medicine

• Ideas about cause of disease- supernatural and astrology M

  The church was super powerful - believe in heaven and hell

  • No education, so people learn from church.
  • They believe God sent the disease as punishment and punishes sinners

  Astrology

  • Ideas that the position of starts affected our lives. Physical would consult star charts and when a patient was born to make a diagnosis
• Ideas about cause of disease - 4 humours

  Ancient idea first put by Hippocrates - a greek physician and philosopher.

  • Body is made up of 4 humours (liquids). If these humours are in balance, you will be healthy, if they are unbalanced, you will be ill.
  • Galen (roman physician) developed idea with theory of opposites. (He also believed in the Ancient Greek theory)

  For example, if you had a phlegmy cold, this should be balanced by eating something hot like a pepper.

  Miasma

  Bad smelling thought to be harmful - corses, rotten matter swamp through to be disease.
• Approaches to treatment and prevention -

  religious/supernatural

  • Prayer, saying mass, fasting, going on pilgrimage - all adviced. Some believe sent by God as punishment so should to try treat it.

  Humoural Treatment

  • Physician suggested a treatment for each symptom, including bleeding, purging; bathing (only available for rich) , remedies (from herbs and spices)

  Prevention

  • Pray, Practise basic hygiene (as recommended In the Regimen Sanittis), Purifying bad air e.g - carrying a sweet - smelling 'posy'; some measures were taken to keep town clean, like clearing animal corpses.
• Who cared for the sick?

  • The Physicians were university educated, - expensive so only available to rich - They diagnosed illnesses by observing samples of: urine/faeces/blood; consulting astrological charts.
  • Apothecary mixed herbal remedies
  • Surgeon - performed basic operations and bleeding.

  Approximately 1100 hospitals by 1500, 30% run by church. Provided clean place to rest and eat well. Many hospitals were places for travellers to stay.

  • Most people cared for at home (kept clear, fed, herbal remedies), this was generally considered to be a woman's role
• Case study - Black Death (1384)

  Killed a 1/3 of British pop, 1348-50.

  Bubonic plague: spread by fleas on rats

  Pneumonic plague: spread by coughing.

  Ideas of cause

  People did not understand the real cause, they thought it was: - - Punishment from God

  • Imbalance of 4 humours
• Case study - Black Death (1384)
Killed a 1/3 of British pop, 1348-50.Bubonic plague: spread by fleas on ratsPneumonic plague: spread by coughing.Ideas of cause People did not understand the real cause, they thought it was:

  • Punishment from God
  • Imbalance of 4 humours
• CS- The Black Death (1384)

  
Killed a 1/3 of British pop, 1348-50.

  Bubonic plague: spread by fleas on rats

  Pneumonic plague: spread by coughing.

  Ideas of cause

  People did not understand real cause, thought:

  • Punishment from God
  • Imbalance of 4 humours

  How was it dealt with?

  Prayer/fasting/flagellation

  Light fires/carry 'posies' to ward off miasma

  Local Govs tried control by:

  building new cemeteries, close parliament by 1349, enforcing street cleaning in cities but this did not happen often.

  Consequences of Black Death

  • Fewer workers, demand higher wages and had more freedom.
• Medieval 1250-1500. E.G of continuity CS

  People still believed in ideas of Hippocrates and Galen: 4 humours, miasma

  Church - controlled education, very few books, therefore very few ideas and little spread of new information

  MINOR CHANGE:

  Use of the Regimen Sanitatis, resulted in more hygienic conditions, although only slightly.
• Key individuals - medieval (1250-1500)

  Hippocrates- Greek physician and philosopher , devised idea of 4 humours.

  Gallen - Roman physician , author of +60 books. Ideas were basis of medical understanding.
• Renaissance - 1500 -1700

  Ideas about cause of disease

  • Church had less control over life, so chance to spread new ideas
  • The printing helped ideas to spread
  • Royal scientists allowed scientists to gather, share research

  This led to lots of new ideas E.G -

  • Better understanding of anatomy - blood circled around body
  • Existence of 'animalcules'
  • 4 Humours theory was proved wrong by scientists. Most people still believed so physicians continued with old methods - e.g bleeding.
  • Miasma still believed.
• Approaches to treatment

  • Transference - disease could be transferred to an object by rubbing it Lots more herbal remedies available from newly discovered lands of the new worldNew science of chemistry resulted in lots of chemical cures e.g - antinomy used to treat typhus.

  In addition,

  Apothecaries and surgeons were better trained

  Less hospitals were available as many has been run by monasteries which were closed down by Henry VIIII
• Approaches to prevention

  Ideas about cause of disease had advanced, but treatments were still not effective. So prevention still very important.

  • Cleanliness - still important; though less use of public baths since arrival of syphills.
  • Moderation - avoiding too much food, alcohol, cold
  • To prevent miasma - homeowners had to pay a fine if they did not clean outside their homes.
• Great Plague (1665)

  Disease continued to strike after 1348 (Black Death) - 1665 was a particularly bad year, more than 65000 died in London.

  Prevention - measures recommended to avoid plague

  • Prayer
  • Quarantine (plague victim kept isolated)
• Disease continued to strike after 1348 (Black Death) - 1665 was a particularly bad year, more than 65000 died in London.

  Prevention - measures recommended to avoid plague

  • Prayer
  • Quarantine (plague victim kept isolated) - "watchmen" guard houses of victims, cross marked on every affected house
  • Pomander (ball full of sweet smelling stiff) to keep away miasma.
  • Plague doctors wore "bird design" to transfer disease away from patient, mask full of herbs
  • Public meeting, fairs , theatres cancelled
  • Carts traveled through city to collect dead
• Examples of change

  • Understanding 4 humours theory was wrong, although was widely used
  • Better understanding of human body
  • More remedies available from New World (newly discovered lands in America)
  • Use of chemical cures
• Examples of continuity

  • Belief in miasma as a cause of disease
  • Herbal remedies were still popular
  • People still used humours treatments (e.g - bleeding) because patients believe them
• Key individuals

  • Thomas Sydenhams - observed patients symptoms. This enabled him to identify the disease that needed to be treated.
  • Vesalius - anatomist. Found human system was made up of systems and groups of organs that carry out specific functions - "father of anatomy". Carried out dissections, found error in Galens ideas (e.g lower jaw = 1 bone, not 2). Published in "Fabric of the Human Body"
  • William Harvey - discovered how blood circulated round into the body.
• C18 - C19 Enlightenment 


  Ideas about cause of disease

  C18 - Age of "enlightenment" - people thinking for themselves not just following Church.
• Ideas about cause of disease 17 - Louis

  • 1861, Louis Pasteur published germ theory. Observed that "microbes" present in air, these made liquids rot. Proved microbes could be killed (pasteurisation). 1878 published Germ Theory of infection, proving microbes caused disease in humans.
• Ideas about cause of disease 1700- 1900 (Robert Koch)

  • Robert Koch identified different microbes caused different diseases Discovered cholera in 1883. Came up with methods to start bacteria(grow in petri - dish, stain with dye to make easier to see) - these method made it possible for other scientists to make further discoveries. Kochs work meant scientist studied diseases, not symptoms.
• How did the idea of causes of diseases impact Britain?

  • GB doctors - led by Henry Bastin - did not believe In germ theory. They still believed in Spontaneous Generation (microbes spread from rotting matter by miasma)
  • GB government did not accept germ theory until end of C19th.
• Approaches to treatment and prevention 1700 -1900 FN


  Hospitals

  • Florence Nightingale - nurse in Crimean war 1854; hospitals appalling.

  Made changes to the way wounded soldiers treated:

  • Sanitation (cleaning hospital, bedding)
  • Nurses to provide care
  • Good meals provided

  Mortality rate fell from 40% to 2%. Nightingale retuned to GB.

  Set up nursing college; designed hospitals with wards to stop disease spreading and she wrote "Notes on Nursing"
• Approaches to treatment 1700 - 1900

  Surgery: 3 major problems - pain, infection, blood loss (not solved until 20th)

  • Anaesthetic developed to deal with pain
  • Other drugs had been used (Esther) but problems
  • James Simpson developed chloroform. Some opposed as though pain was sent by God, but when Queen Victoria used it, it became popular.
  • Antiseptic developed to deal with infection. After reading Pasteurs get, theory, Joseph Lister used carbolic acid during operations to keep wound clean. Many doctors opposed at first, as carbolic was unpleasant.
• Approaches to prevention (1700 -1900)

  Prevention

  • Edward Jenner developed vaccination to protect against smallpox. Previously people had been inoculated (given small dose of disease to develop immunity).
  • 1776 - Jenner found out you can make someone immune to smallpox by injecting a small amount of cowpox.
  • Lots of opposition from Church, inoculators, Scientists.
• Approaches to treatment and prevention 1700 - 1900 PH


  Public Health

  1848 - public health Act encouraged cities to provide clean water, but not compulsory

  1852 - Government makes smallpox vaccinations compulsory.

  1875 - Public Health Act. Realisation government should intervene to improve living conditions in cities. City authorities forced to: pride clean water, dispose of sewage property, public health officer to monitor outbreak of disease, ensure good new housing.
• 1700 - 1900 Chloera

  • Disease first arrived in London 1831.
  • Particularly affected the poor - those living in slums and workhouses.
  • 3 "epidemics" (major outbreak, killing thousands)

  Government tried to prevent by cleaning slums to prevent miasma - didn't work
• 1700 - 1900. Examples of change

  • Germ theory - understanding that germs cause disease
  • Surgery became faster
  • Hospitals more clean
  • Government became more involved in health/medicine
  • Vaccines developed prevent disease.
• 1700 - 1900 Examples of continuity

  • Many people still believed in Miasma
  • Still major public health issues in cities. Widespread poverty
  • No cure for blood loss in surgery
  • There was better understanding of causes of disease, but few cures.
• Key Individuals - 1700 - 1900

  • Louis Pasteur developed germ theory
  • Robert Koch identified specific microbes and developed methods to study them better
  • Florence Nightingale came up with ideas of modern nursing/hospital design
  • James Simpson discovered chloroform
  • Joseph Lister develop use of carbolic acid to tackle infection in sugery
  • John Snow worked out cholera causes by dirty water
  • Edward Jenner came up with concept of using vaccination
• How did John Snow cause cholera is caused by dirty water? 1700-1900

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