubble from war and slums are cleared
• Renaissance 1485-1799 - Medicine - Edward Jenner


  • Originally, variolation (ground up scabs), used. This lowers death rate from 30% to 3%
  • CHANCE - overhears milkmaids saying they haven't got smallpox as they've had cowpox
  • Uses cowpox pathogens to vaccinate patients - death rate lowers to almost 0%
• Vesalius published - "On the fabric of the human body"
• Ignaz Semmelweis - Reduced death rates from 35% to 1%
• Sophia Jex-Blake - part of the Edinburgh 7 - banned from finishing medical degrees at Edinburgh
• Dr Barnardo - Ragged School - "No destitute child ever turned away"
• What was infant mortality at in 1889?

  142 in 1000
• When did Erlich create the anti-diptheria serum?

  1894
• When did Ehrlich create the Salvarsen-606 magic bullet?

  1910
• How much was who given to do what by who when?

  How much: £10000

  Who: Edward Jenner

  What: Open vaccination clinic

  By who: government

  when: 1802
• When was the smallpox vaccination made compulsory for all children by who?

  When: 1853

  Who: government
• In response to the great stink in 1858, the government funds and orders the construction of sewers in 1865
• 1800s Public Health Acts

  1848 - Requested all councils to provide clean water

  1875 - Forces all councils to provide clean water and sewers

  Bit late - 20 years after John Snow
• The books & papers

  • Avicenna - "Canon of Medicine"
  • Vesalius - "On the fabric of the human body - 1543
  • Harvey - "On the motion of the heart" - 1628
  • Lady Johanna St John - Book of cures and remedies
  • Nicholas Culpeper - "Complete Herbal"
  • Pasteur - Germ Theory
  • Edwin Chadwick - "Report into the sanitary conditions of the labouring population of Great Britain" - 1842
  • Alexander Fleming - Penicillin - 1929
  • Beveridge Report - 1942