MEDICINE

• Challenges faced in the Medieval period

  • Poverty and malnutrition
  • Famine
  • War
  • Everyday life
• Medieval towns

  • Upper stories of houses jutted out into the street, limiting light and air circulation
  • Sewage in the streets
  • Manure and animals
• Medieval houses

  • Damp and mouldy, smoky, dirty, unhygienic
• What people thought caused disease in the Medieval period

  • God
  • Supernatural
  • Miasma
  • 4 humours
• Black Death

  Arrived in England in 1348, killed over a third of the population, had two main forms: bubonic and pneumonic
• Great Plague

  Occurred in 1665, killed one sixth of London
• Attempts to stop the spread of the Great Plague

  1. Houses were marked and quarantined

  2. Searchers of the dead determined the cause of death and collected bodies at night
• Doctors still had no idea what really caused illness and disease, it was only the onset of winter that caused the Great Plague to come to an end
• Effects of industrialisation

  • Industrial towns grew rapidly and became overcrowded
  • No regulations around standards of living, sewage, and water supply
• Cholera

  First appeared in 1831, bacterial infection caused by contaminated food or water, over 100,000 people died in first 2 epidemics
• Typhoid

  Caused by poor sanitation and lack of cleanliness in 19th century, the bacterium that caused it was discovered in 1884
• By the end of the 19th century, knowledge of what caused disease and illness had improved considerably
• Other diseases

  • Tuberculosis
  • Influenza - Spanish Flu
  • HIV/AIDS
• Tuberculosis

  • In the 19th and early 20th centuries, it was associated with poor housing and unhealthy working conditions
  • The tuberculosis bacterium was isolated in 1882, but finding a cure was difficult
  • In the 1950s the introduction of the streptomycin antibiotic, along with better sanitation and vaccination, reduced cases significantly
• Early methods of prevention - the Black Death

  • Hippocrates believed in diet, exercise, and rest
  • Romans built reservoirs to bring fresh water to towns
  • The church ordered people to take part in processions and pray for forgiveness
  • Some people thought bathing increased disease
  • Streets were cleaned because of the miasma theory
• Alchemy

  There was often very little difference between scientists and alchemists in medieval times, many were searching for the 'elixir of life'
• Soothsayers

  Most people relied on the local 'wise women' who built up knowledge of sickness and disease over several generations
• Late 18th and early 19th century prevention

  • Rise of the scientific method: microscopes, stethoscopes, scientific papers being published
• John Snow

  Observed that in an area of very high cholera cases, the men working in the brewer who drank beer instead of water didn't get sick, so he forced them to stop using the contaminated water pump
• Edward Jenner

  Observed that local dairy maids seemed to be immune from smallpox and believed they had immunity because they'd had cowpox, so he inoculated a small boy with cowpox and then smallpox - it had no effect
• In the late 19th century, tens of thousands of people protested against compulsory smallpox vaccines, thinking it was unhealthy or unchristian
• In 1995 a handful of scientists claimed that MMR was causing autism in children, vaccination levels fell and disease cases rose, this was essentially a debate about choice
• Germ theory

  Louis Pasteur discovered that germs caused disease, and Robert Koch identified specific bacteria and realised that antibodies can help to destroy bacteria
• Traditional medieval treatments

  • Wisewomen's herbal remedies
  • Monasteries' infirmaries and herbal cures
  • Priests' power of prayer or pilgrimages
  • Barber surgeons' minor operations
• Bleeding

  Patients were bled to rebalance the humours, involving cutting or leeching
• Zodiac charts

  Used to advise on the best time and way to treat a patient based on their star sign
• Urine analysis

  Colour, smell and taste of patients' urine determined the imbalance in their humours
• Barber surgeons

  • Considered lower status than physicians, who were more educated and focused on diagnosing and treating
  • Problems: no effective anaesthetics or antiseptics, loss of blood
• By the end of the Middle Ages there is some evidence that surgery was improving, with Italian surgeon Theodoric suggesting using bandages soaked in wine to clean wounds as a mild antiseptic
• Undergoing surgery still remained extremely risky, as surgeons had no idea that dirt carried disease and were extremely unhygienic
• Medical Renaissance

  • People began to question the teachings of ancient experts like Galen
  • Vesalius made discoveries in anatomy that highlighted key errors made by Galen
  • Artists made detailed analytical drawings to help physicians deepen their understandings
  • Invention of the printing press meant medical books could be produced more easily and quickly
• Liston

  Carried out first operation with anaesthetics, but had a 300% mortality rate
• 19th century methods of anaesthesia

  • Laughing gas
  • Ether
  • Chloroform
• James Simpson

  First used chloroform successfully in 1847, tried it out on himself and his friends until he found a dose that knocked him out
• Some surgeons wanted their patients to stay awake so they could fight for their lives, and many religious people felt that pain had been sent by God and shouldn't be tampered with
• Joseph Lister

  Discovered that carboxylic spray was a very effective antiseptic in 1867, developed antiseptic surgery by spraying medical instruments
• Blood transfusions

  In 1901 Landsteiner discovered blood groups, allowing blood transfusions, and in 1938 a national blood transfusion service was set up
• Marie Curie

  Discovered two new radioactive elements, polonium and radium, which were crucial in the development of x-rays in surgery
• Alexander Fleming

  Discovered penicillin in 1928 but didn't have the resources to continue research, so Chain and Florey produced it for mass use in the late 1930s
• Modern medical advances

  • Chiropractic treatment
  • Osteopathy
  • Acupuncture
  • Herbal medicine