Health and the people

Question 1

what were the 3 main ideas of about the cause of disease in the medieval period

Answer 1

Miasma , imbalance of the 4 humors , punishment from God

Question 2

name 3 different common treatments from the medieval period

Answer 2

blood letting , praying , herbal remedies

Question 3

what was the significance of Avicenna

Answer 3

wrote a book called cannon of medicine, discussed obesity and anorexia and listed 760 new drugs

Question 4

what was the significance of Rhazes

Answer 4

firstt person to distinguish measels from small pox

Question 5

In the medieval period, whose ideas were treatments based on

Answer 5

galen and hippocrates

Question 6

when was the black death

Answer 6

1348

Question 7

how many people were killed by the black death in Britain and Europe

Answer 7

1.5 million in Britain and half of Europes population

Question 8

what did people believe the cause of the black death was in 1948

Answer 8

imbalance of the 4 humors, punishment from god and miasma

Question 9

what was the real cause of the black death

Answer 9

disease from fleas that traveled on rats

Question 10

why did the black death spread so fast

Answer 10

poor hygine, dirty streats, bad disposable of bodies and laws about cleanliness were hard to enforce

Question 11

what was public health like in towns in the medieval period

Answer 11

crowded houses, sewege in streets and drinking water

Question 12

what did councils do to try to improve public health

Answer 12

enforce laws encouraging people to clean up more, stop pollting water and rivers

Question 13

what was public health like in monasteries

Answer 13

much better than towns, baths were more common, drinking water was seperated, isolated from dirty towns

Question 14

what were ideas like before versailles

Answer 14

galens ideas dominated medicine and disections were done to prove him

Question 15

what did versailus do

Answer 15

wrote ‘fabric of the body’ , encouraged students to do disections

Question 16

What was the reaction to Vesalius and his contribution to medical progress?

Answer 16

he was criticised for opposing the ideas of Galen, 1545 his illustrations were copied into ‘Compendosia’ which had 3 editions, overturning centuries of belief in Galen and laying the foundations for better treatments in the future.

Question 17

What was surgery like before Pare?

Answer 17

most treatments were agonising, gunshot wounds were thought to be poisonous, wounds were cauterised with hot oil to stop bleeding

Question 18

What did Pare do?

Answer 18

Discovered healing cream on the battle field when his hot oil ran out so his patients slept well and healed fast. He used ligatures to stop bleeding in amputations

Question 19

What did Harvey do?

Answer 19

challenged Galen by saying blood circulated around the body, dissected human hearts and proved that blood travelled one way by testing valves with wax, published a book ‘De Motu Cordis’ in 1628 about circulation

Question 20

What was the reaction to Harvey and his contribution to medical progress?

Answer 20

he was criticised/ignored for opposing Galen as there was still a lot he couldn’t explain, however many doctors accepted his theory. His discovery was important as blood tests, blood transfusions and transplants wouldn’t be possible without knowledge of circulation.

Question 21

When was the Great Plague?

Answer 21

1665-1666

Question 22

how did people try to treat the great plague

Answer 22

blood letting, animals to ‘draw out’ the plague, making fires to burn out the bad air

Question 23

What was similar about the Black Death and the Great Plague?

Answer 23

In both cases people thought it was caused by god/planets when it was actually caused by disease on fleas on rats that were attracted to dirty areas. In both cases people had no concept of germ theory and tried to ‘ward off evil’

Question 24

Why were there changes to hospitals in the 18th century?

Answer 24

Secularisation of society meant that Christians focused more on helping people and finding cures than letting patients suffer at the hands of God.

Question 25

Who was John Hunter and why were his books/teaching significant?

Answer 25

His books were based on observations, dissections and army experience and they included discoveries about disease, cancer and gunshot wounds
He set up his own surgery practise where he trained successful people like Edward Jenner who impacted medicine in the 1800s.

Question 26

What was smallpox and what were the impacts of it in Britain in the 18/19th century?

Answer 26

A disease that caused fever, headache, pus filled blisters, deep scars, blindness and death.
IMPACT: 1st epidemic in 1756 killed 35000 and 2nd epidemic in 1837-40 killed 42000.

Question 27

What was inoculation

Answer 27

Giving someone a mild dose of a disease from a small pox scab to help boost resistance to it.

Question 28

Who was Edward Jenner and what did he discover?

Answer 28

English country doctor who realised that people who had had cow pox were immune to small pox. In 1796 he tested his theory on an 8 year old boy by injecting him with cow pox pus, letting him recover and then inoculating him with small pox but the small pox never developed. He called this vaccination and repeated it on 16 patients before confirming his theory. He published his findings in 1798

Question 29

Why did people oppose Jenner’s vaccination?

Answer 29

religious objections, Jenner couldn’t fully explain it (lack of germ theory)

Question 30

What were 3 new types of pain relief in the 19th century?

Answer 30

Nitrous Oxide- discovered by Humphrey Davy,
Ether - discovered by William Clarke in 1842,
Chloroform: discovered by James Simpson in 1847,

Question 31

What were 5 ideas about cause of infection in the 19th century?

Answer 31

spontaneous generation, contagionists, anti-contagionists, miasma theory and specificity.

Question 32

Who was Louis Pasteur and what did he do?

Answer 32

French chemist, experimented with growth of microbes (swan necked flask) and how to prevent wine from souring, disproved spontaneity; proved germ theory of disease.
Proved vaccination to work by accidentally giving chickens a weakened form of cholera.

Question 33

Who was Joseph Lister and what did he do?

Answer 33

he was shown Pasteur’s germ theory by Thomas Anderson and thought that a chemical barrier where the skin was broken would stop wounds from getting infected. He used carbolic acid on James Greenlees by soaking his bandages in it, healing his broken leg in six weeks. He left hospital free from infection and without having to have his leg amputated.

Question 34

How did Robert Koch contribute to the acceptance of germ theory?

Answer 34

Identified specific microbes that caused Cholera, Anthrax and Tuberculosis, first to discover a germ that caused a human disease, identified lab method for staining, photographing and cloning bacteria killing organisms, won Nobel prize 1905.

Question 35

What was the long term impact of Koch and Pasteur in Britain?

Answer 35

Encouraged a new generation of scientists to study diseases and find ways of preventing them

Question 36

How many people did the Cholera epidemic kill in 1831? How many cholera epidemics were there between 1831 and 1866?

Answer 36

1831- 50000 killed.
6 epidemics between 1831-66

Question 37

What did people think about the cause of cholera? How was this different/similar to the Black Death and the Great Plague?

Answer 37

people thought cholera was spread by miasma so they cleaned up the streets but they didn’t understand that they needed clean water. Unlike the BD and the GP, a link was made between rising death rates and poor living conditions but people still didn’t have knowledge of germ theory.

Question 38

What was bad about living conditions in cities in the 19th century?

Answer 38

thousands moved from rural to urban areas, factory owners built back-to-back houses for their workers causing disease to spread quickly as they were very crowded, most toilets were outside and shared by many, drinking/cooking water was fed from a pump from a local river that also took away sewage, no fresh running water system

Question 39

What was the key message of Chadwick’s report in 1842

Answer 39

Cleaner air, streets and water were needed in order to improve people’s habits and reduce the spread of disease. A healthier workforce would be economically beneficial in the long run and medical officers should be appointed to take charge of each district

Question 40

What was the reaction to Chadwick’s report in 1842

Answer 40

The government didn’t listen as they believed in ‘laissez-faire’ (not interfering with people’s lives) and MPs didn’t want to spend money on tearing down slums and rebuilding better living spaces.

Question 41

when was the first public health act

Answer 41

1848
wasn’t successful - empowered cities to clean up their streets and recommended local boards of health (not compulsory) so many cities chose to do nothing and in 1854 the Central Board of Health was closed down.

Question 42

Who linked cholera to contaminated water for the first time?

Answer 42

Dr John Snow realised that all the cholera victims in 1854 lived around the same water pump in Soho. He removed the handle so that people had to use another pump and the outbreak stopped.

Question 43

When was the Great Stink?

Answer 43

Summer 1858

Question 44

When was the second Public Health Act? What improvements did it make?

Answer 44

1875
Ordered local councils to appoint Medical Officers for health, remove rubbish and sewage, and supply fresh water

Question 45

What impact did Florence Nightingale have on hospitals?

Answer 45

Her hospital wards in the crimea war became a figurehead for dozens of military/public hospitals

Question 46

What impact did Florence Nightingale have on nursing?

Answer 46

founded the modern nursing profession, opened the first ever nurses’ training programme which still exists, ‘Nightingale Pledge’ recited by all nurses at the end of their training, her influence caused nursing to take on new duties

Question 47

By 1905 what had happened to England’s death rate due to discoveries by Koch and Pasteur?

Answer 47

it had halved

Question 48

How, when and by whom was penicillin discovered?

Answer 48

Alexander Flemming in 1928 was working on killing the Staphylococcus germ and discovered that after leaving some germ plates in his lab, the mould that had grown around them had killed the Staphylococcus - the mould was penicillin. However he didn’t realise the medical significance of this so abandoned his research.

Question 49

How was penicillin developed?

Answer 49

Florey and Chain - discovered Flemming’s report on penicillin and produced enough to test it successfully on 8 mice. Then they tested it on policeman Albert Alexander, who’s infection cleared up but then he died when the penicillin ran out. They turned their Oxford labs into mass producing factories.

Question 50

How as penicillin mass produced?

Answer 50

It was greatly needed for ww2 soldiers, so in 1941 Florey persuaded the US government to fund it. By 1945 Britain and USA had treated 250,000 patients with penicillin as the first antibiotic. After the war drug companies used their production methods to make penicillin open to the public.

Question 51

What was Rowntree’s report called and what did he find?

Answer 51

‘Poverty: A study of town life’
York - 28% population didn’t have the minimum money to live on at some point in their lives

Question 52

What was Booth’s report called and what did it find?

Answer 52

‘Life and Labour of the People in London’
30% population didn’t have enough money to eat properly despite full time employment and demonstrated a link between poverty and high death rate.

Question 53

What were the Liberal reforms aimed at children?

Answer 53

1906 - Free School Meals for poor children
1907 - Free school medical check ups, followed later by free treatment
1908 - Children’s Legal Act made it illegal for parents to neglect children as they were ‘protected persons’

Question 54

What were 4 factors that led to the creation of the welfare state?

Answer 54

The Beveridge Report (1942)
World Wars
NHS (1948)
Labour Government (1945)

Question 55

How did the Beveridge Report lead to the creation of the welfare state?

Answer 55

Sir William Beveridge released report that said all British people should be free of 5 things: disease, want, ignorance, squalor and idleness. it sold 100,000 copies in it’s first month and increased pressure on governments to improve.

Question 56

How did the NHS lead to the creation of the welfare state?

Answer 56

Aneurin Bevan launched the NHS in 1948, providing everyone with free health care which increased life expectancy and improved quality of doctors/opticians

Question 57

What were limitations and oppositions to the NHS?

Answer 57

many doctors were reluctant to go under government control and lose income
prescription charges introduced in 1950s so NHS wasn’t free anymore
cost of the NHS has risen to £116 billion a year
some hospital beds go unused because of NHS debt
improvement of health care created an ageing population that use a lot of NHS services

Question 58

What were the positive impacts of the NHS and welfare state?

Answer 58

Weekly family allowance payment helped poor people with childcare costs
slums were demolished and new houses built
role of family doctors was improved
maternal mortality rates dropped
women’s life expectancy went from 66 to 82.