Medicine in Britain, c. 1250-present

• Give two supernatural causes of disease believed by people in the medieval England.

  - punishment from God

  - evil spirits
• Describe two rational causes of disease believed by people in medieval England.

  - theory of four humours

  - miasma
• What was the four humours theory?

  A theory created by Hippocrates which taught that the body was made up of blood, phlegm, yellow bile and black bile. They needed to be in balance for good health.
• How did Galen build on Hippocrates' ideas?

  He created the theory of opposites, a belief that diseases could be treated using opposites to balance the humour causing the disease.
• How did the Church influence medieval medicine?

  - prevented people from finding cures for disease (they thought only prayer and repentance could cure disease)

  - they outlawed dissection
• Name four treatments for disease used by people in medieval England

  - flagellants whipped themselves to show God they were sorry

  - bloodletting and purging

  - burning incense to purify the air

  - prayer
• What were hospitals like in the Middle Ages?

  Many hospitals were run by monks and nuns and provided care for the sick but they did not aim to provide medical treatment
• List three types of people you might visit if you felt ill in medieval England

  - apothecaries to buy herbal remedies

  - barber-surgeons for minor surgery

  - local wise woman for herbal remedies
• Give three ways people tried to prevent the Black Death.

  - burning incense to purify the air

  - prayer and fasting

  - people in Winchester built cemeteries outside of town
• Explain why Thomas Sydenham was important in renaissance medicine.

  - as a doctor, he made detailed observations of his patients and kept accurate records of their symptoms

  - he wrote a book called 'Medical Observations' which as used as a textbook by doctors for 200 years. his descriptions of medical conditions like gout helped other doctors to diagnose their patients more easily

  - he showed scarlet fever was different to measles
• What was Vesalius' discovery and why did it help improve surgery.

  - Vesalius pointed out some of Galen's mistakes. for example, in the second edition of 'The Fabric' he discovered there were no holes in the septum of the heart.

  - his findings encouraged others to question Galen and showed dissecting bodies was important

  - this helped people learn more about human anatomy, improving surgery
• What did Harvey discover and why did he have a limited impact on diagnosis and treatment?

  - he discovered that blood circulates through the body

  - his discoveries gave doctors a new map showing how the body worked. without this map, blood transfusions or complex surgery couldn't be attempted.

  - this had a limited impact on diagnosis and treatment because when people did attempt blood transfusions they were rarely successful and bloodletting continued to be used anyways
• Describe the impact of the printing press on people's understanding of medicine.

  - It allowed new ideas to be spread much faster and debated more easily

  - Books could be copied much more easily
• How did the Royal Society change perceptions of medicine?

  - Its motto was 'take no-one's word for it', the society wanted to encourage people to question scientific ideas

  - Through its scientific journal 'Philosophical Transactions', more people could read about new inventions and discoveries
• List five ways in which there was continuity between medieval and renaissance medical treatments

  - many doctors continued to do bloodletting and purging

  - doctors were still expensive so people used other healers

  - superstition and religion were still important

  - people sought care from wise women (for example, Lady Grace Mildmay)

  - hospitals were still very basic
• List five treatments people used against the Great Plague

  - bloodletting

  - strapping a live chicken to the swellings (they thought it would transfer the plague to the chicken)

  - carrying herbs and flowers to purify the air (miasma)

  - prayers and fasting

  - wearing lucky charms and amulets
• List five prevention methods people used against the Great plague

  - councils tried to quarantine plague victims. the victim's house was locked and a red cross was painted on their door.

  - areas where people crowded together were closed

  - people tried not to touch other people

  - dead bodies of plague victims were buried away from houses

  - councils paid for dogs and cats to be killed (thy thought they carried the plague)
• Describe how Edward Jenner proved the link between smallpox and cowpox.

  He injected a small boy (James Phipps), with pus from the sores of Sarah Nelmes, a milkmaid with cowpox. Jenner then infected him with smallpox. James didn't catch the disease.
• List three reactions by parliament to Jenner's discovery of the smallpox vaccine

  - they gave Jenner £10,000 in 1802 to open a vaccination clinic

  - in 1840, vaccination against smallpox was made free for infants

  - in 1853, vaccination against smallpox was made compulsory
• What was Pasteur's germ theory? (1861)


  he argued microbes in the air caused decay, not the other way. he also suggested that some germs caused disease.
• Why did it take time for the Germ Theory to have an impact?

  - People couldn't believe tiny microbes caused disease.

  - The germ responsible for each disease had to be identified individually so this meant it was several years before the theory became useful.
• How did Robert Koch build on Pasteur's work?

  - He linked specific diseases to the particular microbe that caused them.

  - For example, he identified anthrax spores (1876), and the bacteria that cause tuberculosis (1882) and cholera (1883).
• Explain how Florence Nightingale changed nursing.

  - in 1859, she published a book, 'Notes on Nursing' emphasising the need for hygiene and a professional attitude

  - she set up the Nightingale School of Nursing in St. Thomas' Hospital. nurses were given three years of training before they could qualify.

  - in 1919 (after her death) the Nurses Registration Act was passed. this made training compulsory for all nurses
• Name the year that chloroform was discovered and explain why it led to a higher death rate initially.

  1847. Anaesthetics led to longer and more complex operations. The longer operating times led to higher death rates from infection
• What is the difference between antisepsis and asepsis?

  Antisepsis is used to kill germs near surgical wounds. Asepsis aim to stop any germs getting near the wound.
• Describe John Snow's 1854 investigation and explain what he showed.


  - he interviewed people living in Broad Street and made a map of the area showing where cases of the disease had been

  - his information was published in his 1855 report which showed that all the victims used the same water pump on Broad Street

  - he showed that cholera was spread through the contaminated water
• What did the Public Health Act force councils to do? (1875)


  - appoint health inspectors and sanitary inspectors to make sure laws on water supplies and hygiene were being followed

  - maintain sewerage systems

  - keep their town's streets clean
• Describe three causes of disease that have been discovered since Pasteur's Germ Theory

  - viruses

  - genetics

  - lifestyle
• What did Watson and Crick discover in 1953 and how did it help medical diagnosis?

  They discovered the double helix structure of DNA. Their discovery allowed other scientists to find the genes that cause genetic conditions.
• How did the knowledge of genetic conditions improve diagnosis and treatment of them in the 20th century?

  Scientists can now produce a synthetic protein to replicate the work of a faulty gene and treat inherited conditions using techniques like gene therapy
• When were x-rays discovered? How are they used in medical diagnosis?

  1895. They give doctor's a detailed picture of what's going on in side their patient's body.
• How did Fleming contribute to the production of penicillin?


  He looked at old petri dishes and noticed that the bacteria he had grown were being killed by a mould - penicillin.

  He published findings in articles between 1929 and 1931 but nobody was willing to fund his research.
• How did Florey and Chain contribute to the production of penicillin?

  They found a way to purify penicillin between 1938 and 1940 by devising the freeze-drying technique.

  Florey knew penicillin could be vital in treating the wounds of soldiers but British chemical firms were busy making explosives so he went to America.
• How did the US government contribute to the production of penicillin?

  In December 1941, the US government gave out grants to businesses that manufactured penicillin making it more accessible for general use
• What was the first magic bullet?

  Salvarsan 606, which killed syphilis, discovered by Ehrlich in 1905
• What was the second magic bullet?

  Prontosil, which cured some types of blood poisoning, discovered by Domagk in 1932
• Give three advances in surgery since 1900 and explain how they have made surgery safer

  - blood transfusions, solved the problem of blood loss

  - immunosuppressants, made transplants safer and more successful

  - key-hole surgery, increased precision
• List five factors that led to the founding of the NHS in 1948.


  - at the start of the 20th century, poor people couldn't afford to access healthcare

  - in 1901, there were 140 infant deaths for every 1000 births

  - when the Boer war broke out in 1899, army officers found that 40% of volunteers were physically unfit for military service

  - the raising of a mass army made powerful people notice the health problems of the poor

  - the Blitz of 1940 prompted the government to set up the Emergency Medical Service which offered free treatment to air raid casualties
• How has the NHS improved access to healthcare?

  Made it free and accessible to everyone

  Provide dental, mental and surgical care
• Describe the diphtheria government vaccination campaign

  - In 1940, there were over 60,000 cases of diphtheria and over 3,000 deaths

  - After fears that wartime conditions could lead to the spread of the disease, the government started a vaccination campaign in 1940

  - The government ran publicity campaigns, using posters, newspaper ads and radio broadcasts

  - By 1957, the number of diphtheria cases dropped to 38, with only 6 deaths.