Health and the People

• medieval hospitals


  - between 1000 and 1500, 700 hospitals started in England

  -> centres of rest for recovery in quiet and clean surroundings

  -> some small, with only enough space for 12 patients (like the disciples)

  -> didn't have doctors but a priest and were run by monks/nuns - strict pattern of diet and prayer

  
  

  - depended on charity for money and mainly financed by church or patron

  
  

  - several types of hospitals:

  -> asylums like Bedlam in London

  -> monasteries with infirmaries that provided free treatment for the sick/poor

  -> a few large hospitals like St Leonards in York:

  -> special hospitals called 'Lazar houses' for the contagious leprosy disease that were outside towns
• medieval surgery

  - surgery was limited as surgeons could not help with deep wounds -> these patients would die from bleeding, shock or infection

  
  

  - most common procedures were:

  -> bloodletting (done to balance the humours)

  -> amputation (successful in cases of breast cancer, bladder stones and haemorrhoids)

  -> trepanning (epilepsy thought to be caused by demons in brain so hole drilled into skull to remove them)

  -> cauterisation (burning wound with heated iron to stop flow of blood, very painful)

  
  

  - they used natural substances for anaesthetics e.g. mandrake root, opium or hemlock but too much may kill patient

  
  

  - they had no idea dirt carried diseases and some believed it was good to cause pus in wounds
• Medieval Public Health: water supply

  - as towns grew, the existing systems of water supply could not cope with increasing demand

  -> towns like Exeter and London used new tech with pipes made of wood or lead

  -> many used the rivers to remove sewage and some threw toilet waste onto the street

  -> people still got water from rivers and wells
• Medieval Public Health: Sewage

  - towns were unhealthy as many people lived close together and their were few regulations about building or waste disposal

  
  

  - clean water was in short supply so water often came from contaminated rivers

  
  

  - waste accumulated in streets

  
  

  - cesspits were not often emptied as you had to pay people to do so, the waste polluted rivers and wells

  
  

  - horses used as transport so created dung everywhere and domesticate pigs roamed about eating scraps before being slaughtered

  
  

  - no sewers so waste chucked into streets and left to rot -> sewage in the streets became deadly in towns as disease spread quickly
• Medieval Public Health: Attempts to improve

  - between 1250 - 1530, number of towns grew as population rose so pressure put on public health facilities

  
  

  - town councils tried to stop businesses who polluted rivers by putting their waste in them

  
  

  - local craft guide tried to restrict the skilled workers activities to certain areas

  -> in Worcester, law of 1466 said entrails and blood of butchered animals had to be removed that same night

  
  

  - some town councils passed laws to encourage people to keep the streets in front of their houses clean and remove their rubbish

  
  

  - in 1371, London mayors and councillors prohibited the killing of large animals within city walls

  
  

  - in 1388, parliament passed a law fining people £20 for throwing dung garbage and entrails into ditches, ponds and rivers - however, was difficult to catch people doing it
• Medieval Public Health: Monasteries and Abbeys

  - christian monasteries were often situated in isolated areas but near to rivers - important to supply water

  
  

  - elaborate systems of pipes to deliver water to wash basins

  
  

  - filtering systems were installed to remove impurities

  
  

  - excellent washing facilities -> done in the lavotorium where waste water could be emptied into a river

  
  

  - had toilets or privies containing potties to collect urine and cesspits which were flushed by diverting river water through them
• Koch's Methods and Discoveries

  Methods:

  - developed technique of growing microbes on a plate made of solidified agar, which encouraged microbes to grow

  
  

  - found ways of using dyes to stain specific microbes under the microscope so they would stand out amongst the other germs

  
  

  - developed ways of photographing microbes so the other scientists could study them in detail and find them in samples

  
  

  Discoveries:

  - 1870s: discovered anthrax germ (deadly disease causing sores on lungs, affecting both animals and humans) -> then able to prove that this bacterium caused disease by injecting mice to make them ill and therefore was able to apply Pasteur's theory to prove germs caused disease

  
  

  - 1878: discovered bacteria that caused septicaemia (blood poisoning)

  
  

  - 1882: identified tuberculosis germ (major killer in 19th century -> his discovery led to a vaccination)

  
  

  - 1883: discovered germ causing cholera (another major killer in 19th century Britain)