health and the people Flashcards

Question

Palliative hospitals Hospitals were designed to help look after the sick not ... Most _______ in medieval times was palliative (relieve symptoms not cure condition) For example, _______ in ______ was founded in _____ to look after those with ______ illnesses.

Answer 1

Palliative hospitals Hospitals were designed to help look after the sick not treat and heal them. Most medicine in medieval times was palliative (relieve symptoms not cure condition) For example, Bedlam in London was founded in 1247 to look after those with mental illnesses.

Answer 2

Medical writings Lots of Ancient Roman and Greek medical texts were lost when the Roman Empire fell. Monks tried to copy and preserve medical texts. Dissent began to be caused by people questioning the Church’s reliance on old books. For example, a monk called Roger Bacon was arrested for challenging the books in the 1200s.

Answer 3

Who funded hospitals? 1 The Church 2 Aristocratic patrons

Answer 4

Some historians have claimed that the Church’s encouragement of the Crusades diverted funds away from hospitals and health towards wars. However, the Crusades meant that Western Europeans met Muslim doctors.

Answer 5

Who were the two key Muslim doctors? 1 Avicenna 2 Ibn Al-Nafis

Answer 6

Abulcasis invented surgical instruments and popularised cauterisation

Answer 7

Muslim hospitals were far more developed than Christian hospitals because they actively sought to treat patients. They had isolation units for patients with contagious illnesses.

Answer 8

Abulcasis, the Islamic physician, wrote a detailed book on: Amputation (cutting off limbs) Fixing (stitching) wounds Dislocations Dental surgery (on teeth)

Answer 9

In the 11th century, Albucasis wrote Al Tasrif, this was a 30-volume book on medicine.

Answer 10

The spreading of medical knowledge trade routes help spread knowledge between civilisation

Answer 11

In the 10th century, Avicenna wrote an encyclopaedia of Ancient Greek and Islamic medicine called ‘Canon of Medicine’. This was vital in Western Europe until the 17th century after it was translated into Latin.

Answer 12

Al-Nafis claimed that Galen was wrong and that blood passed through the heart via the lungs Islam banned human dissection so Al-Nafis could not prove this theory

Answer 13

Examples of Natural Anaesthetics used in Medieval Europe: 1 Hemlock 2 Opium

Answer 14

Lots of surgery in medieval Europe was performed by barber surgeons who were licensed to cut hair and do minor surgery.

Answer 15

In the 13th century, Hugh of Lucca argued that pus was bad for a wound. He began to use wine to disinfect wounds. However, he did not succeed in overturning the dominant idea that pus was necessary for wounds to heal.

Answer 16

John of Ardene Remembered as one of the most famous surgeons in Medieval England, John of Arderne established the ‘Guild of Surgeons’ in 1368. He based his book, Practica, on his experiences in the war with France and his knowledge of Ancient Greek and Arab medicine. Ardene created his own forms of painkillers from substances such as opium.

Answer 17

What were the three main problems of surgery in medieval times? ``` 1 Pain 2 Infection 3 Bloodloss ```

Answer 18

The four common surgical procedures in medieval Europe were: Trepanning Cauterisation Amputation Bloodletting

Answer 19

In medieval times, there was a very limited understanding of what causes diseases and infections. Nobody had discovered the link between dirt and disease and many doctors believed that pus in wounds helped a patient to recover.

Answer 20

11th century Albucasis. 13th century Hugh of Lucca.

Answer 21

The Thames became so dirty that the “Great Conduit” was built to bring drinking water into London. The unsanitary conditions were partly because of population growth and urbanisation. People lived close together in houses made of wood and overcrowding meant that disease spread quickly. The city also tried to keep streets clean and to improve the sewage problems.

Answer 22

Cesspits were used for people to throw their liquid waste and sewage into in medieval Europe. Waste and rubbish were often thrown in rivers and the street.

Answer 23

List reasons why monasteries had better hygiene levels than towns: ``` 1 More money 2 Knowledge and understanding 3 Lower population density 4 Authority of the Abbot ```

Answer 24

Latrines were built over running water so that any sewage could be taken away Latrines were built in different buildings to the monasteries

Answer 25

Who controlled the monastery? an Abbot

Answer 26

Monks were literate and could read books which explained the importance of hygiene. They understood the importance of separating water and that a healthy lifestyle rested on a good diet and sleep.

Answer 27

The disease was a mixture of bubonic plague (spread by fleas on black rats) and pneumonic plague (airborne spread by coughing/sneezing). The plagues could cause death within 2 days of the first symptoms.

Answer 28

Spread of the Black Death The disease began in Asia and spread to Europe on merchant ships. At the time, people thought that the epidemic was caused by supernatural things like the position of the stars (or God’s wrath) or natural reasons such as miasmas or humour imbalances.

Answer 29

It was actually caused by bacteria in fleas’ stomachs. These fleas passed on the disease to rats who passed it on to humans. As many people lived close to each other, the disease spread quickly.

Answer 30

Peasants moved around to earn higher wages. The 1349 (year) Ordinance of Labourers tried to stop peasants moving around so much.

Answer 31

Which town did what to stop the spread of the Plague? Gloucester Tried to stop anyone outside the town entering. Winchester Tried to build cemeteries away from people's’ homes.

Answer 32

The plague led to food shortages (and higher food prices because of this). This made life even more difficult for the people who survived the Black Death.

Answer 33

The worst of the Black Death was over by 1350. But plagues continued for centuries. The worst example was the Great Plague of 1665.

Answer 34

Medieval remedies for the plague: 1 Prayers to appease God 2 Using herbs to keep people safe from miasma 3 Purging, vomiting and bloodletting to keep humours in balance 4 Moving away or avoiding those who had become infected

Answer 35

Impact on peasants The Black Death killed lots of workers. Peasants asked for higher wages and moved around to earn higher wages. The cost of buying land fell because of the lower population and this allowed some peasants to buy land.

Answer 36

When did the Renaissance begin? The Renaissance began in Florence, Italy in the late 15th century and lasted until the 18th century.

Answer 37

Dissection The focus on humans and the increased spread of ideas all encouraged experimentation and the search for explanations. People began to dissect human bodies (corpses) and there were illustrations in medical writings and books. Leonardo da Vinci was a key illustrator of the anatomy

Answer 38

Vesalius published his Six Anatomical Pictures in 1538 and then published On The Fabric of the Human Body in 1543. On The Fabric of the Human Body had illustrations based on Vesalius’ dissections.

Answer 39

Inspiring anatomists Doctors were encouraged to do dissections themselves after Vesalius’ work. Vesalius is credited with inspiring other anatomists, such as Fabricus and Fallopius.

Answer 40

Vesalius thought that surgery would only get better if people understood the body and the anatomy better. He used dissections (of executed criminals) to show that Galen’s understanding of the human body was wrong. He faced opposition for criticising Galen and had to leave his job at the university.

Answer 41

In which years did Vesalius publish his books? 1538 Six Anatomical Pictures. 1543 On The Fabric of the Human Body.

Answer 42

Renaissance was a time of rebirth in the arts and science. The printing press (created in 1440) was very important to share and spread ideas. The printing press allowed knowledge to be shared with more people very cheaply. Books and leaflets could be printed and sent across Europe whereas previously, a lot of information was only told person-to-person.

Answer 43

Gunshot wounds When Paré began work as a battlefield surgeon, gunshot wounds usually became infected. Gunshot wounds were usually treated using boiling oil and this would cauterise (seal) the wound, but often this did not work. In 1537, Paré ran out of oil on the battlefield. He used ointment instead of oil. This seemed to work better than oil.

Answer 44

In the 16th century, Ambroise Paré made significant advancements in surgical techniques. Paré was a barber surgeon who then worked as an army surgeon. These experiences helped him to develop new and better methods.

Answer 45

Amputations Paré used ligatures to tie blood vessels together before amputation instead of burning them as had been done previously. This did increase the risk of infection but was a lot less painful for patients. Paré also seems to be the first person to have fitted prosthetic (artificial) limbs on his patients.

Answer 46

Writings and ideas In 1575, Paré’s Works on Surgery was published. One individuals’ ideas had a huge impact on surgery in medieval times. Surgeons across Europe read Works on Surgery and Queen Elizabeth I’s surgeon William Clowes promoted Paré’s discoveries. Paré then became the surgeon to four French Kings.

Answer 47

The Work of Harvey William Harvey was an English physician (doctor) who was born in 1578. He studied medicine in Padua and was particularly interested in physiology. He was the physician for the English Kings James I and Charles I.

Answer 48

Harvey and Galen Harvey challenged Galen’s understanding of blood and how it circulated around the body. He thought that blood circulated around the body. This view is different to Galen’s view that new blood was made in the liver and used as fuel.

Answer 49

Circulation of blood Harvey used valves to show that blood could only flow one way in the body and he thought that too much blood was in the body to be continually created as fuel. He showed that the heart was a pump for the blood in the body.

Answer 50

Resistance to change When Harvey first published his theory, he was ridiculed. Professional opinion did change, but it took a lot of time and lots of doctors continued to use bloodletting despite Harvey showing it would not be effective. This highlights the limited impact of one individual. Although Harvey made this major discovery, his ideas needed to be accepted by the medical community.

Answer 51

Limited understanding Harvey’s theory implied that bloodletting was a counterproductive (ineffective) method of treatment. But this continued for many years as doctors didn’t know what else to do. Despite his discoveries, Harvey did not understand why blood needed to circulate around the body and why blood in arteries and veins was different.

Answer 52

After Harvey His theory of circulation were the first stage towards blood transfusions becoming possible to save people’s lives. In 1901, the discovery of blood groups made blood transfusions successful. In 1661, after Harvey had died, a microscope was developed. This microscope showed that veins and arteries were linked by capillaries.

Answer 53

More efficient technology Before the printing press, books had to be copied by hand. This either took months for each copy or was not done because it took too much effort. In 1480, there were 110 printers in Europe. By 1500 they were in 77 cities in Italy and by 1600, 151 cities had printing presses.

Answer 54

Spreading ideas Being able to print more books quickly meant that more people could read other people's ideas and theories. The writings of Galen and Pare could be reprinted in lots of different languages for people all across Europe to read.

Answer 55

Scientific process If people do not fully understand a theory, it is hard to critique it. Publishing lots of copies of a theory can mean that lots of people understand a theory in more detail and can then work out what is wrong with it and whether it is right. Students studying medicine and other things could use books and textbooks for reference more often.

Answer 56

Doctors Doctors in the Renaissance period still didn’t have much training. They still used old methods that people like Harvey thought were ineffective but some began to use more modern techniques.

Answer 57

Lack of alternatives The printing press and the works of Harvey, Pare and Vesalius helped to spread new ideas.

Answer 58

Religion and supernatural Europe in the renaissance was still a very religious place. Doctors still believed that supernatural things caused illness. Pilgrimages and prayers were still prescribed to cure illnesses. The people believed the ‘Royal Touch’ could cure disease. People would flock to the King to be cured of scrofula. People still sought wise women and apothecaries to cure disease.

Answer 59

Advances in Medicine Hospitals began to focus on treating patients, not just caring for them. Lots of towns had pharmacies. Books were being published which covered how to treat illness at home.

Answer 60

Quackery Quackery was a form of medicine based on spectacles and displays Many people viewed this as fraudulent medicine and this became more common in the 17th and 18th century. Quacks claimed their medicines could cure everything but they were usually ineffective. Quacks often gave patients stimulants like opium, which gave patients the impression that they were getting better. In reality, they were giving their patients an addiction.

Answer 61

Believed causes People still blamed miasma or supernatural/religious causes (God’s will) just like they did in the Black Death

Answer 62

Remedies Remedies for the plague included bloodletting through leeches, smoking, using animals such as frogs or snakes to ‘draw out the poison’ or moving to the countryside. In 1666 the plague seemed to be ending. Some people think that the Great Fire of London (1666) killed a lot of the bacteria causing the plague and helping to end the epidemic.

Answer 63

Improvements since the Black Death in 1348 There were some significant improvements in the 317 years between the Black Death and the Great Plague. People recognised the connection between dirt and disease. Local governments were more organised. Quarantine was more effective, bodies were collected and buried at least 6 foot deep in plague pits, trade stopped and communal gatherings were banned. People were locked in their houses to stop the disease spreading.

Answer 64

Understanding the Great Plague Plague doctors wore special suits to protect them against “miasma”. They had masks stuffed with aromatic herbs to stop the “bad air” from reaching them. This was not based on correct science but luckily the suits probably helped to reduce the spread of the plague.

Answer 65

Changes in Hospitals in the Renaissance In the renaissance, hospitals started to become more ______. The modern hospitals that we use today were born in the 17th and 18th centuries. These hospitals were funded by wealthy people or by private subscriptions from the local community. Specialist wards (like maternity wards) and specialist hospitals were established to treat certain diseases. This organisation was more effective at curing disease.

Answer 66

Changes in hospitals Reformers like Florence Nightingale drove a lot of reforms in hospitals. Following the work of Nightingale, a higher level of cleanliness and organisation was demanded from hospitals. Hospitals began to create pharmacies which could provide medicine.

Answer 67

Workhouses Poor people were often looked after in workhouses. Workhouses were large buildings where the unemployed, ill or elderly could be looked after. Conditions in workhouses were often very bad, although they got better after 1850.

Answer 68

Number of hospitals In the 18th century there was a significant increase in hospitals. For example, in London there were 5 new general hospitals built between 1720 and 1750. Hospitals like Guy's Hospital opened. This was accompanied by a rise in patient numbers.

Answer 69

Attitudes and beliefs Hospital treatment was free but most treatment was still based on Galen’s four humours. Attitudes to illness began to change in the 18th century. The idea that illness was a punishment for sin was increasingly less popular.

Answer 70

Changes for Physicians and Surgeons in the Renaissance Towards the end of the Middle Ages the ideas of the four humours and miasmas remained common, but there was growing awareness that dirt and disease were connected. The College of Physicians was set up in 1518. Most British doctors were trained here and they were still learning Galen’s works. In the 18th century, most doctors still believed in the four humours or that disease was spread through ‘bad air’ (miasmas). Doctors got a license if they were trained at the college of physicians.

Answer 71

Florence Nightingale (born in 1820) helped nursing to become professional. Her work with 38 nurses (chosen by her) in the Crimean War in 1854 reduced death rates hugely because of her improvements in the hygiene of wards. When Nightingale got back from war, she published a book “Notes on Nursing”. The status of nursing was enhanced as they were expected to care for patients and assist doctors. The Nightingale School of Nursing was set up in St Thomas’ Hospital in London.

Answer 72

Surgeons By this point in the Middle Ages there were 2 main types of surgeon: Professional surgeons, who had trained at university and were expensive and well paid. Barber surgeons, who were unqualified and not very well respected. Surgeons’ status began to improve and in 1800, the London Collage of Surgeons was set up. It created training standards for surgeons.

Answer 73

The Work of John Hunter John Hunter was a pioneer in surgery. People think that he is responsible for improving the status of surgeons. He is now viewed as the father of the scientific approach to surgery. Dissections and knowledge John Hunter observed over 2000 dissections in his 12 years at anatomy school. This gave him a great knowledge of the human anatomy.

Answer 74

Discoveries as an army surgeon and teacher Hunter worked as an army surgeon in France. He learned about the existence of sexually transmitted infections and diseases. This was a main way of spreading disease at the time. In 1785, he discovered a new way to treat patients with aneurysms (weak and bulging artery). By tying the blood vessel to encourage blood to flow elsewhere often stopped patients needing an amputation.

Answer 75

Positions and writings - john hunter His work won him prestigious positions as the Surgeon to King George III Hunter wrote books based on his experience in the army, dissections, experiments and observations. His books included "On Venereal Disease" in 1786

Answer 76

Scientific approach As an individual, Hunter taught hundreds of surgeons. He encouraged them to use his scientific approach. This involved learning as much about the body as possible, testing new ways to treat diseases and observing the outcomes to know what worked best. He often tested his methods on animals to see if they would work on people.

Answer 77

Vaccination and the Spread of Disease Until the late 1700s, diseases spread easily and people did not know many ways to stop their spread. Edward Jenner was born in 1749 and he is famous for his role in vaccinating people against smallpox. Smallpox In the 1700s, smallpox was one of the most fatal diseases in the world. 30% of people who got smallpox died. Those who survived were often blind or had very deep scars.

Answer 78

Inoculation was first brought to Britain by Lady Mary Wortley Montagu who observed it in Turkey. Inoculation involved putting pus from a person with a mild form of smallpox into a cut in a healthy person’s body. People believed this gave them resistance. Inoculation was popular in the 1700s with aristocrats.

Answer 79

Problems with inoculation Many people did not get inoculated for religious reasons. They thought that it interfered with God’s will. The inoculation dose could be too big and kill the patient. People who had been inoculated could still pass smallpox onto other people. Inoculation was a treatment that only rich people could afford.

Answer 80

The Work of Edward Jenner - Vaccination Edward Jenner was a country doctor. He thought that the milkmaid did not get smallpox but did catch a milder disease called cowpox. He tested this theory scientifically and it seemed to be correct. Testing his theory Jenner thought that people who had cowpox were immune to smallpox. Jenner gave an 8 year old boy, James Phipps, cowpox before injecting him with smallpox. James Phipps didn’t catch smallpox. Jenner tested this on 16 more patients and concluded that cowpox was an effective vaccination against smallpox. He published his research in 1798.

Answer 81

Religious opposition Some people in the Church thought that vaccination wasn’t natural and should not be done. The level of opposition is seen by the formation of the Anti-Compulsory Vaccination League in 1866.

Answer 82

Publishing his discovery in 1798, Jenner faced serious opposition. He faced criticism because he could not explain why the vaccination worked. Many doctors did not wish to use the vaccination because they profited (made money) from the smallpox inoculation. Jenner was not part of the clique of fashionable doctors in London. For this reason, he was excluded from academic favour.

Answer 83

Role of government The vaccination was less dangerous than the traditional smallpox inoculation. Gaining the favour of the royal family helped sway popular opinion. Parliament gave Jenner £10,000 to further his research in 1802. By 1853, the vaccination was made compulsory under law.

Answer 84

Was There Progress in Renaissance and 18th Century Medicine? There was a huge advancement in renaissance medicine. However, there were still some setbacks. Progress - Vaccination Government support (£10,000 in 1802 and more money later) helped to encourage this. Parliament then made the vaccination compulsory in 1853.

Answer 85

Germ Theory and the Work of Pasteur Before Louis Pasteur’s work in 1861, there was a debate over how infections were spread. Before Pasteur, most scientists believed spontaneous generation and that diseases could be spread by miasma or contact. Spontaneous generation Surgeons thought that microbes were caused by disease in something called “spontaneous generation”.

Answer 86

Spreading disease The two main groups were contagionists and anti-contagionists. Contagionists believed disease could spread through contact. Anti-contagionists believed disease spread through miasma.

Answer 87

Pasteur In 1857, Pasteur tried to explain why the sugar beet used to ferment alcohol soured. Pasteur thought that germs in the air were responsible. He found that sterilised water was still sterile if the flask was closed, but was not sterile if the flask was open. This suggested that there were germs in the air.

Answer 88

Germ Theory In 1861, he published his Germ Theory – germs were causing infections. Microscopes (invented in the 17th century) eventually allowed Pasteur to see the micro-organisms that he described.

Answer 89

Opposition to Germ Theory Pasteur faced serious opposition for his theory. A famous doctor called Charlton Bastian supported the theory of spontaneous generation, which contradicted Pasteur’s Germ Theory. Pasteur’s research focused on how liquids, such as milk went sour (pasteurisation). Many did not see the connection to humans. Doctors did not believe that small germs could cause such harm to humans.

Answer 90

The Work of Robert Koch – Microbe Hunting Using Pasteur’s Germ Theory, a German doctor called Robert Koch explained that germs could cause human disease. He linked a disease to the microbe that caused it. This was the beginning of ‘bacteriology’. Different germs Koch showed that germs were not all the same. He identified the different microbes that caused anthrax in 1876, septicaemia in 1878, tuberculosis in 1882 and cholera in 1883 by injecting animals with diseases. Other scientists then discovered typhus in 1880, pneumonia in 1880, tetanus in 1884, diphtheria in 1884 and the plague in 1890.

Answer 91

Germ Theory in the UK Koch and Pasteur’s studies were picked up by many scientists in Britain. John Tyndall gave lectures on Germ Theory to British doctors. He refuted (disagreed with) Bastian’s ideas of spontaneous generation.

Answer 92

Koch's work in the UK William Cheyne translated Koch’s work and highlighted that not all microbes caused harmful disease. Koch and Pasteur inspired a generation of scientists who were called ‘microbe hunters’. These scientists became interested in diseases and how to prevent them.

Answer 93

Pasteur and Vaccination Pasteur and Koch tried to apply Germ Theory to develop more advanced vaccinations. Chance discovery In 1879, Pasteur accidentally showed that vaccinations could prevent disease. After a researcher Charles Chamberland left out a cholera culture over the weekend, they discovered that weakened (attenuated) cholera germs could make a chicken immune from later stronger bouts of cholera.

Answer 94

Vaccines in 1884, Pasteur created a vaccine for rabies. A year later this was applied to human subjects.

Answer 95

Rivalry and war In 1871, the Franco-Prussian war (between France and Germany) ended. Some historians think national rivalry between Pasteur and Koch drove developments.

Answer 96

The Work of Paul Ehrlich – Magic Bullets In the 1890s, a German doctor called Paul Ehrlich built upon Koch’s work. Ehrlich won the Nobel Prize for Medicine in 1908. Magic bullets People knew that antibodies (found in the body) attacked different types of microbes. Because of this, they were called magic bullets. Paul Ehrlich decided to create magic bullets that behaved like antibodies using chemicals.

Answer 97

Dyes Ehlrich argued that if certain dyes could stain bacteria, certain chemicals could also kill bacteria. This was the foundation of the idea of ‘chemotherapy’. Ehrlich found a dye that killed malaria germs and he tried hundreds of compounds to kill the bacteria behind syphilis.

Answer 98

Implications of Germ Theory It proved that disease was not spread by miasma. It proved that spontaneous generation was wrong. It proved that an imbalance of the Four Humours did not cause disease, thus meaning the Four Humours were wrong.

Answer 99

Safer medical treatment In 19th century Britain, medical treatments became safer. The survival rate in surgery increased, hospitals became cleaner and vaccinations became more popular. Technological developments meant that diseases could be identified and stopped more effectively.

Answer 100

Anaesthetics in the 19th Century Before the 19th century, people often avoided surgery because it was so painful. Anaesthetics could be used but they were dangerous. This meant that most surgery was quick to try to minimise pain. Complex surgery would be too painful. Problems with surgery in the 1800s Pain – Patients often died from shock because of the pain of surgery. Infection – Before Germ Theory, people did not know that microbes could cause infections. Surgeons wore the same outfit and used the same equipment for multiple patients. Bleeding

Answer 101

Old anaesthetics In 1800, physicians and surgeons gave patients alcohol (made them drunk) or gave them opium to numb the pain.

Answer 102

New anaesthetics Humphrey Davy was the first to use nitrous oxide (laughing gas) to stop patients from feeling pain. Horace Wells then used it in 1844 to numb the pain in dental surgery. Dr James Simpson first used Chloroform in surgery in 1847. It was effective but it led to death in high doses. It killed Hannah Greener in 1848. Queen Victoria used Chloroform in childbirth in 1853. Ether was first used by the American dentist William Clark in 1842 and then by Robert Liston for a leg amputation in 1846. Ether was effective but hard to inhale (it also led to vomiting) and was explosive.

Answer 103

Opposition to anaesthetics Some army surgeons thought that soldiers should endure the pain. Some religious people thought that the pain suffered during surgery was God’s will.

Answer 104

The impact of individuals After Queen Victoria used anaesthetics in childbirth, anaesthetics became more popular. Public demonstrations of the drugs also helped to make anaesthetics more widely accepted.

Answer 105

Lister's techniques carbolic acid was used on surgical instruments the death rate in lister's patients fell from 46% to 15%

Answer 106

Anaesthetics reduced the pain in surgery but infection still killed lots of people in surgery. Antiseptics were used to kill the microbes close to wounds in surgery.

Answer 107

By 1880, Pasteur’s Germ Theory was widely accepted by British doctors. By 1900, aseptic surgery had become very common.

Answer 108

carbolic acid was hard to use because it irritated the skin and lungs

Answer 109

Lister heard about Germ Theory in 1865. He tested his ideas on a boy called Jamie Greenlees who had a broken leg. Instead of an amputation, Lister healed Greenlees’ fracture and the wound was not infected. Lister published the results of Greenlees and ten other patients’ surgery in 1867, proving Pasteur’s Germ Theory.

Answer 110

Elements of aseptic surgery surgeons were scrubbed clean surgeons wore thin rubber gloves surgeons used sterilised instruments surgeons wore new clothes

Answer 111

Public Health Problems in Industrial Britain The Industrial Revolution happened in Britain between 1760 and 1840. Private toilets were rare, most families used toilets outside the house which were shared with others. Sewage would fall into a cesspit, which was often washed away by rain or thrown in rivers. Water came from local rivers, which is where sewage from cesspits often went.

Answer 112

Edwin Chadwick wrote a report on living conditions for the working classes in 1842. It was called the “Report on the Sanitary Conditions of the Labouring Population”.

Answer 113

Chadwick's suggestions to fight cholera: Laws should improve drainage and sewer systems Need for clean water and streets Increase taxes

Answer 114

What policy did the government follow? laissez-faire

Answer 115

Dr John Snow (born in 1813) was a physician who examined the link between cholera and contaminated water after an outbreak of cholera in London in 1854.

Answer 116

Link with water Dr Snow saw that all the victims of the cholera epidemic in 1854 lived near the Broad Street water pump. He removed the pump’s handle and forced everyone to use another pump. This stopped the spread of the disease in the area. Snow discovered that the pump’s water had been contaminated by a leaking street toilet. This confirmed that cholera was not airborne but waterborne.

Answer 117

Second Public Health Act of 1875: 1 Forced local authorities to provide clean water 2 Forced local authorities to provide proper sewage systems 3 Forced local authorities to collect rubbish

Answer 118

What forced the government to intervene in Public Health? ``` 1 Political changes 2 Chance 3 Scientific advances 4 Individuals ```

Answer 119

By 1900, British towns generally had good systems in place to deal with sewage and to provide clean water to their population. It was largely government intervention that led to these changes.

Answer 120

Three key individuals in changing medicine in the 1800s: ``` 1 Louis Pasteur for Germ Theory 2 Edwin Chadwick for Report on Living Conditions 3 John Snow for Cholera investigations ```

Answer 121

In which year did the following occur? 1938 The British National Blood Transfusion Service was opened. 1914 Albert Hustin discovered how to store blood for long periods without clotting. 1895 Wilhelm Röntgen discovered x-rays.

Answer 122

Although the research to develop drugs was very costly, the drugs were very profitable for pharmaceutical companies to make and sell.

Answer 123

X-rays Curie developed mobile machines Discovered by Röntgen First used in battle in WW1

Answer 124

Fleming’s discovery of Penicillin In 1928, he accidentally left out some Staphylococcus bacteria in his laboratory. Mould grew on one of the plates. The germs beside the mould stopped growing. This mould was a fungus called Penicillin. Fleming called it a natural antiseptic (it is actually an antibiotic). He published his research in 1929, but this was not recognised immediately.

Answer 125

Howard Florey and Ernst Chain read Fleming’s article. They experimented on mice at the University of Oxford and then tested penicillin on humans.

Answer 126

When did Fleming, Florey and Chain win the Nobel Prize for Medicine? 1945

Answer 127

Mass production In 1939, the British government would not fund the project because they were too focused on the war and chemicals companies were producing explosives. In the Second World War, lots of soldiers got infected wounds. The USA government funded the team and then Britain in 1943 began to mass produce penicillin.

Answer 128

By 1901, radiotherapy was being used to treat cancer.

Answer 129

Medical advances used in WW1 & WW2: ``` 1 Portable x-ray machines (Rontgen & Curie) 2 Blood transfusions (Landsteiner) 3 Plastic surgery (Gillies) 4 Penicillin (Fleming, Chain & Florey) ```

Answer 130

Anaesthetics were developed which enabled patients to remain unconscious for longer. This meant doctors could try more complicated procedures. In 1950, William Bigelow performed the first open-heart surgery. Anaesthetics made more complex surgery like this possible. In 1958, a pacemaker was fitted in the heart.

Answer 131

In which year did the following advances in surgery happen? 1987 Laser surgery was first used on eyes. 1958 A pacemaker was first fitted in the heart.

Answer 132

William Farr’s collection of medical statistics helped Dr Snow discover the cause of cholera outbreaks and Hippocrates, Galen and Hunter all supported scientific observation of patients to find the best treatment.

Answer 133

In 1952, surgeons successfully performed an organ (kidney) transplant. The first organ transplant in Britain was in 1960.

Answer 134

Advances in Face Transplants: 1 In 2006, the first partial face transplant was successfully performed 2 In 2008, the first full face transplant was successfully performed

Answer 135

The Welfare State In the 20th century, the government began to change their policy from ‘laissez faire’ to the creation of a welfare state. This was influenced by the reports of Charles Booth and Seebohm Rowntree.

Answer 136

In 1911, The National Insurance Act was introduced. This provided unemployment benefits, free medical treatment and sick pay.

Answer 137

The Beveridge Report The report claimed that everyone had a right to be free of the ‘five giants’: disease, want, ignorance, idleness and squalor. It highlighted that people’s quality of life needed to improve and suggested that the government should be responsible for this. The report suggested that welfare should be available to everyone in need. It should be paid for by tax payers, non-means tested (available to everyone) and compulsory for everyone.

Answer 138

The Welfare State The government’s involvement in improving public health and social security is called the welfare state. The welfare state was implemented by the Labour Party in 1945. The welfare state included a health service that was “free at the point of delivery”, a weekly allowance for families to look after their children and a ‘benefits’ system to give financial help to the very poor.

Answer 139

In 1942, Sir William Beveridge (a Liberal politician) wrote a report about the state called the Beveridge Report. It was very popular and sold over 100,000 copies within a month.

Answer 140

Opposition to the NHS Doctors did not want to be employed by the government. This public good meant that doctors could lose some of their income. Bevan promised to pay doctors a salary and allowed them to continue working privately as well. Lots of Conservatives disliked the NHS, but it was too popular to abolish (get rid of).

Answer 141

Success of the NHS Child mortality rates have fallen (and maternity services are likely to have helped this). New and improved hospitals have better facilities Vaccinations provided under the NHS have got rid of diseases like tuberculosis.

Answer 142

War War was a key driver of changes in medicine and health during this period. Battlefield medicine The Crimean War (1853-1856) forced surgeons to develop new procedures for treating injured soldiers. From WW1, blood transfusions and mobile x-rays became part of battlefield treatment. Conclusion: Doctors were able to use their experience to good effect on the battlefield in future wars.

Answer 143

Advances in ideas As early as the Crusades, war led to new ideas in medicine. Western Europeans met Muslim doctors and shared ideas. Florence Nightingale was able to raise the status of nursing because of her heroism in the Crimean War (1853-56) Penicillin was invented during WW2. Alexander Fleming had been motivated by deaths he saw during WW1. Conclusion: Doctors', nurses' and scientists' experiences of war helped to spark new ideas across medicine.

Answer 144

Advances in surgery and technology War in the 20th century led to particular advances in surgery and technology. WW1 led to better x-rays, transfusions and plastic surgery for soldiers with facial wounds. Prosthetic limbs also developed. Conclusion: The brutal injuries experienced by soldiers in war led to new and innovative techniques in surgery.

Answer 145

Wartime incentives Personal rivalry due to war led to innovation too. National rivalry and competition between Pasteur and Koch during the Franco-Prussian War (1870-71) fueled change. War also created the incentive to fund mass production of new medicine. In 1943, the US government funded penicillin. Conclusion: War indirectly influenced medical developments too.

Answer 146

Diet and hygiene During the Crimean War, Florence Nightingale improved the hygiene of wards. She realised that dirt caused certain diseases. The Boer War (1899-1902) made Parliament realise that a malnourished population was not in the country's interests. 1/3 of volunteers to fight were unfit for service. Conclusion: War drove positive changes in hygiene in hospitals at home as well as in people's diet.

Answer 147

Social reform Housing was also built for returning soldiers and poor families. During WW2, the evacuation of children to the countryside made people realise the differences in health between people in different areas. Conclusion: War highlighted inequality and the need for better social care.

Answer 148

Islam The Quran's support for scientific discovering and learning benefited medicine. Muslim hospitals were better developed than Christian hospitals. After Abulcasis' work, surgery was much more effective. Conclusion: In the early part of the period, the Islamic Empire was particularly important for driving medical progress.

Answer 149

Christianity The Church forbade dissections unless they were on criminals that had been executed. This meant that Claudius Galen's mistaken beliefs about the anatomy (holes in the heart and blood being absorbed instead of circulated) could not be corrected. The same beliefs affected Islam. But, Christians also believed in creating hospitals with good hygiene to care for the sick. Conclusion: Christianity had both positive and negative effects on the development of medicine in Britain.

Answer 150

Supernatural beliefs In medieval times, beliefs that illnesses could have supernatural causes stemmed from Ancient Greek, Roman and Egyptian ideas. Astrology, witches and God were all supposed supernatural causes of illness. This was common during the Black Death (1348). Subnatural beliefs were common until humanist thinkers such as Erasmus started to argue against them. Conclusion: As late as the 1800s, supernatural beliefs can be blamed for slowing progress within medicine.

Answer 151

Communication As communication in societies improved, technological and medical advances were an important result. Communication and funding After new medical discoveries were made, communication and funding were crucial. After Fleming discovered penicillin, it was only with US government funding that the drug could reach the wider public. This also required communication with the wider population to ensure they understood what the drug was and its benefits. Conclusion: Fleming's discovery was not recognised for many years, and it was only through communication that penicillin became widespread.

Answer 152

Communication As communication in societies improved, technological and medical advances were an important result. Religious communication The Crusades brought Christians into contacts with Muslims, leading to a spread of scientific knowledge. The printing press also promoted the spread of such ideas. Conclusion: Increased communication between religions was an important forum for the spread of ideas.

Answer 153

Communication As communication in societies improved, technological and medical advances were an important result. Printing press Before the 1400s, most communication happened person-to-person through messengers and ambassadors. During the Renaissance, the printing press was invented in 1440. This sped up the process of communication because leaflets could be printed and sent across Europe. Conclusion: The printing press led to rapid advances in the communication of ideas around the world.

health and the people Flashcards

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