History - Britain: Health & the People

Question 1

In Medieval England, what did people think caused disease? (3)
And how did they work to treat them? (3)

Answer 1

1. Punishment from God for people’s sins. - to cure was through prayer and repentance.
2. Some thought that disease was caused by evil supernatural beings such as demons and witches. - many people were tried as witches and executed.
3. Evil spirits living inside someone. - members of the Church would perform exorcisms, using chants to remove the spirits from the person’s body.

Question 2

Why did then control and how did they control

How did the Church have a big influence on medieval medicine? (3)

Answer 2

1. They would make sure people believed that disease was a punishment from God which prevented people from trying to find cures for diseases, if it was a punishment from God, all you could do was pray and repent.
2. The Church made sure that scholars of medicine learned the works of Galen because his ideas fit the Christian belief that God created human bodies and made them to be perfect. It also stopped anyone from disagreeing with Galen.
3. The Chruch outlawed disssection, this meant that medieval doctors couldn’t discover ideas about human anatomy for themeselves, they instead had to learn Galen’s incorrect ideas.

Question 3

1. What 2. Who?When 3. How

How was astrology used to diagnose diseases? (3)

Answer 3

1. The movement of the plantes and stars had an effect on Earth and people. Astrologers beleived that the movements could cause disease.
2. It was a new way of diagnosing disease, first developed in Islamic medicine and brought to Europe between 1100 and 1300.
3. A type of calender called an almanac included information about where planets and starts were at a given time, which was used to predict how patients’ health could be affected. Where different star signs were thought to affect different parts of the body.

Question 4

Who?What?How?

What was the Four Humours Theory? (3)

Answer 4

1. Created by an Ancient Greek doctor Hippocrates.
2. The body was made up of 4 fluids, blood, phlegm, yellow bile and black bile. These were linked to the four seasons and the four elements. Like someone would get a cold in winter.
3. The theory was further developed by another Greek doctor Galen. He believed that the different foods, drinks, herbs and spices had a humour, which could balance the excessive humour that was causing the disease. e.g. if someone had a cold - too much phlegm - they coule be given chicken, pepper or wine - all considered hot and dry - to correct the imbalance.

Question 5

What?Who?

What was Miasma? (4)

Answer 5

1. A theory that bad air causes disease when someone breathes it in.
2. Galen incorporated the idea into the 4 humours.
3. The theory was influential until the 1860’s when it was replaced by the Germ Theory.
4. Miasma and 4 humours often prompted people to be more sanitary but for all the wrong reasons.

Question 6

Why were Hippocrates and Galen so influential? (3)

Answer 6

1. Many of their beliefs were written down and translated into latin, which were considered important by the Roman Catholic Church.
2. People were not allowed to do their own dissections of humans so could not discover all the mistakes that Hippocrates and Galen made.
3. Some of their beliefs are still used today such as the Hippocratic Oath. And that doctors should observe their patients as they treat them.

Question 7

How? What happened to the information later on?

How did Islamic doctors keep classical knowledge alive? (4)

Answer 7

1. A lot of medical knowledge was lost in the West after the fall of the Roman Empire.
2. In the 9th century, Hunain ibn Ishaq (also known by his Latin name Johannitius) travelled from Baghdad to Byzantium to collect Greek medical text which he translated into Arabic.
3. The knowledge was eventually brought to Europe by Avicenna (or Ibn Sina), a Persian who lived from around AD 980-1037. Avicenna wrote the ‘Canon of Medicine’, which brought together the ideas of Galen and Hippocrates and was the most important way in which classical ideas got back into Western Europe.
4. The work and other Islamic text were translated into Latin in Spain or Italy. The Crusades made Europeans awares of the scientific knowledge of Islamic doctors.

Question 8

What did Islamic doctors discover? (3)

Answer 8

1. Albucasis (or Abu al-Qasim0 wrote a book describing amputations, the removal of bladder stones and dental surgery, as well as methods for handling fractures, dislocation and the stitching of wounds.)
2. In the 12th centuary, Avenzoar (or Ibn Zuhr), described the parasite that causes scabies and began to question the reliability of Galen.
3. ibn al-Nafis, who lived in the 13th century, also questioned Galen’s ideas. He suggested (correctly) that blood flows from one side of the heart to the the other via the lungs - and doesn’t cross the septum. Ibn al-Nafis’ wasn’t recognised in the west until the 20th century.

Question 9

What?How?

How did alchemy help develop new drugs? (4)

Answer 9

1. Alchemy was the attempt to turn base (ordinary) metals into gold and to discover the elixir of eternal life.
2. Alchemy traces its origins back to the Egyptians and it was preserved in the Islamic world.
3. Unlike modern chemistry, much superstition was included - an unsuccessful experiment was as likely to be blamed on the position of the stars or the spiritual purity of the alchemist as anything else.
4. Even so, Islamic alchemists invented useful techniques such as distillation and sublimation, and prepared drugs such as luadanum, benzoin and camphor.

Question 10

Why?How?

How was prayer and repentance a form of treatment for disease? (4)

Answer 10

1. People believed that God made people sick because of their sins.
2. So sick people would pray, go on pilgrimages to holy shrines.
3. Some people would do self-flagellation called flagellants.
4. Some doctors would use astrology to diagnose and treat illness. Or that certain words while giving a treatment could make that treatment more effective.

Question 11

What?How?

How was bloodletting and purging a form of treatment that aimed to make the humours balanced? (4)

Answer 11

1. It was popular because it fit the 4 humours theory.
2. If someone apparently had too much blood inside them, the doctor would let blood out eighet by making a small cut, or using blood-sucking leeches.
3. Some people were accidentally killed by letting out too much blood.
4. Purging is the act of getting rid of other fluids from the body by excreting - doctors gave their patients laxatives to help the purging process.

Question 12

How did the belief of purifying the air help prevent disease? (2)

Answer 12

1. Physicians carried posies or organges around with them when visiting patiants to protect themeselves from catching a disease.
2. During the Black Death, juniper, myrrh and incense were burned so the smoke or scent would fill the room and stop bad air from bringing disease inside.

Question 13

What?Examples?

What did Remedies do?(3)

Answer 13

1. Remedies bought from an apothecary, local wise woman or made at home wer all popular in medieval Britain and contained herbs, spices, animal parts and minerals.
2. These remedies were either passed down or written in books explaining how to mix them together. Some of these books were valled ‘herbals’.
3. Other remedies were based on superstition, like lucky charms containing ‘powdered unicorn’s horn’.

Question 14

What were the different healers that people used to go to? (3)

Answer 14

1. Physicians - male doctors who trained at university for at least 7 years, they read ancient texts as well as writings from the Islamic world, but they had little practical experience. They used handbooks (vademecums) and clinical observation. There wer less than 100 physicians in England in 1300, and they were very expensive.
2. Most people saw an apothecary, they prepared and sold remedies, gave advice on how to use them. They were very common and were most accessible for those who could not afford a physician.
3. Apothecaries were trained through apprenticeships. Most apothecaries were men, but there were also many so-called ‘wise women’, who sold herbal remedies.

Question 15

What were public hospitals like? (4)

Answer 15

1. Most public hospitals were set up by the Church, there were few, but they were popular and highly regarded.
2. Hospitals had the purpose to care for the sick and elderly rather than treat disease. They were also more hygienic than elsewhere, because they had developed water and sewerage systems.
3. Some monasteries also cared for the sick, the elderly or the poor.
4. Most sick people were treated at home by members of their family.

Question 16

How did surgery happen in Medieval England? (2)

Answer 16

1. It was very dangerous, there was no way to prevent blood loss, infection or pain. - so it was rare, only for minor procedures.
2. There were few inversity-trained, highly paid surgeons, but surgery as a whole was not a respected profession in medieval times - most operations were carried out by barber-surgeons who also cut hair.

Question 17

What progress was made in Surgery? (2)

Answer 17

1. Hugh and Theodoric recognised the importance of practical experience and began dressing wounds with bandages soaked in wine, because they noticed that the wine helped to keep wounds clean and prevent infection - discovered by chance.
2. John of Ardern tried to create a recipe for an anaesthetic in 1376, which included hemlock, opium and henbane. In carefull controlled doese this may have worked but it was very likely to kill.

Question 18

What were living conditions like in a major town such as London? (5)

Answer 18

1. Houses were crammed and fires were common.
2. Many towns did not have clean water supplies or sewage systems, or into rivers to be washed away.
3. Businesses and homes weren’t seperated - butchers, tanners and dyers threw their toxic waste into rivers and residential streets. People had to get their water from contaminated water sources.
4. In the 13th century a water channel called the Great Conduit was built to bring clean water into London, as the thames was getting too toxic.
5. In 1388, the government ordered town authorities to keep the streets free of waste.

Question 19

What were monasteries like? (3)

Answer 19

1. They were cleaner, good sewage systems.
2. They were rich so had enough to spend on infrastructure such as infarmaries for the sick and poor.
3. Many would go here for treatment becasue of the sanitation and the herbal remdies grown their because the books records of the different herbal remedies.

Question 20

What was the Black Death? (3)

Answer 20

1. Happened in the 14th century first arriving in Britain in 1348.
2. Consisted of two illnesses, the Bubonic Plague and the Pnuemonic Plague.
3. It is thought that 1/3 of the British population died.

Question 21

What? And how did they react?

What did people believe caused the Black Death? (4)

Answer 21

1. Some believed it was punishment by God - so people prayed and fasted.
2. Some believed it was humour imbalance - so people tried to get rid of the Black Death by bloodletting and purging.
3. Some thought it was caused by Maiasma - so carried strong smelling herbs or lit fires to purify the air.
4. Some people also carried charms or used ‘magic’ potions containing arsenic.

Question 22

How ddi the Local Governments try to prevent the spread of the Black Death? (3)

Answer 22

1. Some people in Wichester believed that being close to the bodies of dead victims could cause people to catch the illness, so when the cemetary was full, they requested more to be built, but far from homes.
2. The town of Gloucester tried to shit itself off from the outside world after the Black Death reached Bristol.
3. In November 1348, the disease reached London. In January 1349, King Edward III closed Parliament.

Question 23

What social change did the Black Death cause? (4)

Answer 23

1. There were far less workers, this meant they could demand higher wages from their employers and move around to find better work.
2. The cost of land also decreased, allowing peasants to buy land for the first time.
3. The changes threatened the power of the elite so the government created laws, such as the 1349 Ordinance of Labourers, to try and stop peasants moving around the country.
4. Some people think the Black Death helped cause the Peasant’s Revolt in 1381, and, eventually, the collapse of the feudal system in Britain.

Question 24

Who was Vesalius? And what did he do? (4)

Answer 24

1. Born in 1514, was a medical professor at Padua University, Italy.
2. He was able to perform dissections on criminals who had been executed.
3. He wrote bookes to illustrate accurate diagrams of the human anatomy - ‘Six Anatomical Pictures’ (1538) and ‘The Fabric of the Human Body’ (1543)
4. Vesalius’s questioning attitude led people to also question Galen’s ideas, and people realised there was more to learn about the body and one could do so through dissections.

Question 25

Education? Job?

Who was William Harvey? (2)

Answer 25

1. British doctor, born in 1578, he studied in Padua University.
2. he worked in London at the Royal College of Physicians.

Question 26

What did William Harvey do? (3)

Answer 26

1. He discovered that Galen’s theory that there were two different types of blood that flowed seperately in the body was wrong.
2. He thought that the blood must circulate, because from experiments he knew that too much blood was being pumped out of the heart for it to continually formed and consumed.
3. However, not everyone believed his theories and people continued to perform bloodlettings even though they did not work.

Question 27

Who was Ambroise Paré? (2)

Answer 27

1. He was a French barber-surgeon born in 1510.
2. He initially worked for a public hospital then became an army surgeon.

Question 28

What surgical advancements did Paré do? (3)

Answer 28

1. Instead of using a red hot iron to burn a wound shut or boiling hot oil, he used cool slave by chance because he ran out of oil, and it did a better job because patients with that treatment often did better than others.
2. He also improved amputations, instead of cuatarising the ends of blood vessels he would use lignatures and tie the vessel shut at the end. It was less painfull but it did increase the risk of infection.
3. People initially did not believe in him because of his low status, but he then became the surgeon of the King and people started to support his ideas.

Question 29

During the Renaissance

What old and new treatments did people use? (5)

Answer 29

1. Many doctors were reluctant to accept that Galen was wrong, so bloodletting and purging were still used. Doctors were reading books more than treating patients.
2. Doctors were expensive, so people used apothecaries or barber-surgeons, or were treated in the home. Herbs were the main ingredient in many drugs.
3. People though the King’s touch would cure scrofula.
4. Some people sold medicines that did not work called Quacker. Quacks. Doctors had to get a licence in order to stop this.
5. Electricity started to be used in some medical tratments by was rarely effective.

Question 30

What were the similarities with the way people reacted to the Great Plague to the Black Death? (3)

Answer 30

1. Many treatments were based on magic, religion and superstition, lucky charms or amulets, saying prayers and fasting.
2. Bloodletting was still used, even though it probably made the plague worse.
3. Some people thought miasma caused the diseas, so they carried posies of herbs or flowers to improve the air.

Question 31

What were the differences between how people racted in the Great Plague to the Black Death? (4)

Answer 31

1. Town and Parish Councils tried to prevent the disease’s spread.
2. Plague victims were quarantined. The victims hous was locked and a red cross was painted on their door.
3. Areas where people crowded together, such as theatres, were closed.
4. The dead bodies of plague victims were buried in mass graves away from houses.

Question 32

What did people think helped get rid of the Great Plague?

Answer 32

1. The Great Fire of London in 1666.

Question 33

How did Doctors’ training and knowledge begin to improve? (5)

Answer 33

1. College of Physicians set up in 1518. Doctors would read books by Galen but also read more recent medical developments. They would also gain a licence which seperated them from Quacks.
2. However a licence did not guarantee they would be better, some more experienced doctors without a licence might be better.
3. New weapons like cannons and guns were used in more so new treatments were needed.
4. Exploration in new ingredients for drugs such a guaiacum - believed to cure syphilis - and quinine, a drug for malaria from the bark of the Cinchona.
5. Dissection, which enable doctors to see how the body actually works, became a key part of medical training in the 1700s.

Question 34

During the Renaissance

How did Surgeons become more important? (2)

Answer 34

1. There were two tpes of surgeons, professional, who trained at university and were highly paid by their rich patients. Then there were the unqualified barber-surgeons. In general surgeons were not respected compared to doctors.
2. In the 1700’s and 1800’s surgeons began to gain the same status as doctors. In 1800, the London College of Surgeons was created which set training standards.

Question 35

Who was John Hunter?

Answer 35

1. (1729-93) was a well-known surgeon and scientist.

Question 36

What did John Hunter do? (3)

Answer 36

1. He believed as much hands on experience was needed. (over 12 years he had witnessed more than 2000 dissections)
2. He became an army surgeon and learned more about STI’s and a new approach to gunshot wounds.
3. In an operation in 1785 he introduced a new way to treat an aneurysm, he tied off the blood cessel to encourage the blood to flow through the other vessel instead of amputation.

Question 37

How did Hospitals change during the Renaissance? (4)

Answer 37

1. There were more that were built by the rich for the poor.
2. Only those who would recover quickly or those who led hardworking respectable lives would be admitted.
3. Dispensaries provided medicines, non-surgical services like dentists and midwives were free.
4. Some universities had hospitals near them for training and scientific research.

Question 38

What did Florence Nightingale do? (4)

Answer 38

1. During the Crimean War she went to the battlfield and helped the nurses there.
2. The hospital there improved a lot, the death rate went from 42% to 2%.
3. in 1859 she wrote a book ‘Notes on Nursing’ emphising how hygine and a professional attitude were necissary.
4. The public raised £44,000 to help her train nurses, and she set up the Nighingale School of Nursing in St. Thomas’ Hostpital, London.

Question 39

How did innoculation help prevent smallpox? (3)

Answer 39

1. In 1751 over 3500 people dies of smallpox in London alone.
2. The only way at the time to prevent smallpox was innoculation. it was promoted by Lady Mary Wortley Montagu.
3. Make a cut put the pus from swealling of somebody who has mild small pox and then build immunity.

Question 40

How did Jenner find a vaccination for Smallpox? (3)

Answer 40

1. Milkmaids who have had cowpox did not get smallpox.
2. Jenner tested this theory in 1796 with James Phipps and innoculated him with sordd from Sarah Nelmes a milkmaid with cowpox. Phipps did not get the disease.
3. Jenner published his finding in 1798. He coined the term vaccination using the latin word for cow, vacca.